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CLDN6 特异性 CAR-T 细胞联合扩增 RNA 疫苗治疗复发/难治性实体瘤:I 期 BNT211-01 试验

英文原题:CLDN6-specific CAR-T cells plus amplifying RNA vaccine in relapsed or refractory solid tumors: the phase 1 BNT211-01 trial.

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CLDN6-specific CAR-T cells plus amplifying RNA vaccine in relapsed or refractory solid tumors: the phase 1 BNT211-01 trial.

PubMed 2023/10/23(内容时间) Nat Med Q1 · IF 52.5(JCR 2025)

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中文摘要

癌胎抗原Claudin 6(CLDN6)在多种实体瘤中高水平且特异性表达,是有前景的治疗靶点。本研究报告正在开展的I/II期BNT211-01试验剂量递增结果;该试验评估靶向CLDN6的嵌合抗原受体(CAR)T细胞单用或联合CAR-T 扩增RNA疫苗(CARVac),用于复发/难治性CLDN6阳性实体瘤的安全性及可行性,设置两个剂量水平(DL)。主要终点为安全性和耐受性、最大耐受剂量及II期推荐剂量(RP2D);次要终点包括客观缓解率(ORR)和疾病控制率。毒性总体可管理:22例患者中10例(46%)发生细胞因子释放综合征,包括1例3级事件;1例(5%)发生1级免疫效应细胞相关神经毒性综合征。较高DL组2例患者发生剂量限制性毒性,均未遗留后遗症。CAR-T 细胞植入强劲,加入CARVac耐受性良好。21例可评估患者中未确认ORR为33%(7/21),包括1例完全缓解;疾病控制率为67%(14/21),其中7例疾病稳定。较高DL组生殖细胞肿瘤患者缓解率最高,ORR为57%(4/7)。由于试验方案已修订,改用自动化制备流程,最大耐受剂量和RP2D尚未确定。剂量递增试验正在重做,以确定关键性试验RP2D。ClinicalTrials.gov注册号:NCT04503278。

展开英文摘要原文

The oncofetal antigen Claudin 6 (CLDN6) is highly and specifically expressed in many solid tumors, and could be a promising treatment target.

We report dose escalation results from the ongoing phase 1/2 BNT211-01 trial evaluating the safety and feasibility of chimeric antigen receptor (CAR) T cells targeting the CLDN6 with or without a CAR-T cell-amplifying RNA vaccine (CARVac) at two dose levels (DLs) in relapsed/refractory CLDN6-positive solid tumors. The primary endpoints were safety and tolerability, maximum tolerated dose and recommended phase 2 dose (RP2D). Secondary endpoints included objective response rate (ORR) and disease control rate.

We observed manageable toxicity, with 10 out of 22 patients (46%) experiencing cytokine release syndrome including one grade 3 event and 1 out of 22 (5%) with grade 1 immune effector cell-associated neurotoxicity syndrome. Dose-limiting toxicities occurred in two patients at the higher DL, resolving without sequelae. CAR-T cell engraftment was robust, and the addition of CARVac was well tolerated. The unconfirmed ORR in 21 evaluable patients was 33% (7 of 21), including one complete response.

The disease control rate was 67% (14 of 21), with stable disease in seven patients. Patients with germ cell tumors treated at the higher DL exhibited the highest response rate (ORR 57% (4 of 7)). The maximum tolerated dose and RP2D were not established as the trial has been amended to utilize an automated manufacturing process. A repeat of the dose escalation is ongoing and will identify a RP2D for pivotal trials. ClinicalTrials. gov Identifier: NCT04503278 .

论文信息

作者
Mackensen A、Haanen JBAG、Koenecke C、Alsdorf W、Wagner-Drouet E、Borchmann P、Heudobler D、Ferstl B
第一作者单位
University Hospital Erlangen, Department of Internal Medicine 5, Hematology/Oncology, Erlangen, Germany.Germany
通讯作者单位
BioNTech SE, Mainz, Germany. Ugur.Sahin@biontech.de.Germany
文献类型
I 期临床试验 · 非美国政府资助研究
期刊
Nature medicine2023 Nov
原文标识
PubMed 37872225 · DOI 10.1038/s41591-023-02612-0