This single-arm, open-label phase I trial evaluates the safety and tolerability of ICG415, autologous CAR-T cells targeting CD33 and CLL1, in patients with relapsed or refractory acute myeloid leukemia (AML). Subjects receive lymphodepleting chemotherapy followed by autologous CAR-T infusion. The primary goal is to assess safety and preliminary anti-leukemic efficacy in patients failing standard AML therapies.
Acute myeloid leukemia (AML) is an aggressive hematologic malignancy with limited treatment options for patients who are relapsed or refractory (R/R) to standard therapies. Leukemic blasts in R/R AML frequently co-express CD33 and CLL1, while sparing normal hematopoietic stem cells, making them rational targets for chimeric antigen receptor (CAR) T-cell therapy. This phase I, single-arm, open-label study evaluates ICG415 CAR-T Cells in patients with R/R AML. After leukapheresis and ex vivo modification, patients receive a single CAR-T cell infusion following lymphodepleting chemotherapy with fludarabine and cyclophosphamide. Primary objectives are safety and tolerability, including dose-limiting toxicities (DLTs), cytokine release syndrome (CRS), and neurological events. Secondary objectives include response rate (CR/CRi/PR), minimal residual disease (MRD) negativity, progression-free survival (PFS), and overall survival (OS). All participants will be followed for up to 24 months with regular clinical, laboratory, and imaging evaluations to monitor both treatment efficacy and potential complications.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Anti-CD33, Anti-CLL1 Compound CAR-T Cells
Jiangxi Provincial People's Hospital (Participating Site)
Nanchang, Jiangxi, China
RECRUITINGThe First Affiliated Hospital of Nanchang University (Lead Site)
Nanchang, Jiangxi, China
RECRUITINGIncidence of Dose-Limiting Toxicities (DLTs)
DLTs assessed according to the protocol-defined criteria.
Time frame: Within 28 days after ICG415 CAR-T cell infusion
Incidence and Severity of Treatment-Emergent Adverse Events (TEAEs)
Frequency and severity of TEAEs graded by NCI-CTCAE Version 5.0, including changes from baseline in vital signs, physical examination, 12-lead ECG, and clinical laboratory parameters (complete blood count, urinalysis, blood chemistry, coagulation function, etc.).
Time frame: From first dose through 24 months post infusion
Objective Response Rate (ORR) at Months 1, 3, and 6
ORR defined as proportion of subjects achieving complete remission (CR), complete remission with incomplete count recovery (CRi), or complete remission with partial hematological recovery (CRh) per response criteria.
Time frame: Month 1, Month 3, Month 6
Rates of CR, CRi, and PR at Year 1 and Year 2
Proportion of subjects achieving complete remission (CR), complete remission with incomplete count recovery (CRi), and partial remission (PR) at 1 and 2 years post infusion.
Time frame: Year 1, Year 2
Cumulative Incidence of Relapse (CIR) at Year 1 and Year 2
Cumulative incidence of disease relapse at 1 and 2 years after CAR-T cell infusion.
Time frame: Year 1, Year 2
Duration of Response (DOR)
Time from first objective response (CR, CRi, or CRh) to relapse or death, whichever occurs first.
Time frame: From first documented response to disease relapse or death from any cause, assessed up to 24 months
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Progression-Free Survival (PFS)
Time from ICG415 infusion to disease progression (relapse or treatment failure) or death from any cause.
Time frame: From date of infusion to disease progression or death from any cause, assessed up to 24 months
Overall Survival (OS)
Time from ICG415 infusion to death from any cause.
Time frame: From date of infusion to death from any cause, assessed up to 24 months
Event-Free Survival (EFS)
Time from ICG415 infusion to any event including lack of response, disease relapse, or death from any cause.
Time frame: From date of infusion to any treatment failure, relapse, or death, assessed up to 24 months
CAR-T Cell Kinetics - Persistence over Time
Number and duration of detectable CAR-T cells in peripheral blood. Testing stops after two consecutive negative results.
Time frame: Days 0, 4, 7, 14, 21, 28; Months 2, 3, 6, 9, 12, 18, 24
Cytokine Level Changes
Changes in serum cytokine levels including IL-6, IL-10, IL-15, TNF-α, and IFN-γ.
Time frame: Days 0, 7, 14, 21, 28; Months 2, 3, 6
Peripheral Blood Lymphocyte Subset Changes
Changes in lymphocyte subsets including T cells, B cells, NK cells, and CD4/CD8 ratio measured by flow cytometry.
Time frame: Days 0, 7, 14, 21, 28; Months 2, 3, 6
Anti-Drug Antibody (ADA) Levels
Incidence and titers of anti-drug antibodies (ADA) against ICG415 CAR-T cells.
Time frame: Day 28; Months 3, 6, 12