The purpose of this clinical trial is to evaluate the safety and efficacy of CRC01, an investigational autologous anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy, in people with lupus nephritis (LN), a serious kidney complication of systemic lupus erythematosus (SLE). The main objectives of the study are: 1. To determine whether CRC01 infusion can improve kidney outcomes and reduce disease activity in participants with lupus nephritis. 2. To assess the safety profile, including potential risks such as cytokine release syndrome (CRS) and neurotoxicity. Study Design This is a single-arm, open-label, multi-center, Phase 1/2 study. All enrolled participants will receive CRC01 after screening and baseline assessments. Study Procedures Participants will: * Undergo eligibility screening, including blood tests, urine tests, and disease activity assessments. * Provide autologous T lymphocytes through a procedure called leukapheresis. * Receive a lymphodepleting pre-conditioning regimen (short course of chemotherapy). * Receive a single intravenous infusion of CRC01 cells. * Be hospitalized for close monitoring to detect and manage early adverse events such as CRS or neurotoxicity. * Return for scheduled follow-up assessments through Week 52 (12 months) post-infusion to evaluate safety and treatment response. Key Outcomes Researchers will measure: * Changes in proteinuria and kidney function. * Changes in disease activity scores. * Incidence and severity of adverse events.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
39
Autologous T lymphocytes genetically modified to express anti-CD19 chimeric antigen receptor (CAR). Administered as a single intravenous infusion.
Phase 1 Study: To evaluate the tolerability of CRC01 in patients with severe refractory autoimmune disease (systemic lupus erythematosus), and to determine the maximum tolerated dose (MTD) and the recommended Phase 2 dose (RP2D)
Safety and tolerability will be assessed by: 1\. Number of participants with dose-limiting toxicities (DLTs) within 28 days after CRC01 infusion, as assessed by CTCAE v5.0 and ASTCT consensus criteria.
Time frame: 28 day
Phase 1 Study: To evaluate the tolerability of CRC01 in patients with severe refractory autoimmune disease (systemic lupus erythematosus), and to determine the maximum tolerated dose (MTD) and the recommended Phase 2 dose (RP2D)
Safety and tolerability will be assessed by: 2\. Determination of the maximum tolerated dose (MTD) defined as the highest dose level at which ≤1 of 6 participants experience a DLT.
Time frame: 28 day
Phase 1 Study: To evaluate the tolerability of CRC01 in patients with severe refractory autoimmune disease (systemic lupus erythematosus), and to determine the maximum tolerated dose (MTD) and the recommended Phase 2 dose (RP2D)
Safety and tolerability will be assessed by: 3\. Determination of the recommended Phase 2 dose (RP2D) based on incidence of DLTs, safety profile, and investigator/sponsor assessment.
Time frame: 28 day
Phase 2 Study: To evaluate the efficacy of CRC01 by assessing Complete Renal Response (CRR)
Complete Renal Response (CRR): Defined as meeting all of the following criteria: 1\. 24-hour urine protein ≤0.5 g, or urine protein-to-creatinine ratio (UPCR) ≤0.5. If a 24-hour urine collection is available and meets adequacy criteria, 24-hour urine protein assessment takes precedence. If the 24-hour urine collection is inadequate or not performed, UPCR will be used for evaluation.
Time frame: 24 weeks
Phase 2 Study: To evaluate the efficacy of CRC01 by assessing Complete Renal Response (CRR)
Complete Renal Response (CRR): Defined as meeting all of the following criteria: 2\. eGFR ≥60 mL/min/1.73m², or a decrease in eGFR ≤20% compared with the pre-flare value.
Time frame: 24 weeks
Phase 2 Study: To evaluate the efficacy of CRC01 by assessing Complete Renal Response (CRR)
Complete Renal Response (CRR): Defined as meeting all of the following criteria: 3\. No use of rescue medication for systemic lupus erythematosus (SLE). (Use of corticosteroids equivalent to ≤7.5 mg/day prednisone is permitted.)
Time frame: 24 weeks
Complete Renal Response (CRR) or Partial Renal Response (PRR) at each assessment Visit
PRR is defined as ≥50% reduction in UPCR compared with baseline.
Time frame: Up to Week 52
Change From Baseline in Urine Protein-to-Creatinine Ratio (UPCR)
Change from baseline in UPCR measured in urine (mg/mg)
Time frame: up to Week 52
Change From Baseline in Serum Creatinine
Change from baseline in serum creatinine. Unit of measure (mg/dL)
Time frame: up to Week 52
Change From Baseline in Estimated Glomerular Filtration Rate (eGFR)
Change from baseline in eGFR. Unit of measure: mL/min/1.73 m²
Time frame: up to Week 52
Change from baseline in UPCR, serum creatinine, urine protein, and eGFR
Composite evaluation of renal parameters including UPCR (mg/mg)
Time frame: up to Week 52
Time to achieve UPCR ≤0.5
Time from baseline to first achievement of UPCR ≤0.5.
Time frame: Up to Week 52
Change from baseline in SLEDAI-2K scores
Evaluation of change in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)
Time frame: Weeks 12, 24, and 52
Change From Baseline in Physician's Global Assessment at Week 12
Change in Physician's Global Assessment (PGA; scale 0-3)
Time frame: Week 12
Change From Baseline in Physician's Global Assessment at Week 24
Change in Physician's Global Assessment (PGA; scale 0-3)
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Time frame: Week 24
Change From Baseline in Physician's Global Assessment at Week 52
Change in Physician's Global Assessment (PGA; scale 0-3)
Time frame: Week 52
Achieving LLDAS at each assessment Visit
Percentage of participants achieving Low Lupus Disease Activity State (LLDAS)
Time frame: Weeks 12, 24, and 52
Change from baseline in SF-36 scores
Change in health-related quality of life assessed by Short Form Health Survey-36 (SF-36)
Time frame: Weeks 12, 24, and 52
Change from screening in immunology parameters
Composite evaluation of immunology markers including C3, C4 (mg/dL), anti-dsDNA antibody (IU/mL), and autoantibody titers (ANA, Anti-Sm, Anti-Ro 52/60, Anti-La). Each marker will be summarized separately and reported by its corresponding unit of measure.
Time frame: up to Week 52