Clinical Study of GT201 in Combination With PD-1 Inhibitor for Advanced Head and Neck Tumors

Inclusion Criteria:

• 1. Voluntarily join the study, signed informed consent form,, willing and able tocomply with the study protocol;
• 2. Age 18 to 70 years old;
• 3. Diagnosis with recurrent or metastatic head and neck malignant tumors andreceived≤2 lines of systemic therapy;
• 4. Have at least one measurable lesion that is untreated with radiotherapy or otherlocal therapies, is accessible for tumor tissue collection (assessed by theinvestigator), and can provide a tissue block with a mass ≥1.0 g (approximately 1.5cm in diameter) for autologous tumor-infiltrating lymphocyte (TIL) preparation. Thetissue collection procedure should be minimally invasive whenever possible.
• 5. After tumor sampling, have at least one measurable lesion as defined by RECISTv1.1.
• 6. Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1;
• 7. Expected survival time of ≥ 12 weeks;
• 8. Adequate function of major organs, with the following requirements (administration of any blood components or cell growth factors is not allowed within 14 days prior to surgery):

1. Hematology:

• Absolute Neutrophil Count (ANC) ≥ 1.0×10⁹/L;
• Lymphocyte Count (LC) ≥ 0.5×10⁹/L;
• Platelet Count (PLT) ≥ 80×10⁹/L;
• Hemoglobin (Hb) ≥ 90 g/L.

2. Liver function:

• Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), andAlkaline Phosphatase (ALP) ≤ 2.5×Upper Limit of Normal (ULN);
• Total Bilirubin (TBIL) ≤ 1.5×ULN.The following exceptions apply:
• For confirmed liver metastases: AST and/or ALT ≤ 5×ULN;
• For confirmed liver or bone metastases: ALP ≤ 5×ULN;
• For confirmed Gilbert's syndrome: TBIL ≤ 3.0 mg/dL.

3. Renal function: • Creatinine Clearance (CrCL) ≥ 45 mL/min (calculated by the Cockcroft-Gaultformula), or serum creatinine within the normal range.

4. Coagulation function:

• Activated Partial Thromboplastin Time (APTT) ≤ 1.5×ULN;
• International Normalized Ratio (INR) or Prothrombin Time (PT) ≤ 1.5×ULNsimultaneously.

5. Adequate cardiac function.

6. Adequate pulmonary function.

• 9. For women of childbearing potential who have not undergone surgicalsterilization:

• Agree to use at least one medically approved contraceptive method (e.g.,intrauterine device, oral contraceptives, or condoms) during the studytreatment period and for 1 year after the end of study treatment;

• Serum human chorionic gonadotropin (HCG) test result must be negative atscreening.

• 10. Adverse reactions caused by prior therapies have resolved to ≤ Grade 1 per CTCAEv5.0 before tumor sampling.
• 11. For subjects enrolled due to insufficient efficacy or intolerability of priortherapies, medical records documenting disease status after prior treatment orimaging records of lesion assessment must be available before tumor sampling.

Exclusion Criteria:

• 1. Uncontrolled local or systemic infections of the oral cavity, head, or neck; anyactive autoimmune disease, history of autoimmune disease, or disease requiringsystemic corticosteroid therapy or immunosuppressive drugs (prednisone equivalentdose > 10 mg/day).
• 2. Subjects with uncontrollable tumor-related pain assessed by the investigator.Subjects requiring analgesic treatment must be on a stable analgesic regimen atstudy entry; symptomatic lesions eligible for palliative radiotherapy should havecompleted treatment prior to study entry.
• 3. Bleeding events occurring within 3 months prior to screening, including but notlimited to gastrointestinal bleeding caused by fundic or esophageal varices,increased bleeding risk due to portal hypertension, active gastrointestinalbleeding, etc.; or subjects assessed by the investigator as having a high risk ofmajor bleeding, including but not limited to tumors encasing or invading major bloodvessels [i.e., carotid artery, jugular vein, bronchial artery] and/or exhibitingother high-risk features (e.g., fistula, significant cavitary lesions, history ofbleeding [≤ 60 days from signing the ICF]).
• 4. Arterial/venous thrombotic events occurring within 6 months prior to screening,such as cerebrovascular accident, deep vein thrombosis, and pulmonary embolism.
• 5. A history of interstitial pneumonia, clinically significant active pneumonia atscreening, or other respiratory diseases that severely impair pulmonary function.
• 6. A history of clinically significant cardiovascular disease, including but notlimited to: (1) congestive heart failure (NYHA class > 2); (2) unstable anginapectoris; (3) myocardial infarction within the past 3 months; (4) anysupraventricular or ventricular arrhythmia requiring treatment or intervention.
• 7. Subjects with ≥ 3 untreated central nervous system (CNS) metastases at screening.Exclusion exception: Subjects with ≤ 3 CNS metastases, with the largest lesion < 1cm in diameter, no peritumoral edema on brain imaging (MRI or CT), and no evidenceof progressive CNS disease on brain imaging for at least 3 months after treatmentmay be enrolled.
• 8. Ineligible for enrollment if spinal cord compression has not been relieved bysurgery and/or radiotherapy. Exclusion exception: Subjects with active CNSmetastases are excluded, except for those with stable brain metastases who have notrequired medical treatment for 3 months and are not dependent on corticosteroids.
• 9. A history of malignant tumors other than the target indication within 5 yearsprior to screening (excluding adequately treated basal cell carcinoma or squamouscell carcinoma of the skin, and breast ductal carcinoma in situ after radicalresection), unless the investigator determines that the benefits to the subjectoutweigh the risks.
• 10. Presence of refractory or intractable epilepsy, massive pleural effusion,ascites, pericardial effusion, etc., that cannot be controlled by medication, orcontraindications to interleukin-2 (IL-2) use.
• 11. A history of infectious diseases within 1 year prior to screening, such as HIV,syphilis, active viral hepatitis, active pulmonary tuberculosis, active EBV and/orCMV infection; or a history of active pulmonary tuberculosis infection for more than 1 year without standard treatment. Active hepatitis B or hepatitis C is excluded.Enrollment exceptions:

• Subjects positive for HBsAg or HBcAb may participate if HBV DNA test resultsare below the lower limit of normal (LLN) at the testing site;

• Subjects positive for HCV antibody may participate if HCV RNA test results arebelow the LLN at the testing site.

Carriers enrolled in the study should receive antiviral therapy as appropriate and undergo regular nucleic acid copy number quantitative testing during the study period.

• 12. Use of anti-angiogenic agents (e.g., bevacizumab, a VEGF inhibitor) within 4weeks prior to surgical tumor sampling.
• 13. Previous allogeneic bone marrow transplantation or solid organ transplantation.
• 14. Receipt of systemic anti-tumor therapy within 4 weeks prior to lymphodepletionconditioning, excluding the following situations:

• Bridging therapy;

• If prior treatment included nitrosourea or mitomycin chemotherapy, the intervalbetween the end of chemotherapy and the expected start of lymphodepletionconditioning must be at least 6 weeks for enrollment;

• If prior treatment included small-molecule targeted therapy, the intervalbetween the end of treatment and the expected start of lymphodepletionconditioning must be at least 5 half-lives of the drug for enrollment.

• 15. Previous receipt of genetically modified or edited cell therapy products (excluding autologous immune cell therapy products without genetic modification orediting if more than 1 year has passed since cell infusion).
• 16. A history of hypersensitivity reactions to any component of the drugs intendedfor use in the study, including but not limited to autologous tumor-infiltratinglymphocytes (TILs), cyclophosphamide, fludarabine, interleukin-2 (IL-2), dimethylsulfoxide (DMSO), human serum albumin (HSA), dextran-40, and antibiotics (β-lactamantibiotics, gentamicin).
• 17. Known history of mental illness, alcoholism, drug addiction, or substance abuse.
• 18. Previous grade 3 or higher adverse reactions to immunotherapy that failed toresolve to CTCAE grade 1 or below within 28 days; or any other disease or conditionthat could reasonably be suspected to contraindicate the use of investigationalproducts, interfere with the interpretation of study results, or place the subjectat high risk of treatment complications (including any other disease, metabolicdisorder, abnormal physical examination finding, or abnormal laboratory testresult).
• 19. Pregnant or lactating women; or women planning to become pregnant, lactate, orconceive within 1 year after cell infusion.
• 20. Receipt of other investigational products within 4 weeks prior tolymphodepletion conditioning, or planned participation in other investigationalproduct studies during the study period.
• 21. Other conditions deemed unsuitable for enrollment by the investigator.