The ONE Study nTreg Trial (ONEnTreg13) (ONEnTreg13)
The ONE Study: A Unified Approach to Evaluating Cellular Immunotherapy in Solid Organ Transplantation - nTregs Trial
調査の概要
状態
詳細な説明
The ONE Study aims to explore the feasibility, safety and efficacy of regulatory cell therapies as adjunct immunosuppressive treatments in the context of living-donor renal transplantation.The clinical trial presented here (ONEnTreg13) will test autologous, polyclonally expanded CD4+CD25+FoxP3+ nTregs as a somatic cell-based medicinal product.
The objective of this study is to determine whether administration of nTregs to recipients of living-donor kidney transplants is safe and able to polarize the immunological response of the recipient away from graft rejection and towards graft acceptance, allowing a reduction in the doses of pharmacological maintenance immunosuppression.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究場所
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Berlin、ドイツ、13353
- Charité University Medicine, Dept. of Nephrology and Internal Intensive Care
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria for organ recipients:
- Chronic renal insufficiency with a GFR < 15 ml/min, accepted by the organ transplantation conference, registered by ET (Euro Transplant) and having a positive vote from the living donor ethic commission (Lebendspendekommission) at the Berlin Medical Association.
- Willing and able to participate in The ONE Study IM and HEC Subprojects.
- Signed and dated written informed consent. For patients unable to read and/or write, oral informed consent observed by an independent witness is acceptable if the patient has fully understood oral information given by the Investigator. The witness should sign the consent form on behalf of the patient.
Exclusion Criteria for organ recipients:
- Patient has previously received any tissue or organ transplant other than the planned kidney graft.
- Known contraindication to protocol-specified treatments / medications.
- Genetically identical to the prospective organ donor at the HLA loci, the so called "full house match" (0-0-0 mismatch).
- Panel-Reactive Antibody (PRA) grade > 40% within last 6 months before transplantation.
- Previous treatment with any desensitization procedure (with or without IVIg).
- Concomitant malignancy or history of malignancy within 5 years before study entry (excluding successfully-treated non-metastatic basal/squamous cell carcinoma of the skin).
- Evidence of significant local or systemic infection.
- CMV-negative recipient receiving a kidney from a CMV-positive donor. EBV-negative recipient receiving a kidney from an EBV-positive donor.
- HIV-positive or suffering chronic viral hepatitis.
- Significant liver disease, defined as persistently elevated AST and/or ALT levels > 2 x ULN.
- Malignant or pre-malignant hematological conditions.
- Any uncontrolled medical condition or concurrent disease that could interfere with the study objectives.
- Any condition which, according to the Investigator, would place the subject at undue risk.
- Ongoing treatment with systemic immunosuppressive drugs at study entry.
- Participation in another clinical trial during the study or within 28 days prior to planned study entry.
- Female patients of childbearing potential with a positive pregnancy test at enrolment.
- Female patients who are breast-feeding.
- All female patients of childbearing potential unless the patient is willing to maintain a highly effective method of birth control for the duration of the study.
- Psychological, familial, sociological or geographical factors potentially hampering compliance with the study protocol and follow-up visit schedule.
- Any form of drug or alcohol abuse, psychiatric disorder, or other condition that, in the opinion of the Investigator, may invalidate communication with the Investigator and/or designated study personnel.
- Patients unable to freely give their informed consent (e.g. patients under legal guardianship).
- Patients who are committed to an institution by virtue of an order issued either by the judicial or the administrative authorities
- Known allergy/hypersensitivity to any component of the study product.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:Treatment arm
Patients in ONEnTreg13 will be treated with four immunosuppressive agents, all of which are classified as an Investigational Medicinal Products (IMPs):
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autologous CD4+CD25+FoxP3+ natural regulatory T cells (nTregs).
nTregs will be infused at escalating doses of 0.5 x 10^6, 1 x 10^6, and 2.5-3 x 10^6 cells/kg body weight in cohorts of three patients each.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
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Incidence of biopsy-confirmed acute rejection (BCAR) within 60 weeks of organ transplantation
時間枠:60 weeks
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60 weeks
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Incidence of infectious complications associated with cell administration.
時間枠:60 weeks
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60 weeks
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Incidence of embolic pulmonary complications and other embolic events.
時間枠:60 weeks
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60 weeks
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Incidence of immune responses resulting in anaphylactic reactions, cardiovascular compromise or other acute organ failure.
時間枠:60 weeks
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60 weeks
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Biochemical disturbances associated with the cell infusion.
時間枠:60 weeks
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60 weeks
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Over-suppression of the immune system assessed by the incidence of opportunistic infections, especially, CMV, EBV and polyoma virus.
時間枠:60 weeks
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60 weeks
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Over-suppression of the immune system assessed by the incidence of neoplasia.
時間枠:60 weeks
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60 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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組織病理学的所見に基づく無症候性急性拒絶反応の治療を受けた患者の発生率
時間枠:60週間
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60週間
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Prevention of acute rejection will be secondarily assessed by measuring
時間枠:60 weeks
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i) time to first acute rejection episode ii) severity of acute rejection episodes based on response to treatment and histological scoring iii) the level of total immunosuppression drugs at the final trial visit.
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60 weeks
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Prevention of chronic graft dysfunction (chronic rejection or IF/TA) will be assessed by clinical (impairment of GFR) and histopathological (Banff staging) measures.
時間枠:60 weeks
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60 weeks
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Incidence of post-transplant dialysis, inclusion on the transplant waiting list or retransplantation following graft loss through rejection (acute or chronic).
時間枠:60 weeks
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60 weeks
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Avoidance of drug-related complications by immunosuppressant reduction will be assessed by the incidence of reported adverse drug reactions.
時間枠:60 weeks
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60 weeks
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協力者と研究者
スポンサー
出版物と役立つリンク
一般刊行物
- Sawitzki B, Harden PN, Reinke P, Moreau A, Hutchinson JA, Game DS, Tang Q, Guinan EC, Battaglia M, Burlingham WJ, Roberts ISD, Streitz M, Josien R, Boger CA, Scotta C, Markmann JF, Hester JL, Juerchott K, Braudeau C, James B, Contreras-Ruiz L, van der Net JB, Bergler T, Caldara R, Petchey W, Edinger M, Dupas N, Kapinsky M, Mutzbauer I, Otto NM, Ollinger R, Hernandez-Fuentes MP, Issa F, Ahrens N, Meyenberg C, Karitzky S, Kunzendorf U, Knechtle SJ, Grinyo J, Morris PJ, Brent L, Bushell A, Turka LA, Bluestone JA, Lechler RI, Schlitt HJ, Cuturi MC, Schlickeiser S, Friend PJ, Miloud T, Scheffold A, Secchi A, Crisalli K, Kang SM, Hilton R, Banas B, Blancho G, Volk HD, Lombardi G, Wood KJ, Geissler EK. Regulatory cell therapy in kidney transplantation (The ONE Study): a harmonised design and analysis of seven non-randomised, single-arm, phase 1/2A trials. Lancet. 2020 May 23;395(10237):1627-1639. doi: 10.1016/S0140-6736(20)30167-7. Erratum In: Lancet. 2020 Jun 27;395(10242):1972.
- Roemhild A, Otto NM, Moll G, Abou-El-Enein M, Kaiser D, Bold G, Schachtner T, Choi M, Oellinger R, Landwehr-Kenzel S, Juerchott K, Sawitzki B, Giesler C, Sefrin A, Beier C, Wagner DL, Schlickeiser S, Streitz M, Schmueck-Henneresse M, Amini L, Stervbo U, Babel N, Volk HD, Reinke P. Regulatory T cells for minimising immune suppression in kidney transplantation: phase I/IIa clinical trial. BMJ. 2020 Oct 21;371:m3734. doi: 10.1136/bmj.m3734.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- ONEnTreg13
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autologous CD4+CD25+FoxP3+ natural regulat. T cells (nTregs)の臨床試験
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Everett MeyerNational Cancer Institute (NCI)引きこもった