This study is a single-arm, open-label, dose-escalation clinical trial to evaluate the safety, tolerability, changes and persistence of peripheral blood Treg cells, and pharmacodynamic characteristics of donor-derived Treg cell injection combined with recombinant human interleukin-2 in treating subjects with refractory cGVHD,and to preliminarily observe the efficacy of the study drugs in subjects with refractory cGVHD.
This study is a single-arm, open-label, dose-escalation clinical trial to evaluate the safety, tolerability, changes and persistence of peripheral blood Treg cells, and pharmacodynamic characteristics of donor-derived Treg cell injection combined with recombinant human interleukin-2 in treating subjects with refractory cGVHD,and to preliminarily observe the efficacy of the study drugs in subjects with refractory cGVHD.In this study, rapid titration of the first dose group and a "3+3" rule design were used for dose escalation to minimize patient exposure to ineffective doses while minimizing the occurrence of risk.Three dose groups were set up: 1×10\^6 Treg cells /kg dose group, 5.0×10\^6 Treg cells /kg dose group and 10×10\^6Treg cells /kg dose group.One infusion per dose group.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Subjects received Treg cell infusion at day D0, and interleukin 2 was administered subcutaneously daily from 1 week before to 12 weeks after infusion.
Shanghai General Hospital
Shanghai, China
RECRUITINGTo evaluate the incidence of DLT in patients with refractory cGVHD treated with donor-derived Treg cell injection combined with low dose rhIL-2 injection
To evaluate the incidence of DLT in patients with refractory cGVHD treated with donor-derived Treg cell injection combined with low dose rhIL-2 injection。 DLT is defined as any of the following conditions related to the study drug within 28 days after the subject's infusion of Treg cell injection, despite treatment: 1. Grade 4 or 5 cytokine release syndrome caused by Treg cell injection treatment; 2. Grade 3 cytokine syndrome caused by Treg cell injection treatment and no remission to grade 2 or below within 7 days; 3. Occurrence of grade 3 or higher neurotoxicity; 4. Grade 4 hematologic toxicity: caused by non-underlying disease and lasting ≥ 28 days (except for lymphopenia, neutrophil and thrombocytopenia caused by chemotherapy pretreatment); 5. Any unanticipated toxicity that necessitates discontinuation of treatment at the discretion of the investigator or collaborating unit.
Time frame: Up to day 28
Incidence of grade 3 and above adverse reactions
Incidence of adverse events associated with the study products;Adverse events assessed according to NCI-CTCAE v5.0.
Time frame: Through study completion, an average of 2 year
Evaluate the number of Treg cells in subjects' peripheral blood
Evaluate the number of Treg cells in subjects' peripheral blood after donor-derived Treg cell injection administration
Time frame: An average of 1 year
Analysis of the number changes of lymphocyte subsets in peripheral blood.
Analysis of the number changes of lymphocyte subsets in peripheral blood, Including T/B/NK cells.
Time frame: Through study completion, an average of 2 year
Score changes in the 36-Item Short Form Health Survey (SF-36)
Adopt 36-Item Short Form Survey (SF-36)to analyze the changes in patients' scores after medication compared with baseline.
Time frame: Through study completion, an average of 2 year
Score changes in Lee Chronic Graft-versus-Host Disease Symptom Scale
Adopt 36-Item Short Form Survey (SF-36)to analyze the changes in patients' scores after medication compared with baseline.
Time frame: Through study completion, an average of 2 year
Changes in cGVHD severity
Changes in cGVHD severity,according to chronic graft-versus-host disease grading system.
Time frame: Through study completion, an average of 2 year
Objective Response Rate (ORR)
To evaluate the efficacy of donor-derived Treg cells combined with low-dose IL-2 in the treatment of refractory cGVHD subjects, including 12 and 24 weeks of ORR.
Time frame: Through study completion, an average of 2 year
Patient-reported Outcomes
Reports directly from patients on their own health, functional status, and treatment experience, excluding explanations from health care workers or anyone else. A score of ≥7 on the Lee cGVHD Symptom Scale was associated with improved quality of life.
Time frame: Through study completion, an average of 2 year
Proportion of subjects able to reduce steroid requirement to <0.25 mg/kg/ day.
Proportion of subjects able to reduce steroid requirement to \<0.25 mg/kg/ day.
Time frame: Through study completion, an average of 2 year
Duration of response after administration (DOR)
Duration of response after administration (DOR),Defined as the time between first remission and disease progression, new cGvHD systemic treatment, or all-cause death, whichever occurs first.
Time frame: Through study completion, an average of 2 year
Failure-free survival after administration (FFS)
Failure-free survival after administration (FFS),The time from the beginning of cell reinfusion to the first disease progression, recurrence after remission, or death from any cause.
Time frame: Through study completion, an average of 2 year
Overall survival
The time from cell retransfusion to death from any cause.
Time frame: Through study completion, an average of 2 year
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