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).
Patient or legal guardian voluntarily signs the informed consent form (ICF), demonstrating understanding of the study purpose and procedures, and willingness to participate.
Age 3 to 75 years, inclusive, male or female.
Cardiac: left ventricular ejection fraction (LVEF) ≥40% by echocardiogram;
Renal: serum creatinine ≤2.0× upper limit of normal (ULN), or creatinine clearance ≥50 mL/min (Cockcroft-Gault formula);
Prior treatment with CAR-T or other genetically modified cell therapies, unless the investigator determines that safety risks have been adequately excluded.
Received the following anti-tumor therapies prior to PID23 infusion: Chemotherapy or molecular targeted therapy within 14 days or 5 half-lives (whichever is longer) (excluding conditioning chemotherapy and intrathecal chemotherapy; intrathecal therapy must be stopped ≥1 week prior to PID23 infusion); Radiotherapy to non-hematopoietic sites within 7 days; Radiotherapy to hematopoietic sites within 14 days.
Single group
PID23 Injection
Biological/VaccinePID23 is an in vivo CAR-T product, a lentiviral vector encoding CD19, BCMA, and CD70 chimeric antigen receptors, administered as a single intravenous infusion
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.
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.
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.
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.
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.
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.
Viral Clearance from Body Fluids
Detection of viral vector sequences in body fluid samples including blood, saliva, urine, and stool. Viral clearance is defined as two consecutive negative results. Samples collected at protocol-specified time points: 0h, 30min, 2h, 6h, 12h, D2, D4, D7, D10, D14, D21, and M1. Samples may be stored at -80°C and shipped in batches to the technology partner for analysis. Viral clearance assessed until two consecutive negative results are obtained.
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Zhujiang Hospital
Lead sponsor
Chongqing Precision Biotech Co., Ltd
Collaborator
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