NCT07241468招募中早期 1 期
An Exploratory Clinical Study on the Safety and Efficacy of Anti-CD19/BCMA Universal Chimeric Antigen Receptor T Cells in the Treatment of Relapsed/Refractory Immune-mediated Kidney Disease
适应症
干预措施
相关药物
试验速览
- 阶段
- 早期 1 期
- 状态
- 招募中
- 入组人数
- 36
- 试验地点
- 1
- 主要终点
- Incidence of Dose-Limiting Toxicity (DLT)
研究概览
简要总结
A single arm, open-label pilot study is designed to determine the safety and effectiveness of anti-CD19/BCMA U CAR T cell injection (KN3601) in patients with Relapsed/Refractory immune-mediated kidney disease
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age: ≥ 18 years old and ≤ 70 years old, male or female;
- •2 B cell CD19 positive expression in peripheral blood detected by flow cytometry;
- •The functions of critical organs meet the following requirements:
- •Neutrophil count ≥ 1 x 10^9/L, Hemoglobin ≥60g/L, platelets ≥ 50×109/L,
- •Liver function: ALT ≤ 3 x ULN,AST≤3 x ULN, TBIL≤1.5 x ULN,
- •Coagulation function: International standardized ratio (INR) ≤ 1.5x ULN, prothrombin time (PT) ≤1.5 x ULN,
- •Cardiac function: good hemodynamic stability, left ventricular ejection fraction (LVEF) ≥55%.
- •Female subjects of childbearing potential and male subjects whose partner is a female of childbearing potential are required to use medically approved contraception or abstain from sex for at least 6 months during and at least 6 months after the end of the study treatment period; female subjects of childbearing potential have had a negative serum HCG test within 7 days prior to study enrollment and are not lactating;
- •Voluntarily participate in this clinical study, sign an informed consent form, have good compliance, and cooperate with follow-up.
- •Specific inclusion criteria:
- •High-risk or relapsed/refractory primary membranous nephropathy
- •Primary membranous nephropathy diagnosed pathologically by renal biopsy;
- •Meets the clinical criteria for high-risk or recurrent/refractory membranous nephropathy, defined as:
- •Subjects at risk who meet any of the following criteria: a) estimated glomerular filtration rate (eGFR, CKD-EPI equation) <60 mL/min/1.73m², and/or urine protein >8g/day persisting for more than 6 months;b) normal GFR, urinary protein >3.5 g/d, treated with ACEI/ARB for 6 months, urinary protein reduction <50%, and serum albumin <25 g/l or aPLA2R >50 RU/mL;
- •Refractory membranous nephropathy subjects are defined as those who have shown poor response or resistance to previous immunosuppressive treatments (including corticosteroids and/or cytotoxic drugs, immunosuppressants and/or biologics), defined as persistent proteinuria ≥3.5g/day with a reduction of <50% compared to baseline;
- •Recurrent membranous nephropathy is defined as a relapse (24-hour urinary protein ≥3.5 g) in subjects who have achieved complete or partial remission following treatment;
- •Subjects with relapsed/refractory MN and eGFR ≥ 45 mL/min/1.73 m2 during the screening period;
- •Primary IgA nephropathy pathologically confirmed by renal biopsy;
- •Subjects have medical records showing they have been on stable and maximally tolerated doses of either ACEI or ARB, as per local SOC and applicable guidelines, for at least 3 months preceding screening;
- •Subjects have been treated with hormones and/or cytotoxic drugs, immunosuppressants and/or biological agents (including but not limited to anti-CD20 monoclonal antibodies) for more than 6 months, and the 24-hour urine protein is ≥1.0 g; subjects with a rapidly progressive decline in kidney function (eGFR decreases by ≥50% within 3 months); or The subject relapsed after achieving complete remission/partial remission (CR/PR) following treatment (24-hour urine protein ≥1.0 g);
- •Estimated glomerular filtration rate (eGFR, CKD-EPI formula) ≥30 mL/min/1.73m2 at screening;
- •Meets the 2022 ACR/EULAR diagnostic criteria for ANCA-associated vasculitis, including microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis;
- •ANCA-related antibodies positive (MPO-ANCA or PR3-ANCA positive);
- •Kidney biopsy pathology is consistent with ANCA-associated vasculitis renal damage;
- •Birmingham Vasculitis Activity Score (BVAS) ≥15 points (total score 63 points), indicating active vasculitis;
- •At least two abnormalities related to the kidneys in the BVAS score;
- •Subjects meeting the definition of relapsed/refractory: standard treatment is ineffective or disease activity recurs after remission. Definition of conventional treatment: using glucocorticoids (more than 1mg/kg/day) and cyclophosphamide, along with any one of the following immunomodulatory drugs for ≥3 months: antimalarials, azathioprine, mycophenolate mofetil, methotrexate, leflunomide, tacrolimus, cyclosporine, and biologics including rituximab, belimumab, and thalidomide;
- •Estimated glomerular filtration rate (eGFR, CKD-EPI formula) ≥30 mL/min/1.73m2 at screening
排除标准
- •Subjects who meet any of the following common exclusion criteria or disease-specific exclusion criteria will not be eligible for this study
- •Common exclusion Criteria:
- •Subjects known to have allergic reactions, hypersensitivity, intolerance, or contraindications to CD19/BCMA universal CAR-T or any drug components that may be used in the study (including fludarabine, cyclophosphamide, and tocilizumab), or who have previously experienced severe allergic reactions;
- •The subject has or is suspected of having uncontrolled or treatable fungal, bacterial, viral, or other infections;
- •Subjects with central nervous system disorders caused by autoimmune diseases or non-autoimmune diseases (including epilepsy, psychiatric disorders, organic brain syndrome, cerebrovascular accidents, encephalitis, central nervous system vasculitis);
- •Subjects with more serious heart conditions, such as angina, myocardial infarction, heart failure, and arrhythmias;
- •Subjects with congenital immunoglobulin deficiency;
- •The subject has other malignant tumours (excluding non-melanoma skin cancer and carcinoma in situ of the cervix, bladder cancer, and breast cancer with disease-free survival of over 5 years);
- •Subjects with end-stage renal failure;
- •Subjects who are positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and have peripheral blood HBV DNA titres above the detection limit; subjects who are positive for hepatitis C virus (HCV) antibodies and peripheral blood HCV RNA; subjects who are positive for human immunodeficiency virus (HIV) antibodies; subjects who test positive for syphilis;
- •Subjects have mental illness and severe cognitive impairment;
- •Subjects who have participated in other clinical trials within 6 months prior to enrolment;
- •Female participants who are pregnant or planning to conceive;
- •Subjects with hypertension and diabetes uncontrolled by medication;
- •Researchers believe that there are other reasons why some subjects cannot be included in this study;
- •Specific exclusion Criteria:
- •Relapsed/Refractory Primary Membranous Nephropathy
- •Secondary membranous nephropathy (e.g., hepatitis B, systemic lupus erythematosus, drug-associated, malignancy-associated, etc.), or in combination with other renal diseases confirmed by renal biopsy;
- •Relapsed/Refractory IgA Nephropathy
- •Exclude secondary IgA nephropathy, including but not limited to: anaphylactic purpura, ankylosing spondylitis, systemic lupus erythematosus, desiccation syndrome, viral hepatitis, cirrhosis of the liver, rheumatoid arthritis, and mixed connective tissue disease; or in combination with other renal diseases confirmed by renal biopsy;
- •Crescentic nephritis (pathologic diagnosis of >50% crescentic bodies), micrognathic nephropathy with IgA deposition, and other specific types of pathologic or clinical renal disease;
- •Relapsed/refractory ANCA-associated vasculitis kidney damage
- •Estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m2;
- •If subjects have alveolar haemorrhage and requires invasive lung ventilation, the expected duration exceeds the screening time.
研究组 & 干预措施
anti-CD19/BCMA U CAR T cells
Experimental
干预措施: anti-CD19/BCMA U CAR T (Biological)
结局指标
主要结局
Incidence of Dose-Limiting Toxicity (DLT)
时间窗: up to 52 weeks after infusion
To characterize the safety of anti-CD19/BCMA U CAR T Cells (KN3601) for Relapsed/Refractory Immune Nephropathy
Incidence of Treatment Emergent Adverse Events (TEAEs)
时间窗: up to 52 weeks after infusion
To characterize the safety of anti-CD19/BCMA U CAR T Cells (KN3601) for Relapsed/Refractory Immune Nephropathy
次要结局
- The overall response rate (ORR)(up to 52 weeks after infusion)
- Disease control rate (DCR)(up to 52 weeks after infusion)
- B cell depletion rate(up to 52 weeks after infusion)
- B cell reconstitution(up to 52 weeks after infusion)
研究者
研究点 (1)
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