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The study was withdrawn prior to site activation and before enrollment of any participants due to sponsor decision to reprioritize the development portfolio.
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RESET-MS: A Phase 1/2 Open-Label Study to Evaluate the Safety and Efficacy of Autologous CD19-specific Chimeric Antigen Receptor T cells (CABA-201) in Participants with Multiple Sclerosis
This is a Phase 1/2, open-label study designed to evaluate the safety, tolerability, and efficacy of different doses of CABA-201 in adult participants with MS to determine an appropriate dose for future studies. Any participant who receives CABA-201 will be followed after infusion for 156 weeks. Two cohorts of participants will be studied based upon their MS diagnosis.
The study will consist of 2 parts: Part A (dose escalation) and Part B (dose expansion).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Relapsing MS Cohort | Experimental |
| |
| Progressive MS Cohort | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CABA-201 | Biological | Single intravenous infusion of CABA-201 following preconditioning with fludarabine and cyclophosphamide |
|
| Measure | Description | Time Frame |
|---|---|---|
| Primary (Part A: Dose Escalation) incidence and severity of adverse events | An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal result of an investigation), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. The term AE is used to include both serious and non-serious AEs. | Up to 28 days after CABA-201 infusion |
| Primary (Part B: Dose Expansion) incidence of and severity of adverse events in order to confirm the dose(s) of CABA-201 | An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal result of an investigation), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. The term AE is used to include both serious and non-serious AEs. | Up to 28 days after CABA-201 infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Part A and Part B: To evaluate the incidence and severity of adverse events | An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal result of an investigation), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. The term AE is used to include both serious and non-serious AEs. |
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Inclusion Criteria
The main inclusion criteria include the following:
Able to provide informed consent.
Age ≥18 and ≤60 years of age.
Diagnosis of MS per the revised 2017 McDonald criteria (Thompson et al, 2018).
For participants with relapsing forms of MS only (RMS Cohort):
For participants with progressive forms of MS only (PMS cohort):
Clinical stability by vital signs assessment at the time of screening
Exclusion Criteria
The main exclusion criteria include the following:
History of fulminant MS
Clinically significant concomitant central nervous system pathologies which, in the Investigator's judgement, may confound the ability to interpret study results or complicate identification or evaluation of neurotoxicity, including but not limited to:
Active, inflammatory autoimmune disorder other than MS requiring immunomodulatory therapies
a. Positive human immunodeficiency virus (HIV), hepatitis C virus (HCV) antibody, or hepatitis B surface antigen test, or evidence of active or chronic tuberculosis (TB) at Screening or other chronic viral infections as described in the protocol
Use of the following therapies:
Known malignancy or a history of malignancy
Current symptoms of severe, progressive, or uncontrolled renal, hepatic, hematological, gastrointestinal, pulmonary, psychiatric, cardiac, or concomitant neurological disease, including severe (requiring medical intervention) and uncontrolled infections
Chronic pulmonary disease
Impaired cardiac function or clinically significant cardiac disease
Prior engineered T cell therapy involving permanent gene modification
Prior solid organ (heart, liver, kidney, lung) transplant or hematopoietic stem cell transplant.
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| Name | Affiliation | Role |
|---|---|---|
| Medical Monitor | Cabaletta Bio | Study Chair |
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| Up to 156 weeks after CABA-201 infusion |
| Part A and Part B: To characterize the pharmacodynamics (PD) | Levels of B cells in the blood | Up to 156 weeks after CABA-201 infusion |
| Part A and Part B: To characterize the pharmacokinetics (PK) | Levels of CABA-201-positive T cells in the blood | Up to 156 weeks after CABA-201 infusion |
| Part A and Part B: To evaluate disease related biomarkers | Levels of MS biomarkers in the blood and CSF | Up to 156 weeks after CABA-201 infusion |
| Part A and Part B: To evaluate the effects of CABA-201 on MS disease activity as measured by Magnetic Resonance Imaging (MRI) | Incidence of accumulated MS-related lesions | Up to 156 weeks after CABA-201 infusion |
| Part A and Part B: The effects of CABA-201 on MS disease activity as measured by EDSS | The EDSS is a scale for assessing neurologic impairment in MS. Values are from 0 points (normal neurological examination) up to 10 points (death). Higher scores represent increased disability. | Up to 156 weeks after CABA-201 infusion |
| Part A and Part B: To evaluate the effect of CABA-201 on use of subsequent MS-related therapy | Proportion of participants who require no subsequent MS-related immunomodulatory therapy | Up to 156 weeks after CABA-201 infusion |
| Part A and Part B: To evaluate the effect of CABA-201 on patient reported and health outcomes as measured by SF-36 v2 | Change in SF-36 v2 | Up to 156 weeks after CABA-201 infusion |
| ID | Term |
|---|---|
| D020528 | Multiple Sclerosis, Chronic Progressive |
| D020529 | Multiple Sclerosis, Relapsing-Remitting |
| D009103 | Multiple Sclerosis |
| D001327 | Autoimmune Diseases |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
| D007154 | Immune System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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