Gaucher disease (GD) is caused by mutations in the GBA1 gene, which leads to a lack or reduction of GCase activity. The consequences of this deficiency are generally attributed to the accumulation of the GCase substrate, Glucosylceramide (GlcCer), in macrophages in the liver, spleen, kidney, bone, lung, and even the brain, inducing their transformation into Gaucher cells whose cell cytoplasm presenting a characteristic "crumpled tissue paper" appearance, leading to pathological changes in involved tissues and organs.LY-M001 Injection is an rAAV8 vector gene therapy product. It can specifically transduce the target organ liver after a single intravenous administration and express the GCase protein in liver cells for a long period of time.
The purpose of this study is to evaluate the safety, tolerability, efficacy, immunogenicity, pharmacokinetics and pharmacokinetics of LY-M001 injection in patients with GD1 using a multicenter, open, single-arm, single-dose, dose-escalation and extended clinical design. This study includes the main study phase and the long-term follow-up study phase. The primary study period is 52 weeks after LY-M001 infusion, and the long-term follow-up period is 53 weeks to 5 years after LY-M001 infusion.Subjects who complete the 52 weeks follow up period or who prematurely withdraw in this study will enter the long-term follow-up study phase to obtain long-term assessment data. Phase I is a dose escalation study consists of three preset dose groups, including one rollback dose group and two incremental dose groups, which are: Backdose (5 × 10\^12 vg/kg) group, dose group 1 (1.5 × 10\^13 vg/kg) and dose group 2 (3.0 × 10\^13 vg/kg), where dose group 1 was the starting dose of the Phase I study. Three subjects are enrolled in each dose group one by one, and each subject is added to the next subject after at least 28 days of DLT observation to determine safety. Phase I studies enrolled approximately 6 to 12 (up to 12) evaluable subjects. Phase II is a dose expansion study. After all subjects in Phase I study have completed the Day 28 (D28) observation following LY-M001 infusion, the Recommended Phase 2 Dose (RP2D) will be determined by the Safety Review Committee (SRC), which will also decide whether to proceed to the dose-expansion Phase II study.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Single Intravenous Infusion of LY-M001 Injection.
Guangzhou First People's Hospital
Guangzhou, Guangdong, China
RECRUITINGShanxi Bethune Hospital
Taiyuan, Shanxi, China
RECRUITINGHematology Hospital, Chinese Academy of Medical Sciences
Tianjin, Tianjin Municipality, China
RECRUITINGPhase I: Incidence of adverse events (AE) and serious adverse events (SAE) within 52 weeks after LY-M001 infusion
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0.
Time frame: From enrollment to 52 weeks after administration
Phase I: Incidence rate of dose-limiting toxicity (DLT) events determined by the data safety review committee (SRC) within at least 28 days after LY-M001 infusion.
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0.The adverse events defined as dose-limiting toxicity (DLT) have been clearly specified in the protocol.
Time frame: From enrollment to 52 weeks after administration
Phase I: Liver function levels (including alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TBIL], alkaline phosphatase [ALP], gamma-glutamyl transferase [GGT]) within 52 weeks after LY-M001 infusion.
Incidence rate of liver function-related adverse events evaluated by CTCAE V5.0.
Time frame: From enrollment to 52 weeks after administration
Phase II: Blood glucocerebrosidase (GCase) activity level.
Evaluation based on the detected values of blood glucocerebrosidase(GCase).
Time frame: From enrollment to 52 weeks after administration
Phase II: The incidence rates of adverse events (AEs) and serious adverse events (SAEs), as well as the occurrence of abnormalities in 12-lead electrocardiogram (ECG) findings, vital signs, laboratory test parameters, and physical examination results.
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0.
Time frame: From enrollment to 52 weeks after administration
Phase I: Liver volume and spleen volume (if applicable)
1. Change from baseline in liver volume as measured by MRI through 52 weeks after infusion of LY-M001; 2. Change from baseline in spleen volume as measured by MRI through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase I: Hemoglobin levels
Evaluate the change from baseline in hemoglobin levels through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase I:Bone mineral density (BMD) after administration
Evaluate the change from baseline in bone mineral density (BMD) by dual-energy X-ray absorptiometry through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase I: Glucocerebrosidase (GCase) protein levels in blood
Evaluate the change from baseline in GCase protein levels through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase I: Glucosylsphingosine (Lyso-GL1) in blood
Evaluate the change from baseline in Lyso-GL1 levels in blood through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase I: Platelet count
Evaluate the change from baseline in platelet count through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase I: Bone marrow burden (BMB) after administration
Evaluate the change from baseline in bone marrow burden as measured by MRI through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase I: Glucocerebrosidase (GCase) enzyme activity levels in blood
Evaluate the change from baseline in GCase enzyme activity levels in blood through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase II: Glucocerebrosidase (GCase) protein levels in blood
Evaluate the change from baseline in GCase protein levels in blood through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase II: Glucosylsphingosine (Lyso-GL1) in blood
Evaluate the change from baseline in Lyso-GL1 levels in blood through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase II: Liver volume and spleen volume (if applicable)
1. Change from baseline in liver volume as measured by MRI through 52 weeks after infusion of LY-M001; 2. Change from baseline in spleen volume as measured by MRI through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase II: Hemoglobin levels
Evaluate the change from baseline in hemoglobin levels through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase II: Platelet count
Evaluate the change from baseline in platelet count through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase II: Bone mineral density (BMD)
Evaluate the change from baseline in bone mineral density by dual-energy X-ray absorptiometry through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
Phase II: Bone marrow burden (BMB)
Evaluate the change from baseline in bone marrow burden as measured by MRI through 52 weeks after infusion of LY-M001.
Time frame: From enrollment to 52 weeks after administration
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