High-risk Plasma Cell Neoplasms
Conditions
Keywords
High-risk Plasma Cell Neoplasms, BCMA, CD70, CAR-T
Brief summary
This is a single arm study to evaluate the safety and efficacy of CAR BCMA-CD70 CAR-T cell therapy for high-risk plasma cell neoplasms.
Interventions
GENETICCAR BCMA-CD70-T cells
Each subject will be infused with single dose of BCMA-CD70-CAR-T cells. A classic "3+3" dose escalation will be employed. The low dose is 1×10\^6 /kg, the medium dose is 2×10\^6 /kg, and the high dose is 3×10\^6 /kg.
Description: Drug: Fludarabine Fludarabine will be given at a dose of 30 mg/m2/day intravenously (IV) for 3 days prior to the infusion of BCMA-CD70-CAR-T cells. Drug: Cyclophosphamide Cyclophosphamide will be given at a dose of 300 mg/m2/day intravenously (IV) for 3 days prior to the infusion of BCMA-CD70-CAR-T cells.
Sponsors
Affiliated Hospital to Academy of Military Medical Sciences
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. The subject or their legally acceptable representative has provided written informed consent and is willing and able to comply with all scheduled study visits, study treatment administration, laboratory tests, and other required trial procedures. 2. Clinically diagnosed with high-risk plasma cell neoplasm, meeting any one of the following molecular/cytogenetic or clinical criteria: 1. Deletion of the short arm of chromosome 17 (del(17p)) with clonal proportion ≥ 20%, and/or TP53 gene mutation; 2. IgH translocation (t(4;14), t(14;16), or t(14;20)) combined with 1q amplification (1q+) and/or deletion of the short arm of chromosome 1 (del(1p32)); 3. Chromosome 1 abnormalities: monoallelic del(1p32) plus 1q+, or biallelic del(1p32); 4. β₂-microglobulin ≥ 5.5 mg/L with normal serum creatinine (\< 1.2 mg/dL). 3. Age 18 to 75 years (inclusive), male or female. 4. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2. 5. Life expectancy \> 3 months from the date of signed informed consent. 6. Hemoglobin (HGB) ≥ 60 g/L (transfusion permitted). 7. Adequate hepatic, renal, and cardiopulmonary function as defined by: 1. Serum creatinine ≤ 2 × ULN; 2. Left ventricular ejection fraction (LVEF%) ≥ 50%; 3. Blood oxygen saturation \> 90%; 4. Total bilirubin ≤ 1.5 × ULN; ALT and AST ≤ 2.5 × ULN. 8. Subject agrees to use highly effective contraception from the date of informed consent until 1 year after CAR-T cell infusion.
Exclusion criteria
1. Severe cardiac insufficiency with left ventricular ejection fraction (LVEF%) \< 50%. 2. History of severe chronic lung disease associated with impaired pulmonary function. 3. Concurrent active or progressive malignant tumors other than the target plasma cell neoplasm. 4. Concurrent severe infection that cannot be effectively controlled with standard therapy. 5. Concurrent severe autoimmune disease or congenital immunodeficiency disorders. 6. Active viral hepatitis, defined as hepatitis B virus DNA (HBV-DNA) or hepatitis C virus RNA (HCV-RNA) levels above the lower limit of detection (LLOD). 7. Human immunodeficiency virus (HIV) infection, known acquired immunodeficiency syndrome (AIDS), or syphilis infection. 8. History of severe allergic reactions to biological products, including antibiotics. 9. Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with persistent acute graft-versus-host disease (aGVHD) that does not resolve within 1 month after discontinuing immunosuppressive therapy. 10. Presence of other severe physical or psychiatric illnesses, or significant laboratory abnormalities, that may increase the risks of study participation, interfere with study outcomes, or render the subject otherwise unsuitable for enrollment as determined by the investigator. 11. Female subjects of childbearing potential who are pregnant or breastfeeding.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| According to the incidence of treatment-related adverse events (AEs) to evaluate the safetyof CAR BCMA-CD70 CAR-T cells in the treatment of CD70/BCMA positive high-risk plasma cell neoplasms. | up to 3 years | Incidence of treatment-related adverse events (AEs) Description: Number and severity of adverse events graded according to CTCAE v5.0, including cytokine release syndrome (CRS) graded by ASTCT criteria and immune effector cell-associated neurotoxicity syndrome (ICANS) graded by ASBMT criteria |
| According to the determine the Maximal Tolerable Dose(MTD) to evaluate the safety of CAR BCMA-CD70 CAR-T cells in the treatment of CD70/BCMA positive high-risk plasma cell neoplasms. | MTD will be determined based on DLTs observed during the first 28 days of study treatment | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| According to the objective response rate (ORR) to evaluate the efficacy of CAR BCMA-CD70 CAR-T cells in the treatment of CD70/BCMA positive high-risk plasma cell neoplasms. | Within 3 months following infusion of CAR BCMA-CD70 CAR-T cells | Overall response rate (ORR) Description: Multiple myeloma (plasma cell neoplasms, plasma cell leukemia) refers to the efficacy evaluation criteria in the Chinese Guidelines for the Diagnosis and Treatment of Multiple Myeloma (revised in 2024),ORR includes strictly defined proportions of complete response (sCR), complete response (CR), very good partial response (VGPR), partial response (PR), and minimal response (MR). |
Countries
China
Contacts
CONTACTYamei Wu
Outcome results
None listed