TCR-JANUS 衔接蛋白实现双特异性靶向以克服 TCR-T 细胞治疗中的肿瘤异质性
TCR-JANUS engager proteins enable bispecific targeting to overcome tumor heterogeneity in TCR-T cell therapy.
基于 T 细胞受体(TCR)的免疫疗法受限于肿瘤抗原异质性,后者常导致复发。
英文原题:Treatment of Patients With Advanced Solid Tumors Using CRTKVA11-03 TCR-T Cell Injection
这是一项 I 期注册临床试验,评估 T 细胞治疗晚期实体瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 6 例。试验地点:中国 · 北京(共 1 个中心,其中中国 1 个)。登记号:NCT07826585。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: * 年龄18-70岁的患者。 * 经组织学或细胞学确诊的晚期实体瘤(如结直肠癌、胰腺癌、NSCLC),且携带KRAS G12V突变和HLA-A*11:01基因型。 * 标准治疗失败或无可用的有效治疗。 * ECOG体能状态评分为0-1。 * 预期生存期≥3个月。 * 根据RECIST 1.1标准,至少存在一个可测量病灶。 * 有生育能力的女性患者必须同意在研究期间及末次给药后至少6个月内采用高效避孕方法。治疗开始前7天内妊娠试验必须为阴性。 * 患者提供书面知情同意书,并预期能够遵守研究程序。 排除标准: * 既往接受过基因修饰T细胞治疗。 * 当前正在接受T细胞抑制药物(如环磷酰胺、FK506、雷公藤多苷)或T细胞刺激药物治疗。 * 入组前2周内接受过化疗、靶向治疗、免疫治疗或研究性药物,或4周内接受过放疗。 * 显著的器官功能障碍,表现为: * 白细胞<3.0 x 109/L * 中性粒细胞绝对计数>1.5 x 109/L * 血红蛋白<90g/L * 血小板<100 x 109/L * 肌酐>1.5×ULN或肌酐清除率<50mL/min * 淋巴细胞<0.5 x 109/L * 总胆红素>3×ULN;ALT/AST>3×ULN(肝转移患者>5×ULN) * INR/APTT>1.5×ULN * SpO2≤93% * 存在严重疾病和合并症,包括但不限于:严重心脏病、脑血管疾病、癫痫、控制不佳的糖尿病(如1型糖尿病或胰岛素依赖型糖尿病)、胰腺功能障碍、严重感染、活动性胃肠道溃疡、胃肠道出血、机械性或麻痹性肠梗阻、肺纤维化、肾衰竭、呼吸衰竭等。 * 过去6个月内有严重心血管疾病史,包括但不限于:心肌梗死、严重或不稳定型心绞痛、冠状动脉或外周动脉搭桥手术、纽约心脏协会(NYHA)III级或IV级心力衰竭等。 * 左心室射血分数(LVEF)< 50%。 * 有症状的脑转移,除非经既往治疗(如手术或放疗)后稳定。 * 已知有骨髓增生异常综合征、淋巴瘤或其他恶性肿瘤病史。 * 已知对白蛋白、研究性药物或其辅料过敏。 * 活动性自身免疫性疾病,包括但不限于获得性/先天性免疫缺陷、器官移植、自身免疫性肝炎、系统性红斑狼疮或炎症性肠病。 * 活动性乙型肝炎、丙型肝炎或HIV感染。 * 妊娠或哺乳期。 * 未控制的精神或神经系统疾病。 * 研究者认为任何不适合参加研究的情况。
Inclusion Criteria: * Patients aged 18-70 years. * Histologically or cytologically confirmed advanced solid tumors (e.g., colorectal cancer, pancreatic cancer, NSCLC) with KRAS G12V mutations and HLA-A\*11:01 genotype. * Failed standard therapies or no effective treatment available. * ECOG performance status of 0-1. * Life expectancy of ≥3 months. * Presence of at least one measurable lesion as defined by RECIST 1.1 criteria. * Female patients of childbearing potential must agree to use highly effective contraceptive methods during the study and for at least 6 months after the last dose. A negative pregnancy test within 7 days prior to treatment initiation is required. * Written informed consent provided by the patient, with an expectation of compliance with study procedures. Exclusion Criteria: * Prior treatment with gene-modified T-cell therapies. * Current treatment with T-cell suppressive agents (e.g., cyclophosphamide, FK506, tripterygium glycosides) or T-cell stimulants. * Chemotherapy, targeted therapy, immunotherapy, or investigational drugs administered within 2 weeks, or radiotherapy within 4 weeks prior to enrollment. * Significant organ dysfunction, as evidenced by: * leukocytes\<3.0 x 109/L * absolute neutrophil count \>1.5 x 109/L * hemoglobin\<90g/L * platelets \<100 x 109/L * Creatinine\>1.5×ULN or creatinine clearance \<50mL/min * lymphocytes\<0.5 x 109/L * total bilirubin\>3×ULN; ALT/AST\>3×ULN (or \>5× ULN in patients with liver metastases) * INR/APTT\>1.5×ULN * SpO2≤93% * Presence of serious diseases and comorbidities, including but not limited to: severe heart disease, cerebrovascular disease, seizures, poorly controlled diabetes (such as Type 1 diabetes or insulin-dependent diabetes), pancreatic dysfunction, severe infections, active gastrointestinal ulcers, gastrointestinal bleeding, mechanical or paralytic bowel obstruction, pulmonary fibrosis, renal failure, respiratory failure, etc. * History of severe cardiovascular diseases within the past 6 months, including but not limited to: myocardial infarction, severe or unstable angina, coronary artery or peripheral artery bypass surgery, New York Heart Association (NYHA) Class III or IV heart failure, etc. * Left ventricular ejection fraction (LVEF) \< 50%. * Symptomatic brain metastases unless stabilized with prior treatment (e.g., surgery or radiotherapy). * Known history of myelodysplastic syndrome, lymphoma, or other malignancies. * Known allergy to albumin, investigational drugs, or their excipients. * Active autoimmune diseases, including but not limited to acquired/congenital immunodeficiency, organ transplantation, autoimmune hepatitis, systemic lupus erythematosus, or inflammatory bowel disease. * Active hepatitis B, hepatitis C, or HIV infection. * Pregnancy or breastfeeding. * Uncontrolled mental or neurological disorders. * Any condition deemed unsuitable for study participation by the investigator.
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:DLT (Dose Limiting Toxicity) Incidence Rate · 28 days;Explore the MTD (Maximum Tolerated Dose) or Subsequent Expansion Dose · 28 days;Safety Assessment: Changes in patient safety parameters at various follow-up time points after TCR-T infusion, as well as the incidence of adverse events (AEs), which were graded according to the CTCAE V6.0 severity scale. · 2 years
次要终点:Objective Response Rate (ORR) Assessed by RECIST 1.1;Disease Control Rate (DCR) Assessed by RECIST 1.1;Duration of Response (DOR) Assessed by RECIST 1.1;Progression-Free Survival (PFS) Assessed by RECIST 1.1;Overall Survival (OS);qPCR Monitoring of TCR-T Cell Copy Numbers in Peripheral Blood
CRTKVA11-03 TCR-T细胞注射液(每剂5×10⁹、1×10¹°或2×10¹° TCR-T细胞),采用Fludarabine和Cyclophosphamide进行预处理淋巴细胞清除,随后给予IL-2支持
这是一项单中心、开放标签、单臂、剂量递增研究,旨在评估KRAS特异性自体TCR-T细胞在携带KRAS G12V突变的晚期实体瘤患者中的安全性和初步疗效。
This is a single-center, open-label, single-arm, dose-escalation study aimed at evaluating the safety and preliminary efficacy of KRAS-specific autologous TCR-T cells in patients with advanced solid tumors harboring KRAS G12V mutation.
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