GP350 CAR-T for Relapse/Refractory and Epstein-Barr Virus Infection Associated Lymphoid Neoplasms
NCT07306156
Summary
This is a Phase 1/Phase 2 open-label, single-arm clinical study of GP350 CAR-T for Relapse/Refractory and Epstein-Barr virus infection associated lymphoid neoplasms. Each participant will undergo leukapheresis after enrolment, receive treatment of the conditioning chemotherapy, and an intravenous infusion of CAR-T cells. Each participant will proceed through the following study procedures: * Screening * Enrollment/Leukapheresis * Conditioning chemotherapy * CAR T treatment * Post-treatment assessment * Long-term follow-up
Eligibility
Inclusion Criteria: 1. Diagnosis: Confirmed diagnosis of lymphoid neoplasms according to WHO-HAEM5 (Alaggio R. et al. doi:10.1038/s41375-022-01620-2); 2. Disease Assessment: 1. Criteria for Relapsed/Refractory lymphoid neoplasms: Meeting any one of the following three conditions: ① Failure to achieve at least a partial response (PR) per Lugano criteria after two cycles of standard first-line therapy; ② Disease progression within six months after achieving a response to first-line therapy, or progression after six months with no response to the original first-line or second-line regimen; ③ Relapse after hematopoietic stem cell transplantation. 2. Criteria for EBV Infection: Meeting any one of the following three conditions: ① Peripheral blood (plasma or whole blood) EBV DNA load ≥ 10³ copies/ml by quantitative PCR; ②Tumor cell GP350 positivity (≥10% of tumor cells by immunohistochemistry or flow cytometry); ③ Serological detection of EBV antibodies indicating any of the following: positive anti-VCA-IgM; positive anti-EA-IgG; or simultaneous positivity for anti-VCA-IgM, anti-VCA-IgG, and anti-EBNA-IgG. 3. At least one evaluable lymphoma lesion according to Lugano criteria, or confirmed active lytic EBV infection. 3. Performance Status: ECOG score 0-2 and expected survival ≥3 months; 4. Age: 18-70 years, regardless of sex; 5. Hematologic Criteria: * Absolute neutrophil count (ANC) ≥1.0×10⁹/L; * Hemoglobin \>60 g/L; * CD3+ T-cell count \>0.5×10⁹/L; * Platelet count \>30×10⁹/L; 6. Organ Function: * Creatinine clearance ≥60 mL/min; * ALT/AST ≤2× upper limit of normal (ULN); * Total bilirubin ≤2× ULN; * Left ventricular ejection fraction (LVEF) ≥50%, no pericardial effusion, and no clinically significant ECG abnormalities; * Minimal or no pleural/ascitic fluid; * Oxygen saturation ≥95%; 7. Contraception: * Women of childbearing potential must have a negative pregnancy test and agree to use effective contraception until the last follow-up; * Male participants with fertile partners must agree to use effective contraception until the last follow-up; 8. Informed Consent: Psychologically stable, capable of understanding the study's purpose and procedures, willing to participate voluntarily, and able to provide signed informed consent and comply with protocol requirements. Exclusion Criteria: 1. Active Infections: Presence of active hepatitis A, B, or C infection, or other uncontrolled severe active infections (excluding EBV infection); 2. Immunosuppression: * History of acquired immunodeficiency syndrome (AIDS); * Chronic use of immunosuppressants (including corticosteroids at doses equivalent to \>15 mg/day of prednisone) for other conditions; 3. Cardiac Dysfunction: 1. NYHA Class III or IV congestive heart failure; 2. Myocardial infarction or coronary artery bypass grafting within the past 6 months; 3. Clinically significant ventricular arrhythmia or unexplained syncope; 4. History of severe non-ischemic cardiomyopathy; 5. Cardiac insufficiency (left ventricular ejection fraction \<45%) within 8 weeks prior to apheresis; 4. Pregnancy/Contraception: * Pregnant or lactating women; * Participants (male or female) unwilling to use contraception; 5. Hepatic/Renal Impairment: * AST/ALT \>3× upper limit of normal (ULN); * Total bilirubin \>3× ULN; * Creatinine clearance \<60 mL/min; 6. Allergies: History of severe hypersensitivity to any study drugs; 7. Prior Stem Cell Transplant: Must have discontinued immunosuppressants for \>6 weeks post-transplant with no signs of graft-versus-host disease (GVHD); 8. Other Exclusionary Conditions: Any other condition deemed unsuitable by the investigator (e.g., coagulation disorders, hemolytic anemia, etc.).
Conditions2
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NCT07306156