ChiCTR2600125577 版本V1.0 版本创建时间2026/05/28 14:41:12 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2600125577 

最近更新日期:

Date of Last Refreshed on:

2026-05-28 14:41:01 

注册时间:

Date of Registration:

2026-05-28 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

托法替布治疗免疫相关不良反应的研究

Public title:

Research on Immune-related Adverse Reactions Treated with Tofacitinib

注册题目简写:

English Acronym:

研究课题的正式科学名称:

托法替布用于治疗免疫检查点抑制剂(ICI)相关的不良反应 (irAE)的前瞻性、单臂Ⅱ期临床研究

Scientific title:

A prospective single-arm phase Ⅱ clinical study of Tofacitinib for the treatment of immune-related adverse events (irAE) related to immune checkpoint inhibitors (ICI)

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

林晶 

研究负责人:

陈誉 

Applicant:

Lin Jing 

Study leader:

Chen Yu 

申请注册联系人电话:

Applicant telephone:

+86 591 62752224

研究负责人电话:

Study leader's
telephone:

+86 597 6275 2224

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

423559148@qq.com

研究负责人电子邮件:

Study leader's E-mail:

13859089836@139.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

福建省福州市晋安区福马路420号

研究负责人通讯地址:

福建省福州市晋安区福马路420号

Applicant address:

420 Fuma Road, Jin'an District, Fuzhou, Fujian Province

Study leader's address:

420 Fuma Road, Jin'an District, Fuzhou, Fujian Province

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

福建省肿瘤医院

Applicant's institution:

Fujian Cancer Hospital

研究负责人所在单位:

福建省肿瘤医院

Affiliation of the Leader:

Fujian Cancer Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

K2025-168-01

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

福建省肿瘤医院伦理委员会

Name of the ethic committee:

Ethics Committee of Fujian Cancer Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025-04-21 00:00:00

伦理委员会联系人:

韦铃铃

Contact Name of the ethic committee:

Wei LingLing

伦理委员会联系地址:

福建省福州市晋安区福马路420号

Contact Address of the ethic committee:

420 Fuma Road, Jin'an District, Fuzhou, Fujian Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 591 62002091

伦理委员会联系人邮箱:

Contact email of the ethic committee:

653610717@qq.com

研究实施负责(组长)单位:

福建省肿瘤医院

Primary sponsor:

Fujian Cancer Hospital

研究实施负责(组长)单位地址:

福建省福州市晋安区福马路420号

Primary sponsor's address:

420 Fuma Road, Jin'an District, Fuzhou, Fujian Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

福建省

市(区县):

Country:

China

Province:

Fujian

City:

单位(医院):

福建省肿瘤医院

具体地址:

福建省福州市晋安区福马路420号

Institution
hospital:

Fujian Cancer Hospital

Address:

420 Fuma Road, Jin'an District, Fuzhou, Fujian Province

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

NA

研究疾病:

免疫心肌炎、免疫性肠炎、免疫性肌炎关节炎、免疫性皮肤反应、免疫性肝炎等  

Target disease:

Immune myocarditis, immune enteritis, immune myositis arthritis, immune skin reactions, immune hepatitis, etc

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

单臂 

Study design:

Single arm 

研究目的:

旨在评估ICIs(包括PD-1/PD-L1,CTLA-4,LAG-3等)治疗实体瘤出现免疫相关不良反应(免疫心肌炎、免疫性肠炎、免疫性肌炎关节炎、免疫性皮肤反应、免疫性肝炎等)且激素治疗出现抵抗或激素依赖的患者,使用托法替布进行治疗的有效性。  

Objectives of Study:

To assess the efficacy of tofacitinib in managing steroid-refractory or steroid-dependent immune-related adverse events (irAEs) - including immune myocarditis, colitis, myositis/arthritis, cutaneous reactions, and hepatitis - arising from immune checkpoint inhibitor (ICI) therapy (PD-1/PD-L1, CTLA-4, LAG-3 inhibitors) in patients with solid tumors

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1. 年龄 >= 18 岁。 2. ECOG 体力状态评分 0-2。 3. 经免疫检查点抑制剂(ICIs)治疗的实体瘤患者。 4. ICIs 的治疗过程包括可以单独使用或联合(包括但不限于放化疗、靶向等)使用。 5. 患者目前诊断为激素抵抗或激素依赖的免疫相关不良反应(免疫心肌炎、免疫性肠炎、免疫性肌炎/关节炎、免疫性皮肤反应、免疫性肝炎等)。 6. 患者尚具有一定的器官和骨髓功能: (1) 血红蛋白值 >= 90 g/L、中性粒细胞计数 >= 1.0 x 10^9/L、血小板计数 >= 75 x 10^9/L;淋巴细胞计数 >= 0.5 x 10^9/L; (2) 凝血功能:INR、APTT 和 PT 均 <= 1.5 x ULN; (3) 肝功能:血清总胆红素 <= 1.5 x ULN、天冬氨酸转移酶 <= 3 x ULN、丙氨酸转移酶 <= 3 x ULN;对于免疫性肝炎的患者具体肝功能生化指标不做限定,具备适当的肝脏功能,根据 Child-Pugh 分级 A-B 即可; (4) 肾功能:血清肌酐 <= 1.5 x ULN 或肌酐清除率 >= 50 ml/min;或经研究者评估判定具有足够的器官功能的患者。 7. 所有具有潜在生育能力的女性在筛选期血清妊娠试验结果必须是阴性,同时在签署知情同意书至末次给药后 3 个月必须采取可靠的避孕措施。 8. 受试者自愿加入本研究,筛选程序前签署知情同意书,依从性好,配合安全性随访。 9. 存在激素使用的禁忌症,或者在使用激素后出现了相关的不良反应拒绝继续使用激素治疗的患者。

Inclusion criteria

1.Inclusion criteria: Age ≥ 18 years old.
2.ECOG physical status score 0-2;
3.Patients with solid tumors treated with immune checkpoint inhibitors (ICIs).
4.The ICIs treatment process can be used alone or in combination (including but not limited to radiotherapy, chemotherapy, targeted therapy, etc.).
5.The patient is currently diagnosed with hormone-resistant or hormone-dependent immune-related adverse reactions (such as immune skin reactions, immune colitis, immune arthritis or myositis, immune myocarditis, immune pneumonia, etc.).
6.The patient still has certain organ and bone marrow functions: Hemoglobin value ≥90g/L, neutrophil count: ≥1.0×10^9/L, platelet count ≥75×10^9/L; Liver Function: Serum total bilirubin ≤1.5× upper limit of normal (UNL), aspartate transferase ≤3×UNL, alanine transferase ≤3×UNL; Renal Function: Serum creatinine ≤1.5×UNL or creatinine clearance rate ≥50ml/min; Coagulation Function: All INR, APTT and PT ≤1.5×UNL; Or patients who have been evaluated and determined by researchers to have sufficient organ function.
7.All potentially fertile women must have negative results from the serum pregnancy test during the screening period, and must take reliable contraceptive measures from the time of signing the informed consent form until 3 months after the last administration;
8.The subjects voluntarily joined this study, signed the informed consent form before the screening procedure, had good compliance and cooperated with the safety follow-up.
9.Patients who have contraindications for hormone use or who have experienced related adverse reactions after hormone use and refuse to continue hormone therapy.

排除标准:

1. 有过敏性疾病、严重药物过敏史、或可能对托法替布或其药物成分过敏者; 2. 入组前 3 个月内诊断有栓塞事件但不包括浅静脉血栓(如深静脉血栓、肺栓塞、栓塞性卒中、心肌梗死或外周动脉供血不足等); 3. 非 irAE 相关的严重的心、肝、肾等器官及系统性疾病的患者; 4. 病人患有活动性肺结核、受试者在患病期间接受了活疫苗接种; 5. 患者有不可控的感染疾患; 6. 中度到重度心力衰竭患者(NYHA 分类 III/IV 级); 7. 乙肝表面抗原(HBsAg)或乙肝核心抗体(HBcAb)阳性,且乙型肝炎病毒(HBV)脱氧核糖核酸(DNA)高于 500 IU/mL 或 1000 拷贝(cps)/mL、丙肝抗体(HCV-Ab)阳性且丙型肝炎病毒(HCV)-核糖核酸(RNA)定量高于检测单位正常值上限、抗人类免疫缺陷病毒抗体(Anti-HIV)阳性、活动性梅毒,符合上述任何一项者; 8. 入组前接受过 JAK 抑制剂治疗; 9. 在入组前 7 天内使用过强的 CYP3A4 诱导剂(如酮康唑); 10. 静脉注射生物制剂治疗其他基线自身免疫性疾病的患者; 11. 妊娠期或哺乳期女性,以及不愿意采取避孕措施的男性和女性; 12. 妨碍研究依从性的精神疾病; 13. 研究者认为不宜参加本研究的其他情况应排除在本研究之外,例如经研究者判断,受试者有其他可能导致本研究被迫中途终止的因素,如其他严重疾病(含精神疾病)需要合并治疗,有严重的实验室检查异常,伴有家庭或社会等因素,会影响到受试者的安全,或资料及样品的收集。

Exclusion criteria:

1.Individuals with allergic diseases, a history of severe drug allergies, or potential allergies to tofacitinib or its drug components;
2.Diagnosed with thrombotic events within the first 3 months of enrollment, excluding superficial vein thrombosis (such as deep vein thrombosis, pulmonary embolism, embolic stroke, myocardial infarction, or peripheral arterial insufficiency);
3.Patients with severe heart, liver, kidney and systemic diseases not related to irAE;
4.The patient has active pulmonary tuberculosis and the subject received live vaccination during the illness period;
5.The patient has uncontrollable infectious diseases;
6.Patients with moderate to severe heart failure (NYNA classification III/IV);
7.Received JAK inhibitor treatment before enrollment;
8.Excessive use of CYP3A4 inducers (such as ketoconazole) within 7 days prior to enrollment.
9.Intravenous injection of biologics for the treatment of patients with other baseline autoimmune diseases;
10.Pregnant or lactating women, as well as men and women who are unwilling to take contraceptive measures;
11.Mental illnesses that hinder research compliance;
12.Researchers believe that participants who are not suitable to participate in this study should be excluded from the study. For example, if the researchers determine that there are other factors that may cause the study to be terminated midway, such as other serious illnesses (including mental illnesses) that require concomitant treatment, serious laboratory examination abnormalities, and family or social factors that may affect the safety of the participants, or the collection of data and samples.
13.Hepatitis B B surface antigen (HBsAg) or hepatitis B B core antibody (HBcAb) positive, hepatitis B virus (HBV) deoxyribonucleic acid (DNA) higher than 500IU/mL or 1000 copies (cps)/mL, hepatitis C antibody (HCV Ab) positive, hepatitis C virus (HCV) - ribonucleic acid (RNA) level higher than the upper limit of the normal value of the testing unit, anti HIV antibody positive, active syphilis, and any of the above.

研究实施时间:

Study execute time:

From 2025-06-01 00:00:00 To 2028-06-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-08-13 00:00:00 To 2028-06-01 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

60

Group:

Experimental group

Sample size:

干预措施:

枸橼酸托法替布片:5-10mg,BID PO,直到症状缓解至 1 级以下或治疗无效,用药最长不超过 30 天。 其它治疗:容许前序激素治疗的维持或缓慢减量。

干预措施代码:

Intervention:

Tofacitinib citrate tablets: 5-10 mg, BID PO, until symptoms improve to less than grade 1 or treatment is ineffective, with a maximum duration of use not exceeding 30 days. Other treatments: Maintenance or gradual tapering of prior steroid therapy is allowed.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

福建省 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

福建省肿瘤医院 

单位级别:

三级甲等 

Institution
hospital:

Fujian Cancer Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

免疫相关性不良反应临床缓解下降一个等级时所需的中位天数

指标类型:

次要指标

Outcome:

Median number of days required for clinical remission of immune-related adverse reactions to decrease by one grade

Type:

Secondary indicator

测量时间点:

30天

测量方法:

Measure time point of outcome:

30day

Measure method:

指标中文名:

免疫相关性不良反应临床缓解疗效(率)

指标类型:

次要指标

Outcome:

Clinical response rate of immune-related adverse events (irAEs)

Type:

Secondary indicator

测量时间点:

30天

测量方法:

根据 NCI CTCAE v5.0 分级,免疫性不良反应缓解 至≤1 级的患者比例

Measure time point of outcome:

30day

Measure method:

According to NCI CTCAE v5.0 grading, immune adverse reactions have been alleviated Proportion of patients with grade ≤ 1

指标中文名:

治疗周期内不良反应的缓解率

指标类型:

主要指标

Outcome:

Adverse event (AE) response rate during the treatment period

Type:

Primary indicator

测量时间点:

30天

测量方法:

根据 NCI CTCAE v5.0 分级,较入组时至少缓解一个等级的患 者比例

Measure time point of outcome:

30day

Measure method:

According to NCI CTCAE v5.0 grading, patients who have relieved at least one level compared to those who were enrolled Proportion of individuals

指标中文名:

免疫相关性不良反应临床缓解达到≤1 级

指标类型:

次要指标

Outcome:

Achievement of immune-related adverse event (irAE) clinical remission to Grade ≤1

Type:

Secondary indicator

测量时间点:

30天

测量方法:

根据 NCI CTCAE v 5.0)时所需的天数

Measure time point of outcome:

30day

Measure method:

According to NCI CTCAE v 5.0, the required number of days

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

论文发表后半年内,通过备案系统网址共享数据https://www.medicalresearch.org.cn/。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Within six months of publication, share data via the filing system website https://www.medicalresearch.org.cn/.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

eCRF

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

eCRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-05-28 14:41:01