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IFN-γ Combined With T Cells in the Treatment of Refractory Malignant Pleural Effusion and Ascites

Primary Purpose

Pleural Effusion, Malignant

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
IFN-γ and CIK cells, Tcm cells or CAR T cells
Sponsored by
Affiliated Hospital of Jiangnan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pleural Effusion, Malignant

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients: ≥18 years old;
  2. Gastric cancer, colon cancer, lung cancer, lymphoma and other tumors confirmed by histology or cytology. The guidelines recommend entry to clinical trials in accordance with the standard treatment progression recommended by each disease guideline;
  3. According to iRECIST criteria, the patient should have at least one target lesion with measurable diameter line (tumor lesion CT scan length ≥10 mm, lymph node lesion CT scan short diameter ≥15 mm, scan thickness ≥ 5 mm); Or an unevaluable lesion, including but not limited to pleural effusion, bone metastasis, etc;
  4. ECOG physical condition score: 0-3;
  5. Estimated survival ≥3 months;
  6. Good function of major organs, that is, relevant examination indexes within the first 14 days of randomization meet the following requirements:(1)Routine blood test: 1)Hemoglobin ≥ 90 g/L (no blood transfusion within 14 days); 2)Neutrophil count > 1.5×109/L; 3)Platelet count ≥ 90×109/L; (2)Biochemical examination: 1)Total bilirubin ≤ 1.5×ULN (upper limit of normal value); 2)Serum alanine aminotransferase (ALT) or AST ≤ 2.5×ULN; ALT or AST ≤ 5×ULN if liver metastasis was present; 3)Endogenous creatinine clearance ≥ 60 mL /min (Cockcroft-Gault formula); (3)Cardiac Doppler ultrasound assessment: left ventricular ejection fraction (LVEF) ≥ 50%;
  7. Signed informed consent;
  8. Good compliance, family members agreed to cooperate with survival follow-up.

Exclusion Criteria:

  1. Participated in clinical trials of other drugs within four weeks;
  2. Patients have a history of other tumors, except cervical carcinoma in situ, treated squamous cell carcinoma or bladder epithelial tumor (Ta and TIS), or other malignant tumors that have received radical treatment (at least 5 years prior to enrollment);
  3. Patients with cardiac clinical symptoms or diseases that are not well controlled, such as NYHA grade 2 or above heart failure, unstable angina pectoris, myocardial infarction within 1 year, and clinically significant ventricular or ventricular arrhythmias requiring treatment or intervention;
  4. For female subjects: surgically sterilized, postmenopausal, or have agreed to use a medically approved contraceptive during study treatment and for 6 months after the study treatment period; Serum or urine pregnancy tests must be negative during the 7 days prior to study enrollment and must be non-lactation. Male subjects: patients who are surgically sterilized or who have agreed to use a medically approved contraceptive during and for 6 months after the study treatment period;
  5. Patients with active tuberculosis, bacterial or fungal infection (grade ≥2 of NCI-CTC, 3rd edition); Have HIV infection, HBV infection, HCV infection;
  6. Those who have a history of psychotropic drug abuse and cannot get rid of it or have mental disorders;
  7. The subject has any active autoimmune disease or a history of autoimmune disease (e.g., but not limited to: interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, nephritis, hyperthyroidism, hypothyroidism); Subjects with vitiligo or asthma in complete remission during childhood without any intervention as adults could be included; Subjects with asthma requiring medical intervention with bronchodilators were excluded);
  8. According to the judgment of the researcher, there are serious concomitant diseases that endanger the patient's safety or affect the patient's ability to complete the study.

Sites / Locations

  • Affiliated Hospital of Jiangnan UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

IFN- Y combined with T cells

Arm Description

First, IFN-γ was combined with CIK cells. After three failed treatments, the CIK cells were replaced with T cells. After three failed treatments, CART cells were finally replaced.

Outcomes

Primary Outcome Measures

Overall survival
The last follow-up time of the lost patient; Patients who were still alive at the end of the study were at the end of follow-up
Progression-free survival
From time of treatment to time of disease progression or death

Secondary Outcome Measures

Disease control rate
Proportion of patients who had a best response rating of complete response, partial response, or stable disease
Objective response rate
Total response and partial response ratio
Molecular markers for efficacy prediction
Prediction effect

Full Information

First Posted
December 6, 2021
Last Updated
January 30, 2023
Sponsor
Affiliated Hospital of Jiangnan University
Collaborators
Sichuan University, Zhejiang Provincial People's Hospital, Hunan Cancer Hospital, West China Hospital, Wuxi People's Hospital, Shenzhen Second People's Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05268172
Brief Title
IFN-γ Combined With T Cells in the Treatment of Refractory Malignant Pleural Effusion and Ascites
Official Title
Single-arm Open Multicenter Study of IFN-γ Combined With T Cells in the Treatment of Refractory Malignant Pleural Effusion Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 20, 2022 (Actual)
Primary Completion Date
December 30, 2023 (Anticipated)
Study Completion Date
December 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Affiliated Hospital of Jiangnan University
Collaborators
Sichuan University, Zhejiang Provincial People's Hospital, Hunan Cancer Hospital, West China Hospital, Wuxi People's Hospital, Shenzhen Second People's Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study was to evaluate the efficacy of IFN- Y combined with T cells in the treatment of refractory malignant pleural effusion and acties, using a multicenter, single-arm, open design.
Detailed Description
Malignant pleural effusion is a common complication of malignant tumor, which usually indicates that the patient has reached the advanced stage, and about 30-40% of the patients are stubborn and refractory cases. The lack of standard therapeutic drugs and protocols in clinical practice seriously affects the anti-tumor treatment effect, quality of life and survival time of patients, and the prognosis is poor. IFN-γ can significantly induce the high expression of the costimulatory molecule ICAM-1 on tumor cells, thereby enhancing the killing of TUMOR cells by T cells. Moreover, IFN-γ can enhance the activity of CAR T cells in the presence of PD-L1-PD-1 pathway, and significantly improve the therapeutic effect of T cells on solid tumors. IFN-γ is an approved clinical treatment with known side effects and well-established symptomatic treatment. Although CIK is not a clinically approved drug, it has been used on a large scale in China with good safety and has entered the medical insurance of some provinces and cities. Tcm is an improved CIK cell and has good safety. Many clinical studies have been carried out, and no serious toxic and side effects have been observed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pleural Effusion, Malignant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
IFN- Y combined with T cells
Arm Type
Experimental
Arm Description
First, IFN-γ was combined with CIK cells. After three failed treatments, the CIK cells were replaced with T cells. After three failed treatments, CART cells were finally replaced.
Intervention Type
Drug
Intervention Name(s)
IFN-γ and CIK cells, Tcm cells or CAR T cells
Intervention Description
A 50ng/ mL IFN-γ solution was prepared, and the required volume of IFN-γ solution was calculated according to the final concentration of 5ng/ mL according to the volume of pleural fluid or ascites of the patient. CIK cells were injected 1.0-2.0×109 on the second day and review three days later.T cells and CAR T cells were selected sequentially according to the re-examination of pleural fluid or ascites.
Primary Outcome Measure Information:
Title
Overall survival
Description
The last follow-up time of the lost patient; Patients who were still alive at the end of the study were at the end of follow-up
Time Frame
From the time of diagnosis of tumor to death from any cause,From initiation of study treatment until date of death from any cause, up to 100 months
Title
Progression-free survival
Description
From time of treatment to time of disease progression or death
Time Frame
From time of treatment to time of disease progression or death from any cause as assessed by the investigator at each treatment period
Secondary Outcome Measure Information:
Title
Disease control rate
Description
Proportion of patients who had a best response rating of complete response, partial response, or stable disease
Time Frame
The tumor shrinks or stabilizes for a certain period of time,Lasts at least 4 weeks
Title
Objective response rate
Description
Total response and partial response ratio
Time Frame
8 weeks
Title
Molecular markers for efficacy prediction
Description
Prediction effect
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients: ≥18 years old; Gastric cancer, colon cancer, lung cancer, lymphoma and other tumors confirmed by histology or cytology. The guidelines recommend entry to clinical trials in accordance with the standard treatment progression recommended by each disease guideline; According to iRECIST criteria, the patient should have at least one target lesion with measurable diameter line (tumor lesion CT scan length ≥10 mm, lymph node lesion CT scan short diameter ≥15 mm, scan thickness ≥ 5 mm); Or an unevaluable lesion, including but not limited to pleural effusion, bone metastasis, etc; ECOG physical condition score: 0-3; Estimated survival ≥3 months; Good function of major organs, that is, relevant examination indexes within the first 14 days of randomization meet the following requirements:(1)Routine blood test: 1)Hemoglobin ≥ 90 g/L (no blood transfusion within 14 days); 2)Neutrophil count > 1.5×109/L; 3)Platelet count ≥ 90×109/L; (2)Biochemical examination: 1)Total bilirubin ≤ 1.5×ULN (upper limit of normal value); 2)Serum alanine aminotransferase (ALT) or AST ≤ 2.5×ULN; ALT or AST ≤ 5×ULN if liver metastasis was present; 3)Endogenous creatinine clearance ≥ 60 mL /min (Cockcroft-Gault formula); (3)Cardiac Doppler ultrasound assessment: left ventricular ejection fraction (LVEF) ≥ 50%; Signed informed consent; Good compliance, family members agreed to cooperate with survival follow-up. Exclusion Criteria: Participated in clinical trials of other drugs within four weeks; Patients have a history of other tumors, except cervical carcinoma in situ, treated squamous cell carcinoma or bladder epithelial tumor (Ta and TIS), or other malignant tumors that have received radical treatment (at least 5 years prior to enrollment); Patients with cardiac clinical symptoms or diseases that are not well controlled, such as NYHA grade 2 or above heart failure, unstable angina pectoris, myocardial infarction within 1 year, and clinically significant ventricular or ventricular arrhythmias requiring treatment or intervention; For female subjects: surgically sterilized, postmenopausal, or have agreed to use a medically approved contraceptive during study treatment and for 6 months after the study treatment period; Serum or urine pregnancy tests must be negative during the 7 days prior to study enrollment and must be non-lactation. Male subjects: patients who are surgically sterilized or who have agreed to use a medically approved contraceptive during and for 6 months after the study treatment period; Patients with active tuberculosis, bacterial or fungal infection (grade ≥2 of NCI-CTC, 3rd edition); Have HIV infection, HBV infection, HCV infection; Those who have a history of psychotropic drug abuse and cannot get rid of it or have mental disorders; The subject has any active autoimmune disease or a history of autoimmune disease (e.g., but not limited to: interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, nephritis, hyperthyroidism, hypothyroidism); Subjects with vitiligo or asthma in complete remission during childhood without any intervention as adults could be included; Subjects with asthma requiring medical intervention with bronchodilators were excluded); According to the judgment of the researcher, there are serious concomitant diseases that endanger the patient's safety or affect the patient's ability to complete the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
liu quan, doctor
Phone
15995299079
Email
Quanliu.lq@outlook.com
First Name & Middle Initial & Last Name or Official Title & Degree
jiang li qing, postgraduate
Phone
15261479578
Email
jjiangliq@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
quan liu, doctor
Organizational Affiliation
Affiliated Hospital of Jiangnan University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
liu quan, doctor
Organizational Affiliation
Affiliated Hospital of Jiangnan University
Official's Role
Study Director
Facility Information:
Facility Name
Affiliated Hospital of Jiangnan University
City
Wuxi
State/Province
Jiangsu
ZIP/Postal Code
214000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
劝 刘
Phone
15995299079

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
The associated efficacy is uncertain

Learn more about this trial

IFN-γ Combined With T Cells in the Treatment of Refractory Malignant Pleural Effusion and Ascites

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