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Sequential Radiotherapy With CAR-T Cells in the Treatment of Relapsed and Refractory Hematological Malignancies With Extramedullary Lesions

Phase 1
Recruiting
Conditions
Hematological Malignancies
Interventions
Drug: CAR-T cells
Registration Number
NCT04790747
Lead Sponsor
Zhejiang University
Brief Summary

Clinical trial for the safety and efficacy of sequential radiotherapy with CAR-T cells in the treatment of relapsed and refractory hematological malignancies with extramedullary lesions

Detailed Description

This is a prospective, single arm study. To evaluate the safety and efficacy of sequential radiotherapy with CAR-T cells in the treatment of relapsed and refractory hematological malignancies with extramedullary lesions. The main endpoints were dose limiting toxicity (DLT) and incidence of adverse events (TEAEs).

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria

Age≥15 years old; Relapsed and refractory hematological malignancies with extramedullary lesions, mainly including B-cell non Hodgkin's lymphoma, multiple myeloma, acute lymphoblastic leukemia, etc; Flow cytometry or pathological biopsy confirmed that tumor cells have potential therapeutic targets for Car-T cells; PET-CT confirmed that the extramedullary lesions were located in a single radiotherapy region; Anticipated survival time more than 12 weeks; Those who voluntarily participated in this trial and provided informed consent.

Exclusion Criteria

History of craniocerebral trauma, conscious disturbance, epilepsy, cerebrovascular ischemia, and cerebrovascular hemorrhagic diseases; Electrocardiogram shows prolonged QT interval, severe heart diseases such as severe arrhythmia in the past; Pregnant (or lactating) women; Patients with severe active infections (excluding simple urinary tract infection and bacterial pharyngitis); Active infection of hepatitis B virus or hepatitis C virus; Concurrent therapy with systemic steroids within 2 weeks prior to screening, except for the patients recently or currently receiving inhaled steroids; Previously treated with any CAR-T cell product or other genetically-modified T cell therapies; Creatinine>2.5mg/dl, or ALT / AST > 3 times of normal amounts, or bilirubin>2.0 mg/dl; Other uncontrolled diseases that were not suitable for this trial; Patients with HIV infection; Any situations that the investigator believes may increase the risk of patients or interfere with the results of study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
radiotherapy and CAR-T therapyCAR-T cellssequential radiotherapy and CAR-T cell therapy
Primary Outcome Measures
NameTimeMethod
Dose-limiting toxicity (DLT)Baseline up to 28 days after CAR-T cells infusion

Adverse events assessed according to NCI-CTCAE v5.0 criteria

Incidence of treatment-emergent adverse events (TEAEs)Up to 2 years after CAR-T cells infusion

Incidence of treatment-emergent adverse events \[Safety and Tolerability\]

Secondary Outcome Measures
NameTimeMethod
Disease-free survival (DFS)Up to 2 years after CAR-T cells infusion

From the complete remission to the occurrence of any event, including death, relapse (any one occurs first), and the last visit

Quality of lifeAt Baseline, Month 1, 3, 6, 9 and 12

Assessment using European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scale \[For item1-28: max score: 112, min score: 28, higher scores mean a better outcome; for item 28-29: max score: 14, min score: 2, higher scores mean a worse outcome\] to measure Quality of life at Baseline, Month 1, 3, 6, 9 and 12

Complete Remission Rateup to 28 days after CAR-T cells infusion

Complete Remission Rate after CAR-T cell therapy

Overall survival (OS)Up to 2 years after CAR-T cells infusion

From the first infusion of CD19 CAR-T cells to death or the last visit

Trial Locations

Locations (1)

The First Hospital of Zhejiang Medical Colleage Zhejiang University

🇨🇳

Hangzhou, Zhejiang, China

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