Safety and Efficacy of Fourth-Generation CAR-T in the Treatment of Hematologic Malignancies

Launched by THE THIRD AFFILIATED HOSPITAL OF SOUTHERN MEDICAL UNIVERSITY · Jan 3, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating a new treatment called Fourth-Generation CAR-T therapy for patients with certain blood cancers, including Multiple Myeloma and B-cell Lymphoma. The goal is to see how safe and effective this therapy is, and to find out the best dose to use. The study is currently looking for participants aged 18 to 75 who have specific types of blood cancers and are expected to live at least three more months. It's important that participants are able to give their consent and meet certain health criteria, such as having stable blood counts and good organ function.

If you decide to join this trial, you will receive the CAR-T therapy, which involves modifying your own immune cells to help fight the cancer. Throughout the study, doctors will monitor your health closely to assess how well the treatment is working and to check for any side effects. This trial is being conducted at a single center, meaning all treatments and evaluations will take place in one location. Remember, it's also essential to discuss any prior treatments or health issues with the study team, as some conditions may prevent eligibility.

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Eligibility criteria

• 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:
• • 1. White blood cell count ≥ 3.0 × 10e9/L; Absolute neutrophil ≥ 1.0 × 10e9/L; Lymphocyte count ≥ 0.5 × 10e9/L. (The growth factor support is allowed, but growth factor must not have been received within 7 days prior to laboratory testing);
• • 2. Platelet count ≥ 50 × 10e9/L (No blood transfusion support within 7 days prior to laboratory tests.); Note: Patients with leukemia, multiple myeloma, and lymphoma are not subject to the above blood picture requirements;
• • 3. Biochemical indicators Serum total bilirubin (TBIL) ≤ 2.5 ULN, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 ULN, or 5 ULN if liver dysfunction is primarily due to tumor invasion); 6. Cardiac function: Subjects must have good hemodynamic stability, left ventricular ejection fraction (LVEF) ≥ 55%; 7. Lung condition: Subjects are not serious infections such as severe pneumonia; 8. ECOG activity status score: 0-2 points; 9. Female subjects must use effective contraception (such as oral prescription contraceptives, injectable contraceptives, intrauterine devices, double blockade, contraceptive patches, male partner sterilization) throughout the study period; Must have a negative serum or urine pregnancy test result at screening and throughout the study.
• Exclusion Criteria:
• Any one of the following conditions cannot be selected as a subject:
• • 1. Having received CAR-T therapy targeting the same molecule;
• • 2. Having received other immunotargeted therapy targeting the same molecules;
• • 3. Pregnant or lactating women;
• 4. Subjects who have previously suffered from other malignancies, with the following exceptions:
• • 1. Having received curative therapy, and no known active disease in the ≥ 3 years prior to the enrollment;
• • 2. Non melanoma skin cancer subjects who have completed sufficient treatment and no evidence of thecurrent disease;
• • 5. Subjects with a severe mental disorder;
• • 6. Subjects with active autoimmune disease requiring immunotherapy;
• • 7. Having received allogeneic hematopoietic stem cell transplantation;
• • 8. 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);
• • 9. 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;
• 10. Subjects with dysfunction of important organssuch as organ function in the following abnormalities:
• • 1. Serum AST or ALT \> 2.5×ULN, or \> 5ULN if liver function is predominantly due to tumor invasion; TBIL \> 2.5 × ULN, unless the subject is Gilbert's syndrome;
• • 2. Serum creatinine\>2.5mg/dl;
• • 3. Partial prothrombin time or activated partial thromboplastin time or international normalized ratio \> 1.5×ULN in the absence of anticoagulant therapy;
• • 11. Participation in other clinical studies or prior treatment with any gene therapy product in the past three months;
• • 12. 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.