An Open-Label, Multicenter Phase IIa Clinical Study Evaluating the Safety, Tolerability, Pharmacokinetics, and Preliminary Efficacy of Puesta Mesylate for Injection for the Treatment of Patients With Relapsed or Refractory Peripheral T-Cell Lymphoma and Cutaneous T-Cell Lymphoma
Objective: To evaluate the relationship between tumor biomarkers and the therapeutic efficacy and safety of puesta mesylate injection.
• patients are fully aware of the study, participate voluntarily and sign the informed consent form (ICF), are able to communicate well with the investigator and are able to comply with the planned visits, treatment plans, laboratory tests and other study procedures;
• aged ≥18 years, male or female;
• have a histologically confirmed diagnosis according to the World Health Organization (WHO) classification criteria as revised in 2022, including but not limited to the following subtypes:
• peripheral T-cell lymphoma non-specific (PTCLNOS). 2) NK/T-cell lymphoma (nasal type), the 3) angioimmunoblastic T-cell lymphoma (AITL) 4) anaplastic large cell lymphoma (ALCL) 5) enteropathic T-cell lymphoma (EATL) 6) Hepatosplenic T-cell lymphoma (HSTL) 7) Cutaneous T-cell lymphoma with TNMB stage IB-IVA 8) Other subtypes of PTCL (except highly aggressive) that the investigator believes are eligible for enrollment and with the consent of the sponsor; 4. Prior therapy: relapsed/refractory PTCL refers to patients who have failed or are intolerant to at least one line of standard systemic systemic therapy (≤5 lines), which needs to have included menadione/pimentase/levulinic acid aminidase in prior therapy for NK/T-cell lymphoma, and anthracyclines in prior therapy for the other subtypes (unless there is a contraindication to anthracyclines). Relapsed/refractory CTCL Refers to patients who have relapsed, progressed, or failed to respond after adequate treatment with at least one systemic therapy (interferon, retinoids). Detailed definitions of relapsed/refractory PTCL are as follows: relapse: disease progression after a subject has previously received adequate first-line therapy to achieve remission (including complete and partial remission), including:
• Completion of treatment in accordance with the standard or conventional protocols recommended by the clinic (first-line chemoradiotherapy combined with at least 2 cycles of the recommended chemotherapy regimen for early-stage patients; first-line systemic therapy for patients with progression, and at least 4 cycles for patients who have received HSCT for consolidation, and at least 6 cycles for those who have not) (At least 6 cycles for patients without transplant consolidation);
• Relapse within 1-3 years of remission and are not suitable for or do not receive autologous hematopoietic stem cell transplantation for rescue therapy. Refractory: a subject who has not remitted on prior adequate first-line therapy, or whose disease has progressed within 1 year during/at the end of adequate therapy, including:
⁃ (1 Treatment in accordance with clinically recommended standard or conventional regimens without achieving stable disease (SD) in ≥ 2 cycles of therapy, or partial remission (PR) in ≥ 3-4 cycles of therapy; (2 If the reason for optimal efficacy or closure is disease progression (PD), the number of cycles of therapy is not required; (3 Repeat disease progression after ≥2 lines of treatment with a clinically recommended standard or conventional regimen; (4 Patients who have relapsed after autologous hematopoietic stem cell transplantation.
⁃ (4) Patients with relapse after autologous hematopoietic stem cell transplantation; 5. Expected survival \> 3 months. 6; 6. ECOG score 0-2. 7; 7. patients with PTCL have at least one measurable lesion according to the 2014 Lugano criteria (lesions that have received radiotherapy can be used as target lesions if there is clear evidence of disease progression after radiotherapy), with a measurable lesion defined as: an intranodal lesion with a maximum diameter of \>1.5 cm on CT cross-sectional images; or an extranodal lesion with a maximum diameter of \>1.0 cm; patients with CTCL must have an mSWAT score ≥10% with or without systemic lymph node invasion; 8. Organ function levels must meet the following requirements: routine blood tests (no growth factors or blood transfusions within 14 days prior to screening): absolute neutrophil count (ANC) ≥1.0×10\^9/L; hemoglobin (HGB) ≥80 g/L; platelet count (PLT) ≥75×10\^9/L (patients with bone marrow infiltration of lymphoma ≥50×10\^9/L can be enrolled); liver and kidney function: serum ≥10%, serum ≥10%, serum ≥50×10\^9/L (patients with bone marrow infiltration of lymphoma ≥50×10\^9/L). ); liver and kidney function: serum total bilirubin ≤1.5 × upper limit of normal (ULN) (TBiL ≤3.0 × ULN in patients with Gilbert's syndrome may be enrolled); aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) ≤2.5 × ULN, or in the judgment of the investigator, when there is hepatic infiltration resulting in hepatic function impairment. ALT, AST, and ALP ≤ 5 × ULN may be enrolled; serum creatinine ≤ 1.5 × ULN or estimated creatinine clearance ≥ 50 mL/min (according to the Cockcroft and Gault formula); coagulation: activated partial thromboplastin time (APTT), International Normalized Ratio (INR), and prothrombin time (PT) ≤ 1.5 × ULN, and Fibrinogen (FIB) ≥ 1.0 g/L; 9. females and males of childbearing potential should agree that effective contraception (hormonal or barrier methods or abstinence) is required during the study and for 6 months after study completion; female patients of childbearing potential must have a negative serum or urine pregnancy test within 7 days prior to administration of the drug and must be non-lactating.