This is a single-center, open-label, single-arm study to evaluate the safety and efficacy of the bispecific CAR T cells targeting CS1 and BCMA in patients with relapsed or refractory multiple myeloma.
* Multiple myeloma(MM) is one of the most common hematological malignancies with substantial morbidity and mortality. * In recent years, several new therapies have prolonged survival of patients with MM, but it is still an incurable malignancy of plasma cells. * B-cell maturation antigen (BCMA) is expressed by normal and malignant plasma cells and a small subset of B cells. This specific expression pattern makes BCMA an ideal target antigen for immunotherapies in MM. * BCMA-targeted chimeric antigen receptor (CAR) T cells have exhibited significant efficacy in MM, but relapse due to single-target escape or poor in vivo persistence has been reported. * Dual-targets or sequential infusion have been proposed to reduce relapse and improve outcomes post BCMA-specific CAR T therapies. * CS1 is expressed on pro-B cells and plasma cells especially malignant ones and some evidence suggests it plays a role in stromal cell interaction in the BM tumour microenvironment. * We have constructed a bispecific CAR containing anti-CS1 single chain variable region (scFv) and an anti-BCMA scFv in 4-1BB-containing second-generation formats. * The bispecific CAR T cells have exhibited potent cytotoxicity in various BCMA+ or/and CS1+ MM cells and can effectively eradicate MM cells in xenograft mice models. * This study aims to evaluate prelimary safety and efficacy of the CS1\&BCMA CAR T cells in patients with relapsed or refractory MM.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Conditioning chemotherapy: Cyclophosphamide 250 mg/m\^2 and fludarabine 30 mg/m\^2 IV infusion on days -5, -4, and -3 CAR T cells infusion: 0.75x10\^6-3.0X10\^6 CAR+ T cells per kg of recipient bodyweight. if DLTs don't occur at the dose of 3.0X10\^6 CAR+ T cells per kg, the investigators will discuss whether to try higher dose.
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, 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 5.0).
Time frame: within 2 years after infusion
Overall response rate(ORR) and complete response rate(CRR) of administering T cells Expressing a bispecific CAR Targeting CS1 and BCMA in Relapsed/Refractory Multiple Myeloma
OR and CRR will be assessed from CAR T cell infusion to death or last follow-up (censored).
Time frame: 2 years after infusion
Overall survival(OS), duration of Response(DOR), progress-free survival(PFS) of administering T cells Expressing a bispecific CAR Targeting CS1 and BCMA in Relapsed/Refractory Multiple Myeloma
OS, PFS and DOR will be assessed from CAR T cell infusion to death or last follow-up (censored).
Time frame: 2 years after infusion
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