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A Phase Ib/II Exploratory Clinical Trial of Memory-Enhanced 7×19-THEMIS CAR-T Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma

A Phase Ib/II Exploratory Clinical Trial of Memory-Enhanced 7×19-THEMIS CAR-T Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma: A Single-Arm Design Using a Historical Control (7×19 CAR-T)

This study is aimed to explored the safety and efficacy of 7×19-THEMIS CAR-T cell therapy for large B-cell lymphoma and to conduct an exploratory comparison of the 3-month objective response rate (ORR) and complete remission rate (CR rate) between the experimental cohort and the historical control cohort (NCT04833504).

Descripción general del estudio

Tipo de estudio

Intervencionista

Inscripción (Estimado)

70

Fase

  • Fase 2
  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Wenbin Qian,Professor
  • Número de teléfono: +86 13605801032
  • Correo electrónico: qianwb@zju.edu.cn

Copia de seguridad de contactos de estudio

  • Nombre: Wen Lei,Doctor
  • Número de teléfono: +86 18258448016
  • Correo electrónico: leiwen2017@zju.edu.cn

Ubicaciones de estudio

    • Zhejiang
      • Hangzhou, Zhejiang, Porcelana, 310009
        • Reclutamiento
        • The Second Affiliated Hospital,School of Medicine,Zhejiang University, Hangzhou, Zhejiang 310009
        • Contacto:
          • Wenbin Qian,Professor
          • Número de teléfono: +86 13605801032
          • Correo electrónico: qianwb@zju.edu.cn
        • Contacto:

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto
  • Adulto Mayor

Acepta Voluntarios Saludables

No

Descripción

Inclusion Criteria:

  1. Voluntarily participate in this study and sign the informed consent form.
  2. Age range: 18 - 75 years old. Gender is not restricted.
  3. Histologically confirmed large B-cell lymphoma, including: diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), transformed follicular lymphoma (tFL), and mantle cell lymphoma (MCL).
  4. CD19-positive (as determined by immunohistochemistry or flow cytometry; based on the most recent tumor biopsy results).
  5. Definition of relapsed/refractory: Failure to achieve complete remission (CR) after at least two lines of therapy (which must include a CD20 monoclonal antibody and an anthracycline); or disease progression during any course of treatment; or relapse/progression within 12 months after autologous hematopoietic stem cell transplantation.
  6. At least one measurable lesion: any lymph node lesion with a longest dimension >1.5 cm, or any extranodal lesion with a longest dimension >1.0 cm, and the lesion shows uptake on PET-CT (SUV greater than the hepatic pool).
  7. Absolute neutrophil count in peripheral blood ≥ 1,000/μL; platelet count ≥ 45,000/μL.
  8. Cardiac, hepatic, and renal function: creatinine < 1.5 mg/dL; ALT/AST ≤ 2.5 times the upper limit of normal; total bilirubin < 1.5 mg/dL; ejection fraction ≥ 50%.
  9. Possess sufficient cognitive capacity to voluntarily sign the informed consent form.
  10. Participants of reproductive potential must be willing to use effective contraception (from the time of signing the informed consent form until 12 months after CAR-T infusion).
  11. The investigator estimates a life expectancy of at least 4 months.
  12. Willing to comply with the schedule of visits, dosing regimen, laboratory tests, and other trial procedures.

Exclusion Criteria:

  1. History of other malignant tumors (excluding cured basal cell carcinoma, cervical carcinoma in situ, papillary thyroid carcinoma, etc.).
  2. Autologous hematopoietic stem cell transplantation within the past 6 weeks.
  3. Any targeted CAR-T therapy within 3 months prior to this CAR-T treatment.
  4. Patients who have previously received PD-1 monoclonal antibodies must have a washout period of ≥3 months before enrollment.
  5. Received cytotoxic drugs, glucocorticoids (except for prednisone-equivalent doses of ≤10 mg/day), or other targeted therapies within 2 weeks prior to cell collection.
  6. Active autoimmune diseases (e.g., systemic lupus erythematosus, inflammatory bowel disease, etc.).
  7. Uncontrolled active bacterial, fungal, or viral infections.
  8. HIV infection, syphilis; active hepatitis B or C: Hepatitis B: HBsAg-positive and HBV-DNA ≥ 1,000 IU/mL; Hepatitis C: HCV RNA-positive and abnormal liver function.
  9. Known central nervous system lymphoma (confirmed by brain MRI or CT and cerebrospinal fluid examination).

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: 7×19-THEMIS CAR-T
A single dose intravenous injection of 7X19-Themis at day 0
IL7 and CCL19 Armed anti-CD19 CAR-T with coexpressing Themis

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Determination of the Recommended Phase II Dose (RP2D)
Periodo de tiempo: Up to 3 months
Based on the incidence of DLTs, CAR-T cell kinetics, preliminary efficacy, and safety data from the Phase Ib dose-escalation phase, the Safety Review Committee (SRC) determined the RP2D following a comprehensive evaluation.
Up to 3 months
Objective Response Rate (ORR)
Periodo de tiempo: Up to 3 months
At 3 months (±7 days) after infusion, the proportion of patients achieving complete remission (CR) or partial remission (PR) was assessed according to the Lugano 2014 criteria, and a descriptive comparison was made with the historical control cohort.
Up to 3 months
Complete Remission Rate (CR Rate)
Periodo de tiempo: Up to 3 months
At 3 months (±7 days) after infusion, the proportion of patients who achieved complete remission (CR) was assessed according to the Lugano 2014 criteria, and a descriptive comparison was made with the historical control cohort.
Up to 3 months

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Incidence and severity of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) graded according to ASTCT 2019 criteria
Periodo de tiempo: up to 28 days
The incidence and severity of CRS and ICANS will be assessed according to the American Society for Transplantation and Cellular Therapy (ASTCT) 2019 consensus grading criteria. The incidence of each grade (Grades 1-4) will be summarized, with particular attention to the incidence of Grade ≥3 CRS and Grade ≥3 ICANS.
up to 28 days
Incidence and duration of Grade ≥3 hematologic toxicities assessed according to CTCAE version 5.0
Periodo de tiempo: up to 28 days
The incidence and duration of Grade ≥3 neutropenia, anemia, and thrombocytopenia will be assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
up to 28 days
Incidence of clinically significant infections requiring anti-infective treatment or hospitalization
Periodo de tiempo: up to 28 days
The incidence of bacterial, fungal, and viral infections requiring anti-infective treatment or hospitalization will be recorded and summarized.
up to 28 days
Progression-Free Survival (PFS)
Periodo de tiempo: up to 2-5 years
Progression-free survival is defined as the time from CAR-T cell infusion to the first documented disease progression (PD) or death from any cause, whichever occurs first. Median PFS and PFS rates at 12 and 24 months will be estimated using the Kaplan-Meier method.
up to 2-5 years
Overall Survival (OS)
Periodo de tiempo: up to 2-5 years
Overall survival is defined as the time from CAR-T cell infusion to death from any cause. Median OS and OS rates at 12 and 24 months will be estimated using the Kaplan-Meier method.
up to 2-5 years
Duration of Response (DOR)
Periodo de tiempo: up to 2-5 years
Among participants who achieve complete response (CR) or partial response (PR), duration of response is defined as the time from the first documented response to disease progression or death from any cause, whichever occurs first. Median DOR will be estimated using the Kaplan-Meier method.
up to 2-5 years
In Vivo Kinetics of CAR-T Cells
Periodo de tiempo: up to 2-5 years
Measurement of CAR-T Cell Counts in Peripheral Blood and Comparison of Kinetic Parameters
up to 2-5 years
Serum Cytokine Dynamics
Periodo de tiempo: day-5,day4,day7,day11,day14,day18,day21,day28,month 3
Measure the concentrations of cytokines such as IL-6, IFN-γ, IL-7, and CCL19 in serum at various time points following infusion.
day-5,day4,day7,day11,day14,day18,day21,day28,month 3
B-Cell Recovery
Periodo de tiempo: month1, month3, month6, month9, months12, month24, year3 and year5
Determine the absolute count of CD19+CD20+ cells in peripheral blood to assess the dynamics of B-cell recovery following infusion.
month1, month3, month6, month9, months12, month24, year3 and year5

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Single-Cell Functional Characterization of CAR-T Products
Periodo de tiempo: day-5, day4, day7, day11, day14, day18, day21, day28, month2
Detection of various cytokines secreted by CAR-T infusion products at the single-cell level upon stimulation with the CD19 antigen.
day-5, day4, day7, day11, day14, day18, day21, day28, month2
Spearman correlation between memory T-cell subset proportions in the CAR-T infusion product and 3-month complete response
Periodo de tiempo: day-5, day4, day7, day11, day14, day18, day21, day28, month3
The proportions of stem cell memory T cells (TSCM), central memory T cells (TCM), effector memory T cells (TEM), and terminal effector T cells (TTE) in the CAR-T infusion product will be measured by multicolor flow cytometry. T-cell subsets will be defined as TSCM (CD45RA+CCR7+CD95+), TCM (CD45RA-CCR7+), TEM (CD45RA-CCR7-), and TTE (CD45RA+CCR7-). The proportion of each subset will be expressed as the percentage of CAR-T cells. The correlation between memory T-cell subset proportions and complete response at 3 months will be assessed using Spearman rank correlation and exploratory group comparisons using the Mann-Whitney U test.
day-5, day4, day7, day11, day14, day18, day21, day28, month3
Trends in Anti-CAR Antibodies (ADA)
Periodo de tiempo: day-5, day4, day7, day11, day14, day18, day21, day28, month3,month6,month12, year2 and year5
Determination of the Prevalence and Titer of Anti-FMC63 Antibodies (ADA) in Serum
day-5, day4, day7, day11, day14, day18, day21, day28, month3,month6,month12, year2 and year5
Area under the receiver operating characteristic curve (AUC) of peak serum cytokine and chemokine levels within 28 days after CAR-T infusion for discrimination of objective response
Periodo de tiempo: month6, month12, year2, year5
Peak serum concentrations of IL-7, CCL19, MIP-1α, MIP-1β, and SDF-1α during the first 28 days after CAR-T cell infusion will be measured using the protocol-specified serum cytokine/chemokine assay. Receiver operating characteristic (ROC) curve analysis will be performed to evaluate the ability of each biomarker to discriminate objective response, defined as complete response or partial response according to protocol-defined disease response criteria. The AUC and the optimal biomarker cutoff value will be determined for each biomarker.
month6, month12, year2, year5

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Silla de estudio: Wenbin Qian,Professor, Second Affiliated Hospital, Zhejiang University, School of Medicine

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de septiembre de 2026

Finalización primaria (Estimado)

1 de septiembre de 2029

Finalización del estudio (Estimado)

1 de septiembre de 2031

Fechas de registro del estudio

Enviado por primera vez

12 de agosto de 2026

Primero enviado que cumplió con los criterios de control de calidad

23 de agosto de 2026

Publicado por primera vez (Actual)

26 de agosto de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

26 de agosto de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

23 de agosto de 2026

Última verificación

1 de agosto de 2026

Más información

Términos relacionados con este estudio

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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