单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:Optimizing Tumor-Infiltrating Lymphocyte (TIL) Harvest Site and Patient Selection With CD8-PET Imaging in Patients With
这是一项分期未标注的注册临床试验,评估细胞治疗用于黑色素瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 6 例。试验地点:美国 · 休斯顿(共 1 个中心)。登记号:NCT07819474。
不限性别 · ≥ 18 Years
纳入标准: • 参与者须组织学确诊为晚期黑色素瘤,已被选定为符合条件并同意接受标准治疗TIL(Iovance)。 • 参与者须另有2个符合RECIST 1.1可测量标准的转移灶,其中至少1个手术并发症风险较低;定义为皮肤、皮下、软组织或淋巴结转移灶,采集时不需要进入腹腔或盆腔。 • 年龄≥18岁。由于目前没有18岁以下参与者使用crefmirlimab的剂量或不良事件数据,儿童不纳入本研究。 • 目前尚不清楚crefmirlimab对发育中胎儿的影响;本试验所用标准治疗TIL也已知具有致畸性,因此有生育能力的女性和男性须同意在入组前及整个研究期间采用适当避孕措施(激素或屏障避孕法;禁欲)(参见Pregnancy Assessment Policy MD Anderson Institutional Policy # CLN1114)。适用范围为月经初潮(最早可至8岁)至55岁的所有女性参与者,除非符合以下任一排除条件: • 绝经后(连续至少12个月无月经); • 有子宫切除或双侧输卵管卵巢切除史; • 卵巢功能衰竭(促卵泡激素和雌二醇处于绝经范围,且接受过全盆腔放疗); • 有双侧输卵管结扎或其他外科绝育史。 • 可接受的避孕方法:激素避孕(如避孕药、注射剂、植入剂、经皮贴剂、阴道环)、宫内节育器(IUD)、输卵管结扎或子宫切除、受试者/伴侣已接受输精管切除术、植入式或注射式避孕药、避孕套联合杀精剂。试验全程及药物洗脱期内不发生性行为也可接受;定期禁欲、日历避孕法和体外排精不属于可接受方法。若女性在本人或伴侣参加本研究期间妊娠或怀疑妊娠,应立即告知主管医生。 • 接受本方案治疗或入组的男性还须同意在研究前、研究期间及[药物]给药结束后4个月内采取适当避孕措施。 • 能够理解并愿意签署书面知情同意书。 排除标准: • 不符合接受标准治疗Iovance TIL的条件或未同意接受该治疗。 • 计划在28天内接受标准治疗Iovance TIL。 • 正在接受其他任何试验性药物。 • 患有精神疾病或存在社会状况,可能限制其遵守研究要求的能力。 • 妊娠女性不纳入研究,因为crefmirlimab具有放射性,可能造成致畸或流产。由于母亲使用crefmirlimab治疗可能给哺乳婴儿带来未知但潜在的不良事件风险,接受该药治疗时应停止哺乳。上述潜在风险也可能适用于本研究使用的其他药物。
Inclusion Criteria * Participants must have histologically confirmed advanced melanoma and have been selected for, eligible for, and consented for treatment with standard-of-care TIL (Iovance). * Participants must have two additional metastases that are measurable based on RECIST 1.1 criteria, one of which must have low surgical morbidity, defined as dermal, subcutaneous, soft tissue, or nodal metastasis not requiring entry into the abdominal or pelvic cavity to harvest. * Age ≥18 years. Because no dosing or adverse event data are currently available on the use of crefmirlimab in Participants \<18 years of age, children are excluded from this study. * The effects of crefmirlimab on the developing human fetus are unknown. For this reason and because standard-of-care TIL used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. (Refer to Pregnancy Assessment Policy MD Anderson Institutional Policy # CLN1114). This includes all female Participants, between the onset of menses (as early as 8 years of age) and 55 years unless the Participant presents with an applicable exclusionary factor which may be one of the following: * Postmenopausal (no menses in greater than or equal to 12 consecutive months). * History of hysterectomy or bilateral salpingo-oophorectomy. * Ovarian failure (Follicle Stimulating Hormone and Estradiol in menopausal range, who have received Whole Pelvic Radiation Therapy). * History of bilateral tubal ligation or another surgical sterilization procedure. * Approved methods of birth control are as follows: Hormonal contraception (i.e. birth control pills, injection, implant, transdermal patch, vaginal ring), Intrauterine device (IUD), Tubal Ligation or hysterectomy, Subject/Partner post vasectomy, Implantable or injectable contraceptives, and condoms plus spermicide. Not engaging in sexual activity for the total duration of the trial and the drug washout period is an acceptable practice; however periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of birth control. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. * Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of \[Agent\] administration. * Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria * Participants who are not eligible and consented for standard-of-care Iovance TIL therapy. * Participants who are due to receive standard-of-care Iovance TIL therapy in less than 28 days. * Participants who are receiving any other investigational agents. * Participants with psychiatric illness/social situations that would limit compliance with study requirements. * Pregnant women are excluded from this study because crefmirlimab is radioactive substance with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants' secondary to treatment of the mother with crefmirlimab, breastfeeding should be discontinued if the mother is treated with crefmirlimab. These potential risks may also apply to other agents used in this study.
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:safety and adverse events (AEs) · Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0 · Through study completion; an average of 1 year.
患者将在基线研究评估后于第0天单次输注crefmirlimab。
研究旨在确定采集TIL细胞的部位CD8免疫细胞数量是否与患者对治疗的应答有关。
To find out if the amount of CD8 immune cells at the place where TIL cells are collected is linked to how well a patient responds to treatment.
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