Description:
Title: Single-center, open clinical study on the efficacy and safety of c-Met/PD-L1 T cell
injection in the treatment of primary hepatocellular carcinoma
Stage: Phase I clinical trial
Purpose: To evaluate the efficacy and safety of c-Met/PD-L1 CAR-T cells in patients with
primary hepatocellular carcinoma
Object: patients with primary hepatocellular carcinoma
Sample size: 50 cases
Number of centres:1
Study design: CT, MRI, PET and blood biochemical tests were performed before treatment to
evaluate the state of HCC. Peripheral blood of the patient was extracted and PBMC was
isolated. CAR-T cells were obtained by tranducing PBMC with c-Met/PD-L1 CAR lentivirus, and
the proliferation capacity and immune phenotype of the cells were tested. After passing the
inspection, the cells were re-injected into the patient three times. The efficacy and safety
of c-Met/PD-L1 CAR-T cells was assessed respectively at 4 week, 12 week, 24 week and 48 week
after treatment.
Trial product: c-Met/PD-L1 CAR-T cells
Course of treatment: 3 days for a course of treatment, only one course of treatment. A second
course is given as appropriate if the treatment is beneficial to the patient.
Title
- Brief Title: Clinical Study on the Efficacy and Safety of c-Met/PD-L1 CAR-T Cell Injection in the Treatment of HCC
- Official Title: Single-center, Open Clinical Study on the Efficacy and Safety of c-Met/PD-L1 Chimeric Antigen Receptor T Cell Injection in the Treatment of Primary Hepatocellular Carcinoma
Clinical Trial IDs
- ORG STUDY ID:
JGZNO1
- NCT ID:
NCT03672305
Conditions
- Primary Hepatocellular Carcinoma
Interventions
Drug | Synonyms | Arms |
---|
c-Met/PD-L1 CAR-T cell injection | | c-Met/PD-L1 CAR-T cells treating group |
Purpose
Title: Single-center, open clinical study on the efficacy and safety of c-Met/PD-L1 T cell
injection in the treatment of primary hepatocellular carcinoma
Stage: Phase I clinical trial
Purpose: To evaluate the efficacy and safety of c-Met/PD-L1 CAR-T cells in patients with
primary hepatocellular carcinoma
Object: patients with primary hepatocellular carcinoma
Sample size: 50 cases
Number of centres:1
Study design: CT, MRI, PET and blood biochemical tests were performed before treatment to
evaluate the state of HCC. Peripheral blood of the patient was extracted and PBMC was
isolated. CAR-T cells were obtained by tranducing PBMC with c-Met/PD-L1 CAR lentivirus, and
the proliferation capacity and immune phenotype of the cells were tested. After passing the
inspection, the cells were re-injected into the patient three times. The efficacy and safety
of c-Met/PD-L1 CAR-T cells was assessed respectively at 4 week, 12 week, 24 week and 48 week
after treatment.
Trial product: c-Met/PD-L1 CAR-T cells
Course of treatment: 3 days for a course of treatment, only one course of treatment. A second
course is given as appropriate if the treatment is beneficial to the patient.
Detailed Description
Title: Single-center, open clinical study on the efficacy and safety of c-Met/PD-L1 CAR-T
cell injection in the treatment of primary hepatocellular carcinoma
Research purpose:
Primary outcome:
To evaluate the efficacy of c-Met/PD-L1 CAR-T cell injection in the treatment of primary
hepatocellular carcinoma.
Secondary purpose:
1. To evaluate the clinical safety of c-Met/PD-L1 CAR-T cell injection in the treatment of
primary hepatocellular carcinoma;
2. To assess the amplification and persistence of c-Met/PD-L1 CAR-T cells in subjects.
Study design:Single center, open clinical study
Subjects:Patients with primary hepatocellular carcinoma
Clinical trial cycle:
Screening stage:Selecting enrolled patients and collecting peripheral mononuclear cells;
Treating stage: Pretreating and the backtransfusing c-Met/PD-L1 CAR-T cells Follow-up
stage:Treatment was observed for 28 days (short-term follow-up), 28 days to 24 weeks
(mid-term follow-up), and 24 weeks to progression/death (long-term follow-up);
Trial product:
Trial product:c-Met/PD-L1 CAR-T cells Dosage:The backtransfusion dose was determined by the
investigator based on the subject's own/disease condition and in vitro preparation
(recommended dose: 2 * 10^6/kg); Infusion way:Steady intravenous drip within 15 to 30 minutes
Clinical trial procedure:
1. The screening period:
The subjects signed the informed consent form and performed a series of examinations
according to the interview flow chart. The researchers judged whether the subjects met
the inclusion criteria according to the examination results and inclusion/exclusion
criteria, and did not meet the exclusion criteria. If the subjects were enrolled,
peripheral blood mononuclear cells were collected, and the collection standard was 2-4 *
10^8 white blood cells;
2. nonmyeloablative pretreatment:(The following options are selected on a case-by-case
basis)
1. Fludarabine+Cyclophosphamide (FC)
2. Bis-1-nitrosourea+Etoposide+Arabinoside+Cyclophosphamide (BECA);
3. Retransfusion period:
The specific time and dose of retransfusion can be determined by the researchers;
4. Short-term follow-up period:
Subjects will undergo a series of examinations according to the visit flow chart within
28 days after the expected dose of c-Met/PD-L1 CAR-T cells injection.The short-term
efficacy and safety of c-Met/PD-L1 CAR-T cells injection were evaluated by the
researchers based on the test results.
5. Mid-term follow-up:
Subjects will undergo a series of examinations according to the visit flow chart 28 days
to 24 weeks after re-transfusion of c-Met/PD-L1 CAR-T cells injection.The researchers
will evaluate the mid-term efficacy and safety of c-Met/PD-L1 CAR-T cells based on the
test results.
6. Long-term follow-up:
Subjects will undergo a series of examinations according to the visit flow chart 24
weeks later until progress or death after retransfusion of c-Met/PD-L1 CAR-T cells.The
long-term efficacy and safety of c-Met/PD-L1 CAR-T cells will be evaluated according to
the test results.
7. Withdrawal visit (at any time) :All subjects may withdraw from this study at any stage
of the trial.If the subjects withdraw from the study after returning to the c-Met/PD-L1
CAR-T cells, they shall complete the inspection items required in the visit flow chart,
and the reason for the withdrawal shall be recorded in detail by the researchers.If the
subject passes screening but withdraws from the visit before returning to the
c-Met/PD-L1 CAR-T cells, only the baseline and screening tests need to be completed, and
the reason for withdrawal will be recorded in detail by the investigators.If the subject
withdraws from the screening test before the end of the screening test, only the
screening test shall be completed and the reason for withdrawal shall be recorded in
detail by the investigators.If treatment is discontinued due to adverse reactions (AE),
the investigators will follow up with the necessary safety until the subjects return to
baseline or to a stable state.
Evaluation index Main evaluation index
1. Objective tumor remission rate (ORR),complete remission (CR) and partial remission (PR)
at 4 weeks, 12 weeks, 24 weeks and 48 weeks after treatment with c-Met/PD-L1 CAR-T
cells;
2. Overall survival
3. Progression free survival
4. Event-free survival
Secondary evaluation index
1. Incidence of treatment-related adverse events (level 3 or level 4 adverse reactions,
CTCAE V4.03 criteria). These included adverse events related to the treatment of
c-Met/PD-L1 CAR-T cells, severe adverse events and clinically significant laboratory
abnormalities;
2. The amplification level of c-Met/PD-L1 CAR-T cells in the subjects varied with time;
3. Duration of c-Met/PD-L1 CAR-T cells in the subjects;
4. The abatement features of hepatocellular carcinoma in subjects.
Statistical analysis SPSS18.0 was used for statistical analysis
1. The primary and secondary end points were analyzed by intentionality. The statistical
analysis method of the end point was used to describe tumor ORR according to different
follow-up time. Kaplan-meier method and survival curve were used to describe OS, PFS and
EFS
2. The statistical analysis method of the secondary study endpoint was to describe the
occurrence number and incidence of treatment-related adverse events, and to compare the
difference of vital signs and laboratory indexes before and after treatment
Trial Arms
Name | Type | Description | Interventions |
---|
c-Met/PD-L1 CAR-T cells treating group | Other | Intervention Name:c-Met/PD-L1 CAR-T cell injection dosage form: injection dosage:The backtransfusion dose (recommended dose: 2 * 10^6/kg) was determined by the investigator based on the subject's own/disease condition and in vitro preparation. | - c-Met/PD-L1 CAR-T cell injection
|
Eligibility Criteria
Inclusion Criteria:
1. Male or female patients aged 18 to 70 years (including 18 and 70 years);
2. Immune histochemistry detection was confirmed as c-met positive ; hepatocellular
carcinoma, and the patient has no effective treatment at present
3. Liver tissue type: non-diffuse hepatocellular carcinoma, no extra hepatic metastasis
or portal vein infiltration;
4. Cirrhosis of the liver: child-pugh A grade or child-pugh B grade, child-pugh-turcotte
score <7;
5. Routine blood test: white blood cell count (WBC) or 3 * 10^9/L, lymphocyte percentage
(LY) 15% or higher, hemoglobin (Hb), 90g/L or higher, prothrombin time (PT),
international standardization ratio (INR) 1.7 or less, or prothrombin time (PT) extend
the 4 s or less, lymphocyte acuity 0.8 * 10^9/L;
6. The main tissues and organs of the patients are functioning well (if the organs do not
meet the following standards, but the researchers believe that the diseases themselves
can be included):
1. Hepatic and pancreatic functions: alanine aminotransferase/aspartate
aminotransferase (ALT/AST) is 5 times of normal value, total bilirubin (TBiL) is
3.0mg/dL, albumin (ALB) is 35g/L, serum lipase is 1.5 times of normal value, and
serum amylase is 1.5 times of normal value. Renal function: creatinine <2 ULN
2. Lung function: indoor oxygen saturation greater than or equal to 95% (without
oxygen inhalation)
3. Cardiac function: LVEF is greater than or equal to 40%
4. The absolute number of neutrophils is greater than or equal to 0.75 * 10^9/L, and
platelets are greater than or equal to 50 * 10^9/L
7. ECOG score 0-1 or Karnofsky performance status (card score) (KPS) is greater than 60,
and the expected survival time is greater than or equal to 12 weeks;
8. There are adequate venipuncture or venous sampling channels and no contraindications
for lymphocyte separation;
9. No anti-tumor therapy, including chemotherapy, radiotherapy and immunotherapy (such as
immunosuppressive drugs), was received within 4 weeks before enrollment, and the
toxicity response of previous treatment was restored to level 1 or less (except for
low-level toxicity such as hair loss);
10. Female subjects of reproductive age must have negative serum or urine pregnancy test
during screening, and male and female patients agree to take effective contraceptive
measures during the trial;
11. There were no other serious complications;
12. Voluntarily sign informed consent.
Exclusion Criteria:
1. Women during pregnancy (positive urine/blood pregnancy test) or lactation; A male or
female who has a plan to conceive within the last 1 year; Effective contraceptive
(condom or birth control pill, etc.) cannot be guaranteed for 1 year after enrollment;
2. The patients had uncontrollable infection within 4 weeks before enrollment. However,
prophylactic antibiotics, antiviral and antifungal infection treatment are allowed;
Active hepatitis b hepatitis c; People infected with human immunodeficiency virus
(HIV);
3. Suffering from severe autoimmune disease or immunodeficiency disease;
4. The patient is allergic to large molecular biological drugs such as antibodies or
cytokines;
5. The patient who has mentally ill;
6. The patient has substance abuse/addiction;
7. The patient who has a history of hepatocellular carcinoma;
8. Having severe peptic ulcer or bleeding;
9. A patient who receives an organ transplant or waits for one;
10. Patients requiring anticoagulation (e.g., warfarin or heparin);
11. Patients requiring long-term antiplatelet therapy (aspirin > 300 mg/d; Clopidogrel
dose > 75 mg/d);
12. Organ failure patient:
1. Cardiac function: grade 3 or above according to the New York heart association
(NYHA) standard
2. Liver function: C level above, according to child-pugh standard
3. Chronic kidney disease (CKD) stage 4 or above; Renal insufficiency or above
4. Lung function: severe respiratory failure, involving other organs
5. Brain function: abnormal central nervous system or disturbance of consciousness;
13. Systemic use of hormones within 4 weeks before enrollment (use of prednisone 20mg/ d
or less is allowed, except for inhaled hormones);
14. The patient participated in other clinical trials within 4 weeks before enrollment;
15. The patient has been treated with radiation for the past four weeks;
16. Investigators determined that the patient was unable or unwilling to comply with
protocol requirements.
Maximum Eligible Age: | 70 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | The efficacy of c-Met/PD-L1 CAR-T cells in the treatment of HCC |
Time Frame: | 6 months after treatment |
Safety Issue: | |
Description: | assessing the efficacy of c-Met/PD-L1 CAR-T cells through overall survival |
Secondary Outcome Measures
Measure: | the incidence of treatment-emergent adverse events of c-Met/PD-L1 T cell injection in the treatment of HCC |
Time Frame: | 6 months after treatment |
Safety Issue: | |
Description: | the level 3 or level 4 adverse reactions according to CTCAE V4.03 standard |
Measure: | The amplification and persistence of c-Met/PD-L1 CAR-T cell in the subjects varied with time |
Time Frame: | 6 months after treatment |
Safety Issue: | |
Description: | The amplification level of c-Met/PD-L1 CAR-T cells varied with time and the duration of anti-c-met/pd-l1 CAR-T cells in the subjects |
Details
Phase: | Early Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Unknown status |
Lead Sponsor: | The Second Hospital of Nanjing Medical University |
Last Updated
September 18, 2018