IM19 CAR-T Cell Therapy for IgA Nephropathy Patients and Membranous Nephropathy Patients

Early Phase 1

Not yet recruiting

• Conditions: Membranous Nephropathy; IgA Nephropathy

• Registration Number: NCT06690359
• Lead Sponsor: Beijing Immunochina Medical Science & Technology Co., Ltd.

Brief Summary

IM19 CAR-T cell therapy for IgA nephropathy patients with urinary protein and renal dysfunction, as well as patients with intermediate to high-risk primary membranous nephropathy

Detailed Description

IgA nephropathy:

The investigators plan to recruit IgA nephropathy subjects with urinary protein and renal dysfunction who meet the inclusion and exclusion criteria. They will receive IM19 CAR-T cell infusion therapy at doses of 0.5 × 10 \^ 8 and 1 × 10 \^ 8 CAR-T cells, with 3 subjects enrolled at each dose. The investigators will evaluate the changes in urinary protein and eGFR relative to baseline values within 6 months of the first infusion, the rate of reaching the threshold, and the occurrence of adverse events related to IM19 CAR-T cell infusion within 28 days after the infusion.

And evaluate the long-term efficacy, namely the changes in urinary protein and eGFR relative to baseline values and the ratio of reaching threshold values after 360 days of cell transfusion. The retention amount and duration of IM19 CAR-T cells in the peripheral blood of subjects.

Primary membranous nephropathy:

The investigators plan to recruit primary membranous nephropathy subjects who meet the inclusion and exclusion criteria and receive IM19CAR-T cell infusion therapy at doses of 0.5 × 10 \^ 8 and 1 × 10 \^ 8 CAR-T cells. Three subjects will be enrolled at each dose to evaluate the changes and disappearance rate of PLA2Rab relative to baseline within 6 months after the first infusion, as well as the overall response rate (CR+PR), complete response rate, partial response rate, and incidence of adverse events related to IM19 CAR-T cell infusion within 28 days after IM19 CAR-T cell infusion.

And evaluate the long-term efficacy, that is, assess the rate of PLA2Rab changes and disappearance relative to baseline, overall response rate (CR+PR), complete response rate, and partial response rate of the subjects after 360 days of cell transfusion. The retention amount and duration of IM19 CAR-T cells in the peripheral blood of subjects.

Study Timeline

• Status Verified: 2024-11
• Study First Submitted: 2024-11-05
• Study First Submitted QC: 2024-11-13
• Study First Posted: 2024-11-15
• Last Update Submitted: 2024-11-25
• Last Update Posted: 2024-11-26
• Study Start: 2024-12-13
• Primary Completion: 2025-08-04
• Study Completion: 2026-12-20

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 12

Inclusion Criteria

Not provided

Exclusion Criteria

• IgA nephropathy:

  1. Kidney diseases other than IgA nephropathy, as well as primary and secondary nephrotic syndrome

  2. After examination by the researchers, it was determined that the subjects had diseases that were not suitable for participation in this study, such as life-threatening conditions (such as catastrophic antiphospholipid syndrome, acute severe renal failure, and acute severe central nervous system disease manifestations)

  3. Serious complications unrelated to IgA nephropathy

  4. Use or increase the dosage of corticosteroids, immunosuppressants, biologics (including but not limited to CD20 monoclonal antibodies, taceptil, etc.), anticoagulants (warfarin), and n-3 fatty acids (fish oil) for the drug treatment of IgA nephropathy within 3 months

  5. Uncontrollable hypertension or hyperglycemia

  6. Perform palatal tonsillectomy within 6 months

  7. Study subjects with a history of alcohol or drug abuse within the past 24 weeks

  8. Have undergone major surgery (including joint surgery) within 24 weeks prior to screening, or plan to undergo surgery within 24 weeks after enrollment in the study

  9. Used other cell therapies

  10. Have participated in or participated in other clinical trials within the past 3 months

  11. Within 3 years or planning to undergo a kidney transplan

  12. Active hepatitis B or hepatitis C virus, defined as: subjects with positive hepatitis B B virus surface antigen (HBsAg) and/or hepatitis B B core antibody (HBcAb, Hepatitis B core antibody) and HBV DNA titer in peripheral blood higher than the lower limit of detection; Individuals with positive hepatitis C virus (HCV) antibodies and positive peripheral blood HCV RNA (HCV RNA); Syphilis infected individuals

  13. Active EB virus and cytomegalovirus, defined as: subjects with positive or negative IgM antibodies in EB virus serum but EBV-DNA higher than normal values; Subjects with IgM antibody positive or IgM antibody negative but CMV-DNA higher than normal in the serum of cytomegalovirus (CMV)

  14. Serious history of cardiovascular and cerebrovascular diseases, including but not limited to:

      14.1. Serious cardiac rhythm or conduction abnormalities, such as ventricular arrhythmias requiring clinical intervention, third degree atrioventricular block, etc; 14.2. At rest, QT interval prolongation (QTc>450 milliseconds in males or>470 milliseconds in females); 14.3. Acute coronary syndrome, congestive heart failure, aortic dissection, stroke or other grade 3 or above cardiovascular and cerebrovascular events occurred within 6 months prior to the first administration; 14.4. There is heart failure with NYHA functional class ≥ II in the United States;

  15. History of symptomatic deep vein thrombosis or pulmonary embolism within the past 6 months prior to the start of screening;

  16. History of malignant tumors other than non melanoma skin cancer or carcinoma in situ (e.g. cervix, bladder, breast) (unless in a disease-free state for at least 3 years)

  17. Infections (fungal, bacterial, viral, or other) that require intravenous injection of antibiotics for control or are uncontrollable, such as simple urinary tract infections and bacterial pharyngitis, may be included if the researcher evaluates that they can be controlled through treatment

  18. The researchers believe that it does not meet the criteria for joining this clinical trial

  19. During pregnancy or lactation, it may be due to pregnancy or the male and female not agreeing to undergo contraception under the guidance of the researcher during the study period.

• Primary membranous nephropathy:

  1. Secondary membranous nephropathy;
  2. Urinary protein decreased by more than 50% within the first 6 months of screening;
  3. After examination by the researchers, it was determined that the subjects had diseases that were not suitable for participation in this study, such as life-threatening conditions (such as catastrophic antiphospholipid syndrome, acute severe renal failure, and acute severe central nervous system disease manifestations);
  4. Serious complications unrelated to primary membranous nephropathy;
  5. Uncontrollable hypertension or hyperglycemia;
  6. The study subjects have a history of alcohol or drug abuse within the past 24 weeks;
  7. Have undergone major surgery (including joint surgery) within 24 weeks prior to screening, or plan to undergo surgery within 24 weeks after enrollment in the study;
  8. Have used other cell therapies;
  9. Have participated in or taken part in other clinical trials within the past 3 months;
  10. Within 3 years or planning to undergo kidney transplantation;
  11. Active hepatitis B or hepatitis C virus, defined as: subjects with positive hepatitis B B virus surface antigen (HBsAg) and/or hepatitis B B core antibody (HBcAb, Hepatitis B core antibody) and HBV DNA titer in peripheral blood higher than the lower limit of detection; Individuals with positive hepatitis C virus (HCV) antibodies and positive peripheral blood HCV RNA (HCV RNA); Syphilis infected individuals;
  12. Active EB virus and cytomegalovirus, defined as: subjects with positive or negative IgM antibodies in EB virus serum but EBV-DNA higher than normal values; Subjects with IgM antibody positive or IgM antibody negative but CMV-DNA higher than normal in the serum of cytomegalovirus (CMV);
  13. History of serious cardiovascular and cerebrovascular diseases, including but not limited to: severe cardiac rhythm or conduction abnormalities, such as ventricular arrhythmias requiring clinical intervention, third degree atrioventricular block, etc; At rest, QT interval prolongation (QTc>450 milliseconds in males or>470 milliseconds in females); Acute coronary syndrome, congestive heart failure, aortic dissection, stroke or other grade 3 or above cardiovascular and cerebrovascular events occurred within 6 months prior to the first administration; There is heart failure with NYHA functional class ≥ II in the United States;
  14. History of symptomatic deep vein thrombosis or pulmonary embolism within the past 6 months prior to the start of screening;
  15. History of malignant tumors other than non melanoma skin cancer or carcinoma in situ (such as cervix, bladder, breast) (unless in a disease-free state for at least 3 years);
  16. Infections (fungal, bacterial, viral, or other) that require intravenous injection of antibiotics for control or are uncontrollable, such as simple urinary tract infections and bacterial pharyngitis, may be included if the researcher evaluates that they can be controlled through treatment;
  17. The researcher believes that it does not meet the criteria for joining this clinical trial;
  18. During pregnancy or lactation, it may be due to pregnancy or the male and female not agreeing to undergo contraception under the guidance of the researcher during the study period.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Primary Outcome Measures

Name	Time	Method
PMN primary safety endpoint（Adverse event incidence rate）	IM19 CAR-T cell reinfusion within 28 days	The incidence of adverse events related to IM19 CAR-T cell reinfusion within 28 days after IM19 CAR-T cell reinfusion, as well as clinically significant laboratory test results.
IgA nephropathy-Main safety endpoint（Adverse event incidence rate）	IM19 CAR-T cell reinfusion within 28 days	The incidence of adverse events related to IM19 CAR-T cell reinfusion within 28 days after IM19 CAR-T cell reinfusion, as well as clinically significant laboratory test results.
IgA primary efficacy endpoint（Urinary protein ratio）	6 months after the first administration	Changes in urinary protein levels (1 day, 14 days, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months after initial administration) relative to baseline values and the rate of reaching the threshold
PMN primary efficacy endpoint（Relief rate）	6 months after the first administration	Evaluate the overall response rate (CR+PR), complete response rate, and partial response rate of the subjects 6 months after the first infusion.; Complete remission criteria: Urinary protein ≤ 0.3g and serum albumin\>3.5g/dl. Partial relief criteria: Urinary protein reduction\>50% compared to baseline and final 0.3g\<urinary protein ≤ 3.5g.

Secondary Outcome Measures

Name	Time	Method
IgA secondary endpoint（EGFR ratio）	360 days after IM19 CAR-T cell reinfusion	The ratio of eGFR levels reaching the threshold after IM19CAR-T cell reinfusion
IgA secondary endpoint（Urinary protein ratio）	360 days after IM19 CAR-T cell reinfusion	The ratio of urinary protein levels reaching the threshold after IM19CAR-T cell reinfusion
PMN secondary endpoint（Relief rate）	360 days after IM19 CAR-T cell reinfusion	Evaluate the rate of relative baseline changes and disappearance of PLA2Rab, overall response rate (CR+PR), complete response rate, and partial response rate in subjects after 360 days of cell transfusion