The purpose of the study is to evaluate the safety and preliminary efficacy of ATA3219 for treatment of participants with lupus nephritis (LN) following lymphodepletion (LD) and in participants with extrarenal systemic lupus erythematosus (SLE) without LD.
This is a Phase 1, multi-centered, open-labeled, dose escalation study to evaluate the safety and preliminary efficacy of ATA3219 (as monotherapy) in participants with LN following LD (Cohort LN) and in participants with extrarenal SLE (ERL) without LD (Cohort ERL). This study is planned to be conducted in the United States, Canada, and Australia. For each cohort, up to 3 dose levels (DLs) will be explored in the dose escalation portion of the study and if needed a lower dose may be explored. Prior to undergoing any screening procedure, prospective participants must undergo the ATA3219 inventory check assessments to ensure availability of an appropriate partially human leukocyte antigen (HLA)-matched ATA3219 product lot. Before administration of ATA3219, participants will receive LD treatment (Cohort LN) or methylprednisolone treatment (Cohort ERL). For all enrolled participants, hospitalization during and following ATA3219 dosing is mandatory. Participants will receive a single dose intravenous (IV) infusion of ATA3219 (monotherapy) on Day 1. Participants will remain inpatient for a minimum of 1 week post ATA3219 dosing, where they will be frequently monitored. Clinical responses will be assessed by the investigator on Day 28 (+ 5 days) following each dose of ATA3219. For each cohort, during dose escalation, up to 3 DLs of ATA3219 are planned to be evaluated sequentially and a lower dose may be added. At least 3 and up to 6 dose-limiting toxicity (DLT)-evaluable participants, those who complete the 28-day DLT observation period, will be assessed at each DL. Within each DL, treatment will be staggered to allow appropriate safety monitoring by an independent Data Safety Monitoring Committee (DSMC). Enrolled participants who do not receive ATA3219 for any cause (e.g., rapid deterioration) will be replaced. Participants who experience an adverse event (AE) during the 28-day DLT observation and complete the observation period will not be replaced. In addition, if a participant is treated with ATA3219 and discontinues for any reason other than due to a DLT prior to completing the 28-day DLT observation period, an additional participant may be enrolled at the dose level to ensure that the recommended phase 2 dose (RP2D) can be determined, with a goal not to exceed 6 participants treated/dose level. In rare situations, retreatment of participants with inadequate renal response may be considered. After treatment is completed or discontinued, participants will be followed for safety and clinical response for up to 24 months from the last dose of ATA3219. A separate long-term follow-up study will be conducted to follow participants for up to a total of 15 years after their last dose of ATA3219.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
ATA3219 is an allogeneic chimeric antigen receptor (CAR) T-cell therapy containing a second generation CD19 CAR construct in Epstein Barr virus (EBV) T cells, administered intravenously on Day 1.
Atara Biotherapeutics
Thousand Oaks, California, United States
Number of Participants With treatment-emergent adverse events, including adverse events of special interest
Time frame: From administration of pretreatments (LD or methylprednisolone) through 90 days after administration of study drug
Number of Participants With Dose-limiting Toxicities
Time frame: Day 1 through Day 28 of first dose of study drug
Maximum Tolerated dose
Time frame: Day 1 through Day 28 of first dose of study drug
Recommended Phase 2 dose of ATA3219
Time frame: Day 1 through Day 28 of first dose of study drug
Maximum Observed Plasma Concentration (Cmax) of ATA3219
Time frame: Pre-dose on Day 1 through 24 months after the last dose on a defined schedule
Time to Reach Cmax (Tmax) of ATA3219
Time frame: Pre-dose on Day 1 through 24 months after the last dose on a defined schedule
Partial Area Under the Curve (pAUC) of ATA3219
Time frame: Pre-dose on Day 1 through 24 months after the last dose on a defined schedule
Last Observed Plasma Concentration (Clast) of ATA3219
Time frame: Pre-dose on Day 1 through 24 months after the last dose on a defined schedule
Time of Clast of ATA3219
Time frame: Pre-dose on Day 1 through 24 months after the last dose on a defined schedule
Terminal Half-life (t1/2) of ATA3219
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Time frame: Pre-dose on Day 1 through 24 months after the last dose on a defined schedule
Complete Renal Response
Time frame: Weeks 24 and 52
Partial Renal Response
Time frame: Weeks 24 and 52
Renal Objective Response Rate
Time frame: Weeks 24 and 52
Change From Baseline in Urine protein-to-Creatinine Ratio
Time frame: Baseline (Day -5) through 24 months after the last dose on a defined schedule
Change From Baseline in Estimated Glomerular Filtration Rate
Time frame: Baseline (Day -5) through 24 months after the last dose on a defined schedule
Duration of Urine Protein-to-Creatinine ratio ≤ 0.5
Time frame: Baseline (Day -5) through 24 months after the last dose on a defined schedule
Change From Baseline in Lupus Low Disease Activity State (LLDAS)
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule
Change From Baseline in Definition of Remission in Systemic Lupus Nephritis (DORIS)
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule
Change From Baseline in the Modified Version of the Safety of Estrogens in Lupus Erythematosus National Assessment version of the Systemic Lupus Nephritis Disease Activity (Hybrid SELENA-SLEDAI) Index
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule
Change From Baseline in British Isles Lupus Assessment Group (BILAG) Index
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule
Change From Baseline in SLE Responder Index (SRI)-4
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule
Change From Baseline in BILAG-based Composite Lupus Assessment (BICLA) Response
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule
Change From Baseline in Antibodies to Double Stranded Deoxyribonucleic Acid
Time frame: Baseline (Day -5) through 24 months after the last dose on a defined schedule
Change From Baseline in Complement Component 3 (C3) and Complement Component 4 (C4) Levels
Time frame: Baseline (Day -5) through 24 months after the last dose on a defined schedule
Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Activity Score
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule
Number of Swollen and/or Tender Joints
Time frame: Baseline (Day 28) through 24 months after the last dose on a defined schedule