This is a single-center, open-label, exploratory clinical study to evaluate the efficacy and safety of Equecabtagene Autoleucel Injection (Eque-cel) in patients with Relapsed /refractory systemic lupus erythematosus (SLE).
SLE is a chronic diffuse connective tissue disease with unexplained etiology that can involve multiple systems. SLE is considered as an incurable disease and traditional SLE treatment aims at long-term remission. Eque-cel is an autologous chimeric antigen receptor T-cell (CAR-T) therapy that targets B-cell maturation antigen (BCMA), which expressed on both mature B lymphocytes and malignant plasma cells. BCMA CAR-T cells offer another potential therapeutic option to eliminate plasma cells in patients with SLE driven by abnormal antibody who still suffer recurrent attacks from conventional treatments. In this study subjects will receive a three-day consecutive lymphodepletion therapy, and 1.0×10\^6 total CAR T cells/kg after enrollment. A follow-up phase will include assessments for safety, efficacy evaluation and pharmacokinetics monitoring. The duration of this trial is about 2-3 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
dosage form: injection, dosage: 1.0×10\^6 CAR-T/kg, frequency: single dose.
Tongji Hospital
Wuhan, Hubei, China
RECRUITINGResponse rate of SRI-4 at 6 months after Eque-cel infusion
SLE Responder Index (SRI)-4 is defined as follows with all criteria compared to Baseline: * ≥ 4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score. * No worsening of the overall condition (\< 0.3 point increase in Physician's Global Assessment \[PhGA\]) . * No new British Isles Lupus Assessment Group (BILAG) A or more than 1 new BILAG B disease activity scores.
Time frame: 6 months post Eque-cel infusion.
lupus low disease activity state (LLDAS) rate through 2 years after Eque-cel infusion
Proportions of subjects achieving LLDAS by timepoint;
Time frame: up to 2 years from Eque-cel infusion
Definitions of Remission in SLE (DORIS) rate through 2 years after Eque-cel infusion
Proportions of subjects achieving remission according to the DORIS as assessed by SLEDAI-2K Scale,PhGA Scale and concomitant medication usage.
Time frame: up to 2 years from Eque-cel infusion
Complete and Partial Renal Response(Lupus Nephritis Patients)through 2 years after Eque-cel infusion
Proportion of Participants Who Achieve Overall Complete and Partial Renal Response (CRR+PRR).
Time frame: up to 2 years from Eque-cel infusion
Safety Endpoint -Adverse Events(AEs)
Type and incidence of AEs as Assessed by CTCAE 5.0 (except CRS and ICANS assessed according to the criteria of NCI-CTCAE v5.0).
Time frame: up to 2 years from Eque-cel infusion
Pharmacokinetic Endpoint-Cmax
The maximum concentration (Cmax) of CAR VCN in peripheral blood after CAR-T infusion.
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Time frame: up to 2 years from Eque-cel infusion
Pharmacokinetic Endpoint-Tmax
the time for CAR VCN to reach the maximum concentration (Tmax) after CAR-T infusion.
Time frame: up to 2 years from Eque-cel infusion
Pharmacokinetic Endpoint-AUC
Area under the curve of 28, 90 days and the last time point of PK detection (AUC0-28d, AUC0-90d, AUC0-last) for CAR VCN.
Time frame: up to 2 years from Eque-cel infusion
Pharmacokinetic Endpoint-Cmax
The maximum concentration (Cmax) of BCMA CAR-T in peripheral blood after CAR-T infusion.
Time frame: up to 90 days from Eque-cel infusion
Pharmacokinetic Endpoint-Tmax
the time for BCMA CAR-T to reach the maximum concentration (Tmax) after CAR-T infusion.
Time frame: up to 90 days from Eque-cel infusion
Pharmacokinetic Endpoint-AUC
Area under the curve of 28 days, 90 days (AUC0-28d, AUC0-90) for BCMA CAR-T.
Time frame: up to 90 days from Eque-cel infusion
Pharmacodynamic Endpoint- pathogenic antibodies
Changes in serum levels of pathogenic antibodies such as ANA, anti-dsDNA, and anti-Smith.
Time frame: up to 2 years from Eque-cel infusion
Pharmacodynamic Endpoint- Complement levels
Changes in measures of C3, C4.
Time frame: up to 2 years from Eque-cel infusion
Pharmacodynamic Endpoint-sBCMA
The concentration of soluble BCMA in peripheral blood of experimental group at each time point.
Time frame: up to 2 years from Eque-cel infusion