Allogene Therapeutics has received FDA clearance for its Investigational New Drug (IND) application for ALLO-329, an allogeneic CAR T-cell therapy designed to treat various autoimmune diseases. The Phase 1 RESOLUTION trial is set to begin in mid-2025, marking a significant step forward in developing off-the-shelf CAR T-cell therapies for autoimmune conditions.
The RESOLUTION trial is a rheumatology basket study that will evaluate the safety and preliminary efficacy of ALLO-329 in patients with systemic lupus erythematosus (SLE), including lupus nephritis (LN), idiopathic inflammatory myopathies, and systemic sclerosis. This trial design includes two distinct lymphodepletion arms: one using cyclophosphamide alone, a common practice among rheumatologists, and another that eliminates lymphodepletion entirely.
Dual-Targeting Approach
ALLO-329 is a CD19/CD70 dual AlloCAR T investigational product. It utilizes CRISPR-based site-specific integration for dual CAR expression, targeting both CD19+ B cells and CD70+ T cells, which play a role in autoimmune disease pathogenesis. The rationale behind this dual-targeting approach is to address both B-cell and T-cell dysfunction, which are key drivers of immune dysregulation in autoimmune diseases.
Dagger Technology
ALLO-329 incorporates Allogene's clinically validated Dagger technology, designed to reduce or eliminate the need for lymphodepletion. Lymphodepletion, a pre-treatment regimen, can be a significant barrier to CAR T-cell therapy adoption in autoimmune indications due to its potential side effects and the need for specialized medical care. The Dagger technology aims to overcome rejection, potentially simplifying treatment protocols and expanding access to CAR T-cell therapy across a wider range of autoimmune disease indications.
Addressing Unmet Needs in Autoimmune Diseases
Autoimmune diseases affect millions worldwide, with many patients experiencing inadequate responses to current treatments. CAR T-cell therapy offers a potential avenue for achieving deep and durable remissions by resetting the immune system. David Chang, M.D., Ph.D., President, CEO, and Co-Founder of Allogene, stated that demonstrating the power of an allogeneic CAR T to reset the immune system, combined with the ability of their Dagger technology to reduce or eliminate lymphodepletion, could represent a transformative step forward.
Trial Design and Objectives
The Phase 1 RESOLUTION trial aims to provide critical insights into the potential of ALLO-329 to transform the treatment landscape for autoimmune diseases. The trial's primary objectives include assessing the safety and tolerability of ALLO-329 and evaluating preliminary efficacy signals in the target patient populations. By including two distinct lymphodepletion arms, the trial will also provide valuable data on the impact of lymphodepletion on CAR T-cell expansion and persistence.
Future Implications
If successful, ALLO-329 could represent a significant advancement in the treatment of autoimmune diseases. The dual-targeting approach, combined with the potential to reduce or eliminate lymphodepletion, could offer a more effective and accessible therapy for patients with SLE, idiopathic inflammatory myopathies, systemic sclerosis, and other autoimmune conditions. Allogene anticipates a proof-of-concept from the basket study by the end of 2025, which could pave the way for expanding into a broad range of autoimmune indications beyond rheumatology.
