In Vivo PICX CAR-T Therapy for R/R Multiple Myeloma

Official title

In Vivo Prepared PICX Chimeric Antigen Receptor T-Cell Therapy for the Treatment of Relapsed/Refractory Multiple Myeloma

Overview

This study is an investigator-initiated, single-center, single-arm clinical study with a target population of patients with relapsed or refractory multiple myeloma. It is an early exploratory clinical study evaluating the safety, tolerability, and preliminary efficacy of PICX Injection, an in vivo prepared CAR-T cell therapy, in the treatment of relapsed or refractory multiple myeloma.

Detailed description

This is a prospective, open-label, single-arm clinical investigation to assess the safety and efficacy of in vivo CAR-T cell therapy in patients with relapsed or refractory multiple myeloma.

Eligible subjects will be treated with PICX Injection as a single intravenous infusion. Post-infusion, subjects will remain hospitalized for close observation and undergo serial evaluations for adverse events and treatment response. Long-term follow-up will continue for up to 2 years to assess disease status and durability of response.

Interventions

• Biological Invivo CAR-T
  Patients were enrolled and given a single dose of CAR-T injection intravenously, hospitalized for observation over the following month, and followed up for observation over the following 2 years.

Primary outcome measures

• Maximal Tolerated Dose (MTD) [Time frame: Up to 28 days after infusion]
• Incidence of Adverse Events (AE) after infusion [Time frame: Up to 28 days after infusion]

Secondary outcome measures (6)

• Objective Response Rate (ORR) [Time frame: Day 28#Month 2#Month 3#Month 6#Month 12#Month 18#Month 24]
• Minimal Residual Disease (MRD) Negative Rate [Time frame: Month 3#Month 6#Month 12#Month 18#Month 24]
• Time to Response (TTR) [Time frame: Up to 24 months]
• Duration of Response (DOR) [Time frame: up to 24 months]
• Progression-Free Survival (PFS) [Time frame: up to 24 months]
• Overall Survival (OS) [Time frame: up to 24 months]

Eligibility criteria

Inclusion criteria

• Age ≥ 18 years, male or female;
• Confirmed diagnosis of multiple myeloma meeting at least one of the following criteria:

• Disease progression after at least 2 prior standard treatment regimens; or poor response to primary therapeutic agents (e.g., immunomodulatory agents, proteasome inhibitors)
• Disease progression within 18 months after first-line therapy
• Presence of features associated with high risk of disease relapse or progression (e.g., high-risk cytogenetic abnormalities);
• At least one measurable disease indicator:

• Serum M-protein ≥ 0.5 g/dL
• Urine M-protein ≥ 200 mg/24 hours
• Involved serum free light chain (sFLC) ≥ 10 mg/dL with an abnormal serum free light chain κ/λ ratio
• No evidence of extramedullary plasmacytoma (soft tissue plasmacytoma);
• ECOG performance status score 0-2;
• Expected survival period ≥ 3 months;
• Adequate bone marrow function within 1 month prior to screening:

• Hemoglobin ≥ 60 g/L;
• Absolute neutrophil count (ANC) ≥ 0.5 × 10⁹/L;
• Platelet count (PLT) ≥ 50 × 10⁹/L;
• Lymphocyte count ≥ 0.5 × 10⁹/L;
• CD3-positive T-cell absolute count ≥ 0.15 × 10⁹/L;
• Adequate vital organ function within 1 month prior to screening:

• Renal function: creatinine clearance rate (CrCl) ≥ 30 mL/min (calculated using the Cockcroft-Gault formula), or serum creatinine (Scr) ≤ 2.0 × upper limit of normal (ULN);
• Hepatic function: alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3.0 × ULN; total bilirubin (TBIL) ≤ 2.0 × ULN (except for patients with congenital hyperbilirubinemia such as Gilbert's syndrome, in which case direct bilirubin may be ≤ 1.5 × ULN);
• Cardiac function: left ventricular ejection fraction (LVEF) ≥ 40%; no clinically significant pericardial effusion; and no clinically significant electrocardiogram (ECG) abnormalities (e.g., severe arrhythmia, myocardial ischemia, conduction block);
• Pulmonary function: blood oxygen saturation (SpO₂) ≥ 90% without supplemental oxygen;
• Women of childbearing potential must have a negative pregnancy test during the screening period and before study drug administration, and must not be lactating during the study;
• Men and women of childbearing potential must agree to use effective contraceptive measures (excluding unreliable methods such as rhythm method) from the time of signing the informed consent form until 1 year after the last dose of study drug, and must agree not to donate sperm or eggs;
• The subject or their legally authorized representative has signed the informed consent form (ICF), indicating understanding of the study purpose and procedures and voluntary participation.

Exclusion criteria

• Prior treatment with CAR-T therapy or other gene-modified cell therapy before screening;
• Presence of active central nervous system (CNS) involvement at screening (including brain parenchymal, meningeal, or spinal meningeal involvement, or positive cerebrospinal fluid for tumor cells), or other CNS diseases;
• Received the following anti-tumor therapies prior to PICX Injection infusion:

• Chemotherapy, combination therapy with proteasome inhibitors and immunomodulatory agents, or other systemic anti-tumor drug therapy within 14 days or at least 5 half-lives before infusion (excluding intrathecal chemotherapy, which must be discontinued at least 1 week prior to infusion);
• Radiotherapy to non-hematopoietic sites within 7 days, or to hematopoietic sites within 14 days before infusion;
• BCMA-targeting antibody-based therapy within 3 months before infusion;
• Active or uncontrolled infection requiring systemic treatment at screening (including bacterial, viral, fungal, or other infections);
• Presence of any of the following cardiac conditions:

• New York Heart Association (NYHA) Class III or IV congestive heart failure;
• Myocardial infarction, or coronary artery bypass grafting (CABG), or coronary stent placement within 6 months prior to screening;
• Clinically significant ventricular arrhythmia, or history of syncope of unknown cause (excluding vasovagal or dehydration-related);
• History of severe non-ischemic cardiomyopathy;
• Presence of other clinically significant diseases or conditions, including:

• Primary immunodeficiency disease;
• Cerebrovascular accident or seizure within 6 months prior to screening;
• Definite cognitive impairment or psychiatric/behavioral abnormalities (e.g., dementia, altered mental status), or severe psychiatric disorders;
• Parkinson's disease, Parkinsonism, or other movement disorders;
• Grade 2-4 acute graft-versus-host disease (GVHD) or moderate to severe chronic GVHD within 4 weeks prior to screening;
• History of other malignancies other than multiple myeloma prior to screening, except for:

• Malignancies treated with curative intent with no known active disease for ≥ 2 years prior to enrollment;
• Adequately treated cervical carcinoma in situ, basal cell or squamous cell skin carcinoma, localized prostate cancer after radical surgery, or ductal carcinoma in situ after radical surgery;
• Vaccination with live-attenuated vaccine within 4 weeks prior to screening;
• Known severe hypersensitivity to PICX Injection or any of its formulation components;
• Inability to establish venous access;
• Other conditions deemed by the investigator to be unsuitable for participation in the study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

China · 1 center

• 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China — Kunming

Identifiers

NCT: NCT07715630 · PBC027-2

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗