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| Name | Class |
|---|---|
| Second Affiliated Hospital, School of Medicine, Zhejiang University | OTHER |
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This is a single-arm, open, dose-increasing and dose-expanding phase I clinical trial to investigate the safety, tolerability and cytodynamic characteristics of MC-1-50 cell preparation, and to preliminatively observe the efficacy of MC-1-50 cell preparation in patients with refractory SLE, and to explore the applicable dose regimen for phase II clinical trials.
Based on the specific CD19-targeting CAR-T developed by PrimeCARTM platform, the cell preparation time is about 3 days, which can greatly shorten the waiting time of patients, improve production efficiency and reduce production costs.At the same time, MC-1-50 products contain a high proportion of T naive cells, which can play a therapeutic role at a very low infusion dose and improve safety.
In this study, three dose groups were composed of 0.3×10^5/kg, 1×10^5/kg and 3×10^5/kg CAR-positive cells, respectively.All subjects received only one infusion of MC-1-50 cells.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MC-1-50 | Experimental | Patients will be be treated with CD19 CAR- T cells |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MC-1-50 | Biological | A single infusion of CD19 CAR-T cells will be administered intravenously after lymphodepletion chemotherapy |
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| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] | Dose-limiting toxicity after CD19 CAR-T cell infusion | 1 month |
| Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] | The incidence of adverse events after CAR-T cell infusion was assessed by the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, version 5.0) | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Validity endpoint of MC-1-50 cells [Efficacy] | 3M SRI-4 response rate, 6M LLDAS, DORIS response rate,SLEDAI-2K score, PGA, and BILAG-2004 change from baseline | 3 months |
| AUCS of MC-1-50 cells [Cell dynamics] |
| Measure | Description | Time Frame |
|---|---|---|
| Response rate after MC-1-50 infusion [Long-term Efficacy] | The DORIS response rate, LLDAS maintenance rate, and SRI-4 response rate at the remaining sites after reinfusion when other drugs (including hormones, hydroxychloroquine, immunosuppressants, and biologics) were discontinued.And changes from baseline in SLEDAI-2K scores, PGA scores, BILAG-2004 scores, and serological indicators, including anti-DSDNA, anti-nuclear antibodies, and complement C3 and C4 levels |
Inclusion Criteria:
The patient or their guardian agrees to participate in this clinical trial and sign the ICF, indicating their understanding of the purpose and procedures of this clinical trial and willingness to participate in the study;
Age ≥ 18 years old , gender not limited;
Patients diagnosed with SLE according to the 2019 EULAR/ACR classification criteria,And by hydroxychloroquine, sufficient glucocorticoid (≥1mg/kg/d prednisone or equivalent amount of other hormones), to less than 2Treatment with immunosuppressants (including cyclophosphamide, motecophanate, azathioprine, methotrexate, cyclosporine, tacrolimus, sirolimus, leflunomide, etc.), and at least one approved biological agent (including titacept, Beliuzumab, etc.), with a total duration of treatment ≥3 months, still in a disease active state, or unable to tolerate conventional therapy;
SLEDAI-2K score ≥7 points;
Autoantibody test results are positive: ANA antibody positive and/or serum anti-DSDNA positive;
Adequate renal, hepatic, pulmonary and cardiac function defined as:
No serious mental disorders;
Meet standards for apheresis or venous blood collection, and no other cell collection contraindications;
Women of childbearing age who have a negative blood pregnancy test and all subjects agree to use reliable and effective contraceptive methods (excluding safe period contraception) for contraception within one year after receiving MC-1-50 cell infusion from the time of signing the informed consent form. Including but not limited to: abstinence, implantable progestogen contraceptives that can inhibit ovulation; Intrauterine device (IUD); Intrauterine hormone release system; Spouse vasectomy; Compound hormone contraceptives that can inhibit ovulation (oral, vaginal, and transdermal); Progesterone contraceptives (oral or injectable) that can inhibit ovulation; When male subjects have sex with fertile women, they must agree to use barrier contraception (such as condom plus spermicidal foam/gel/film/emulsion/suppository). At the same time, participants should commit not to donate eggs (oocytes, oocytes) or sperm for assisted reproduction within one year after cell infusion.
Exclusion Criteria:
There were severe active central nervous system lupus that required therapeutic intervention at the time of screening;
Acute severe nephritis: had or was undergoing renal replacement therapy within 3 months prior to reinfusion, or had significant renal deterioration that the investigator believed was likely to cause the subject to require high doses of corticosteroids (prednisone ≥1mg/kg/ day or equivalent of other hormones), cyclophosphamide, or mycophanate during the first 3 months of the study;Clinical stable lupus nephritis that can be controlled during screening can be considered;
There were other lupus crises that were not controlled at the time of screening;
Individuals who have received CAR-T therapy or other gene modified cell therapies;
Combined with other autoimmune diseases requiring systemic treatment;
HBsAg or HBcAb positive and HBV DNA test greater than the normal range;HCV antibody positive and HCV RNA detection greater than the normal range;HIV antibody positive;Treponema pallidum antibody positive;
Suffered from any of the following heart diseases:
Uncontrollable infection in the 1 weeks before enrollment;
History of solid organ transplantation or hematopoietic stem cell transplantation prior to screeningï¼›
Cerebrovascular accident or seizure occurred within 6 months prior to screeningï¼›
Deep vein or deep artery embolism event within the past 6 months prior to screening;
history of malignant neoplasms (other than tumors with no active lesion and ending treatment > 2 years ago, and adequately treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after radical surgery, and ductal carcinoma in situ after radical surgery);
(attenuated) Live vaccine ≤ 4 weeks prior to screening;
Have participated in other clinical trials within one month or five drug half lives (whichever is shorter) before enrollment;
Women who are pregnant or breastfeeding, and male or female subjects who plan to have children within 1 year after receiving MC-1-50 cell infusion;
Other situations considered by the investigator to be unsuitable to participate in the study.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jing Xue, M.D. | Contact | +8613858121751 | xuej@zju.edu.cn | |
| Zhu Chen, M.D. | Contact | +8613956963042 | doczchen@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) | Recruiting | Hefei | Anhui | China |
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| ID | Term |
|---|---|
| D008180 | Lupus Erythematosus, Systemic |
| ID | Term |
|---|---|
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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AUCS is defined as the area under the curve in 28/90 days
| 3 months |
| CMAX of MC-1-50 cell preparation [Cell dynamics] | CMAX is defined as the highest concentration of MC-1-50 cells expanded in peripheral blood | 3 months |
| TMAX of MC-1-50 cell preparation[Cell dynamics] | TMAX is defined as the time to reach the highest concentration | 3 months |
| Pharmacodynamics of MC-1-50 cell preparation[Cell dynamics] | The clearance degree of CD19-positive B cells in peripheral blood was detected by flow cytometry at the visit points specified in the research protocol | 3 months |
| Immunogenicity of pCAR-19B cells | The anti-CAR antibody was detected by ELISAt the visit points specified in the research protocol | 3 months |
| 2 years |
| The rebuilding of the immune system | Proportion of B-cell subtypes at each site and their association with reduced disease activity | 2 years |
| The Second Affiliated Hospital of Zhejiang University School of Medicine | Recruiting | Hangzhou | Zhejiang | China |
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