A Study of Anti-CD19 Chimeric Antigen Receptor T-Cell (CD19 CAR T) Therapy, in Subjects with Refractory Primary and Secondary Progressive Multiple Sclerosis
Multiple sclerosis (MS) is an autoimmune and neurodegenerative disease in which lymphocytes at first attack the myelin sheaths within the central nervous system (CNS), accompanied or later followed by axonal damage. B cells play a central and multifunctional role in the immunopathogenesis of MS. B cells present antigen to T cells in stimulating a pro-inflammatory immune cascade, secrete pathogenic cytokines, moderate T cell and myeloid cell functions, form structural B cell meningeal follicles within the human central nervous system and produce pathogenic antibodies upon evolution to plasma cells. CD19-targeted chimeric antigen receptor (CAR) T cells harness the ability of cytotoxic T cells to directly and specifically lyse target cells to effectively deplete B cells in the circulation and in lymphoid and potentially non-lymphoid tissues. KYV-101, a fully human anti-CD19 CAR T-cell therapy, will be investigated in adult subjects with refractory primary and secondary progressive multiple sclerosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Stanford University Medical Center
Palo Alto, California, United States
To evaluate efficacy of KYV-101
Confirmed disability Progression on the EDSS scale. The EDSS scale ranges from 0 to 10 in 0.5- unit increments that represent higher levels of disability. Scoring is based on an examination by a neurologist.
Time frame: at least 12 weeks
To characterize the safety and tolerability of KYV-101
Incidence and severity of adverse events (AEs)
Time frame: Up to 2 years
To characterize the safety and tolerability of KYV-101
Incidence and severity of adverse events of special interests (AESIs)
Time frame: Up to 2 years
To characterize the safety and tolerability of KYV-101
Incidence and severity of serious adverse events (SAEs)
Time frame: Up to 2 years
To evaluate efficacy of KYV-101
Composite Confirmed Disability Progression (CCPD)
Time frame: up to 12 weeks
To characterize the pharmacokinetics (PK)
Levels of Chimeric antigen receptor positive (CAR-positive) T cell counts
Time frame: Up to 2 years
To characterize the pharmacokinetics (PK)
Levels of CAR Transgene levels
Time frame: Up to 2 years
To characterize the Pharmacodynamics (PD)
Levels of B cell in the blood
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Time frame: Up to 2 years
To characterize the Pharmacodynamics (PD)
Serum cytokines will be measured by multiplexed mesoscale discovery (MSD) assay and will include cytokines historically associated with potential CAR T toxicity (CRS and ICANS) such as gamma interferon (IFNg) and interleukin 6 (IL-6).
Time frame: Up to 2 years
To evaluate the immunogenicity (humoral response) of KYV-101
Percentage of participants who develop anti-KYV-101 antibodies by immunoassays)
Time frame: Up to 2 years