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The purpose of the study is to evaluate the safety and efficacy of CD20xCD3 T-cell engager (GB261) in patients with refractory seropositive systemic lupus erythematosus.
B cells play an important role in the pathogenesis of systemic lupus erythematosus (SLE). CD20 is a transmembrane receptor that is highly expressed on approximately 95% of B lineage cells. The use of anti-CD20 for B cell depletion represents a significant breakthrough in the treatment of B-cell-mediated autoimmune diseases. GB261 is a novel CD20/CD3 bispecific TCE that is designed to have very low affinity for CD3 and high affinity for CD20 to enable efficient T cell-mediated killing while minimizing risk of cytokine release syndrome (CRS). GB261 has shown promising safety and anti-tumor activity in a Phase 1/2 study in patients with relapsed/refractory B-cell non-Hodgkin lymphoma and chronic lymphocytic leukemia. GB261 offers a promising mechanism of action for SLE. This study aims to assess the safety, tolerability, PK, pharmacodynamics (PD), immunogenicity, and preliminary clinical activity of GB261 administered in patients with SLE. Patients will be invited to participate in the study, to receive GB261 intravenous infusion and monitored from the first dose of GB261 until Week 52.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GB261 intravenous intervention | Experimental | GB261 will be administered by intravenous infusion, including 3 escalating dose levels and subsequent dose expansion. Timepoint of treatment: Day 1, Day 8 and Day 15. Anticipated enrollment: 9-18 participants in Dose Escalation group; 10 participants in Dose Expansion group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GB261 | Biological | GB261 will be dosed according to the assigned group. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety and tolerability | Incidence and severity of TEAEs through end of study. Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are graded by ASTCT criteria, other AEs are assessed by CTCAE V5.0 criteria | Baseline to Month 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetics of GB261 | PK profiles and parameters, including Peak Plasma Concentration (Cmax), derived for GB261 | Baseline to Month 12 (Day1-4, 8-11, 15-18, 22, 29, 36 Week 8, 52) |
| Pharmacokinetics of GB261 |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacodynamics of GB261 | Changes from baseline in CD19+ B cells counts. | Baseline to Month 12(Screening, Day1, Day 8, 15, 22, 29, 36, Week 8, 16, 24, 36, 52) |
| Pharmacodynamics of GB261 | Changes from baseline in inflammatory cytokines. |
Inclusion Criteria:
Additional Inclusion Criteria for SLE with Active LN
SLE patients with active LN are eligible to be included in the study only if all of the following additional criteria apply:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Qiubai Li, Professor | Contact | 85726808 | 027 | qiubaili@hust.edu.cn |
| Di Wu | Contact | +8618790696175 | 86 | 373181302@qq.com |
| Name | Affiliation | Role |
|---|---|---|
| Qiubai Li, Professor | Union Hospital, Tongji Medical College, Huazhong University of Science and Technology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wuhan Union Hospital | Wuhan | Hubei | 430000 | 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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PK profiles and parameters, including Area under the plasma concentration versus time curve (AUC), derived for GB261
| Baseline to Month 12 (Day1-4, 8-11, 15-18, 22, 29, 36 Week 8, 52) |
| Pharmacokinetics of GB261 | PK profiles and parameters, including Time to Maximum Concentration (Tmax) derived for GB261 | Baseline to Month 12 (Day1-4, 8-11, 15-18, 22, 29, 36 Week 8, 52) |
| Pharmacokinetics of GB261 | PK profiles and parameters, including Half-life (t½), derived for GB261 | Baseline to Month 12 (Day1-4, 8-11, 15-18, 22, 29, 36 Week 8, 52) |
| Baseline to Month 12(Screening, Day1, Day 8, 15, 22, 29, 36, Week 52) |
| Immunogenicity of GB261 | Proportion of patients with ADAs before and after treatment | Baseline to Month 12 (Day1, Day 8, 15, 22, 29, 36, Week 8, 12, 16, 24, 52) |
| Patient-reported outcomes | Change from baseline through Week 52 in Health Assessment Questionnaire - Disability Index (HAQ-DI). Range [0, 3], higher score represents more severe disability. | Baseline to Month 12 (Screening, Day1, Day 8, 15, 29, Week 8, 12, 16, 24, 36, 52) |
| Effect on affected tissues | Changes from baseline in cellular composition. Lymph node biopsy or Bone marrow biopsy. | From the baseline to Month 12 (Screening and Day 29). |
| Clinical activity of GB261 | Change from baseline in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Range[0, 105], higher score represents worse disease activity | Baseline to Month 12 (Screening, Day1, Day 8, 15, 29, Week 8, 12, 16, 24, 36, 52) |