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Because the implementation of the new regulation policy by the Chinese authority
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This is an investigator initiated trial to assess the efficacy and safety of a GPC3-targeting CAR-T therapy (REVO-UWD-03) in the HCC and Lung Cancer. It also aims to explore the feasibility of using a novel universal CAR-T cell platform.
The study will use T cells from healthy donors, modified using a novel universal CAR-T technology, to treat HCC and Lung Cancer patients. The antigen-binding site of the CAR molecule recognizes GPC3 as the target.
The main questions it aims to answer are: • What is the maximum tolerated dose (MTD) of GPC3-CAR-T therapy in universal CAR-T cell treatments? • What are the dose-limiting toxicities (DLT) and treatment-emergent adverse events (TEAE)? • What is the treatment efficacy, as measured by objective response rate (ORR) and progression-free survival (PFS)? Researchers will assess whether the universal CAR-T cells have good safety and efficacy in treating HCC or Lung cancer, while improving accessibility and lowering treatment costs. Participants will: • Receive universal GPC3-CAR-T cells through a 3+3 dose escalation scheme. • Undergo chemotherapy conditioning before CAR-T infusion. • Be monitored for adverse events, immune response, and disease progression.
The study will collect data on both short-term outcomes (within the first few months post-treatment) and long-term safety and efficacy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single dose injection of REVO-UWD-03 | Experimental | Dose escalation will be performed for the single dose injection of REVO-UWD-03 for treating HCC and NSCLC |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Universal CAR-T cells injection for treating HCC and NSCLC | Biological | Eligible participants will undergo FC lymphodepleting chemotherapy preconditioning after signing an informed consent form, followed by a one-time injection of one dose of universal REVO-UWD-03 CAR-T cells |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose (MTD) | The highest dose of universal GPC3-CAR-T cells that can be administered without causing unacceptable side effects, measured during the dose escalation phase. | Within the first month post-infusion |
| Dose-Limiting Toxicities (DLT) | The incidence of treatment-related toxicities that prevent further dose escalation. | Within the first month post-infusion. |
| Treatment-Emergent Adverse Events (TEAE) | The frequency and severity of adverse events that arise following the administration of universal GPC3-CAR-T cells. | From the administration of UWD-03 CAR-T cells through six months post-infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | The proportion of patients with a measurable reduction in tumor size (complete or partial response) following universal GPC3-CAR-T therapy. | Measured at 3 and 6 months after treatment. |
| Progression-Free Survival (PFS) |
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Inclusion Criteria:
(1) Barcelona Clinic Liver Cancer (BCLC) stage B (not amenable to hepatic surgery and/or other local therapies, or disease progression after local therapy) or stage C; (2) Or China Liver Cancer (CNLC) stage IIb or III (not amenable to hepatic surgery and/or other local therapies, or disease progression after local therapy); 3. Immunohistochemistry (IHC) evaluation showing GPC3 expression ≥1+ in ≥50% of the tumor lesion area (randomly select at least 5 fields of view from tumor regions for evaluation; at least 5 unstained slides must be provided for assessment); 4. At least one measurable lesion: The measurable lesion must not have received prior radiotherapy, interventional therapy, or other local treatments (lesions in previously treated fields may be selected as target lesions if confirmed to have progressed); 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; 6. Expected survival ≥90 days; 7. Adequate major organ function, meeting the following criteria:
Exclusion Criteria
(1) LVEF <50%; (2) New York Heart Association (NYHA) Class III or IV; (3) History of myocarditis, cardiomyopathy, or myocardial infarction within 6 months prior to enrollment (unless cardiac function has recovered as assessed by the investigator); (4) Uncontrolled arrhythmias (e.g., atrial fibrillation, ventricular tachycardia) or requiring long-term antiarrhythmic therapy; (5) QTcF interval >480 ms on screening ECG; (6) Uncontrolled hypertension (systolic blood pressure >160 mmHg or diastolic blood pressure >100 mmHg); (7) History of ischemic or hemorrhagic stroke (unless stable for >6 months with no sequelae); (8) Uncontrolled intracranial lesions (e.g., brain tumors, aneurysms); (9) History of deep vein thrombosis (DVT) or pulmonary embolism (PE) (unless treated with anticoagulation for ≥6 months and stable); (10) Significantly elevated troponin or BNP/NT-proBNP levels suggestive of potential cardiac injury or dysfunction; 5. Non-healing wounds or fractures for a prolonged period; 6. History of substance abuse (including psychiatric drugs) that cannot be discontinued, or history of psychiatric disorders; 7. Uncontrolled or active fungal, bacterial, viral, or other infections; 8. Active or documented gastrointestinal bleeding within 6 months (e.g., esophageal varices or ulcer bleeding); 9. Prior antitumor treatment-related toxicities not recovered to ≤Grade 1 (or to the level specified in inclusion/exclusion criteria); 10. Known HIV infection; known active syphilis infection; or active hepatitis B (HBsAg positive and HBV-DNA ≥500 IU/mL or above the lower limit of detection, whichever is higher) or hepatitis C virus (anti-HCV positive and HCV-RNA above the lower limit of detection) infection; 11. Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage despite appropriate intervention; 12. Severe allergic reaction history to key study drugs (including fludarabine, cyclophosphamide, mycophenolate sodium, tocilizumab, and anti-infective agents used during preconditioning); 13. Active autoimmune disease requiring systemic treatment within 2 years (including but not limited to autoimmune hepatitis, uveitis, enteritis, hypophysitis, vasculitis, nephritis, hyperthyroidism, etc.); physiologic corticosteroid replacement therapy (e.g., thyroxine, insulin, or corticosteroids for adrenal or pituitary insufficiency) is not considered systemic treatment; 14. Female subjects unwilling to use contraception from informed consent signing through 6 months after CAR-T cell infusion; 15. Patients with meningeal metastases, brainstem metastases, spinal cord metastases and/or compression, or active/symptomatic central nervous system (CNS) metastases not treated locally; 16. History of interstitial lung disease (ILD) or non-infectious pneumonitis requiring steroid treatment; 17. Clinically significant pulmonary impairment due to underlying lung disease, including but not limited to any baseline pulmonary disease (e.g., pulmonary embolism within 3 months prior to enrollment, severe asthma, severe chronic obstructive pulmonary disease), or any autoimmune, connective tissue, or inflammatory disease that may involve the lungs (e.g., rheumatoid arthritis, sarcoidosis), or prior pneumonectomy; 18. Any condition that, in the investigator's opinion, interferes with drug evaluation, participant safety, or study outcomes, or any other condition deemed unsuitable for study participation.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| First Affiliated Hospital of Xi'an Jiaotong University | Xi'an | Shaanxi | 710061 | China |
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| MMF Immunosuppression | Drug | One day after the completion of fludarabine preconditioning (D-2), initiate oral mycophenolate sodium at a dose of 1440 mg twice daily (BID) for 15 consecutive days, or extend the duration appropriately based on CAR-T cell expansion status (discontinuation may occur at the end of CAR-T cell expansion or on the day of patient discharge). The maximum duration of administration must not exceed 30 days. |
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The length of time during and after treatment that the patient lives without disease progression.
| From the start of treatment up to 5 years. |
| Overall Survival (OS) | The duration from the start of treatment to the time of death from any cause. | From the start of treatment up to 5 years. |
| Duration of Response (DOR) | The time from initial tumor response (CR or PR) to disease progression or relapse. | From the administration of UWD-03 CAR-T cells to a maximum follow-up period of five years. |
| ID | Term |
|---|---|
| D006528 | Carcinoma, Hepatocellular |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008113 | Liver Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D008107 | Liver Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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