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Systemic lupus erythematosus (SLE) is the most common systemic autoimmune disease in China. The kidneys are the organ most frequently affected in SLE and a major cause of mortality among SLE patients. Currently, cell-based therapy has emerged as an innovative treatment approach for SLE. CHT105 injection is an allogeneic chimeric antigen receptor T (CAR-T) cell product derived from healthy donors' T cells, which are transduced with a lentiviral vector encoding an anti-CD19/CD70 CAR. This engineered T-cell product effectively recognizes and eliminates immune cells expressing CD19 and/or CD70 antigens-including autoreactive T and B cells-and holds promise as a novel therapeutic option for patients with refractory lupus nephritis (LN).
This study is a clinical trial evaluating the safety and preliminary efficacy of CHT105 injection-a CD19/CD70-targeting allogeneic CAR-T cell product-in adult patients with relapsed or refractory LN. Eligible participants will first undergo lymphodepleting preconditioning. Following confirmation of eligibility per standard infusion criteria, participants will receive a single intravenous infusion of CHT105 on Day 0 (D0). After CHT105 infusion, participants will undergo a 52-week short-term follow-up and up to a 15-year long-term follow-up.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| anti-CD19/CD70 CAR T cells(CHT105) | Experimental | All subjects will receive fludarabine/cyclophosphamide lymphodepletion followed by CHT105 infusion. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| anti-CD19/70 CAR T cells (CHT105) | Biological | All subjects will receive fludarabine/cyclophosphamide lymphodepletion followed by CHT105 infusion. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety of CHT105 Injection in Subjects with Refractory Lupus Nephritis |
| From enrollment to the end of treatment at 52 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Complete Renal Response (CRR) | Evaluated only in participants with lupus nephritis; participants meeting all the following criteria are considered to have achieved CRR: Urinary protein excretion <0.5 g/24 h or urine protein-to-creatinine ratio (UPCR) <0.5 g/g; Estimated glomerular filtration rate (eGFR) decline ≤10-15% from baseline or eGFR ≥60 mL/min/1.73 m²; No use of rescue medications exceeding protocol-specified thresholds prior to assessment. |
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Inclusion Criteria:
Exclusion Criteria:
Individuals with a history of severe drug allergy or allergic constitution;
Presence of, or suspicion of, uncontrolled fungal, bacterial, viral, or other infections requiring hospitalization or intravenous therapy within one month prior to baseline;
Any of the following cardiovascular or cerebrovascular events within six months prior to screening: unstable angina requiring hospitalization, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention (diagnostic coronary angiography is permitted), moderate-to-severe congestive heart failure (NYHA Class III or IV), atrial or ventricular arrhythmias requiring hospitalization (e.g., atrial fibrillation, ventricular tachycardia), implantation of a pacemaker or defibrillator, cerebrovascular accident (e.g., stroke), or planned coronary artery bypass surgery or vascular reconstruction during the trial;
Participants with congenital immunoglobulin deficiency;
History of malignancy within the past five years (except for basal cell carcinoma, localized cutaneous squamous cell carcinoma, cervical carcinoma in situ, or thyroid carcinoma, all of which must have been definitively cured for at least one year);
Participants with end-stage renal failure;
Active tuberculosis risk at screening, regardless of whether adequate treatment has been completed-including signs or symptoms of active tuberculosis as judged by the investigator at screening (e.g., fever, cough, night sweats, weight loss); or evidence of active pulmonary tuberculosis on chest imaging (e.g., chest X-ray or chest CT scan) performed at screening or at any time within six months prior to screening;
Participants who are positive for hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (HBcAb), with peripheral blood HBV DNA levels exceeding the upper limit of quantification; participants who are positive for hepatitis C virus (HCV) antibody and peripheral blood HCV RNA; participants who are positive for human immunodeficiency virus (HIV) antibody; or participants with a positive syphilis test;
At screening, organ function must meet the following criteria:
a) Bone marrow function: i. Absolute neutrophil count < 0.8 × 10⁹/L (within two weeks prior to assessment, without administration of colony-stimulating factors, except in cases attributable to SLE); ii. Hemoglobin < 60 g/L (except in cases attributable to SLE); b) Hepatic function: ALT > 3 × ULN; AST > 3 × ULN; total bilirubin (TBIL) > 1.5 × ULN; c) Renal function: creatinine clearance (CrCl) < 30 mL/min (calculated using the Cockcroft-Gault formula, except in cases attributable to SLE); d) Coagulation function: international normalized ratio (INR) > 1.5 × ULN or prothrombin time (PT) > 1.5 × ULN;
Presence of psychiatric disorders or severe cognitive impairment (excluding neuropsychiatric SLE);
Participation in another clinical trial within one month prior to enrollment;
Pregnant women or women planning pregnancy;
Participants deemed ineligible for this study by the investigator for any other reason.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School | Nanjing | Jiangsu | 210008 | China |
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| ID | Term |
|---|---|
| D008180 | Lupus Erythematosus, Systemic |
| D008181 | Lupus Nephritis |
| ID | Term |
|---|---|
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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| at Week 24 after CHT105 infusion. |
| Partial Renal Response (PRR) | Evaluated only in participants with lupus nephritis; participants meeting all the following criteria are considered to have achieved PRR: eGFR decline ≤10-15% from baseline or eGFR ≥60 mL/min/1.73 m²; Improvement in 24-hour UPCR:
No use of rescue medications exceeding protocol-specified thresholds prior to assessment. | At at Week 24 after CHT105 infusion. |
| Primary Efficacy Renal Response (PERR) | Evaluated only in participants with lupus nephritis; participants meeting all the following criteria are considered to have achieved PERR: UPCR ≤0.7 g/g; eGFR decline ≤20% from baseline or eGFR ≥60 mL/min/1.73 m²; No use of rescue medications exceeding protocol-specified thresholds prior to assessment. | At at Week 24 after CHT105 infusion. |
| Overall Renal Response (ORR) | Evaluated only in participants with lupus nephritis, encompassing those achieving either complete renal response (CRR) or partial renal response (PRR). | At at Week 24 after CHT105 infusion. |
| CRR, PRR, or PERR, and overall response rate | percentage of participants achieving CRR, PRR, or PERR, and overall response rate (i.e., percentage achieving either CRR or PRR) | At each follow-up visit between the first dose and Week 52. |
| the Systemic Lupus Erythematosus Responder Index-4 (SRI-4) criteria | Trial participants who meet all of the following criteria are considered to have achieved the SRI response:
| At each follow-up visit between the first dose and Week 52. |
| D005921 | Glomerulonephritis |
| D009393 | Nephritis |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |