Relapsed or refractory acute leukemia (R/R AL) is a life-threatening blood cancer with poor outcomes and limited treatment options. PID23 Injection is an innovative in vivo CAR-T therapy that delivers a viral vector encoding three targets (CD19, BCMA, and CD70) directly into patients, enabling their own T cells to generate functional CAR-T cells against leukemia cells. This single-center, single-arm, open-label, dose-escalation study (3 dose levels: 0.8×10⁹, 2×10⁹, and 4×10⁹ TU) plans to enroll 3-18 patients with R/R AL aged 3-75 years, ECOG 0-2, and positive for at least one target. The primary objective is to evaluate safety, tolerability, and determine the recommended dose. Secondary objectives include preliminary efficacy (remission, survival), pharmacokinetics (CAR-T expansion), pharmacodynamics (cytokine changes), and exploratory viral clearance. After a single intravenous infusion, patients are hospitalized for ≥3 weeks, followed by monthly visits for 3 months, then every 3 months for up to 2 years. Enrollment is from May 2026 to May 2027, with follow-up through May 2029. The study is conducted at Zhujiang Hospital of Southern Medical University (PI: Prof. Li Yuhua).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
PID23 is an in vivo CAR-T product, a lentiviral vector encoding CD19, BCMA, and CD70 chimeric antigen receptors, administered as a single intravenous infusion
Department of Hematology, Zhujiang Hospital, Southern Medical University
Guangzhou, Guangdong, China
Incidence of Dose-Limiting Toxicities (DLTs)
Number of participants experiencing DLTs during the DLT observation period. DLT is defined as any treatment-emergent adverse event meeting protocol-specified severity criteria assessed per CTCAE v6.0 and ASTCT criteria for CRS/ICANS.
Time frame: Up to 21 days post-PID23 infusion
Incidence and Severity of Treatment-Emergent Adverse Events
Number and percentage of participants experiencing adverse events (AEs), graded per CTCAE v6.0. Includes all AEs, serious AEs (SAEs), and AEs of special interest (CRS, ICANS, HLH/MAS). Causality assessment performed by the investigator.
Time frame: Up to 2 years post-PID23 infusion
Objective Response Rate at 3 Months
Proportion of participants achieving complete remission (CR) or CR with incomplete blood count recovery (CRi) at 3 months post-infusion. CR defined as bone marrow blasts \<5%, no peripheral blasts, ANC ≥1.0×10⁹/L, platelets ≥100×10⁹/L, no extramedullary disease. CRi defined as meeting all CR criteria except platelet \<100×10⁹/L and/or ANC \<1.0×10⁹/L.
Time frame: At 3 months post-infusion
Duration of Remission (DOR)
Time from first documented CR or CRi to first documented disease progression (PD) or death from any cause, whichever occurs first. Participants who do not achieve CR/CRi are not applicable for this analysis. Assessed per protocol until 2 years post-infusion.
Time frame: Up to 2 years post-infusion
Progression-Free Survival (PFS)
Time from PID23 infusion to first documented disease progression (PD) or death from any cause, whichever occurs first. Participants alive without progression are censored at the date of last disease assessment. Assessed per protocol through 2 years post-infusion or until event.
Time frame: Up to 2 years post-infusion
Overall Survival (OS)
Time from PID23 infusion to death from any cause. Participants alive at the end of follow-up are censored at the date of last known survival status. Assessed through 2 years post-infusion or until death, whichever occurs first.
Time frame: Up to 2 years post-infusion
Change from Baseline in Bone Marrow Blast Percentage
Change from baseline in percentage of bone marrow blasts assessed by bone marrow morphology. Measured at screening and at protocol-specified follow-up time points (M1, M2, M3, and every 3 months thereafter). Assessed per protocol schedule.
Time frame: Baseline through 2 years post-infusion
Maximum Concentration (Cmax) of CAR-T Cells in Peripheral Blood
Maximum concentration (Cmax) of CAR-T cells in peripheral blood, measured as CAR DNA copy number by quantitative PCR (copies/μg DNA) and/or percentage of CAR+ cells by flow cytometry. Blood samples collected at protocol-specified time points: 0h, 30min, 2h, 6h, 12h, D2, D4, D7, D10, D14, D21, M1, M2, M3, and long-term follow-up. Samples analyzed by the technology partner.
Time frame: Day 0 through 2 years post-infusion
Time to Maximum Concentration (Tmax) of CAR-T Cells
Time to reach maximum concentration (Tmax) of CAR-T cells in peripheral blood, measured as CAR DNA copy number by quantitative PCR. Blood samples collected at protocol-specified time points from immediately post-infusion through long-term follow-up. Tmax determined from the concentration-time profile.
Time frame: Day 0 through 2 years post-infusion
Area Under the Curve (AUC0-28d) of CAR-T Cells
Area under the concentration-time curve from Day 0 to Day 28 (AUC0-28d) of CAR-T cells in peripheral blood, measured as CAR DNA copy number by quantitative PCR. Calculated using the linear trapezoidal rule. Blood samples collected at protocol-specified time points through Day 28.
Time frame: Day 0 through Day 28
Change from Baseline in Serum Cytokine Levels
Change from baseline in serum cytokine concentrations, including but not limited to IL-6, IL-1β, IL-2/IL-2R, IL-8, IL-10, TNF-α, IFN-γ, CRP, and ferritin. Blood samples collected at protocol-specified time points: screening, D0 (pre-infusion), D2, D4, D7, D10, D14, and M1.
Time frame: Baseline through Month 1
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