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A Study of CD19 Redirected Autologous T Cells for CD19 Positive Systemic Lupus Erythematosus (SLE)

Phase 1
Conditions
Systemic Lupus Erythematosus (SLE)
Interventions
Drug: anti-CD19-CAR-T cells
Registration Number
NCT03030976
Lead Sponsor
Shanghai GeneChem Co., Ltd.
Brief Summary

CAR-T therapy was therefore proposed and has been recently used for cancer treatment. It has been hailed for its promising remission rates after early stage clinical trials for acute lymphoblastic leukemia. However, CAR-T therapy is seldom used for autoimmune diseases. Researchers only use it for the treatment of multiple sclerosis (MS, an autoimmune disease of the central nervous system). SLE is a kind of autoimmune diseases which involving multiple systems, organs and with the present of a variety of autoantibodies. In the conventional treatment options, SLE could be treated with chemotherapy drugs or hormone drugs. But chemotherapy and hormone drugs could barely cured SLE. And now, chimeric antigen receptor modified T cell infusion maybe an effective treatment to solve these problems. The investigators use a 2nd CAR- T with the optimized hinge and transmembrane domain to treat patients with SLE. The purpose of this study is to assess the safety and efficacy of this 2nd CAR-T cells in the treatment of SLE.

Detailed Description

This study is being conducted to assess anti-CD19-CAR-T cells safety and efficacy in treating patients with systemic lupus erythematosus(SLE).The investigators constructed a 2nd CAR, using CD19 as target, using 4-1BB as co-stimulator, and optimized the spatial conformation by a suitable hinge and transmembrane domain sequences. The infusion dose is (1-10)E6 CAR positive T cells/kg, and the specific cells numbers depends on the situation of individual CAR-T cells preparation.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
5
Inclusion Criteria
  • Clinical diagnosis of systemic lupus erythematosus (SLE) patients
  • Patients with CD19+ B-cell SLE as confirmed by Flow Cytometry
  • Age: 18-69 years old
  • Creatinine < 1.5 mg/dl
  • cardiac ejection fraction>55%
  • hemoglobin>9g/dL
  • Bilirubin <2.0 mg/dl
  • Successful test expansion of T-cells
  • Adequate venous access for apheresis, and no other contraindications for leukapheresis
  • Voluntary informed consent is given
Exclusion Criteria
  • Pregnant or lactating women
  • Uncontrolled active infection
  • Concurrent use of systemic steroids. Recent or current use of inhaled steroids is not exclusionary
  • Previously treatment with any gene therapy products
  • Feasibility assessment during screening demonstrates<5% transduction of target lymphocytes, or insufficient expansion (<5-fold) in response to CD3/CD28 costimulation
  • Any serious, uncontrolled diseases (including, but not limit to, unstable angina pectoris, congestive heart failure, serious arrhythmia)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment of SLEanti-CD19-CAR-T cellsPatients receive anti-CD19-CAR-T cells to treatment of SLE. The purpose of this study is to assess the safety and efficacy of CD19 CAR-T cells in the treatment of SLE.
Reduce B cellscyclophosphamidePatients receive cyclophosphamide to reduce B cells before CD19-CART infusion. It will also reduce the side effects of cell damage due to antitumor activity.
Primary Outcome Measures
NameTimeMethod
Safety of CAR-T cell(i.v.)by number of patients with adverse event6 weeks

adverse event is evaluated with CTCAE, version 4.0

Secondary Outcome Measures
NameTimeMethod
3. Detection of transferred T cells in the circulation using quantitative -PCR6 weeks
Number of patients with tumor response8 weeks

summarize tumor response by overall response rates

Trial Locations

Locations (1)

Shanghai Jiaotong University School of Medicine, Renji Hospital

🇨🇳

Shanghai, China

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