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Clinical Trials/NCT06333483
NCT06333483Active, not recruitingPhase 1

A Single-Arm, Open-Label, Phase I Study to Determine the Safety, Tolerability and Preliminary Efficacy of Obecabtagene Autoleucel in Patients With Severe, Refractory Systemic Lupus Erythematosus

Autolus Limited12 sites in 2 countries16 target enrollmentStarted: February 2, 2024Last updated:
Conditions
Interventions

Trial Snapshot

Phase
Phase 1
Status
Active, not recruiting
Enrollment
16
Locations
12
Primary Endpoint
Adverse events

Study Overview

Brief Summary

This is a Phase 1 study of obecabtagene autoleucel (obe-cel), autologous T cells engineered with a chimeric antigen receptor (CAR) targeting CD19, to establish the tolerability, safety, preliminary efficacy, and pharmacokinetics of obe-cel in patients with severe, refractory SLE.

Detailed Description

This is a single-arm, open-label Phase 1 Study to determine the safety, tolerability, and preliminary efficacy of obe-cel in patients with severe, refractory SLE. Up to a maximum of 18 patients will be treated in a maximum of 3 dose levels.

By using the Bayesian Optimal Interval (BOIN) design for overdose control, the Sponsor will review the Safety Review Committee (SRC) and Independent Data Monitoring Committee (IDMC) recommendation and determine if a dose level is suitable for a subsequent study.

Study Design

Study Type
Interventional
Allocation
Na
Intervention Model
Single Group
Primary Purpose
Treatment
Masking
None

Eligibility Criteria

Ages
12 Years to — (Child, Adult, Older Adult)
Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Key Inclusion Criteria-
  • Women or men ≥ 18 years at screening [Spain only] or patients 12 to 65 years of age (inclusive) at the time of signing the informed consent [UK only]
  • Diagnosis of SLE fulfilling the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) Classification Criteria for Systemic Lupus Erythematosus
  • Positive for at least one of the following autoantibodies: antinuclear antibodies (ANA) at a titer of ≥ 1:80, or anti-dsDNA (≥ 30 IU/mL) or anti-Smith (> upper limit of normal [ULN]), anti-histone or anti-chromatin (> ULN)
  • Severe, refractory SLE

Exclusion Criteria

  • Key Exclusion Criteria-
  • Medications
  • Within 2 months of leukapheresis: use of anti-CD20 therapy
  • Prior treatment with anti-CD19 therapy (including bispecifics), adoptive T cell therapy or any prior gene therapy product (e.g., CAR T cell therapy)
  • Immunization with a live or attenuated vaccine within 2 months of leukapheresis
  • SLE and Autoimmunity:
  • Recurrent neuropsychiatric lupus or active, severe or unstable neuropsychiatric lupus within 2 years from screening
  • Diagnosis of drug-induced SLE rather than idiopathic SLE
  • Any acute, severe lupus-related flare during screening that needs immediate treatment and/or makes the immunosuppressive washout impossible; thus, making the patient ineligible for CD19 CAR T therapy as judged by the Investigator or Sponsor
  • Significant, likely irreversible organ damage related to SLE (e.g., end-stage renal disease) that in the opinion of the Investigator renders CD19 CAR T cell therapy unlikely to benefit the patient
  • Diagnosis of another non-SLE autoimmune disease (e.g., dermatomyositis, polymyositis, scleroderma, rheumatoid arthritis) or overlap syndrome
  • Medical History:
  • History or presence of: (Within 3 months before screening visit)
  • Clinically relevant central nervous system (CNS) pathology such as epilepsy, paresis, aphasia, or stroke
  • Evidence of deep venous thrombosis or pulmonary embolism
  • History or presence of severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, uncontrolled mental illness, or psychosis
  • Clinically significant, uncontrolled heart disease not due to SLE (New York Heart Association Class III or IV heart failure, uncontrolled angina, severe uncontrolled cardiac arrhythmia, or electrocardiographic evidence of acute ischemia or Grade 3 conduction system abnormalities unless the patient has a pacemaker) or a recent (within 12 months of screening) cardiac event
  • Active or uncontrolled fungal, bacterial, viral (including COVID-19), or other infection requiring systemic antimicrobials for management
  • Active or latent hepatitis B or active hepatitis C
  • Human immunodeficiency virus, human T-cell leukemia virus (HTLV)-1, HTLV-2 or syphilis positive test at screening
  • History of malignant neoplasms unless disease free for at least 24 months (basal cell or squamous cell carcinoma in situ, or in situ breast cancer on hormonal therapy allowed)
  • History of heart, lung, kidney, liver transplant or hematopoietic stem cell transplant
  • Pregnancy or lactating
  • Laboratory and Organ Function:
  • Left ventricular ejection fraction < 45% (or < institute's lower limit of normal) confirmed by echocardiogram
  • Oxygen saturation (SpO2) < 90% in the absence of oxygen support
  • B cell aplasia

Arms & Interventions

AUTO1

Experimental

Intervention: Obecabtagene autoleucel (obe-cel) (Biological)

Outcomes

Primary Outcomes

Adverse events

Time Frame: Up to Month 12

Adverse event (AE) type, frequency, severity, and relationship with obe-cel and lymphodepletion of AEs

Dose-limiting toxicities

Time Frame: Up to 28 days from obe-cel infusion

Percentage of patients receiving obe-cel who experience dose-limiting toxicities (DLTs)

Adverse events

Time Frame: Up to Month 12

Adverse event (AE) type, frequency, severity, and relationship with obe-cel and lymphodepletion of AEs

Secondary Outcomes

  • Remission rate according to Definition of Remission in SLE (DORIS)(Up to Month 12)
  • Response over time according to Definition of Remission in SLE (DORIS)(Up to Month 12)
  • Time to response according to Definition of Remission in SLE (DORIS)(Up to Month 12)
  • Change over time in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)(Up to Month 12)
  • Change over time in Physician's global assessment (PGA)(Up to Month 12)
  • Remission rate according to Definition of Remission in SLE (DORIS)(Up to Month 12)
  • Response over time according to Definition of Remission in SLE (DORIS)(Up to Month 12)
  • Time to response according to Definition of Remission in SLE (DORIS)(Up to Month 12)
  • Change over time in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)(Up to Month 12)
  • Change over time in Physician's global assessment (PGA)(Up to Month 12)
  • Pharmacokinetics (maximum serum concentration [Cmax]): Detection of CAR-T cells by polymerase chain reaction (PCR) in peripheral blood(Up to Month 12)
  • Pharmacokinetics (time to reaching maximum serum concentration [Tmax]): Detection of CAR-T cells by polymerase chain reaction (PCR) in peripheral blood(Up to Month 12)
  • Pharmacokinetics (area under the curve [AUC]): Detection of CAR-T cells by polymerase chain reaction (PCR) in peripheral blood(Up to Month 12)
  • Pharmacokinetics (last observed quantifiable concentration [Clast]): Detection of CAR-T cells by polymerase chain reaction (PCR) in peripheral blood(Up to Month 12)
  • Pharmacokinetics (time to reach last observed quantifiable concentration [Tlast]): Detection of CAR-T cells by polymerase chain reaction (PCR) in peripheral blood(Up to Month 12)
  • Pharmacodynamics: B cell aplasia(Up to Month 12)

Investigators

Sponsor Class
Industry
Responsible Party
Sponsor

Study Sites (12)

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