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:Nanobody-Based CD19/CD20 Tandem Dual CAR-T-cell Therapy of Relapsed/Refractory B-Cell Lymphoma
这是一项早期 I 期注册临床试验,评估 CD19CAR-T 细胞治疗 B 细胞淋巴瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 20 例。登记号:NCT07546630。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 受试者已充分了解并自愿签署知情同意书,愿意且能够遵守计划访视、研究治疗、实验室检查和其他试验流程。 2. 按WHO 2022年分类,经细胞学或组织学确诊为复发/难治性B细胞淋巴瘤: • 免疫分型或组织病理免疫组化证实淋巴瘤细胞表达CD19和/或CD20抗原。 • B细胞淋巴瘤包括侵袭性B细胞淋巴瘤(大B细胞淋巴瘤(LBCL)、伯基特淋巴瘤(BL)、套细胞淋巴瘤(MCL))及惰性B细胞淋巴瘤(慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)、滤泡性淋巴瘤(FL)、边缘区淋巴瘤(MZL)、淋巴浆细胞性淋巴瘤(LPL)、毛细胞白血病(HCL))。 • 复发/难治定义:侵袭性淋巴瘤患者至少接受一线和二线药物治疗后,最佳疗效为≤12个月疾病稳定或疾病进展;或自体干细胞移植后≤12个月进展/复发。惰性淋巴瘤患者至少接受3线治疗后进展、复发或转化。 3. 年龄18~75岁(含),男女不限。 4. ECOG体能状态评分0~2分。 5. 自签署知情同意书之日起预计总生存期超过3个月。 6. 血红蛋白(HGB)≥70 g/L(允许输血)。 7. 肝、肾及心肺功能充足,符合以下标准:肌酐≤ULN的1.5倍;左心室射血分数(LVEF)≥50%;血氧饱和度>90%;总胆红素≤ULN的1.5倍;ALT和AST≤ULN的2.5倍。 8. 受试者同意从签署知情同意书起至CAR-T细胞输注后1年采取避孕措施。 排除标准: • 严重心功能不全,左心室射血分数<50%。 • 有导致严重肺功能损害的疾病史。 • 合并其他晚期恶性肿瘤。 • 合并无法有效控制的严重感染。 • 合并严重自身免疫性疾病或先天性免疫缺陷病。 • 活动性肝炎(乙肝病毒DNA(HBV-DNA)或丙肝病毒RNA(HCV-RNA)高于检测下限)。 • HIV感染或已知艾滋病,或梅毒感染。 • 有对生物制品(包括抗生素)严重过敏史。 • 异基因造血干细胞移植患者停用免疫抑制药物1个月后仍有急性移植物抗宿主病(GVHD)。
Inclusion Criteria: 1. The subject has voluntarily signed the informed consent form with full consent, and is willing and able to comply with the scheduled visits, study treatments, laboratory tests, and other trial procedures 2. Patients with relapsed/refractory B-cell lymphoma confirmed by cytology or histology according to the WHO 2022 Classification: * Lymphoma cells confirmed to express CD19 and/or CD20 antigen by immunophenotyping or histopathological immunohistochemistry * B-cell lymphomas include: aggressive B-cell lymphomas (LBCL, BL, MCL) and indolent B-cell lymphomas (CLL/SLL, FL, MZL, LPL, HCL) * Relapsed/refractory B-cell lymphoma: For patients with aggressive lymphoma, disease stable for ≤12 months or disease progression after achieving best response following at least first- and second-line pharmacotherapy; or disease progression or relapse within ≤12 months after autologous stem cell transplantation. For patients with indolent lymphoma, disease progression, relapse or transformation following at least three lines of prior therapy 3. Aged 18-75 years (inclusive), male or female 4. Subjects with an Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2 5. Estimated overall survival of more than 3 months from the date of signing the informed consent form 6. Hemoglobin (HGB) ≥ 70 g/L (transfusion permitted) 7. Adequate hepatic, renal and cardiopulmonary function meeting the following criteria: * Creatinine ≤ 1.5 × ULN; * Left ventricular ejection fraction (LVEF) ≥ 50%; * Blood oxygen saturation \> 90%; * Total bilirubin ≤ 1.5 × ULN; ALT and AST ≤ 2.5 × ULN 8. The subject agrees to use contraceptive measures from the date of signing the informed consent form until 1 year after CAR-T cell infusion Exclusion Criteria: * Severe cardiac insufficiency with left ventricular ejection fraction \< 50% * History of severe pulmonary function-impairing diseases * Concomitant other advanced malignant neoplasms * Concomitant severe infection that cannot be effectively controlled * Concomitant severe autoimmune diseases or congenital immunodeficiency disorders * Active hepatitis (hepatitis B virus deoxyribonucleic acid \[HBV-DNA\] or hepatitis C virus ribonucleic acid \[HCV-RNA\] test result above the lower limit of detection) * Human immunodeficiency virus (HIV) infection or known acquired immunodeficiency syndrome (AIDS), or syphilis infection * History of severe allergy to biological products (including antibiotics) * Patients with allogeneic hematopoietic stem cell transplantation who still have acute graft-versus-host disease (GVHD) after one month of discontinuation of immunosuppressive agents
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:According to the incidence of treatment-related adverse events (AEs) to evaluate the safety of Nanobody-Based CD19/CD20 Tandem Dual CAR-T-cell therapy for CD20/CD19 positive relapsed/refractory B-Cell lymphoma. · Incidence of treatment-related adverse events (AEs) Description: Number and severity of adverse events graded according to CTCAE v5.0, including cytokine release syndrome (CRS) graded by ASTCT criteria and immune effector cell-associated neurotoxicity syndrome (ICANS) graded by ASBMT criteria · up to 3 years;According to the determine the Maximal Tolerable Dose(MTD) to evaluate the safety of Nanobody-Based CD19/CD20 Tandem Dual CAR-T-cell therapy for CD20/CD19 positive relapsed/refractory B-Cell lymphoma. · MTD will be determined based on DLTs observed during the first 28 days of study treatment
次要终点:According to the objective response rate (ORR) to evaluate the efficacy of Nanobody-Based CD19/CD20 Tandem Dual CAR-T-cell therapy for CD20/CD19 positive relapsed/refractory B-Cell lymphoma.
纳米抗体CD19/CD20串联双靶点CAR-T细胞治疗。研究产品:CD19/CD20串联双靶点CAR-T。给药途径:静脉注射。输注CAR-T细胞前给予氟达拉滨联合环磷酰胺淋巴细胞清除化疗。
这是一项单臂研究,旨在评估纳米抗体CD19/CD20串联双靶点CAR-T细胞治疗复发/难治性B细胞淋巴瘤的安全性和疗效。
This is a single arm study to evaluate the safety and efficacy of Nanobody-Based CD19/CD20 Tandem Dual CAR-T-cell therapy for Relapsed/Refractory B-Cell Lymphoma
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