This is a single center, non-randomized, open-label, phase 2 study to evaluate the efficacy and safety of BCMA-PD1-CART cells therapy for patients with relapsed/refractory Multiple Myeloma.
Previous studies have found that multiple myeloma cells express PD-L1 at a high level. Therefore, the combination of anti-PD-1 or PD-L1 antibodies with CART therapy may further improve the clinical efficacy of CART cell for multiple myeloma. The investigators screened PD-1 mutant that have high affinity bind with the PD-L1 ligand, and the affinity of the prepared mutant PD-1 Fc fusion protein to bind to PD-L1 reached clinical anti-PD-L1 antibody levels. The investigators prepared BCMA CART cells which secretes the mutant PD-1Fc fusion protein, and the prepared CART cell culture supernatant can well block the binding of PD-L1 to PD-1. Preclinical studies have shown that BCMA CART cells secreting mutant PD-1Fc fusion protein have a superior killing effect on PD-L1 positive multiple myeloma tumor cells to BCMA CART cells which does not express PD-1 fusion protein. The trial was conducted to explore the safety and efficacy of BCMA-PD1-CART cells in Relapsed/Refractory Multiple Myeloma.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
This study was a single-center, open-label, single-arm, non-randomized clinical trial, which was divided into 3 groups by infusion dose level. Firstly, each dose group has 3 patients. The pretreatment regimen of cyclophosphamide (25mg/m2 for 3 consecutive days) and fludarabine (10mg/kg for 3 consecutive days) was given before CART cells were reinfused. CART cells were reinfused on the third day after the pretreatment. If no serious side effects emerges in the group, then the next group uses the subsequent higher dose. If serious side effects emerges in a single patient in any dose level, 3 more patients will be enrolled to the same dose level. After 9 or more patients, we select the safest dose and recruit more patients for CART test to explore its effectiveness.
Hainan Hospital of Chinese PLA General Hospital
Sanya, Hainan, China
RECRUITINGIncidence of Treatment-related Adverse Events
Therapy-related adverse events will be recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0).
Time frame: 3 years
Overall Remission Rate(ORR) of BCMA-PD1-CART cells in Lymphoma
ORR will be assessed from the first CAR-T cell infusion to death or last follow-up
Time frame: 3 years
Overall survival(OS) of BCMA-PD1-CART cells in Lymphoma
OS will be assessed from the first CAR-T cell infusion to death or last follow-up
Time frame: 3 years
Progress-free survival(PFS) of BCMA-PD1-CART cells in Lymphoma
PFS will be assessed from the first CAR-T cell infusion to death or last follow-up
Time frame: 3 years
Rate of BCMA-PD1-CARTcells in peripheral blood cells
In vivo (peripheral blood) rate of BCMA-PD1-CARTcells were determined by means of flow cytometry.
Time frame: 3 years
Quantity of BCMA-PD1-CART cells copies in peripheral blood cells.
In vivo (peripheral blood) quantity of BCMA-PD1-CART cells copies copies were determined by means of qPCR.
Time frame: 3 years
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