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An Exploratory Clinical Study of Anti-CD19 CAR NK Cells in the Treatment of Systemic Lupus Erythematosus

Primary Purpose

Systemic Lupus Erythematosus (SLE)

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
anti-CD19 CAR NK cells (KN5501)
Sponsored by
Changhai Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Systemic Lupus Erythematosus (SLE) focused on measuring Lupus Erythematosus, Systemic, Autoimmune disorders, Connective Tissue Diseases

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Age: ≥ 18 years old and ≤ 65 years old, male or female, subjects voluntarily participate in this clinical study and sign the Informed Consent Form (ICF) Previous diagnosis of systemic lupus erythematosus (SLE) (according to the 1997 American Rheumatology Association criteria) Females of childbearing potential must use effective contraception during study treatment and for 90 days after the last dose of study treatment. In addition, subjects must not donate eggs during the study and for at least 90 days after the last dose of study treatment Subjects with Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) score ≥ 8 points prior to screening Subject has ≥ 1 organ system with BILAG-2004 Class A mobility score or ≥ 2 organ systems with BILAG-2004 Class B mobility score prior to screening Subjects meets one of the following: Antinuclear antibody (ANA) ≥ 1:80, determined by immunofluorescence method; Anti-dsDNA antibodies are higher than normal level; Anti-Smith antibodies are higher than normal level Absolute number of neutrophils ≥ 1.0×109/L, hemoglobin ≥ 60g/L, platelets ≥ 50×109/L Left ventricular ejection fraction (LVEF) ≥ 50% Subjects have been treated with oral corticosteroids (OCS) in combination with an immunosuppressive or biologic agent for at least 6 months prior to enrollment Exclusion Criteria: Subjects with known severe allergic reactions, hypersensitivity, contraindication to any medications during the trial (cyclophosphamide, fludarabine, obinutuzumab), or subjects with a history of severe allergic reactions Subjects with active infection receiving intravenous (IV) antibiotic treatment, or received intravenous (IV) antibiotic treatment within one week prior to anti-CD19 CAR NK Cells infusion Subjects with acquired and congenital immunodeficiency diseases Subjects with grade III or IV heart failure (NYHA classification) History of epilepsy or other central nervous system (CNS) diseases History of severe herpetic infection, such as herpetic encephalitis, ocular herpes, or diffuse herpes History of other primary malignant tumors except: Cured non-melanoma skin cancer by surgical excision, for example basal cell carcinoma (BCC) ; Cured primary malignant tumors, such as cervical cancer, superficial bladder cancer, breast cancer Signs of herpes or varicella-zoster virus infection (especially chickenpox, shingles) within 12 weeks prior to screening; History of any cardiac, endocrine, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic, dermatologic, psychiatric, and renal disease or other major medical condition that would prevent the administration of anti-CD19 CAR NK Cells (KN5501), except for lupus (determined by the investigator) Females who are pregnant, lactating, or planning a pregnancy within six months Any active skin disease that may interfere with the study assessment of SLE, including but not limited to psoriasis, dermatomyositis, systemic sclerosis, non-LE cutaneous lupus manifestations (eg, cutaneous vascular disease, periungual telangiectasia, fingertip sclerosis, rheumatoid nodules, erythema multiforme, leg ulcers) or drug-induced lupus Subjects who have received other clinical trial treatment within 3 months Subjects who have received B cell-targeted drug therapy within 1 month before enrollment Any abnormal laboratory test results judged by the investigator to be clinically significant and prevent the subject from participating in the study. Laboratory test values that are out of range and not of clinical significance will not be considered as exclusion criteria Any situation judged by the investigators that may increase the risk of the subjects or interfere with the clinical trial outcome

Sites / Locations

  • Changhai HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

anti-CD19 CAR NK cells

Arm Description

To evaluate the safety and effectiveness of anti-CD19 CAR NK cells (KN5501) in patients with moderate to severe refractory SLE. All subjects will receive fludarabine/cyclophosphamide lymphodepletion followed by anti-CD19 CAR NK cells infusion on Day 0, 7, and 14.

Outcomes

Primary Outcome Measures

Incidence of Dose Limiting Toxicity (DLTs)
To characterize the safety of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
Incidence of Treatment Emergent Adverse Events (TEAEs)
To characterize the safety of anti-CD19 CAR NK Cells for moderate to severe refractory SLE

Secondary Outcome Measures

SRI-4 response rate of subjects
To characterize the efficacy of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
LLDAS rate of subjects
To characterize the efficacy of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
DORIS remission rate of subjects
To characterize the efficacy of anti-CD19 CAR NK Cells for moderate to severe refractory SLE

Full Information

First Posted
August 7, 2023
Last Updated
August 25, 2023
Sponsor
Changhai Hospital
Collaborators
Nanjing Enricnk Biotech Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT06010472
Brief Title
An Exploratory Clinical Study of Anti-CD19 CAR NK Cells in the Treatment of Systemic Lupus Erythematosus
Official Title
An Exploratory Clinical Study of the Safety and Efficacy of Anti-CD19 Chimeric Antigen Receptor (CAR) Nature Killer Cells (KN5501) in the Treatment of Moderate to Severe Refractory Systemic Lupus Erythematosus (SLE)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 24, 2023 (Actual)
Primary Completion Date
August 25, 2024 (Anticipated)
Study Completion Date
August 25, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Changhai Hospital
Collaborators
Nanjing Enricnk Biotech Co., Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A single arm, open-label pilot study is designed to determine the safety and effectiveness of anti-cluster of differentiation antigen 19 (CD19) chimeric antigen receptor (CAR) natural killer (NK) cells (KN5501) in patients with moderate to severe refractory systemic lupus erythematosus (SLE). 9-12 patients are planned to be enrolled in the dose-escalation trial (3×10^8 cells, 6×10^8 cells, 1.2×10^9 cells). The primary objective of the study was to evaluate the safety of allogeneic anti-CD19 CAR-NK cells (KN5501) for the treatment of patients with moderate to severe refractory active SLE. The secondary objective is to evaluate the efficacy of anti-CD19 CAR NK cells (KN5501) in patients with moderate to severe refractory SLE, including British Isles Lupus Assessment Group 2004 (BILAG-2004) index, Systemic Lupus Erythematosus Responder Index (SRI)-4 response rate, Lupus Low Disease Activity State (LLDAS) rate, and Definitions Of Remission In SLE (DORIS) remission rate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Systemic Lupus Erythematosus (SLE)
Keywords
Lupus Erythematosus, Systemic, Autoimmune disorders, Connective Tissue Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
anti-CD19 CAR NK cells
Arm Type
Experimental
Arm Description
To evaluate the safety and effectiveness of anti-CD19 CAR NK cells (KN5501) in patients with moderate to severe refractory SLE. All subjects will receive fludarabine/cyclophosphamide lymphodepletion followed by anti-CD19 CAR NK cells infusion on Day 0, 7, and 14.
Intervention Type
Drug
Intervention Name(s)
anti-CD19 CAR NK cells (KN5501)
Intervention Description
Patients will receive Fludarabine (25 mg/m2 per day) and Cyclophosphamide (300mg/m2 per day) on day -5, -4, and -3. Doses of 3×10^8, 6×10^8, 1.2×10^9 anti-CD19 CAR NK cells (KN5501) will infused in each group using the "3 + 3" dose-escalation strategy.
Primary Outcome Measure Information:
Title
Incidence of Dose Limiting Toxicity (DLTs)
Description
To characterize the safety of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
Time Frame
within 4 weeks after infusion; 12, 24, 36 and 52 weeks after infusion
Title
Incidence of Treatment Emergent Adverse Events (TEAEs)
Description
To characterize the safety of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
Time Frame
within 4 weeks after infusion; 12, 24, 36 and 52 weeks after infusion
Secondary Outcome Measure Information:
Title
SRI-4 response rate of subjects
Description
To characterize the efficacy of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
Time Frame
12, 24,36, and 52 weeks after infusion
Title
LLDAS rate of subjects
Description
To characterize the efficacy of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
Time Frame
12, 24,36, and 52 weeks after infusion
Title
DORIS remission rate of subjects
Description
To characterize the efficacy of anti-CD19 CAR NK Cells for moderate to severe refractory SLE
Time Frame
12, 24,36, and 52 weeks after infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age: ≥ 18 years old and ≤ 65 years old, male or female, subjects voluntarily participate in this clinical study and sign the Informed Consent Form (ICF) Previous diagnosis of systemic lupus erythematosus (SLE) (according to the 1997 American Rheumatology Association criteria) Females of childbearing potential must use effective contraception during study treatment and for 90 days after the last dose of study treatment. In addition, subjects must not donate eggs during the study and for at least 90 days after the last dose of study treatment Subjects with Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) score ≥ 8 points prior to screening Subject has ≥ 1 organ system with BILAG-2004 Class A mobility score or ≥ 2 organ systems with BILAG-2004 Class B mobility score prior to screening Subjects meets one of the following: Antinuclear antibody (ANA) ≥ 1:80, determined by immunofluorescence method; Anti-dsDNA antibodies are higher than normal level; Anti-Smith antibodies are higher than normal level Absolute number of neutrophils ≥ 1.0×109/L, hemoglobin ≥ 60g/L, platelets ≥ 50×109/L Left ventricular ejection fraction (LVEF) ≥ 50% Subjects have been treated with oral corticosteroids (OCS) in combination with an immunosuppressive or biologic agent for at least 6 months prior to enrollment Exclusion Criteria: Subjects with known severe allergic reactions, hypersensitivity, contraindication to any medications during the trial (cyclophosphamide, fludarabine, obinutuzumab), or subjects with a history of severe allergic reactions Subjects with active infection receiving intravenous (IV) antibiotic treatment, or received intravenous (IV) antibiotic treatment within one week prior to anti-CD19 CAR NK Cells infusion Subjects with acquired and congenital immunodeficiency diseases Subjects with grade III or IV heart failure (NYHA classification) History of epilepsy or other central nervous system (CNS) diseases History of severe herpetic infection, such as herpetic encephalitis, ocular herpes, or diffuse herpes History of other primary malignant tumors except: Cured non-melanoma skin cancer by surgical excision, for example basal cell carcinoma (BCC) ; Cured primary malignant tumors, such as cervical cancer, superficial bladder cancer, breast cancer Signs of herpes or varicella-zoster virus infection (especially chickenpox, shingles) within 12 weeks prior to screening; History of any cardiac, endocrine, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic, dermatologic, psychiatric, and renal disease or other major medical condition that would prevent the administration of anti-CD19 CAR NK Cells (KN5501), except for lupus (determined by the investigator) Females who are pregnant, lactating, or planning a pregnancy within six months Any active skin disease that may interfere with the study assessment of SLE, including but not limited to psoriasis, dermatomyositis, systemic sclerosis, non-LE cutaneous lupus manifestations (eg, cutaneous vascular disease, periungual telangiectasia, fingertip sclerosis, rheumatoid nodules, erythema multiforme, leg ulcers) or drug-induced lupus Subjects who have received other clinical trial treatment within 3 months Subjects who have received B cell-targeted drug therapy within 1 month before enrollment Any abnormal laboratory test results judged by the investigator to be clinically significant and prevent the subject from participating in the study. Laboratory test values that are out of range and not of clinical significance will not be considered as exclusion criteria Any situation judged by the investigators that may increase the risk of the subjects or interfere with the clinical trial outcome
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Dongbao Zhao, Doctor
Phone
+86-15921061314
Email
dongbaozhao@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dongbao Zhao, Doctor
Organizational Affiliation
ChanghaiHospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Changhai Hospital
City
Shanghai
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dongbao Dongbao Zhao, Doctor
Phone
+86-15921061314
Email
dongbaozhao@163.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

An Exploratory Clinical Study of Anti-CD19 CAR NK Cells in the Treatment of Systemic Lupus Erythematosus

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