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Dual-Targeting CAR-NK Cells for Recurrent/Progressive Glioblastoma and High-Grade Glioma
Bu Faz 1 (Phase 1), insanda ilk kez uygulanan çalışma, standart tedaviden sonra nükseden veya ilerleyen glioblastomu (glioblastoma, GBM) ya da yüksek dereceli gliomu (high-grade glioma, HGG) olan yetişkinlerde çift hedefli kimerik antijen reseptörü taşıyan doğal öldürücü hücrelerin (CAR-NK) bölgesel uygulanmasını değerlendiriyor. Katılımcıların tümörleri IL13Rα2, EGFR/EGFRvIII ve B7-H3 (CD276) antijenleri açısından incelenerek, antijen kaçışı riskini azaltmak amacıyla her katılımcıya en uygun çift hedefli yapı veriliyor; hücreler siklofosfamid ve fludarabin ile birlikte kafa içi kateter/rezervuar aracılığıyla uygulanıyor. Çalışmaya 18-75 yaş arası, doku incelemesiyle doğrulanmış glioblastom (DSÖ derece 4) veya yaygın yüksek dereceli glioma (DSÖ derece 3 veya 4) tanısı olan ve klinik olarak tümör çıkarımı ya da biyopsi planlanan hastalar alınıyor.
Yukarıdaki özet, resmî kaydın sade dile aktarılmış halidir. Orijinal İngilizce başlık referans için gösterilir.
Kriterler ClinicalTrials.gov kaydından orijinal İngilizce haliyle alınmıştır. Uygunluk kararını yalnızca deneyi yürüten ekip verebilir.
Inclusion Criteria: * Age 18 to 75 years at the time of consent. * Histologically confirmed glioblastoma (WHO grade 4) or diffuse high-grade glioma (WHO grade 3 or 4) that is recurrent or progressive after standard therapy. * Planned clinically indicated tumor resection or stereotactic biopsy (or availability of adequate archived tumor tissue) to support antigen testing and locoregional catheter placement. * Tumor demonstrates expression of at least two of the following antigens above protocol-defined thresholds: IL13Rα2, EGFR (wild-type) and/or EGFRvIII, B7-H3 (CD276). * Karnofsky Performance Status (KPS) ≥ 60. * Adequate organ function (hematologic, renal, hepatic) as defined by protocol laboratory criteria. * Ability to undergo brain MRI with contrast (unless contraindicated and alternative imaging is permitted). * Negative pregnancy test for women of childbearing potential; agreement to use effective contraception during study participation and for a protocol-defined period after infusion. * Ability to understand and willingness to sign informed consent. Exclusion Criteria: * Active, uncontrolled infection (including uncontrolled bacterial, viral, or fungal infection). * Known HIV infection with uncontrolled viral load; active hepatitis B or hepatitis C with detectable viral load (unless permitted per protocol). * Clinically significant autoimmune disease requiring systemic immunosuppression within the past 6 months. * Requirement for high-dose systemic corticosteroids (e.g., \>4 mg/day dexamethasone equivalent) within 7 days prior to lymphodepletion/infusion (physiologic replacement permitted). * Prior gene-modified cellular therapy (e.g., prior CAR-T/CAR-NK) within 6 months, or prior therapy targeting IL13Rα2, EGFR/EGFRvIII, or B7-H3 where residual engineered cells could confound safety assessments. * Diffuse leptomeningeal disease as the only site of disease, or anatomy that precludes safe catheter placement (unless specifically allowed by protocol). * Uncontrolled seizures despite optimal medical therapy. * Clinically significant cardiovascular disease (e.g., recent myocardial infarction, uncontrolled arrhythmia) that would increase risk with lymphodepletion or infusion procedures. * Pregnant or breastfeeding. * Any condition that, in the investigator's judgment, would make the participant unsuitable for the study or could interfere with protocol adherence.