PO.CT01.04 · 临床试验
印度首例,一项针对复发或难治性多发性骨髓瘤的本土化改良、经济高效的自体双靶点BCMA/CD19 CAR T细胞疗法的1/2期研究
First in India, phase 1/2 study of an indigenously adapted, cost-efficient autologous dual-target BCMA/CD19 CAR T-cell therapy for relapsed or refractory multiple myeloma
该海报暂无可下载的资料
AACR 官方页面
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景:靶向B细胞成熟抗原(BCMA)的CAR T细胞疗法已改变了复发或难治性多发性骨髓瘤(R/R MM)的治疗格局;然而,由于高昂的生产成本、物流复杂性以及对进口产品的依赖,在中低收入国家的可及性仍然有限。双靶向BCMA和CD19提供了一种生物学上合理的策略,以减轻抗原逃逸和疾病异质性。VL-2511是一种自体BCMA-CD19双靶向CAR-T细胞疗法,已被本土化采用,以实现印度市场的高效、可扩展和经济高效的生产。VL-2511此前已在中国接受治疗的患者中(NCT06223646和NCT04714827)展现出令人信服的临床活性,目前正在包括美国在内的多个地区开展全球临床开发。
方法:这项开放标签、多中心1/2期研究评估VL-2511在经过大量既往治疗的R/R MM成人患者中的安全性、可行性和初步疗效。在白细胞单采后,使用慢病毒载体和经优化的、本地实施的GMP工艺制造CAR T细胞,该工艺旨在改善周转时间、通量和可负担性。在标准清淋后,患者按预定剂量水平或在推荐的2期剂量下接受单次CAR T细胞输注。主要目的是评估疗效,依据IMWG标准以ORR及其他临床相关疗效终点衡量。次要目的包括表征CAR-T细胞的药代动力学和药效学特征,评估CAR-T细胞的扩增和持久性,包括CRS和ICANS的发生率和严重程度。
结果:来自超过35例患者(且仍在进行中)的临床数据显示出令人信服的疗效,总体缓解率(ORR)为96.6%,89.7%为CR/sCR,并有良好的安全性特征支持。印度临床方案和生产活动的监管审查正在进行中,并按照适用的监管要求进行计划。将收集有关方案实施、安全性评估、生产可行性、药代动力学和初步临床活性的数据,如有可获得的数据,将在会议上呈现。报告的结局将包括使用本土化改良工艺对产品可制造性的评估以及早期临床观察。
结论:本研究代表了VL-2511在印度的首次临床评估,目的是评估临床上有前景的双靶点CAR T的高效、成本可控的本地化生产和递送。这一方法有可能显著扩大印度及其他资源受限环境中先进细胞疗法的可及性。除R/R MM和B细胞NHL外,双靶向VL-2511在其他免疫介导和浆细胞驱动的疾病中具有更广泛的适用性,包括POEMS综合征(NCT06518876)、系统性红斑狼疮、重症肌无力和AL淀粉样变性。
查看英文原文 English abstract
Background: B-cell maturation antigen (BCMA) directed CAR T-cell therapies have transformed the treatment landscape of relapsed or refractory multiple myeloma (R/R MM); however, access remains limited in low- and middle-income countries due to high manufacturing costs, logistical complexity, and reliance on imported products. Dual targeting of BCMA and CD19 offers a biologically rational strategy to mitigate antigen escape and disease heterogeneity. VL-2511, an autologous BCMA-CD19 dual-targeted CAR-T cell therapy has been adopted indigenously to enable efficient, scalable, and cost-effective manufacturing for the Indian market. VL-2511 has previously demonstrated compelling clinical activity in patients treated in China (NCT06223646 & NCT04714827) and is currently under global clinical development across multiple geographies, including the United States.
Methods: This open-label, multicenter Phase 1/2 study evaluates the safety, feasibility, and preliminary efficacy of VL-2511 in adults with heavily pretreated R/R MM. Following leukapheresis, CAR T-cells are manufactured using a lentiviral vector and an optimized, locally implemented GMP process designed to improve turnaround time, throughput, and affordability. After standard lymphodepletion, patients receive a single CAR T-cell infusion across a predetermined dose levels or at the recommended Phase 2 dose. The primary objective is to assess the efficacy, as measured by the ORR and other clinically relevant efficacy endpoints in accordance with IMWG criteria. Secondary objectives include characterization of the pharmacokinetic and pharmacodynamic profiles of CAR-T cells, assessment of CAR-T cell expansion and persistence, including the incidence and severity of CRS and ICANS.
Results: Clinical data from over 35 Patients (and ongoing) have shown compelling efficacy, with an overall response rate (ORR) of 96.6%, and 89.7% CR/sCR, supported by a favorable safety profile. The regulatory review of the clinical protocol and manufacturing activities in India are ongoing and planned in accordance with applicable regulatory requirements. Data relating to protocol implementation, safety assessments, manufacturing feasibility, pharmacokinetics, and preliminary clinical activity will be collected and, if available, will be presented at the meeting. Reported outcomes will include evaluation of product manufacturability using the indigenously adapted process and early clinical observations.
Conclusions: This study represents first-in-India clinical evaluation of VL-2511 with an objective to assess efficient, cost-conscious, local manufacturing and delivery of clinically promising Dual CAR T. This approach has the potential to meaningfully expand access to advanced cellular therapies in India and other resource-constrained settings. Beyond R/R MM, and B-cell NHL, the dual-targeted VL-2511 has broader applicability across additional immune-mediated and plasma cell-driven disorders, including POEMS syndrome (NCT06518876), systemic lupus erythematosus, myasthenia gravis, and AL amyloidosis.
利益披露 Disclosure
U. K. Surampudi, None..
P. K. Bhavar, None..
P. P. Sarma, None..
R. Rahangdale, None..
G. Wu, None.