This is a single-center, single-arm, open-label, dose-escalation, early-phase 1 study to evaluate the safety, tolerability and preliminary efficacy of ZZSW-01 injection in patients with relapsed/refractory B-cell malignancies.
This investigator-initiated clinical study aims to evaluate ZZSW-01 injection, the extracellular vesicle vector that carries CD19 CAR mRNA, in patients with relapsed/refractory B-cell hematologic malignancies. Under this design, eligible subjects will receive multiple injections. The study adopts a dose-escalation design to assess safety, tolerability, and preliminary efficacy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
ZZSW-01 is an extracellular vesicle that carries functional CD19 CAR mRNA, which can be administered intravenously to generate CAR-T cells in vivo.
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, China
RECRUITINGIncidence of Adverse Events
All adverse events (AEs), including severe adverse events (SAEs) and clinically significant laboratory abnormalities, will be recorded and graded for severity using the Common Terminology Criteria for Adverse Events (CTCAE), Version 5.0.
Time frame: Up to 28 days post-infusion
Incidence of Dose-Limiting Toxicities (DLTs)
Dose-limiting toxicities (DLTs) will be specifically identified, recorded, and monitored during the designated DLT observation period.
Time frame: Up to 28 days post-infusion
Incidence and Severity of Cytokine Release Syndrome (CRS)
Cytokine release syndrome (CRS) events will be identified and graded for severity according to the American Society for Transplantation and Cellular Therapy (ASTCT) consensus grading.
Time frame: Up to 28 days post-infusion
Incidence and Severity of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS)
Immune effector cell-associated neurotoxicity syndrome (ICANS) will be assessed using the Immune Effector Cell-Associated Encephalopathy (ICE) score and subsequently graded for severity according to the ASTCT consensus grading.
Time frame: Up to 28 days post-infusion
Complete Response (CR) Rate of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Tumor response after ZZSW-01 infusion will be assessed according to the Lugano 2014 criteria or the 2017 ELN criteria, including complete response (CR).
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks
Partial Response (PR) Rate of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
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Tumor response after ZZSW-01 infusion will be assessed according to the Lugano 2014 criteria or the 2017 ELN criteria. The Partial Response (PR) rate will be determined.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks
Stable Disease (SD) Rate of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Tumor response after ZZSW-01 infusion will be assessed according to the Lugano 2014 criteria or the 2017 ELN criteria. The Stable Disease (SD) rate will be determined.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks.
Progressive Disease (PD) Rate of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Tumor response after ZZSW-01 infusion will be assessed according to the Lugano 2014 criteria or the 2017 ELN criteria. The Progressive Disease (PD) rate will be determined.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks.
Objective response rate (ORR) of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Objective response rate (ORR) after ZZSW-01 infusion will be evaluated according to the Lugano 2014 criteria or the 2017 ELN criteria.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks
Overall survival (OS) of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Overall survival (OS) after ZZSW-01 infusion will be evaluated according to the Lugano 2014 criteria or the 2017 ELN criteria.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks
Progression-free survival (PFS) of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Progression-free survival (PFS) after ZZSW-01 infusion will be evaluated according to the Lugano 2014 criteria or the 2017 ELN criteria.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks
Time to response (TTR) of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Time to response (TTR) after ZZSW-01 infusion will be evaluated according to the Lugano 2014 criteria or the 2017 ELN criteria.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks
Duration of response (DOR) of administering ZZSW-01 in the treatment of relapsed/refractory of B-cell malignancies.
Duration of response (DOR) after ZZSW-01 infusion will be evaluated according to the Lugano 2014 criteria or the 2017 ELN criteria.
Time frame: From ZZSW-01 infusion to the end of the treatment at 96 weeks
Peak Level (Cmax) of CAR-T Cells
PK parameters: The peak level (Cmax) of CAR-T cells in the peripheral blood will be measured and reported.
Time frame: Baseline, DAY1, Day 4, Day 7, Day 14, Day 21, Day 28, Week 8, Week 12, Week 24, Week 36, Week48 or withdrawal from the study, whichever came first.
Pharmacodynamic (PD) characteristics of ZZSW-01 in patients with relapsed/refractory B cell malignancies
PD parameters: including lymphocyte subgroups, CD19 positive B cell and other cell proportions, various cytokines, immunoglobulins, etc.
Time frame: Baseline, DAY1, Day 4, Day 7, Day 14, Day 21, Day 28, Week 8, Week 12, Week 24, Week 36, Week48 or withdrawal from the study, whichever came first.
Time to Peak Level (Tmax) of CAR-T Cells
PK parameters: The time to reach the peak level (Tmax) of CAR-T cells in the peripheral blood will be determined.
Time frame: Baseline, DAY1, Day 4, Day 7, Day 14, Day 21, Day 28, Week 8, Week 12, Week 24, Week 36, Week48 or withdrawal from the study, whichever came first.
Area Under the Curve (AUC0-28d) of CAR-T Cells
PK parameters: The area under the concentration-time curve from time zero to 28 days (AUC0-28d) for CAR-T cells in the peripheral blood will be calculated.
Time frame: Baseline, DAY1, Day 4, Day 7, Day 14, Day 21, Day 28, Week 8, Week 12, Week 24, Week 36, Week48 or withdrawal from the study, whichever came first.
Duration of Persistence of CAR-T Cells
PK parameters: The duration for which CAR-T cells persist in the peripheral blood will be monitored.
Time frame: Baseline, DAY1, Day 4, Day 7, Day 14, Day 21, Day 28, Week 8, Week 12, Week 24, Week 36, Week48 or withdrawal from the study, whichever came first.