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Type 1 diabetes mellitus (T1DM) is a T cell-mediated autoimmune disease characterized by autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency and lifelong dependence on exogenous insulin. The disease results from loss of immune tolerance, with autoreactive T-cell responses against beta-cell antigens, and is typically associated with islet autoantibodies and insulitis. Although insulin therapy remains the standard of care, it does not correct the underlying autoimmune process.
Non-insulin therapeutic strategies for T1DM are mainly directed toward immunomodulation and beta-cell replacement or regeneration. Among immunomodulatory approaches, previous studies have primarily focused on regulation of effector T cells and B cells. Novel immune-based therapies are needed to explore whether modulation of pathogenic immune cell populations may alter disease activity and preserve residual beta-cell function.
The purpose of this study is to evaluate the safety, preliminary efficacy, and cellular kinetics of an allogeneic CD7-targeted CAR-T cell injection in participants with early stage T1DM. Participants will receive the investigational product and undergo regular assessments of safety, tolerability, treatment-emergent adverse events, cellular kinetics, glycemic parameters, exogenous insulin requirement, beta-cell function, and immunologic biomarkers. This study is expected to generate preliminary clinical evidence regarding the feasibility and potential therapeutic effects of CD7-targeted CAR-T cell therapy in T1DM.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Allogeneic CD7-Targeted CAR-T Cell (RD13-02) Injection for the Treatment of T1DM | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Allogeneic CD7-Targeted CAR-T Cell Injection | Biological | RD13-02 will be administered as a single intravenous infusion using a dose-escalation design. The starting dose is dose level 1 (DL1, 5×10^7). If no dose-limiting toxicity (DLT) is observed within 28 days after infusion, dose escalation will proceed to dose level 2 (DL2, 1×10^8). If a DLT is observed, the cohort will be expanded to 6 participants and subsequent dose decisions will follow the standard 3+3 design. The study will be terminated if 2 participants experience DLTs at DL1. If DL1 shows acceptable safety and strong biological activity, the DL2 cohort may be omitted and expansion may proceed at DL1. The planned enrollment is up to 9 participants. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety: Incidence of dose-limiting toxicities (DLTs), adverse events (AEs), serious adverse events (SAEs), and adverse events of special interest (AESIs) in participants with type 1 diabetes mellitus treated with RD13-02. | From the date of signing informed consent to 3 months after CAR-T cell infusion. | |
| Change from baseline in 4-hour MMTT C-peptide AUC at Months 3, 6, and 12. | From baseline to Month 12. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in peak C-peptide during a mixed-meal tolerance test (MMTT) at Months 3, 6, and 12. | From baseline to Month 12. | |
| Change from baseline in blood glucose area under the curve (AUC) during a mixed-meal tolerance test (MMTT) at Months 3, 6, and 12. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jingjing JIANG, MD, PhD | Contact | 86-021-64041990 | jiang.jingjing@zs-hospital.sh.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhongshan Hospital, Fudan University | Recruiting | Shanghai | 201508 | China |
All IPD that underlie results in a publication.
After publication.
IPD and supporting information will be avaible to researchers upon reasonable request (e.g. with a practical and meaningful research proposal).
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| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| From baseline to Month 12. |
| Change from baseline in mean daily dose of exogenous insulin at Months 1, 3, 6, 9, and 12. | From baseline to Month 12. |
| Change from baseline in glycated hemoglobin (HbA1c) at Months 3, 6, 9, and 12. | From baseline to Month 12. |
| Change from baseline in fasting blood glucose at Months 1, 3, 6, 9, and 12. | From baseline to Month 12. |
| Change from baseline in time in range (TIR, %) on continuous glucose monitoring (CGM), defined as the percentage of time with glucose levels between 70-180 mg/dL (3.9-10.0 mmol/L), at Months 3, 6, and 12. | From baseline to Month 12. |
| Proportion of participants with HbA1c ≤7.0% and a reduction of ≥50% in insulin dose at Month 12. | Month 12. |
| Proportion of participants with MMTT C-peptide AUC >0.2 nmol/L at Month 12. | Month 12. |
| Incidence of clinically significant hypoglycemic events during the study period. | From baseline to Month 12. |
| Incidence of diabetic ketoacidosis (DKA) events. | From baseline to Month 12. |
| Expansion and persistence of RD13-02 in participants with type 1 diabetes mellitus. | From infusion through Month 12. |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |