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This study is a single-center exploratory clinical trial. It is estimated that 6-12 subjects will be enrolled. The "BOIN" dose escalation design is adopted. The main purpose is to evaluate the safety of FKC288 in the treatment of subjects with relapsed or refractory AL amyloidosis and explore the recommended phase II dose of FKC288 in the treatment of patients with relapsed/refractory systemic Light Chain (AL) amyloidosis.
A leukapheresis procedure will be performed to manufacture FKC288 chimeric antigen receptor (CAR) modified T cells. Bridging therapy is allowed between PBMC collection and lymphodepletion. Lymphodepletion with fludarabine and cyclophosphamide was performed for three consecutive days. After 1-day rest, subjects will receive a single dose infusion of FKC288 at 0.1, 0.3, 1.0, or 3.0x 10^6 CAR+ T cells/Kg. Subjects will be followed in the study for a minimum of 2 years after FKC288 infusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment arm | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FKC288 | Drug | Administration of FKC288 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. 3 to 6 subjects are expected to be enrolled in each dose group according to observed DLT. |
| Measure | Description | Time Frame |
|---|---|---|
| The proportion of subjects with dose-limiting toxicity | The number of participants with dose limiting toxicity in each dose group and the type of dose limiting toxicity that occurred. | Within 28 days after FKC288 injection infusion |
| The proportion of subjects with adverse events | All adverse events were evaluated according to NCI-CTCAE v5.0 criteria. | Within 24 weeks after FKC288 injection infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects achieving hematologic response | The proportion of subjects who achieve any type of hematologic response according to the 2023 National Comprehensive Cancer Network (NCCN) systemic light-chain amyloidosis guidelines within 6 months after receiving FKC288 infusion. | Within 6 months after FKC288 injection infusion |
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Inclusion Criteria:
1) Absolute neutrophil count ≥ 1.0×109/L (use of granulocyte colony-stimulating factor (G-CSF) support is allowed, but must be without supportive treatment within 7 days before the examination); 2) Platelet count ≥ 75×109/L (no transfusion support [including component transfusion] or treatments aimed at raising platelets such as thrombopoietin [TPO] should be received within 7 days before the examination); 3) Hemoglobin ≥ 9 g/dl (no transfusion support [including component transfusion] should be received within 7 days before the examination); 4) Bilirubin value ≤ 1.5× upper limit of normal (ULN) (except bile duct obstruction caused by tumor compression); 5) Creatinine clearance rate ≥ 40 ml/min; 6) ALT or AST ≤ 2.5× ULN (≤5 times the upper limit of normal in patients with liver involvement); 7) Echocardiography results indicate left ventricular ejection fraction ≥ 50% with no significant pericardial effusion; 8) NTproBNP < 1800pg/ml, TNT < 0.06ng/ml; 9) Stable coagulation function: INR ≤ 1.5, APTT ≤ 1.2× ULN (excluding tumor-related anticoagulant therapy); 10) >95% basic blood oxygen saturation in the natural indoor air environments.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Xianghua Huang, MD | Contact | 86-25-80862002 | hxhszb@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Xianghua Huang, MD | Jinling Hospital, China | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jinling Hospital | Recruiting | Nanjing | Jiangsu | 210016 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41920709 | Derived | Huang X, Wu X, Chen W, Wang W, Xu W, Guo J, Zhao J, Xu X, Wang C, Shan A, Xu J, Liu Z. B -Cell Maturation Antigen-CD19 Dual-Targeted Chimeric Antigen Receptor- T -Cell Therapy for Relapsed or Refractory AL Amyloidosis. J Am Soc Nephrol. 2026 Apr 1. doi: 10.1681/ASN.0000001096. Online ahead of print. |
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| ID | Term |
|---|---|
| D000075363 | Immunoglobulin Light-chain Amyloidosis |
| ID | Term |
|---|---|
| D054219 | Neoplasms, Plasma Cell |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D000686 | Amyloidosis |
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| Proportion of subjects achieving organ response |
The proportion of subjects who achieve any type of organ response according to the 2023 National Comprehensive Cancer Network (NCCN) systemic light-chain amyloidosis guidelines within 2 years after receiving FKC288 infusion. |
| Within 2 years after FKC288 injection infusion |
| Progression-free survival (PFS) of all subjects | Time from the first FKC288 infusion to the first assessment of disease progression/relapse or death from any cause. | Within 2 years after FKC288 injection infusion |
| Overall survival (OS) of all subjects | Time from the first FKC288 infusion to death from any cause. | Within 2 years after FKC288 injection infusion |
| D057165 |
| Proteostasis Deficiencies |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D008232 | Lymphoproliferative Disorders |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D010265 | Paraproteinemias |