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This is a Phase I/II, multicenter study designed to evaluate the safety, tolerability, and preliminary efficacy of GKL-006RTU injection in participants with moderate to severe Acute Respiratory Distress Syndrome (ARDS).
The study consists of two parts:
Phase I is a single-arm, open-label study. Eligible participants will receive a single intravenous infusion of GKL-006RTU injection (1 bag or 3 bags, containing approximately 5.0±0.5×10^8 invariant natural killer T (iNKT) cells per bag) in addition to standard background treatment. The primary objective of this phase is to assess the safety and tolerability of the investigational product.
Phase II is a randomized, double-blind, placebo-controlled study. Based on the results from Phase I, participants will receive GKL-006RTU injection or placebo via intravenous infusion, in addition to standard background treatment. The primary objective of this phase is to evaluate the efficacy of GKL-006RTU injection in treating moderate to severe ARDS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phase I: GKL-006RTU injection (1 or 3 Bags) | Experimental | A single-arm, open-label dose-escalation study. Dose Level 1: 1 bag of GKL-006RTU injection (25 mL/bag, containing 5.0±0.5×10^8 iNKT cells). Dose Level 2: 3 bags of RTU injection (25 mL/bag, containing 5.0±0.5×10^8 iNKT cells per bag). Dose escalation follows the '3+3' design based on dose-limiting toxicities (DLTs) observed within a 28-day safety window. All participants will receive standard of care background therapy as per clinical guidelines, including restrictive fluid management and lung-protective ventilation strategies. Supportive care medications (for example, antibiotics, albumin, diuretics) and organ support will be administered at the investigator's discretion based on individual patient needs. |
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| Phase II: GKL-006RTU Injection | Experimental | Participants in this arm will receive the Recommended Phase II Dose of GKL-006RTU injection . This is a randomized, double-blind portion of the study. All participants will receive standard of care background therapy as per clinical guidelines, including restrictive fluid management and lung-protective ventilation strategies. Supportive care medications (for example, antibiotics, albumin, diuretics) and organ support will be administered at the investigator's discretion based on individual patient needs. |
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| Phase II: Placebo | Placebo Comparator | Participants in this arm will receive matching placebo. They will be randomized in a 1:1 ratio to the GKL-006RTU injection arm. The study is double-blind. All participants will receive standard of care background therapy as per clinical guidelines, including restrictive fluid management and lung-protective ventilation strategies. Supportive care medications (for example, antibiotics, albumin, diuretics) and organ support will be administered at the investigator's discretion based on individual patient needs. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GKL-006RTU injection | Drug | iNKT cell injection |
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| Measure | Description | Time Frame |
|---|---|---|
| Phase I: Incidence and Severity of Adverse Events and Serious Adverse Events | To evaluate the safety and tolerability of GKL-006RTU injection in participants with moderate-to-severe Acute Respiratory Distress Syndrome (ARDS). Safety will be assessed throughout the study duration, from Day 1 to Day 180. | Day 1 to Day 180 |
| Phase II: Difference in Ventilator-Free Days within 28 Days Compared to Placebo | To evaluate the efficacy of GKL-006RTU injection compared to placebo in participants with moderate-to-severe ARDS. The primary efficacy endpoint is the difference in ventilator-free days (days alive and free from mechanical ventilation) within 28 days post-treatment between the GKL-006RTU injection group and the placebo group. | Day 1 to Day 28 |
| Measure | Description | Time Frame |
|---|---|---|
| Phase I: All-cause Mortality at Day 1 to Day 28, Day 90, and Day 180 | To assess the all-cause mortality rate in participants treated with GKL-006RTU injection at Day 1 to Day 28, Day 90, and Day 180. | Day 1 to Day 28, Day 90, and Day 180 |
| Phase I: Ventilator-Free Days, ICU-Free Days, and Organ Support-Free Days within Day 1 to Day 28 |
| Measure | Description | Time Frame |
|---|---|---|
| [Phase I & II] Immunogenicity Assessment: Anti-MHC Antibodies and Donor-Specific Antibodies (DSA) | Detection of allogeneic antibodies against Major Histocompatibility Complex (MHC) Class I and Class II. If positive, the Mean Fluorescence Intensity (MFI) of Donor-Specific Antibodies (DSA) will be measured. This applies to both Phase I and Phase II cohorts. | Day 1, Day 14, Day 28, and Day 90 |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Bin Du, M.D. | Contact | +86-10-69151188 | dubin98@gmail.com |
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There are no plans to share individual participant data at this time.
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| ID | Term |
|---|---|
| D055371 | Acute Lung Injury |
| ID | Term |
|---|---|
| D055370 | Lung Injury |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| Placebo | Drug | Matching placebo for GKL-006RTU injection |
|
To evaluate the number of days alive and free from mechanical ventilation, intensive care unit (ICU) stay, and organ support from Day 1 to Day 28. |
| Day 1 to Day 28 |
| Phase I: Change in Arterial Partial Pressure of Oxygen/Fraction of Inspired Oxygen Ratio (PaO2/FiO2) from Baseline | The ratio is calculated by dividing the arterial partial pressure of oxygen by the fraction of inspired oxygen. Measurements will be taken at baseline and various time points from Day 1 to Day 28. | Day 1 to Day 28 |
| Phase I: Change in Arterial Potential of Hydrogen (pH) from Baseline | To evaluate the change in arterial pH from baseline at various time points from Day 1 to Day 28. | Day 1 to Day 28 |
| Phase I: Change in Arterial Partial Pressure of Oxygen (PaO2) from Baseline | To evaluate the change in arterial partial pressure of oxygen (PaO2) from baseline at various time points from Day 1 to Day 28. | Day 1 to Day 28 |
| Phase I: Change in Arterial Partial Pressure of Carbon Dioxide (PaCO2) from Baseline. | To evaluate the change in arterial partial pressure of carbon dioxide (PaCO2) from baseline at various time points from Day 1 to Day 28. | Day 1 to Day 28 |
| Phase I: Change in Arterial Lactate from Baseline | To evaluate the change in arterial lactate levels from baseline at various time points from Day 1 to Day 28. | Day 1 to Day 28 |
| Phase I: Change in Sequential Organ Failure Assessment (SOFA)-2 Score from Baseline | To evaluate the change in the Sequential Organ Failure Assessment (SOFA)-2 score from baseline. The SOFA-2 score ranges from 0 to 24, with higher scores indicating more severe organ dysfunction/failure. Assessments will be made at various time points from Day 1 to Day 28. | Day 1 to Day 28 |
| Phase II: Difference in All-cause Mortality Compared to Placebo at Day 7, Day 14, Day 28, Day 90, and Day 180 | To evaluate the difference in all-cause mortality between the GKL-006RTU injection group and the placebo group at Day 7, Day 14, Day 28, Day 90, and Day 180. | Day 7, Day 14, Day 28, Day 90, and Day 180 |
| Phase II: Difference in ICU-Free Days and Organ Support-Free Days Compared to Placebo within Day 1 to Day 28 | To evaluate the difference in days free from intensive care unit (ICU) stay and days free from organ support between the GKL-006RTU injection group and the placebo group from Day 1 to Day 28. | Day 1 to Day 28 |
| Phase II: Difference in Change of Arterial Partial Pressure of Oxygen/Fraction of Inspired Oxygen Ratio (PaO2/FiO2) Compared to Placebo | To evaluate the difference in the change of the PaO2/FiO2 ratio from baseline between the GKL-006RTU injection group and the placebo group. | Day 1 to Day 28 |
| Phase II: Difference in Change of Arterial Potential of Hydrogen (pH) Compared to Placebo. | To evaluate the difference in the change of arterial pH from baseline between the GKL-006RTU injection group and the placebo group. | Day 1 to Day 28 |
| Phase II: Difference in Change of Arterial Partial Pressure of Oxygen (PaO2) Compared to Placebo. | To evaluate the difference in the change of arterial partial pressure of oxygen (PaO2) from baseline between the GKL-006RTU injection group and the placebo group. | Day 1 to Day 28 |
| Phase II: Difference in Change of Arterial Partial Pressure of Carbon Dioxide (PaCO2) Compared to Placebo | To evaluate the difference in the change of arterial partial pressure of carbon dioxide (PaCO2) from baseline between the GKL-006RTU injection group and the placebo group. | Day 1 to Day 28 |
| Title: Phase II: Difference in Change of Arterial Lactate Compared to Placebo | To evaluate the difference in the change of arterial lactate levels from baseline between the GKL-006RTU injection group and the placebo group. | Day 1 to Day 28 |
| Phase II: Difference in Change of Sequential Organ Failure Assessment (SOFA)-2 Score Compared to Placebo | To evaluate the difference in the change of the Sequential Organ Failure Assessment (SOFA)-2 score from baseline between the GKL-006RTU injection group and the placebo group. The SOFA-2 score ranges from 0 to 24, with higher scores indicating more severe organ dysfunction or failure. | Day 1 to Day 28 |
| Phase II: Incidence and Severity of Adverse Events (AEs) and Serious Adverse Events (SAEs) | Day 1 to Day 180 |
| [Phase I & II] Pharmacokinetics (PK): Count of Allogeneic Invariant Natural Killer T (iNKT) Cells | Enumeration of allogeneic invariant natural killer T (iNKT) cells in peripheral blood post-treatment. This assessment is conducted in both Phase I and Phase II. | Day 1 to Day 4, Day 7, Day 14, Day 28, and Day 90 |
| [Phase I & II] Pharmacodynamics (PD): Inflammatory Cytokines and Acute Phase Reactants | Measurement of changes in peripheral blood levels of: oC-reactive protein (CRP) oInterleukin-1 Receptor Antagonist (IL-1RA) oInterleukin-6 (IL-6) oInterleukin-8 (IL-8) oTumor Necrosis Factor-alpha (TNF-α) oInterferon-gamma (IFN-γ) Soluble Tumor Necrosis Factor Receptor 1 (sTNFr1) | Day 1, Day 4, Day 7, Day 14, Day 28, and Day 90 |
| [Phase I & II] Pharmacodynamics (PD): Serum Bicarbonate (HCO3-) Levels | Measurement of changes in serum bicarbonate (HCO3-) levels in peripheral blood post-treatment for both Phase I and Phase II cohorts. | Day 1, Day 4, Day 7, Day 14, Day 28, and Day 90 |