Inclusion Criteria:
The subject can understand the informed consent, participate in and sign the
informed consent voluntarily;
No gender limitation;
Age: ≥18;
Expected survival time ≥3 months;
Patients with primary CNS lymphoma (PCNSL) and secondary CNS lymphoma (SCNSL)
confirmed by histology or cytology;
A. Patients with recurrent/refractory primary central nervous system lymphoma
(PCNSL) and recurrent/refractory secondary central nervous system lymphoma (SCNSL)
may be associated with ocular lymphoma;B. Patients with relapsed or refractory
primary CNS lymphoma (PCNSL) and relapsed or refractory secondary CNS lymphoma
(SCNSL) who were not eligible or intolerant to other therapies were determined by
the investigator;Recurrence and refractory are defined as follows: Recurrence refers
to the emergence of new lesions after adequate treatment to complete response
(CR).Refractory refers to a patient who has experienced at least first-line
treatment without disease remission, e.g. induction chemotherapy with methotrexate
without CR.
KPS score ≥60;
Adverse reactions of previous antitumor therapy returned to CTCAE 5.0 grade ≤1
(except for the indicators that the researchers considered to be related to the
disease, such as anemia, and toxicities that the researchers determined to be
without safety risk, such as alopecia, grade 2 peripheral neurotoxicity,
hypothyroidism stabilized by hormone replacement therapy, etc.);
Before the first administration, the organ function level should meet the
following requirements:
Bone marrow function: In the absence of blood transfusion, G-CSF (long-acting white
needle within 2 weeks) and medication correction within 7 days prior to screening:
Absolute neutrophil count (ANC) ≥15×10^9/L (subjects with bone marrow infiltration should
be ≥0.5×10^9/L);Hemoglobin ≥90 g/L;Platelet count ≥90×10^9/L; Liver function: Total
bilirubin ≤1.5 ULN (Gilbert's syndrome ≤3 ULN), transaminase (AST/ALT) ≤2.5 ULN (≤5.0 ULN
for subjects with tumor invasive changes in the liver) without correction with
hepatoprotective drugs within 7 days prior to screening; Renal function: Creatinine (Cr)
≤1.5 ULN and creatinine clearance (Ccr) ≥50 mL /min according to the Cockcroft and Gault
formula; Routine urine / 24-hour urine protein quantification: qualitative urine protein
≤1+ (if qualitative urine protein ≥2+, 24-hour urine protein < 1g can be included);
Cardiac function: left ventricular ejection fraction ≥50%; Coagulation function:
fibrinogen ≥1.5g/L; Activated partial thrombin time (APTT) ≤1.5 ULN; Prothrombin time
(PT) ≤1.5 ULN.
Fertile female subjects or male subjects with fertile partners must use highly
effective contraception beginning 7 days before the first dose and up to 12 weeks
after the last dose. Fertile female subjects must have a negative serum/urine
pregnancy test within 7 days prior to initial dosing;
The subject is able and willing to follow the visits, treatment plans,
laboratory tests, and other study-related procedures specified in the study
protocol.
Exclusion Criteria:
Lung disease defined as grade ≥3 according to NCI-CTCAE V5.0; Patients with
current interstitial lung disease (ILD) (except those who have recovered from
previous interstitial pneumonia);
Active infections requiring systemic treatment, such as severe pneumonia,
bacteremia, sepsis, etc.;
Active tuberculosis;
Brain stem tumor infiltration or only eye lesions;
Patients with active autoimmune diseases, such as: Systemic lupus erythematosus,
systemic treatment of psoriasis, rheumatoid arthritis, inflammatory bowel disease,
and hashimoto's thyroiditis, etc., with the exception of type I diabetes, only
replacement therapy can control the hypothyroidism, no systemic treatment of skin
disease (e.g., vitiligo, psoriasis), B cells caused by autoimmune disease;
Non-melanoma skin cancer in situ, superficial bladder cancer, cervical cancer in
situ, gastrointestinal intramucosal cancer, breast cancer, localized prostate cancer
and other cancers that have been cured and have not recurred within 5 years prior to
the first administration are excluded;
HBsAg positive or HBcAb positive, and HBV-DNA test ≥ the upper limit of normal;
HCV antibody positive and HCV-RNA≥ the upper limit of normal value; HIV antibody
positive;
Poorly controlled hypertension (systolic blood pressure >150 mmHg or diastolic
blood pressure >100 mmHg);
Have a history of serious cardiovascular and cerebrovascular diseases, including
but not limited to: Severe cardiac rhythm or conduction abnormalities, such as
ventricular arrhythmias and degree ⅲ ATrioventricular block requiring clinical
intervention; Longer QT interval at rest (QTc > 450 msec for men or 470 msec for
women); Acute coronary syndrome, congestive heart failure, aortic dissection,
stroke, or other grade 3 or higher cardiovascular and cerebrovascular events
occurred within 6 months prior to first administration; Heart failure with the New
York Heart Association (NYHA) Heart function rating ≥II; 10. Patients with a history
of allergy to recombinant humanized antibodies or to any excipient ingredient of
GNC-038;
Pregnant or breastfeeding women;
Patients who cannot tolerate MRI examination;
Patients who underwent major surgery within 28 days prior to administration of
the drug in this study, or who planned to undergo major surgery during the study
period (except for puncture or biopsy surgery);
Prior organ transplantation or allogeneic hematopoietic stem cell
transplantation (ALLO-HSCT);
Autologous hematopoietic stem cell transplantation (AUTO-HSCT) within 12 weeks
prior to initiation of GNC-038 therapy;
Immunosuppressants are being used, including but not limited to: Cyclosporine,
tacrolimus, etc. within 2 weeks prior to gnC-038 treatment; Gnc-038 received a high
dose of glucocorticoid for 2 weeks prior to treatment (longer than 14 days, a steady
dose of dexamethasone >5mg per day or equivalent dose of other glucocorticoids);
Received radiotherapy within 4 weeks prior to initiation of GNC-038 treatment;
Received anti-CD20 or anti-CD79B treatment within 4 weeks prior to initiation of
GNC-038 and still responded;
Received chemotherapy and small molecule targeted therapy within 2 weeks prior
to treatment;
Received CAR-T therapy within 12 weeks prior to initiation of GNC-038;
Participated in any other clinical trials within 4 weeks prior to administration
of this trial;
Past or present central nervous system disease, including, but not limited to,
stroke (imaging)
Medical examination indicated "lacunar cerebral infarction" except those
requiring no treatment), severe brain injury, Senile dementia, Parkinson's disease,
organic brain syndrome, psychosis;
Other conditions that the investigator considers inappropriate for participation
in this clinical trial.