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| ID | Type | Description | Link |
|---|---|---|---|
| 2024-Lunli-020 | Other Identifier | The clinical Trial Ethics Committee |
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This is a single center, open-label, dose-escalation/expansion clinical study to evaluate the safety and effectiveness of Fourth-Generation CAR-T, and determine the recommended dose of the CAR T-cells for patients with Multiple Myeloma,B-cell lymphoma and other hematologic malignancies.
This is a single center, open-label, dose-escalation/expansion clinical study to evaluate the safety and efficacy of Fourth-Generation CAR-T in the Treatment of Multiple Myeloma,B-cell lymphoma and other hematologic malignancies.. -Prior to Fourth-Generation CAR-T cells infusion, subjects will receive lymphodepleting therapy with fludarabine and cyclophosphamide. After infusion, the investigators will observe the characteristics of dose limited toxicity (DLT), and determine the maximum tolerable agent MTD and RP2D were confirmed. To provide basis for the dosage and treatment plan of cell products in follow-up clinical trials. Meanwhile, subjects will be followed for side effects and effect of the CAR-T.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phase 1:Low dose group | Experimental | Infusion of CAR T-cells by single dose of 0.5×10^6 CAR-T cells/kg |
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| Phase 1: Medium dose group | Experimental | Infusion of CAR T-cells by single dose of 1.5×10^6 CAR-T cells/kg |
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| Phase 1: High dose group | Experimental | Infusion of CAR T-cells by single dose of 5.0×10^6 CAR-T cells/kg |
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| Phase 2a: RP2D | Experimental | After all subjects in the Phase 1 dose-escalation study completed DLT observation, RP2D was determined based on the analysis results for the phase 2a expansion study. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CAR-T | Biological | CAR T-cell therapy involves autologous chimeric antigen receptor T-cells, capable of targeting human B cell maturation antigen (BCMA) ,CD19 or CD-7 etc. target molecules of other hematologic malignancies. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with dose-limiting toxicity (DLT) | For DLT evaluation, severity (grade) is classified according to common terminology criteria for adverse events version 4.03 (CTCAE v4.03). | Within 30 days of receiving CAR T-cells transfusion therapy |
| Maximum Tolerated Dose (MTD) | At least 6 subjects in the MTD dose group must complete the DLT assessment. | Within 30 days of receiving CAR T-cells transfusion therapy |
| Adverse Event | Safety will be assessed by adverse events (AEs), which include clinically significant abnormalities identified during medical tests (e.g. laboratory tests, electrocardiogram, imaging examinations or physical examinations). AEs will be coded by Medical Dictionary for Regulatory Activities (MeDRA) and their severity will be graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE, version 4.03). | Minimum 2 years after CAR T-cells infusion (Day 1) |
| Recommended Phase 2 Dose (RP2D) | To determine after all subjects in the Phase 1 dose-escalation study completed DLT observation | Through study completion, an average of 1 year |
| Objective response rate (ORR) | The definition of ORR is the proportion of subjects achieving sCR, CR, VGPR, or PR confirmed by efficacy reassessment after a minimum interval of three months. ORR is calculated as (sCR+CR+VGPR+PR) divided by the total number of cases of Multiple Myeloma, or (CR+PR) divided by the total number of cases of B-cell lymphoma and other hematologic malignancies, multiplied by 100%. | Through study completion, an average of 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Stringent complete response rate (sCRR) | The definition of sCRR is the proportion of subjects achieving sCR confirmed by efficacy re-assessment after a minimum interval of three months. Efficacy assessment for multiple myeloma only. | Through study completion, an average of 2 years |
| Progression-free Survival (PFS) |
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Inclusion Criteria:
Subjects must meet all of the following criteria to be enrolled:
1. Voluntarily participate in this clinical study and sign the informed consent form; 2. 18 to 75 years old (including cut-off value), Male and female;; 3. Expected survival of at least 3 months; 4.1 CD19-positive B lymphocyte-derived hematologic malignancies; 4.2 Multiple myeloma patients; 4.3 Non-B cell-derived hematologic malignancies patients with CD7 or other target molecules; 5. The clinical trial values during the screening period meet the following criteria:
Exclusion Criteria:
Any one of the following conditions cannot be selected as a subject:
Having received CAR-T therapy targeting the same molecule;
Having received other immunotargeted therapy targeting the same molecules;
Pregnant or lactating women;
Subjects who have previously suffered from other malignancies, with the following exceptions:
Subjects with a severe mental disorder;
Subjects with active autoimmune disease requiring immunotherapy;
Having received allogeneic hematopoietic stem cell transplantation;
Subjects with significant cardiovascular diseasesa.uncontrolled or symptomatic arrhythmias, congestive heart failure, or any heart disease with cardiac function grade 3 or grade 4 (according to the functional classification method of the New York Heart Association NYHA); b. Myocardial infarction or coronary artery bypass grafting within 6 months prior to screening); c. Clinically significant history of ventricular arrhythmia or unexplained syncope (non vaso-vagal or not due to dehydration);
Subjects with active infectious disease including positive Hepatitis B surface antigen (HBsAg) or Hepatitis B core antibody (HBcAb) and peripheral blood Hepatitis B virus(HBV) DNA titer is ≥500IU/mL, hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive, human immunodeficiency virus(HIV) antibody positive, syphilis primary screening antibody positive, active pulmonary tuberculosis; or with any significant infection requiring high-grade antibiotics Event;
Subjects with dysfunction of important organssuch as organ function in the following abnormalities:
Participation in other clinical studies or prior treatment with any gene therapy product in the past three months;
Subjects with uncontrolled diabetes mellitus (glycosylated hemoglobin HbAlc >8% at screening);13. Highly allergic constitution or history of severe allergies, and having contraindications to cyclophosphamide or fludarabine;
14. Feasibility assessment screening demonstrated <10% transfection of targeted lymphocytes or underamplification under CD3 / CD28 costimulation (<5-fold); 15. Subjects who are considered unsuitable to participate in this trial by the investigator.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yan Yi, MD. | Contact | +86 13617493781 | yiyan@smu.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Yan Yi, MD. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Third Affiliated Hospital of Southern Medical University | Recruiting | Guangzhou | Guangdong | 510630 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34464155 | Result | Roddie C, Dias J, O'Reilly MA, Abbasian M, Cadinanos-Garai A, Vispute K, Bosshard-Carter L, Mitsikakou M, Mehra V, Roddy H, Hartley JA, Spanswick V, Lowe H, Popova B, Clifton-Hadley L, Wheeler G, Olejnik J, Bloor A, Irvine D, Wood L, Marzolini MAV, Domning S, Farzaneh F, Lowdell MW, Linch DC, Pule MA, Peggs KS. Durable Responses and Low Toxicity After Fast Off-Rate CD19 Chimeric Antigen Receptor-T Therapy in Adults With Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia. J Clin Oncol. 2021 Oct 20;39(30):3352-3363. doi: 10.1200/JCO.21.00917. Epub 2021 Aug 31. | |
| 35432352 |
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| ID | Term |
|---|---|
| D009101 | Multiple Myeloma |
| D016393 | Lymphoma, B-Cell |
| D019337 | Hematologic Neoplasms |
| ID | Term |
|---|---|
| D054219 | Neoplasms, Plasma Cell |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D020141 | Hemostatic Disorders |
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The time interval from the first administration of the investigational drug to the first observation of disease progression is calculated, considering the date of entry for patients who died for reasons other than disease progression before progression occurred. |
| Through study completion, an average of 2 years |
| Overall Survival (OS) | OS is the time from the start of cell infusion to the death of the subject. | Through study completion, an average of 2 years |
| Result |
| Sang W, Wang X, Geng H, Li T, Li D, Zhang B, Zhou Y, Song X, Sun C, Yan D, Li D, Li Z, Li C, Xu K. Anti-PD-1 Therapy Enhances the Efficacy of CD30-Directed Chimeric Antigen Receptor T Cell Therapy in Patients With Relapsed/Refractory CD30+ Lymphoma. Front Immunol. 2022 Apr 1;13:858021. doi: 10.3389/fimmu.2022.858021. eCollection 2022. |
| 35488407 | Result | Du J, Wei R, Jiang S, Jiang H, Li L, Qiang W, He H, Shi L, Ma Q, Yu K, Zhang X, Ding H, Sun X, Xiang F, Zhu L, Cheng Z, Fu W. CAR-T cell therapy targeting B cell maturation antigen is effective for relapsed/refractory multiple myeloma, including cases with poor performance status. Am J Hematol. 2022 Jul;97(7):933-941. doi: 10.1002/ajh.26583. Epub 2022 May 5. |
| 35798714 | Result | Yang J, He J, Zhang X, Li J, Wang Z, Zhang Y, Qiu L, Wu Q, Sun Z, Ye X, Yin W, Cao W, Shen L, Sersch M, Lu P. Next-day manufacture of a novel anti-CD19 CAR-T therapy for B-cell acute lymphoblastic leukemia: first-in-human clinical study. Blood Cancer J. 2022 Jul 7;12(7):104. doi: 10.1038/s41408-022-00694-6. |
| 36059523 | Result | Qu C, Zou R, Wang P, Zhu Q, Kang L, Ping N, Xia F, Liu H, Kong D, Yu L, Wu D, Jin Z. Decitabine-primed tandem CD19/CD22 CAR-T therapy in relapsed/refractory diffuse large B-cell lymphoma patients. Front Immunol. 2022 Aug 17;13:969660. doi: 10.3389/fimmu.2022.969660. eCollection 2022. |
| 36477110 | Result | Ying Z, Xie Y, Zheng W, Liu W, Lin N, Tu M, Wang X, Ping L, Deng L, Zhang C, Wu M, Feng F, Du T, Tang Y, Su F, Guo Z, Li J, Song Y, Zhu J. Efficacy and safety of relmacabtagene autoleucel, an anti-CD19 chimeric antigen receptor T cell, in relapsed/refractory B-cell non-Hodgkin's lymphoma: 2-year results of a phase 1 trial. Bone Marrow Transplant. 2023 Mar;58(3):288-294. doi: 10.1038/s41409-022-01888-z. Epub 2022 Dec 7. |
| 37774014 | Result | Liang EC, Albittar A, Huang JJ, Hirayama AV, Kimble EL, Portuguese AJ, Chapuis A, Shadman M, Till BG, Cassaday RD, Milano F, Kiem HP, Riddell SR, Turtle CJ, Maloney DG, Gauthier J. Factors associated with long-term outcomes of CD19 CAR T-cell therapy for relapsed/refractory CLL. Blood Adv. 2023 Nov 28;7(22):6990-7005. doi: 10.1182/bloodadvances.2023011399. |
| 37883795 | Result | Minson A, Hamad N, Cheah CY, Tam C, Blombery P, Westerman D, Ritchie D, Morgan H, Holzwart N, Lade S, Anderson MA, Khot A, Seymour JF, Robertson M, Caldwell I, Ryland G, Saghebi J, Sabahi Z, Xie J, Koldej R, Dickinson M. CAR T cells and time-limited ibrutinib as treatment for relapsed/refractory mantle cell lymphoma: the phase 2 TARMAC study. Blood. 2024 Feb 22;143(8):673-684. doi: 10.1182/blood.2023021306. |
| D014652 |
| Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D006474 | Hemorrhagic Disorders |
| D008232 | Lymphoproliferative Disorders |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D008206 | Lymphatic Diseases |
| D009371 | Neoplasms by Site |