CAR-T 细胞治疗与美国 Medicare 受益者的心血管结局
Chimeric antigen receptor T-cell therapy and cardiovascular outcomes in US Medicare beneficiaries.
在接受 CAR-T 的最大规模全国性老年人群样本中,5.8% 的患者发生 MACE,且与院内死亡率和 1 年死亡率升高相关。
英文原题:KSD-101 in Patients With EBV-associated Hematological Malignancies
这是一项分期未标注的注册临床试验,评估自体树突状细胞治疗肿瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 80 例。试验地点:中国 · 琼海(共 1 个中心,其中中国 1 个)。登记号:NCT07525024。
不限性别 · ≥ 12 Years
纳入标准: • 患有EBV相关血液系统恶性肿瘤,并接受KSD-101疫苗治疗(非基因修饰)。 1. 签署知情同意书当日年龄≥12岁。 2. 确诊EBV相关血液系统恶性肿瘤,且标准治疗失败;或患者和/或其法定监护人自愿选择KSD-101作为预防/抗复发治疗。 • 受试者和/或其法定监护人自愿同意参加,并已签署知情同意书。 排除标准: • 妊娠试验(尿液或血清)阳性的女性患者、哺乳期女性,或入组后1年内计划生育的男性/女性患者。 • 乙型肝炎表面抗原(HBsAg)或乙型肝炎核心抗体(HBcAb)阳性且外周血HBV DNA滴度高于正常值上限;抗HCV抗体阳性且外周血HCV RNA阳性;抗HIV抗体阳性;或梅毒特异性抗体阳性。 • 存在中枢神经系统(CNS)受累(如需要糖皮质激素干预的脑水肿或进展性脑转移)。 • 筛选前4周内存在未控制的感染性疾病。 • 患有严重基础疾病,包括心血管疾病、呼吸系统疾病、肾功能不全、凝血障碍、自身免疫性疾病或免疫缺陷病。 • 筛选前4周内接种过预防性活疫苗或减毒活疫苗。 • 筛选前4周内参加过其他临床研究。 • 有严重药物过敏或青霉素过敏史。 • 有药物滥用或成瘾史。 • 研究者团队认为不适合入组的任何其他情况。
Inclusion Criteria: * Patients with EBV-associated hematological malignancies who receive KSD-101 Vaccine Therapy (non-genetically modified) . 1. Patients aged 12 years or older on the date of signing the informed consent form. 2. Patients with a confirmed diagnosis of EBV-associated hematological malignancies who either: have failed standard treatment; or have voluntarily chosen KSD-101 as prophylactic / anti-relapse therapy by the patient and/or their legal guardian. * The participant and/or their legal guardian voluntarily agrees to participate and has signed the informed consent form. Exclusion Criteria: * Female patients who are pregnant (positive urine or serum pregnancy test), breastfeeding, or male/female patients planning to conceive within 1 year after enrollment. * Patients positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) with peripheral blood HBV DNA titer above the upper limit of normal; patients positive for anti-HCV antibody and peripheral blood HCV RNA; patients positive for anti-HIV antibody; or patients positive for syphilis-specific antibody. * Patients with central nervous system (CNS) involvement (e.g., cerebral edema requiring steroid intervention, or progressive brain metastasis). * Patients with uncontrolled infectious disease within 4 weeks prior to screening. * Patients with severe underlying diseases, including cardiovascular disease, respiratory disease, renal insufficiency, coagulation disorders, autoimmune disease, or immunodeficiency disease. * Patients who have received prophylactic live or attenuated live vaccines within 4 weeks prior to screening. * Patients who have participated in other clinical studies within 4 weeks prior to screening. * Patients with a history of severe drug allergy or penicillin allergy. * Patients with a history of drug abuse or addiction. * Any other conditions deemed inappropriate for study enrollment by the investigator team.
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:Overall Response Rate · The proportion of patients with complete and partial response after treatment. · Baseline up to 24 months after DC vaccines injection.
次要终点:Complete Response Rate;Disease Control Rate;Duration of Response;Progression-free survival;Overall survival rate;Treatment-Related Adverse Events rate as assessed by CTCAE version 5.0;Changes of EBV DNA load, lymphocytes and cytokines
EB病毒(EBV)是疱疹病毒科γ疱疹病毒亚科的一种双链DNA病毒,主要感染B细胞和咽部上皮细胞,也可感染NK细胞和T细胞。EBV与多种血液系统恶性肿瘤密切相关,包括EBV阳性弥漫性大B细胞淋巴瘤(EBV+DLBCL)、NK/T细胞淋巴瘤(NKTCL)、霍奇金淋巴瘤(HL)、伯基特淋巴瘤(BL)、EBV阳性结内滤泡辅助性T细胞淋巴瘤血管免疫母细胞型(EBV+nTFHL-AI)和原发性皮肤T细胞淋巴瘤(CTCL)。EBV阳性血液系统恶性肿瘤预后较差、治疗选择有限,目前尚无获批的EBV特异性疗法。KSD-101是一种新型树突状细胞疫苗,负载EBV相关肿瘤样复合抗原,具有较强的抗原呈递能力,可启动EBV特异性T细胞免疫。本研究旨在探讨KSD-101在真实世界中的临床疗效和安全性,为优化其临床应用提供重要参考,并为进一步开发新型治疗策略提供理论依据。
Epstein-Barr virus (EBV) is a double-stranded DNA virus belonging to the Gammaherpesvirinae subfamily of Herpesviridae. It primarily infects B cells and pharyngeal epithelial cells, and can also infect NK cells and T cells. EBV is closely associated with a variety of hematological malignancies, including EBV-positive diffuse large B-cell lymphoma (EBV+DLBCL), NK/T-cell lymphoma (NKTCL), Hodgkin lymphoma (HL), Burkitt lymphoma (BL), EBV-positive nodal T-follicular helper cell lymphoma, angioimmunoblastic type (EBV+nTFHL-AI), and primary cutaneous T-cell lymphoma (CTCL). EBV-positive hematological malignancies are characterized by poor prognosis and limited therapeutic options, and there are currently no approved EBV-specific therapies. KSD-101 is a novel dendritic cell vaccine loaded with EBV-associated tumor-like composite antigens, which possesses strong antigen-presenting capacity and can initiate EBV-specific T-cell immunity. This study aims to investigate the real-world clinical efficacy and safety of KSD-101, providing an important reference for optimizing its clinical application, as well as theoretical support for the further development of novel therapeutic strategies.
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