决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:CAR 70-BCMA CAR-T Cells for the Treatment of Relapsed or Refractory Plasma Cell Neoplasms
CAR 70-BCMA CAR-T Cells for the Treatment of Relapsed or Refractory Plasma Cell Neoplasms
这是一项早期 I 期注册临床试验,评估 BCMACAR-T 细胞治疗浆细胞肿瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 20 例。试验地点:中国 · 成都(共 1 个中心,其中中国 1 个)。登记号:NCT07519187。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 受试者或其法定授权代表已提供书面知情同意,并且愿意且能够遵守计划访视、研究治疗、实验室检查及其他研究程序 2. 诊断为复发或难治性浆细胞肿瘤,定义如下: * 经流式细胞术或免疫组织化学检测,克隆性浆细胞表达BCMA和/或CD70阳性 * 多发性骨髓瘤、浆细胞瘤或浆细胞白血病患者,既往接受过至少三线治疗,包括蛋白酶体抑制剂(PI)、免疫调节剂(IMiD)和抗CD38单克隆抗体,且最佳疗效低于部分缓解(PR),或在达到至少PR后出现疾病进展 * 系统性轻链淀粉样变性患者,既往接受过至少两线治疗,包括抗CD38单克隆抗体以及蛋白酶体抑制剂(PI)或免疫调节剂(IMiD),且最佳疗效低于部分缓解(PR),或在达到至少PR后出现疾病进展 3. 年龄18至75岁(含),男性或女性 4. 美国东部肿瘤协作组(ECOG)体能状态评分为0至2 5. 自知情同意之日起预期生存期大于3个月 6. 血红蛋白(HGB)≥ 60 g/L(允许输血) 7. 充分的肝、肾、心、肺功能,符合以下标准: * 肌酐 ≤ 2 × 正常上限(ULN) * 左心室射血分数(LVEF)≥ 50% * 血氧饱和度 > 90% * 总胆红素 ≤ 1.5 × ULN;丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)≤ 2.5 × ULN 8. 受试者同意自签署知情同意书之时起至CAR-T细胞输注后1年内采取避孕措施 排除标准: * 严重心功能障碍,左心室射血分数(LVEF)< 50% * 严重肺功能损害病史 * 合并进行性恶性肿瘤 * 合并无法充分控制的严重感染 * 合并严重自身免疫性疾病或先天性免疫缺陷 * 活动性肝炎,定义为乙型肝炎病毒脱氧核糖核酸(HBV-DNA)或丙型肝炎病毒核糖核酸(HCV-RNA)高于检测下限 * 人类免疫缺陷病毒(HIV)感染或已知获得性免疫缺陷综合征(AIDS),或梅毒感染 * 对生物制品(包括抗生素)有严重过敏反应史 * 接受过异基因造血干细胞移植且停用免疫抑制剂一个月后仍存在急性移植物抗宿主病(GVHD)的患者 * 存在任何其他严重躯体或精神疾病,或实验室异常,经研究者判断可能增加研究参与风险、干扰研究结果解读,或使患者不适合入组研究 * 妊娠期或哺乳期的育龄期女性患者
Inclusion Criteria: 1. The subject or their legally authorized representative has provided written informed consent and is willing and able to comply with scheduled visits, study treatment, laboratory tests, and other study procedures 2. Diagnosis of relapsed or refractory plasma cell neoplasms, defined as follows: * Clonal plasma cells positive for BCMA and/or CD70 expression as determined by flow cytometry or immunohistochemistry * Patients with multiple myeloma, plasmacytoma, or plasma cell leukemia who have received at least three prior lines of therapy, including a proteasome inhibitor (PI), an immunomodulatory agent (IMiD), and an anti-CD38 monoclonal antibody, and whose best response was less than partial response (PR) or who experienced disease progression after achieving at least PR * Patients with systemic light chain amyloidosis who have received at least two prior lines of therapy, including an anti-CD38 monoclonal antibody and either a proteasome inhibitor (PI) or an immunomodulatory agent (IMiD), and whose best response was less than partial response (PR) or who experienced disease progression after achieving at least PR 3. Aged 18 to 75 years (inclusive), male or female 4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 5. Life expectancy greater than 3 months from the date of informed consent 6. Hemoglobin (HGB) ≥ 60 g/L (transfusion permitted) 7. Adequate hepatic, renal, cardiac, and pulmonary function meeting the following criteria: * Creatinine ≤ 2 × upper limit of normal (ULN) * Left ventricular ejection fraction (LVEF) ≥ 50% * Oxygen saturation \> 90% * Total bilirubin ≤ 1.5 × ULN; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN 8. The subject agrees to use contraceptive measures from the time of signing the informed consent form until 1 year after CAR-T cell infusion Exclusion Criteria: * Severe cardiac dysfunction with left ventricular ejection fraction (LVEF) \< 50% * History of severe pulmonary function impairment * Concurrent progressive malignancy * Concurrent severe infection that cannot be adequately controlled * Concurrent severe autoimmune disease or congenital immunodeficiency * Active hepatitis, defined as hepatitis B virus deoxyribonucleic acid (HBV-DNA) or hepatitis C virus ribonucleic acid (HCV-RNA) above the lower limit of detection * Human immunodeficiency virus (HIV) infection or known acquired immunodeficiency syndrome (AIDS), or syphilis infection * History of severe allergic reaction to biological products (including antibiotics) * Patients who have undergone allogeneic hematopoietic stem cell transplantation and still have acute graft-versus-host disease (GVHD) one month after discontinuation of immunosuppressive agents * Presence of any other serious physical or mental illness, or laboratory abnormality that may increase the risk of study participation, interfere with the interpretation of study results, or render the patient unsuitable for study enrollment in the opinion of the investigator * Female patients of childbearing potential who are pregnant or breastfeeding
以上为辅助阅读译文。是否适合入组须由主治医生判断,最终以登记平台与研究者确认为准。
主要终点:To evaluate the safety of CAR70-BCMA dual-target chimeric antigen receptor T-cell therapy in patients with relapsed or refractory plasma cell neoplasms expressing CD70 and/or BCMA based on the incidence of treatment-emergent adverse events (AEs). · Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE v5.0 · Up to 3 years;To evaluate the safety of CAR70-BCMA CAR-T cells in the treatment of relapsed or refractory plasma cell neoplasms positive for CD70/BCMA based on the determination of the maximum tolerated dose (MTD). · Incidence of dose-limiting toxicity (DLT) · Up to 28 days after CAR-T treatment
次要终点:To evaluate the efficacy of CAR70-BCMA CAR-T cells in the treatment of relapsed or refractory plasma cell neoplasms positive for CD70/BCMA based on the objective response rate (ORR).
CAR 70-BCMA CAR-T疗法。研究产品:CAR 70-BCMA CAR-T。给药途径:静脉注射。淋巴细胞清除性化疗方案:在输注CAR 70-BCMA CAR-T细胞之前,将给予氟达拉滨和环磷酰胺的联合方案。
这是一项单臂研究,旨在评估CAR70-BCMA双靶点CAR-T细胞疗法治疗复发和难治性浆细胞肿瘤的安全性和有效性。
This is a single arm study to evaluate the safety and efficacy of CAR70-BCMA dual-target CAR-T cell therapy for relapsed and refractory plasma cell neoplasms.
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