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This study is a single-arm, open-label, dose-escalating + dose-expansion clinical study, aiming to evaluate the safety and efficacy of CEA-targeted CAR-T cell preparations, and to preliminarily observe the study drug in CEA-positive advanced malignant tumors. The pharmacokinetic characteristics of CAR-T cell preparations for the treatment of patients with CEA-positive advanced malignancies were obtained and the recommended dose and infusion schedule.
According to the different infusion methods, patients will be assigned to three parallel subgroups: intravenous infusion, intrapleural infusion, and intraperitoneal infusion.
Within each subgroup, the study is conducted in two sequential parts:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intravenous of CEA-targeted CAR-T | Experimental | Infusion of CEA-targeted CAR-T cells by dose of 1-15x10^5 cells/kg |
|
| Intrapleural infusion of CEA-targeted CAR-T | Experimental | Infusion of CEA-targeted CAR-T cells by dose of 1-15x10^5 cells/kg |
|
| Intraperitoneal infusion of CEA-targeted CAR-T | Experimental | Infusion of CEA-targeted CAR-T cells by dose of 1-15x10^5 cells/kg |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CEA-targeted CAR-T cells | Biological | Administration method: intravenous infusion. Subjects will receive conditioning therapy by Fludarabine and Cyclophosphamide before cell infusion. |
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the safety of CAR-T cell preparations in the treatment of CEA-positive advanced malignancies [Safety and Tolerability] | Incidence of adverse events during the study, evaluated per the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and American Society for Transplantation and Cellular Therapy (ASTCT) criteria | 1 month |
| Obtained the recommended dose and infusion regimen of CAR-T cells for the treatment of patients with CEA-positive advanced malignancies[Safety and Tolerability] | Dose-limiting toxicity after CEA CAR-T cell infusion | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Assessing disease control rates of CAR-T cell preparations in CEA-positive advanced malignancies [Effectiveness] | Disease control rate: The proportion of subjects who achieved CR, PR, SD after CAR-T infusion accounted for all treated subjects (Assessed based on RECIST criteria),the minimum value is 0%,maximum value is 100%, and higher scores mean a better outcome. | From infusion through Month 3 |
| Measure | Description | Time Frame |
|---|---|---|
| Objective response rate (ORR) of CEA CAR-T treatment in patients with CEA-positive advanced malignancies [Effectiveness] | Objective response rate includes:The proportion of subjects who achieved CR, PR after CAR-T infusion accounted for all treated subjects (Assessed based on RECIST criteria),the minimum value is 0%,maximum value is 100%, and higher scores mean a better outcome. | 2 years |
Inclusion Criteria:
Age ≥ 18 years, no gender restriction;
Histopathologically confirmed diagnosis of advanced, metastatic, or recurrent malignant tumors, primarily including colorectal cancer, esophageal cancer, gastric cancer, pancreatic cancer, lung cancer, and cholangiocarcinoma;
Failure of at least second-line standard treatment (disease progression or intolerance, such as surgery, chemotherapy, radiotherapy, etc.) or lack of effective treatment options;
Immunohistochemical staining of tumor samples showing CEA positivity (clear membrane staining, positivity rate ≥ 10%) within the past 3 months; if the immunohistochemical result is older than 3 months (clear membrane staining, positivity rate ≥ 10%), serum CEA must exceed 10 µg/L;
At least one evaluable lesion according to RECIST 1.1 criteria;
ECOG performance status of 0-2;
Expected survival of ≥ 12 weeks;
No severe psychiatric disorders;
Unless otherwise specified, the following important organ function criteria must be met:
Eligible for single or venous blood collection, and no contraindications for cell collection;
The subject agrees to use reliable and effective contraception methods from the time of signing the informed consent form until 1 year after CAR-T cell infusion (excluding rhythm method);
The subject or their authorized guardian agrees to participate in this clinical trial and signs the informed consent form (ICF), indicating understanding of the trial's purpose and procedures and willingness to participate in the study.
Exclusion Criteria:
Clinically symptomatic central nervous system metastasis or meningeal metastasis at screening, or other evidence indicating that central nervous system or meningeal metastasis has not been controlled, as determined by the investigator, making the patient unsuitable for enrollment.
Participation in another clinical trial within 1 month prior to screening.
Receipt of live attenuated vaccines within 4 weeks prior to screening.
Received the following anti-tumor treatments within 14 days or at least 5 half-lives (whichever is shorter) prior to screening: chemotherapy, targeted therapy, or other experimental drug treatments.
Active infection requiring systemic treatment or an uncontrolled infection.
Bowel obstruction, active gastrointestinal bleeding, or a history of major gastrointestinal bleeding within the last 3 months, or severe gastrointestinal conditions such as severe gastric or duodenal ulcers, severe ulcerative colitis, or other severe gastrointestinal inflammations.
Toxicity from prior anti-tumor treatments has not improved to baseline levels or ≤ grade 1, except for alopecia or peripheral neuropathy.
Any of the following cardiac conditions:
Active autoimmune diseases or other conditions requiring long-term use of immunosuppressive therapy.
History of another malignancy within the past 3 years, excluding treated and stable in situ cervical cancer or basal cell carcinoma of the skin.
Positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) with peripheral blood hepatitis B virus (HBV) DNA levels above the normal range; positive for hepatitis C virus (HCV) antibodies with peripheral blood HCV RNA levels above the normal range; positive for HIV antibodies; or positive for syphilis testing.
Pregnant or breastfeeding women.
Any other conditions that, in the opinion of the investigator, make the patient unsuitable for participation in the study.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Donglai Lv, MD | Contact | +86 13655600090 | lvxunhuan@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Donglai Lv, MD | The 901 Hospital of Joint Logistics Support Force of People Liberation Army | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The 901 Hospital of Joint Logistics Support Force of People Liberation Army | Recruiting | Hefei | Anhui | 230031 | China |
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| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| D013274 | Stomach Neoplasms |
| D003110 | Colonic Neoplasms |
| D012004 | Rectal Neoplasms |
| D004938 | Esophageal Neoplasms |
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| CEA-targeted CAR-T cells | Biological | Administration method: intrapleural infusion. Subjects will receive conditioning therapy by Fludarabine and Cyclophosphamide before cell infusion. |
|
| CEA-targeted CAR-T cells | Biological | Administration method: intraperitoneal infusion. Subjects will receive conditioning therapy by Fludarabine and Cyclophosphamide before cell infusion. |
|
| To evaluate the efficacy of CAR-T cell preparations in CEA-positive advanced malignancies【Effectiveness】 | Changes in serum tumor marker levels: CEA, CA19-9, CA-125, etc. | From infusion through Month 3 |
| To characterize the in-vivo cellular kinetics of CAR-T cells【pharmacokinetics】 | Cmax: maximum observed level of circulating CAR-T cells in peripheral blood after infusion | From infusion through Month 3 |
| To characterize the in-vivo cellular kinetics of CAR-T cells【pharmacokinetics】 | To determine the time to maximum observed level of circulating CAR-T cells (Tmax) | From infusion through Month 3 |
| To characterize the in-vivo cellular kinetics of CAR-T cells【pharmacokinetics】 | To estimate AUC0-28d and AUC0-90d for circulating CAR-T cells | From infusion through Month 3 |
| Duration of Response (DOR) of CEA CAR-T treatment in patients with CEA-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 | 2 years |
| Progress-free survival(PFS) of CEA CAR-T treatment in patients with CEA-positive advanced malignancies [Effectiveness] | PFS will be assessed from the first CEA-CAR-T cell infusion to death from any cause or the first assessment of progression(Assessed based on RECIST criteria) | 2 years |
| Overall survival(OS)of CEA CAR-T treatment in patients with CEA-positive advanced malignancies [Effectiveness] | OS will be assessed from the first CEA-CAR-T cell infusion to death from any cause (Assessed by investigators based on IRECIST criteria) | 2 years |
| D008171 |
| Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |
| D015179 | Colorectal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D006258 | Head and Neck Neoplasms |
| D004935 | Esophageal Diseases |
| D004701 | Endocrine Gland Neoplasms |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |