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NK 细胞治疗卵巢癌、非小细胞肺癌:I 期临床试验(Zelluna Immunotherapy AS)

英文原题:A Study to Test the Safety, Tolerability and Effect of ZI-MA4-1 for Patients With Locally Advanced or Metastatic Solid Malignancies

ClinicalTrials.gov 2026/05/29(首次登记) I 期注册临床试验 · 招募中

简要介绍

这是一项 I 期注册临床试验,评估 NK 细胞治疗卵巢癌、非小细胞肺癌、肉瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 9 例。试验地点:欧洲 · 伦敦、曼彻斯特(共 2 个中心)。登记号:NCT07613723。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 75 Years

纳入标准:

* HLA-A*02:01 阳性
* 肿瘤显示 MAGE-A4 蛋白表达高于规定阈值
* 经组织病理学或细胞学诊断为不可手术的局部晚期或转移性恶性肿瘤:卵巢癌、鳞状非小细胞肺癌(NSCLC)、滑膜肉瘤或头颈癌。
* 无已获批且具有临床获益的疗法可用于治疗该患者,或患者对标准治疗不耐受或已拒绝标准治疗。
* 有记录的影像学确认在最近一次治疗期间或结束后 6 个月内出现疾病进展。
* 受试者必须已接受过 ≥2 线既往抗癌治疗,但滑膜肉瘤患者为 ≥1 线既往抗癌治疗。
* 根据 RECIST v1.1 标准存在可测量病灶。
* ECOG 体能状态为 0 或 1,且在过去 2 周内无恶化,预期生存期 >3 个月
* 女性受试者如未怀孕或未哺乳,则有资格参加。有生育能力的女性必须妊娠试验阴性,并同意使用有效的避孕方法。

其他方案规定的纳入标准可能适用。

排除标准:

* 患者既往接受过任何细胞或基因治疗。
* 在淋巴细胞清除前 4 周内接受试验性研究产品。
* 近期治疗(淋巴细胞清除前最多 4 周内),包括生物制剂(如单克隆抗体)、抗癌免疫治疗(如针对 PD-1 受体或配体的单克隆抗体)。
* 因既往治疗导致的残留毒性 ≥2 CTCAE 级,且研究者认为可能干扰研究实施。
* 筛选前 3 年内除所研究肿瘤外的任何其他活动性恶性肿瘤,但原位切除的基底细胞癌或充分治疗的宫颈原位癌除外。
* 活动性或记录有自身免疫性疾病病史,或任何其他需要免疫抑制治疗或皮质类固醇治疗的疾病。允许生理性替代、局部和吸入性类固醇。
* 显著的中枢神经系统疾病。
* 入组前 6 个月内心肌梗死、心脏血管成形术或支架植入术、需要药物治疗的心律失常、不稳定型心绞痛、纽约心脏协会 II 级或以上充血性心力衰竭、心脏心房或心室淋巴瘤受累,或其他临床显著心脏疾病。
* 淋巴细胞清除前 7 天内需要静脉抗生素、抗真菌或抗病毒药物治疗的活动性真菌、细菌、病毒或其他感染。
* 在计划开始淋巴细胞清除前 ≤6 周内已接种或计划接种活疫苗。
* 严重或未控制的医学状况(例如严重慢性阻塞性肺疾病、间质性肺病、严重帕金森病、活动性炎症性肠病)或精神状况,经研究者判断会干扰研究活动。
* 活动性出血素质,包括但不限于治疗性抗凝,以及在淋巴细胞清除前28天内接受过大手术(允许进行小手术操作,如淋巴结活检/切除或导管置入)。
* 患者存在显著免疫抑制
* 已知显著的肝脏或胆道异常。活动性乙型肝炎、丙型肝炎感染。
* 任何医学、心理或社会状况,药物或酒精滥用,会使患者难以参与研究并遵守研究程序、限制和要求。
* 对与环磷酰胺、氟达拉滨或研究中使用的其他药物化学或生物学相似的化合物有过敏反应史
* 男性参与者QTc > 450毫秒或女性参与者 > 470毫秒
* 医学状况,如抗凝,不适合逆转,经研究者判断,妨碍或使患者成为活检的不良候选者。
* 对局部麻醉药有过敏或不耐受的个人史。
* 近期接受过免疫抑制药物治疗
* 因既往治疗导致的残留毒性≥2级常见不良事件术语标准(CTCAE),经研究者判断可能干扰研究实施。其他方案定义的排除标准可能适用。
核对登记原文(英文)
Inclusion Criteria:

* HLA-A\*02:01 positive
* Tumour(s) show expression of the MAGE-A4 protein above a defined threshold
* Histopathological or cytological diagnosis of inoperable Locally Advanced or Metastatic malignant disease: ovarian cancer, squamous non-small cell lung cancer (NSCLC), synovial sarcoma or head and neck cancer.
* No approved therapy with demonstrated clinical benefit is indicated or available to treat the patient, or the patient is intolerant of or has refused standard of care therapy.
* Documented imaging confirmed disease progression while on or within 6 months after the end of the most recent therapy.
* Participant must have received ≥2 prior lines of cancer therapy except for patient with synovial sarcoma for whom ≥1 prior lines of cancer therapy.
* Measurable disease according to RECIST v1.1 criteria.
* ECOG performance status of 0 or 1 with no deterioration over the previous 2 weeks, and an anticipated life expectancy of \>3 months
* Female participants are eligible to participate if they are not pregnant or breastfeeding. Woman of childbearing potential must have negative pregnancy test and agree to use an effective contraceptive method.

Other protocol defined inclusion criteria could apply.

Exclusion Criteria:

* Patients have received any prior cellular or gene therapy.
* Receiving experimental investigational products within 4 weeks of lymphodepletion.
* Recent therapies (within up to 4 weeks prior to lymphodepletion) including biologic agents (such as monoclonal antibodies), anti-cancer immunotherapy (such as monoclonal antibodies against PD-1 receptor or ligand).
* Residual toxicities ≥2 CTCAE grade due to prior therapy, that in the opinion of the investigator may interfere with study conduct.
* Any other active malignancy besides the tumour under study within 3 years prior to screening except for in situ removal of basal cell carcinoma or adequately treated cervix carcinoma in-situ.
* Active or documented history of autoimmune disease or any other diseases requiring immunosuppressive therapy or corticosteroid therapy. Physiological replacement, topical, and inhaled steroids are permitted.
* Significant CNS disorders.
* Myocardial infarction, cardiac angioplasty or stenting, cardiac arrhythmia requiring medication, unstable angina, New York Heart Association Class II or greater congestive heart failure, cardiac atrial or ventricular lymphoma involvement, or other clinically significant cardiac disease within 6 months of enrolment.
* Active fungal, bacterial viral, or other infection requiring intravenous antibiotic, antifungal, or antiviral medication within 7 days prior to lymphodepletion.
* Received or planned to receive a live vaccine ≤6 weeks before the planned start date of lymphodepletion.
* Severe or uncontrolled medical condition (e.g., severe chronic obstructive pulmonary disease, interstitial lung disease , severe Parkinson's disease, active inflammatory bowel disease) or psychiatric condition, which in the opinion of the investigator would interfere with study activities.
* Active bleeding diatheses, including but not limited to therapeutic anticoagulation, and treatment with major surgery within 28 days before lymphodepletion (minor surgical procedures such as lymph node biopsy/excision or catheter placement are permitted).
* Patients have significant immunosuppression
* Known significant hepatic or biliary abnormalities. Active infection with hepatitis B, hepatitis C.
* Any medical, psychological, or social condition, drug or alcohol abuse that would make it difficult for the patient to participate in the study and comply with the study procedures, restrictions, and requirements.
* History of allergic reactions to compounds chemically or biologically similar to cyclophosphamide, fludarabine or other agents used in the study
* QTc \> 450 msec for male participants or \> 470 msec for female participants
* Medical conditions, such as anti-coagulation, which is not suitable for reversal which, at the opinion of the investigator, preclude or make the patient a poor candidate for biopsy.
* Personal history of allergies or intolerance to local anaesthetic.
* Recent treatment with immunosuppressive agents
* Residual toxicities ≥2 Common Terminology Criteria for Adverse Events (CTCAE) grade due to prior therapy, that in the opinion of the investigator may interfere with study conduct Other protocol defined exclusion criteria could apply.

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。

研究终点衡量什么算有效

  • 主要终点ZI-MA4-1的安全性和耐受性从基线至研究结束访视(最长5年)
  • 次要终点ZI-MA4-1的MTD和RP2D
  • 次要终点长期安全性
  • 次要终点ZI-MA4-1的最小生物活性剂量(MBAD)
  • 次要终点客观缓解率(ORR)
  • 次要终点最佳总体缓解(BOR)
  • 次要终点疾病控制率(DCR)
  • 次要终点ZI-MA4-1的药代动力学
核对登记原文(英文)

主要终点:Safety and tolerability of ZI-MA4-1 · Assessed using clinical assessments and adverse event reporting, including dose-limiting toxicities (DLTs), treatment-emergent adverse events (TEAEs), and treatment-related adverse events (TRAEs) · From baseline through end of study visit (up to 5 years)
次要终点:MTD and RP2D of ZI-MA4-1;Long term safety;Minimum biologically active dose (MBAD) of ZI-MA4-1;Objective Response Rate (ORR);Best Overall Response (BOR);Disease Control Rate (DCR);Pharmacokinetics of ZI-MA4-1

研究设计怎么做的

研究类型
干预性研究
入组人数
9 人(预计)
分组方式
不适用(单臂)
  • ZI-MA4-1 (TCR-NK cells)试验组

    受试者在每个治疗周期内接受3次静脉输注指定剂量的ZI-MA4-1。计划所有参与研究的受试者至少接受一个治疗周期,最多接受两个治疗周期。在治疗周期前,受试者接受氟达拉滨和环磷酰胺以暂时减少体内淋巴细胞(淋巴细胞清除)。

核对分组登记原文(英文)
  • ZI-MA4-1 (TCR-NK cells) · EXPERIMENTAL · Participants receive ZI-MA4-1 administered via IV infusion 3 times per treatment cycle at their assigned dose. It is planned that all participants in the study will get a minimum of one treatment cycle and up to a maximum of two treatment cycles. Prior to a treatment cycle, a participant is given fludarabine and cyclophosphamide to temporarily reduce lymphocytes in the body (lymphodepletion).

关键日期

开始日期
2026-05-11
主要完成日期
2028-12
全部完成日期
2032-12
登记状态核实于
2026-09

联系与责任方

申办方
Zelluna Immunotherapy AS
联系邮箱
ctinfo@zelluna.com
联系电话
+47 413 80 080

登记简述

本研究将招募具有以下癌症适应症的患者:卵巢癌、鳞状非小细胞肺癌、滑膜肉瘤和头颈癌,伴不可手术的局部晚期或转移性实体瘤。目前,这些患者预后较差,总生存期相对较短。缺乏有意义且有效的疗法来改善这些患者的结局。本研究正在研究的治疗药物为ZIMA4-1,一种同种异体细胞治疗产品。这是ZI-MA4-1首次用于人体。本研究计划包括两部分(A和B)。A部分包括最多四个剂量递增队列,旨在确定ZI-MA4-1的最大耐受剂量,并为推荐的2期剂量(RP2D)提供依据。B部分包括一个扩展队列,旨在进一步评估A部分确定的RP2D在一个或多个适应症中的效果。除ZI-MA4-1的剂量水平外,A部分和B部分参与者的研究程序和入选标准将相同。

核对登记原文(英文)

This study will recruit patients with the following cancer indications: ovarian cancer, squamous non-small cell lung cancer, synovial sarcoma and head and neck cancer, with inoperable locally advanced or metastatic solid tumours. Currently, these patients have a poor prognosis and a relatively short overall survival. There is a lack of meaningful, effective therapies available that improve the outcome for these patients. The treatment being investigated in this study is ZIMA4-1, an allogeneic cell therapy product. This is the first time ZI-MA4-1 will be administered to humans. The study is planned to consist of two parts (A and B). Part A includes up to four dose escalation cohorts and aims to identify the maximum tolerated dose of ZI-MA4-1 and give insight into the recommended Phase 2 dose (RP2D). Part B consists of an expansion cohort and is designed to further evaluate the RP2D identified in Part A across one or more indications. The study procedures and eligibility criteria will be the same for participants in Parts A and B, except for the dose level of ZI-MA4-1.

登记原文与核验信息

试验登记号
NCT07613723
试验期别
I 期
试验状态
招募中
试验中心
The Royal Marsden NHS Foundation Trust · 伦敦 · 英国 | The Christie NHS Foundation Trust · 曼彻斯特 · 英国
适应症(原文)
Ovarian Cancer; Squamous Non-Small Cell Lung Cancer (NSCLC); Synovial Sarcomas; Head and Neck Cancer
干预方式(原文)
ZI-MA4-1 (TCR-NK cells); Cyclophosphamide; Fludarabine