면역치료 | 위암 CAR-T 임상 LCAR-C182A/LCAR-C182B/LCAR-C182C
페이지 정보
작성자 HK HIS 작성일19-09-16 18:18 조회4,628회 댓글0건관련링크
본문
Brief Summary:
This is an open label,phase 1 study,to evaluate the safety , tolerability and efficacy of LCAR-C182A/LCAR-C182B/LCAR-C182C cells targeting Claudin 18.2 in the treatment of patients with advanced gastric cancer and Pancreatic Ductal Adenocarcinoma.
Gastric Cancer
Pancreatic Ductal
Adenocarcinoma
Biological: LCAR-C182A/LCAR-C182B/LCAR-C182C cells
Arms and Interventions
Arm
Experimental: chimeric Antigen Receptor T cell
LCAR-C182A/LCAR-C182B/LCAR-C182C Cells
Intervention
Biological: LCAR-C182A/LCAR-C182B/LCAR-C182C cells
Patients receive fludarabine phosphate(3×300 mg/m^2) and cyclophosphamide (3×30 mg/m^2) IV on days -5 to-3, and then Patients receive CAR-T cells IV as multiple infusions.
Primary Outcome Measures :
- Number of Participants With Adverse Events [ Time Frame: within 90 days after cell infusion ]
An adverse event is any untoward medical event that occurs in a participant administered an investigational product,and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
- Transgene Levels of LCAR-C82 CAR-T Cells [ Time Frame: 4 years ]
Transgene Levels of LCAR-C82CAR-T Cells using sensitive assay methods will be assessed
- Chimeric Antigen Receptor T (CAR-T) Positive Cell Concentration [ Time Frame: 4 years ]
Venous blood samples will be collected for measurement of CAR-T positive cellular concentration
- Systemic Cytokine Concentrations [ Time Frame: 4 years ]
Serum cytokine concentrations such as Interleukin IL-6, TNF-α, IL-10, 1L-15, IFN-γ,will be measured for biomarker assessment
Secondary Outcome Measures :
- Overall Response Rate (ORR) [ Time Frame: 4 years ]
The ORR is defined as the percentage of participants who achieve partial response (PR) or better according to Response Evaluation Criteria In Solid Tumors(RECIST) criteria.
- Duration of Overall Response(DOR) [ Time Frame: 4 years ]
The DOR is defined as the time from documentation of tumor response to disease progression according to Response Evaluation Criteria In Solid Tumors(RECIST) criteria.
- progression-free survival(PFS) [ Time Frame: 4 years ]
The PFS is defined as the Time from enrollment until disease progression or death according to Response Evaluation Criteria In Solid Tumors(RECIST) criteria.
- Overall Survival (OS) [ Time Frame: 4 years ]
The PFS is defined as Time from enrollment until death from any cause according to Response Evaluation Criteria In Solid Tumors(RECIST) criteria.
Ages Eligible for Study: | 18 Years to 75 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
· the subject has fully understood the possible risks and benefits of participating in this study, and has signed informed consent form;
· aged 18-75 years;
· histologically confirmed metastatic or unresectable advanced gastric adenocarcinoma or advanced pancreatic duct carcinoma;
· Claudin18.2 positive was detected by immunohistochemistry (at least 50% of the tissues, staining degree 2 (level 3));
· have previously received second-line and above system chemotherapy combined with or without combined targeted drug treatment;
· There were measurable nidus of > 1cm by CT scan or MRI(RECIST 1.1) (only patients with measurable nidus, those where the target lesion is lymph node metastasis, need permission from the principal investigator)
· ECOG 0 ~ 1;
· expected survival period≥ 3 months
· blood routine was in line with the following standards: ANC≥ 1.0× 10^9/L;Hemoglobin≥ 9g/dL;Platelet count ≥75×10^9/L;
· blood biochemical test meets the following criteria: total bilirubin ≤1.5 times of the normal upper limit (ULN);AST and ALT ≤3 times ULN (in the presence of liver metastasis, ULN 5 times);Creatinine clearance > 60 mL/min;Fasting serum cholesterol <300 mg/dL or <7.75 mmol/L;Fasting triglyceride < 2.5 times of ULN;INR≤ 3.5 (for patients with warfarin);
· blood pregnancy test of school-age women was negative;After completion of study treatment, fertile subjects must use an effective contraceptive for at least 4 months (for the purposes of this study, oral, implantable or injectable emergency contraception is not considered an effective contraceptive).
Exclusion Criteria:
· has received CAR-T therapy targeting any target.
· ever received any treatment targeting Claudin18.2.
· brain metastasis with central nervous system symptoms;
· pregnant or lactating women;
· uncontrolled diabetes was defined as > 1.5 times of fasting serum glucose ULN;
· serious impairment of lung function;
· pyloric obstruction and gastric perforation;
· known liver diseases (such as cirrhosis, chronic active hepatitis or chronic protracted hepatitis);Chronic active HBV/HCV infection;
· known HIV infection;
· have any active autoimmune diseases or medical history, including but not limited to autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, pituitary inflammation, vasculitis, nephritis, hyperthyroidism, etc.;
· have obvious bleeding tendency, such as gastrointestinal bleeding, coagulation dysfunction, and hypersplenism;
· unstable angina within the past 6 months, symptomatic congestive heart failure or myocardial infarction;
· severe uncontrolled arrhythmias;Left ventricular ejection fraction <50%;
· activity requiring parenteral antibiotics or uncontrolled infection;There is evidence of severe active viral, bacterial or uncontrolled systemic fungal infection
· other malignancies in the past 5 years except for non-melanoma skin cancer or in-situ cervical cancer;
· chronic diseases treated with steroids or other immunosuppressive agents;
· simultaneously use hematopoietic growth factor prophylaxis;
· anticancer drugs or therapies (including radiotherapy) used at the same time;
· other parallel clinical trials;
· received surgery, radiotherapy, chemotherapy or other experimental treatment within 4 weeks before signing the informed consent
· stroke or convulsion occurred within 6 months before enrollment;
· inoculated with live attenuated vaccine within 4 weeks before single component blood collection;
· major surgery should be performed within 2 weeks before the single component blood collection, or surgery should be planned during the study period or within 2 weeks after the study treatment is given.(note: subjects planning local anesthesia may participate in this study.)
· have a severe and rapid allergic reaction to any medication.
· the investigator considered that other patients in this study should not be enrolled.