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This multi-center, open-label, Phase 1/2 study aims to evaluate the safety, tolerability, and preliminary efficacy of C-CAR168, an autologous anti-CD20/BCMA CAR-T therapy, in patients with autoimmune diseases refractory to standard treatments. The study includes both dose escalation and dose expansion phases, with participants grouped into condition-specific cohorts.
The purpose of this study is to:
Participants will be asked to:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 2: Dose Level 1 (DL1) | Experimental | Dose: 0.75 × 10⁶ CAR+ cells/kg Starting dose for escalation phase. First 3 subjects must be staggered by 28 days. |
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| Arm 3: Dose Level 2 (DL2) | Experimental | Dose: 1.5 × 10⁶ CAR+ cells/kg Second dose level in escalation phase. Subject enrollment staggered by 28 days. |
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| Arm 1: Dose Level -1 (DL-1) | Experimental | 0.5 × 10⁶ CAR+ cells/kg Optional dose level, administered only upon Safety Review Committee (SRC) recommendation. |
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| Arm 4: Dose Level 3 (DL3) | Experimental | Dose: 2.0 × 10⁶ CAR+ cells/kg Optional dose level pending SRC review and approval. |
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| Arm 5: Dose Expansion Cohort | Experimental | Dose: To be selected based on MTD/RD identified in escalation phase. 12-24 additional subjects will be treated at the selected dose level. No staggered dosing required. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| C-CAR168 | Biological | This is a multi-center, Phase 1/2, open-label, dose-escalation and dose-expansion study evaluating C-CAR168 for the treatment of autoimmune diseases refractory to standard therapy. A traditional 3+3 design is used to identify the Maximum Tolerated Dose (MTD) and/or Recommended Dose (RD) in disease-specific cohorts. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Adverse Events or Dose Limiting Toxicities | The number and severity of Adverse Events (AE) and Serious Adverse Events (SAE), including dose limiting toxicities (DLTs) will be recorded. | Up to 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the efficacy of C-CAR168 | Proportion of subjects meeting the KDIGO 2024 Clinical Practice Guidelines' Definition of Remission, which includes complete response, primary efficacy renal response, or partial response. | Up to 24 months |
| To evaluate the efficacy of C-CAR168 |
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Inclusion Criteria:
Informed Consent: Voluntary signed consent required.
Age & Gender: Males and females, 18-70 years old.
Diagnosis: Clinical diagnosis of SLE per EULAR/ACR criteria for at least 6 months.
Lupus Nephritis (LN): Biopsy-confirmed active proliferative LN (Class III/IV ± V) within the past 12 months.
Refractory Disease:
Disease Activity at Screening:
Autoantibody Status:
o Positive ANA (≥1:80), anti-dsDNA (≥30 IU/mL), and/or anti-Smith antibody.
Infection Status: No active infection within 2 weeks before leukapheresis.
Life Expectancy: Greater than 6 months.
Adequate Organ Function:
Pregnancy & Contraception:
Exclusion Criteria:
Any other concomitant diseases requiring long term systemic steroids (oral or intravenously) treatment that may confound the interpretation of study results or have interference with background steroid tapering for the subjects.
Any of the following:
Have an uncontrolled active infection.
History of major organ transplantation (such as heart, lung, liver, kidney) or history of bone marrow/hematopoietic stem cell transplantation.
History of any of stroke, unstable angina, myocardial infarction, congestive heart failure (NYHA Class III or IV), severe cardiomyopathy or ventricular arrhythmia requiring medication or mechanical control within 6 months of screening.
History of ≥ Grade 2 bleeding within the past 30 days.
Received a live vaccine within 4 weeks prior to signing the ICF.
Received any of the following treatments:
Pregnant or breastfeeding women.
History of seizure disorder, cerebrovascular ischemia/hemorrhage, dementia or cerebellar disease or other severe neuropsychiatric syndromes.
History of deep vein thrombosis or pulmonary embolism within six months of infusion (line associated DVT is allowed)
Diagnosed with malignant tumors within 5 years prior to signing the ICF, with the following exceptions: non-melanoma skin cancer that has been treated with radical therapy, localized prostate cancer, biopsy-confirmed cervical carcinoma in situ or squamous intraepithelial lesions detected by cervical smear, and completely excised breast carcinoma in situ.
Poor compliance, unwilling or unable to adhere to the study protocol based on the investigator's assessment.
Allergies to fludarabine, cyclophosphamide and/or known allergies to excipients of C-CAR168 cell product.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yihong Yao, PhD | Contact | 301-785-6047 | clinicaltrials@abelzeta.com | |
| Nurat Quadri, MS | Contact | 2405525870 | clinicaltrials@abelzeta.com |
| Name | Affiliation | Role |
|---|---|---|
| Scott Antonia | Duke University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| AbelZeta, Inc. | Rockville | Maryland | 20850 | United States |
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| ID | Term |
|---|---|
| D008181 | Lupus Nephritis |
| D008180 | Lupus Erythematosus, Systemic |
| ID | Term |
|---|---|
| D005921 | Glomerulonephritis |
| D009393 | Nephritis |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
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This study uses a 3+3 dose escalation design to determine the Maximum Tolerated Dose (MTD) and/or Recommended Dose (RD) of C-CAR168. Subjects in each dose level will be enrolled sequentially with a minimum 28-day interval between infusions. Upon completion of dose escalation, 12-24 additional subjects may be enrolled in a dose expansion phase, pending Safety Review Committee (SRC) approval. No staggering is required during the expansion phase.
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|
Proportion of subjects achieving SLEDAI-2K response over time. |
| Up to 24 months |
| To evaluate the efficacy of C-CAR168 | Proportion of subjects achieving British Isles Lupus Assessment Group (BILAG)(BILAG) response over time. | Up to 24 months |
| Renal Related Events | Record any renal related events during the study, including disease flare and the time to the event. | Up to 24 months |
| Time to Response | The number of days to response from the infusion of C-CAR0168 to the first recorded remission. | Up to 24 months |
| Corticosteroid use | The number of patients who achieved a low dose of steroids or no longer require. | Up to 24 months |
| To characterize the cellular kinetics of C-CAR168 | Level of C-CAR168 positive cells in the blood. | Up to 24 months |
| To assess immunogenicity of C-CAR168 | Presence of C-CAR168 antibodies. | Up to 24 months |
| To evaluate the efficacy of C-CAR168 | Proportion of subjects whose for Physician Global Assessment (PGA) score does not worsen over time. | Up to 24 months |
| To evaluate the efficacy of C-CAR168 | Proportion of subjects achieving a predefined score on the Visual Analog Scale (VAS) at specified time points. Efficacy will be assessed by evaluating changes in pain intensity as perceived by subjects, using the Visual Analog Scale (VAS). Subjects will rate their pain intensity on a scale from 0 (no pain) to 10 (worst imaginable pain). This will provide a subjective measure of pain severity over the course of the study. | Up to 24 months |
| To assess changes for reported health-related quality of life, overall health status | To assess changes from baseline for Functional Assessment of Chronic Illness Therapy (FACIT). The 13-item questionnaire will measure the level of fatigue and its impact on daily functioning. Higher scores reflect less fatigue and better overall energy levels. | Up to 24 months |
| To assess changes for reported health-related quality of life, overall health status | To assess changes from baseline for SF-36 (Short Form Health Survey). Efficacy will be assessed by evaluating changes in quality of life using the SF-36. Higher scores indicate better overall health and quality of life. | Up to 24 months |
| D052776 |
| Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |