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This is a phase I clinical study to evaluate the safety and tolerability of CAR-T in patients with advanced/metastatic renal cell carcinoma, and to obtain the maximum tolerated dose of CAR-T and phase II Recommended dose.
This is a single-center, single-arm, open-label study. Intravenous infusion group have 4 dose groups, adopting a dose-escalating 3+3 design, and plan to recruit about 12 subjects with CD70-positive advanced/metastatic renal cell carcinoma in Dose discovery phase and 12 subjects in dose expansion phase.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CD70-targeted CAR-T | Experimental | Infusion of CD70-targeted CAR-T cells by dose of 1-10x106 cells/kg |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CD70 CAR-T cells | Biological | Administration method: intravenous infusion; Subjects will be treated with Fludarabine and Cyclophosphamide before cell infusion. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Adverse events after CD70 CAR-T cells infusion [Safety and Tolerability] | Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0) | 28 days |
| Obtain the maximum tolerated dose of CD70 CAR-T cells[Safety and Tolerability] | Dose-limiting toxicity after cell infusion | 28 days |
| Measure | Description | Time Frame |
|---|---|---|
| Disease control rate of CAR-T cell preparations in CD70 positive advanced malignancies [Effectiveness] | Disease control rate: including CR, PR and SD(Assessed based on RECIST criteria) | 3 months |
| Objective response rate (ORR) of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness] |
| Measure | Description | Time Frame |
|---|---|---|
| The correlation between CD70 positive rate and safety | assessment the correlation between CD70 positive rate and the incidence of CRA and ICANS | 2 years |
| Correlation between CD70 positive rate and efficacy |
Inclusion Criteria:
Age ≥18 years old, male or female;
Diagnosed with advanced/metastatic renal cell carcinoma (staging according to 2017AJCC) by histopathology or cytology (paraffin section or fresh biopsy tumor tissue specimens), and the tumor is positive for CD70 expression (positive for tumor CD70 confirmed by histology or pathology) (IHC 3+));
At least after TKI, anti-vascular drug treatment is ineffective, there is no available standard treatment plan or standard treatment fails or cannot tolerate (disease progression or intolerance such as surgery, chemotherapy, radiotherapy, targeted therapy, etc.) no effective treatment;
Measurable and evaluable lesions specified by RECIST version 1.1: Measurable disease is defined as at least one lesion that can be accurately measured on at least one level (long diameter needs to be recorded); ), each lesion must be >10mm when measured by Magnetic Resonance Imaging (MRI), The lymph node must be >15mm in the short axis;
ECOG 0-2 points (Appendix 2);
The expected survival time is more than 12 weeks;
No serious mental disorder;
The functions of important organs are basically normal:
Have apheresis or venous blood collection standards, and have no other contraindications for cell collection;
Subjects agree to use reliable and effective contraceptive methods for contraception within 1 year after signing the informed consent form to receiving CAR-T cell infusion (excluding rhythm contraception);
Subjects or their guardians agree to participate in this clinical trial and sign the ICF, indicating that they understand the purpose and procedures of this clinical trial and are willing to participate in the research.
Exclusion Criteria:
Those who have received CAR-T therapy or other gene-modified cell therapy before screening;
Received anti-CD70 drug treatment before screening;
Active/symptomatic central nervous system metastases or meningeal metastases at the time of screening; subjects with brain metastases who have been treated must be confirmed to have no imaging evidence of progression ≥ 4 weeks after the end of treatment before they can be enrolled;
Received any of the following treatments before screening:
Active infection or uncontrollable infection requiring systemic treatment within 1 week before screening;
Patients with other malignancies other than renal cancer within 3 years before screening, except for the following cases: malignant tumors that have received radical treatment, and no known active disease within ≥3 years before enrollment; or Treated non-melanoma skin cancer with no evidence of disease;
Suffering from any of the following heart diseases:
Known to have active or uncontrolled autoimmune diseases, such as Crohns disease, rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis, etc.;
Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer detection is greater than the normal range; hepatitis C virus (HCV) antibody positive and peripheral blood type C Hepatitis virus (HCV) RNA titer detection greater than normal range Human immunodeficiency virus (HIV) antibody positive; syphilis positive test; cytomegalovirus (CMV) DNA test positive;
The subject has experienced venous thromboembolic events (for example: pulmonary embolism) and still needs anticoagulation therapy, or meets the following conditions: a. Bleeding with grades 3 to 4 for more than 30 days; b. There are veins Sequelae caused by embolism (such as persistent dyspnea and hypoxia); (Note: subjects who have venous embolism but do not meet the above conditions can participate in the trial);
Poorly controlled hypertension, defined as systolic blood pressure ≥150 mmHg and/or diastolic blood pressure ≥90 mmHg (The measurement of blood pressure is based on the average of 3 readings at least 2 minutes apart. Patients with blood pressure ≥150/90mmHg at the initial screening can receive antihypertensive treatment, and if they are well controlled after treatment, and blood pressure <150/90mmHg can be performed. filter);
Women who are pregnant or breastfeeding, and male or female subjects who plan to have children within 1 year after receiving CAR-T cell reinfusion;
Other investigators deem it unsuitable to participate in the study.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jingwang Bi, M.D | Contact | 13066029387 | jingwangbi@live.cn |
| Name | Affiliation | Role |
|---|---|---|
| Jianfeng Bi, M.D | The Second People's Hospital of Shandong Province | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Second People's Hospital of Shandong Province | Recruiting | Jinan | Shandong | 250000 | China |
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| ID | Term |
|---|---|
| D009362 | Neoplasm Metastasis |
| D002292 | Carcinoma, Renal Cell |
| ID | Term |
|---|---|
| D009385 | Neoplastic Processes |
| D009369 | Neoplasms |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Objective response rate includes:CR、PR(Assessed based on RECIST criteria) |
| 3 months |
| Duration of Response (DOR) of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness] | DOR will be assessed from the first assessment of CR/PR/SD to the first assessment of recurrence or progression of the disease or death from any cause | 3 months |
| Overall survival(OS)of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness] | OS will be assessed from the first CD70-CAR-T cell infusion to death from any cause (Assessed based on RECIST criteria) | 2 years |
| Progress-free survival(PFS) of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness] | PFS will be assessed from the first CD70-CAR-T cell infusion to death from any cause or the first assessment of progression(Assessed based on RECIST criteria) | 2 years |
| AUCS of CD70 CAR-T cells [Cell dynamics] | AUCS is defined as the area under the curve in 90 days | 3 months |
| CMAX of CD70 CAR-T cells [Cell dynamics] | CMAX is defined as the highest concentration of CD70 CAR-T cells expanded in peripheral blood | 3 months |
| TMAX of CD70 CAR-T cells[Cell dynamics] | TMAX is defined as the time to reach the highest concentration | 3 months |
| Pharmacodynamics of CD70 CAR-T cells[Cell dynamics] | Concentration levels of CAR-T-related serum cytokines such as CRP, IL-6, ferritin at each time point | 3 months |
assessment the correlation between CD70 positive rate and the disease control rate,Disease control rate: including CR, PR and SD
| 2 years |
| Overall survival(OS)of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness] | OS will be assessed from the first CD70-CAR-T cell infusion to death from any cause (Assessed by investigators based on IRECIST criteria) | 2 years |
| Progress-free survival(PFS) of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness] | PFS will be assessed from the first CD70-CAR-T cell infusion to death from any cause or the first assessment of progression (Assessed by investigators based on IRECIST criteria) | 2 years |
| Duration of Response (DOR) of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness] | DOR will be assessed from the first assessment of CR/PR/SD to the first assessment of recurrence or progression of the disease or death from any cause (Assessed by investigators based on IRECIST criteria) | 2 years |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D007680 | Kidney Neoplasms |
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |