Evaluation of the Safety and Efficacy of the BCMA/CD19 Dual Targeted CAR-T Cell in Participants With Autoimmune Kidney Diseases: A Single-center Exploratory Clinical Study

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

This study is a single-center, open-label, dose-escalation exploratory clinical trial, expected to enroll 6 to 12 participants. It will use a BOIN (Bayesian Optimal Interval) design for dose escalation, with four predetermined dose groups (0.3×10\^6 cells/kg, 1.0×10\^6 cells/kg, 3.0×10\^6 cells/kg, and an alternative dose of 0.1×10\^6 cells/kg). Each dose group plans to enroll 1-2 or 3-6 participants with relapsed or refractory autoimmune-mediated kidney diseases (such as lupus nephritis, ANCA-associated vasculitis, membranous nephropathy, and IgG4-related diseases).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 65
Healthy Volunteers: f
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• Participants must personally sign an informed consent form approved by the Ethics Committee before the start of the study.

• Participants must be aged ≥18 and ≤65 years.

• Disease-specific inclusion criteria:

• Active, relapsing, refractory Lupus Nephritis (LN):

• LN diagnosed by kidney biopsy within the last 2 years, with pathological types III, IV, or V, and a chronicity index (CI) score≤3

• Meets one of the following criteria:

• Refractory LN, defined as no remission after at least one standard regimen (CTX and/or MMF) for 6 months.

• Relapsing LN, defined as a need to increase steroid dosage to control disease activity during maintenance treatment.

• Clinical criteria: eGFR \> 45 ml/min/1.73 m²; urinary protein quantification ≥ 1.5g/24h; SLE-DAI score ≥ 8.

• ANCA-associated vasculitis (AAV) patients:

• Diagnosed as AAV according to the 2012 Chapel Hill Consensus Conference criteria, meeting one of the following:

• Newly diagnosed AAV with renal involvement:

• Renal involvement must meet both:

• Kidney biopsy showing pauci-immune necrotizing glomerulonephritis. Urinary red blood cells \>30/high power field.

• Relapsing or refractory AAV:

• Relapse: Defined as an increase in BVAS V3.0 score of ≥1 after remission, requiring adjustment of immunosuppressive treatment to regain remission.

• Refractory: Defined as a) less than 50% reduction in BVAS V3.0 after 6 weeks of standard induction treatment; or b) persistent disease activity (BVAS V3.0 ≥3) after 12 weeks of treatment.

• Membranous nephropathy (MN) patients:

• Tissue biopsy diagnosed as aPLA2R-related membranous nephropathy.

• Clinical criteria for high-risk or relapsing/refractory membranous nephropathy:

• High-risk patients:

• Defined as meeting any of the following: eGFR normal, urinary protein \>3.5g/d, ACEI/ARB treatment for 6 months with \<50% reduction in urinary protein, combined with serum albumin \<25g/l or aPLA2R \>50RU/ml; or eGFR \<60ml/min/1.73m², and/or urinary protein \>8g/d for over 6 months.

• Refractory/relapsing membranous nephropathy patients:

• Refractory: Defined as resistance to previous immunosuppressive treatment (persistent urinary protein ≥3.5g/d with \<50% reduction compared to baseline).

• Relapse: Defined as complete or partial remission achieved with previous immunosuppressive treatment, followed by reappearance of urinary protein ≥3.5g/d.

• eGFR ≥ 45 ml/min/1.73 m².

• IgG4-related disease patients:

• Meeting the 2019 ACR/EULAR diagnostic criteria for IgG4-related disease, and meeting one of the following:

• Newly diagnosed active IgG4-related disease (Respond Index (RI) ≥3).

• Refractory or relapsed IgG4-related disease:

• Refractory: Defined as no remission with steroid or steroid plus immunosuppressant treatment (no clinical or imaging improvement, RI decrease \<2) Relapse: Defined as new progression or recurrence of clinical symptoms or imaging findings in a patient who had achieved remission, with or without elevated blood IgG4 (RI increase≥2)

• Expected survival ≥ 12 weeks.

• ECOG performance status ≤ 2.

• Female participants of childbearing potential must agree to use effective contraception from the day of signing the informed consent until 365 days after the infusion. Effective contraception is defined as abstinence or the use of a contraceptive method with a failure rate of \<1% per year.

• Participants must have adequate organ function, meeting all of the following criteria before enrollment:

‣ Absolute neutrophil count ≥ 1.0×10⁹/L \[Granulocyte colony-stimulating factor (G-CSF) support is allowed, but no supportive treatment should be received within 7 days before the assessment\].

⁃ Platelet count ≥ 50×10⁹/L \[No transfusion support (including component transfusion) or treatments aimed

Locations
Other Locations
China
Jinling Hospital
RECRUITING
Nanjing
Contact Information
Primary
Xianghua Huang, MD
hxhszb@163.com
13770648824
Time Frame
Start Date: 2024-03-04
Estimated Completion Date: 2028-12-31
Participants
Target number of participants: 24
Treatments
Experimental: Treatment arm
Administration of the BCMA/CD19 dual targeted CAR-T cells Four dose groups of 0.1×10\^6 CAR-T/kg, 0.3×10\^6 CAR-T/kg, 1.0×10\^6 CAR-T/kg, and 3.0×10\^6 CAR-T/kg FKC288 are designed in this study.~Each dose group plans to enroll 1-2 or 3-6 participants with relapsed or refractory autoimmune-mediated kidney diseases (such as lupus nephritis, ANCA-associated vasculitis, membranous nephropathy, IgG4-related diseases) according to observed DLT.~the BCMA/CD19 dual targeted CAR-T cells will be intravenously infused at least 24 hours after lymphodepletion preconditioning. According to the assigned dose group, the designated dose of the BCMA/CD19 dual targeted CAR-T cells will be infused in a single infusion within 30 minutes on day 0.
Sponsors
Leads: Nanjing University School of Medicine

This content was sourced from clinicaltrials.gov

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