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:CD30 CAR-T Cells for Low Risk Relapsed Classical Hodgkin Lymphoma
这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗霍奇金淋巴瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 12 例。登记号:NCT07575893。
不限性别 · ≥ 6 Years 且 ≤ 29 Years
纳入标准: 1. Lansky或Karnofsky评分≥60%(见附录VI)。 2. 确诊CD30阳性经典型霍奇金淋巴瘤,且符合再诱导治疗条件。 3. 入组前通过再次活检确认CD30阳性cHL复发。 4. 符合既定低危因素: • 诊断分期IA或IIA:距治疗结束12个月;或治疗结束3–12个月、治疗周期≤3个且未接受放疗;无B症状;复发时无结外病变;复发不在既往放疗野内。 • 诊断分期IB、IIB或IIIA:距治疗结束12个月;无B症状;复发时无结外病变;复发不在既往放疗野内。 5. 有生育可能的女性须同意自签署知情同意至研究治疗停止后6个月内避免异性性行为,或采用两种有效避孕方式。避孕方式可为两种屏障法,或一种屏障法联合一种激素避孕法,或产品说明书所示妊娠保护失败率<1%的宫内节育器。 6. 有女性伴侣的男性受试者须既往接受输精管结扎,或同意自首次研究治疗至细胞输注后3个月采取适当避孕(即双重屏障法:避孕套加杀精剂)。 7. 既往或同时患有其他恶性肿瘤,但其自然病程或治疗不会影响研究方案安全性/疗效评估者,可入组。 8. 研究者判断受试者愿意且能够遵守研究程序。 9. 计划接受再诱导治疗,且一线再诱导治疗后反应良好。首次再诱导治疗难治者视为高危,不符合细胞产品给药条件,并将退出研究。 排除标准: 1. 复发性经典型霍奇金淋巴瘤属高危,且存在以下任一项:B症状、复发时结外病变、复发发生在既往放疗野内。 2. 年龄<6岁或>29岁。
Inclusion Criteria: 1. Lansky OR Karnofsky score of ≥ 60% (see Appendix VI) 2. Disease Status: Confirmed diagnosis of CD30+ classical Hodgkin Lymphoma and meets eligibility to undergo re-induction therapy. 3. Confirmatory re-biopsy of relapsed CD30+ cHL prior to study entry. 4. Risk Factors: Patient must meet established low-risk factors: Stage at Diagnosis = IA, IIA * 12 months from end of therapy OR 3-12 months from end of therapy with ≤3 cycles of treatment and no radiation NO B symptoms NO extra nodal disease at relapse NO relapse in a prior radiation field Stage at Diagnosis = IB, IIB, IIIA * 12 months from end of therapy NO B symptoms NO extranodal disease at relapse NO relapse in a prior radiation field 5. Female subjects of childbearing potential must be willing to abstain from heterosexual activity or to use 2 forms of effective methods of contraception from the time of informed consent until 6 months after study treatment discontinuation. The two contraception methods can be comprised of two barrier methods, or a barrier method plus a hormonal method or an intrauterine device that meets \< 1% failure rate for protection from pregnancy in the product label. 6. Male subjects with female partners must have had a prior vasectomy or agree to use an adequate method of contraception (i.e., double barrier method: condom plus spermicidal agent) starting with the first dose of study therapy through 3 months after the cell infusion therapy. 7. Subjects with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial. 8. Subject is willing and able to comply with study procedures based on the judgement of the investigator. 9. Planned to undergo reinduction therapy and found to have a favorable response to one line of reinduction therapy. Patients who are refractory to initial reinduction attempts are considered high-risk and thus not eligible for Cell Product Administration and will be removed from study. Exclusion: 1. High-risk relapsed classical Hodgkin Lymphoma with any of the following: B symptoms extra nodal disease at relapse relapse in a prior radiation field 2. Patients under 6 years and over 29 years of age.
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 determine the RP2D of CD30 CAR T-cells · dose escalation will occur for the CD30 CAR T-cells to determine optimal dose with no DLTs. · 1 year
患者在使用苯达莫司汀和氟达拉滨进行淋巴细胞清除后,接受预先制备的自体CD30阳性CAR-T细胞输注。剂量将持续调整,直至确定RP2D。
复发的低危CD30阳性经典型霍奇金淋巴瘤患者将接受自体CD30 CAR-T细胞制备。通过剂量递增确定II期推荐剂量(RP2D)。淋巴细胞清除后输注CAR-T细胞。
Patients with relapsed low-risk CD30 classical Hodgkin Lymphoma will have autologous CD30 CAR T-cell manufactured. Dose escalation will be used to determine the RP2D. Following lymphodepletion, CAR T-cell will be infused.
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