This is an investigator-initiated trial aimed at assessing the safety and efficacy of PTOC1 cells Injection in the treatment of refractory systemic lupus erythematosus.
Systemic lupus erythematosus (SLE) is a serious autoimmune disease that can lead to extensive damage in multiple organs and systems, ultimately resulting in disability and even death. Currently, the primary treatment for SLE relies on glucocorticoids and immunosuppressants to alleviate symptoms. However, due to the absence of a curative treatment, patients typically need to remain on medication indefinitely. In recent years, biological agents such as belimumab and rituximab have been introduced for the treatment of SLE, but these treatments cannot completely eliminate autoimmune B cells in the bone marrow, leading to unsatisfactory overall outcomes. In addition, discontinuing these drugs can lead to disease relapse, and patients still face the challenges of lifelong medication and an incurable disease. CAR-T therapy is an adoptive cell therapy that uses genetic modification technology to reprogram T cells and eliminate target cells expressing disease-related antigens through antigen-specific recognition. Clinical studies have demonstrated that CD19-targeted CAR-T cells hold significant therapeutic potential for SLE. Compared with traditional CAR-T cells, PTOC1 cells Injection, relying on an innovative CAR-T manufacturing system, can be produced in an extremely short period of time (with a preparation time of only 10 minutes). The purpose of this study is to assess the safety and efficacy of PTOC1 cells Injection in the treatment of refractory SLE.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Three dose groups (1.5×10\^5/kg, 5×10\^5/kg,1×10\^6/kg) were set up, starting from the low dose group climbing to explore the safe and effective dose.
Children's Hospital of Chongqing Medical University
Chongqing, China
RECRUITINGThe safety of PTOC1 cell therapy in patients with refractory SLE [Safety]
Types, frequency and severity of adverse events.
Time frame: 3 months
The changes in SLEDAI-2K from baseline [efficacy]
Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) ranges from 0 to 105 points. The higher the score, the higher the disease activity.
Time frame: 6 months
The changes in PGA from baseline [efficacy]
Physician Global Assessment(PGA) is a continuous visual analogue scale with 0, 1, 2, and 3 scores. "0" indicates no disease activity and "3" indicates the most severe disease activity.
Time frame: 6 months
The changes in BILAG-2004 from baseline [efficacy]
British Isles Lupus Assessment Group Index 2004(BILAG-2004) consists of 8 systems, each of which is graded as A, B, C and D. "A" indicates that the condition is highly active and requires active treatment. "B" indicates that the condition is active and requires close monitoring or symptomatic treatment. "C" indicates a stable condition. "D" indicates that the system is uninvolved.
Time frame: 6 months
The number of patients with SRI-4 response [efficacy]
The definition of SRI-4 response: SLEDAI-2K ≥ 4 points improvement; PGA \<0.3 points increase; BILAG 2004 with no new A grade score and no more than 1 new B grade score.
Time frame: 3 months
The number of patients with LLDAS [efficacy]
The definition of LLDAS: SLEDAI-2K ≤ 4 points and no disease activity in major organs (kidney, central nervous system, heart and lung), and no vasculitis or fever; no new disease activity symptoms compared with previous disease assessments; PGA ≤ 1; serological parameters not required; with the permitted use of low-dose glucocorticoids (prednisolone ≤ 7.5 mg/day), and/or stable immunosuppressives and biologics.
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Time frame: 6 months
The number of patients with DORIS [efficacy]
The definition of DORIS: SLEDAI-2K = 0 points; PGA \< 0.5 points; serological parameters not required; with the permitted use of antimalarials, low-dose glucocorticoids (prednisolone ≤ 5 mg/day), and/or stable immunosuppressives and biologics.
Time frame: 6 months
Cmax of PTOC1 cells [PK parameter]
The peak concentration (Cmax) of amplified PTOC1 cells in peripheral blood after infusion can be measured.
Time frame: 3 months
Tmax of PTOC1 cells [PK parameter]
The time for amplified PTOC1 cells in peripheral blood to reach the maximum concentration (Tmax) can be measured.
Time frame: 3 months
AUC28d/90d of PTOC1 cells [PK parameter]
The area under the plasma concentration-time curve from 28 to 90 days after infusion (AUC28d/90d) can be measured.
Time frame: 3 months
The degree of B cell depletion [PD parameter]
The degree of CD19+ B cell depletion at different time points.
Time frame: 3 months
The concentration of IL-6 [PD parameter]
The serum concentration of CAR-T therapy-related cytokines such as IL-6 at different time points.
Time frame: 3 months
The concentration of CRP [PD parameter]
The serum concentration of CAR-T therapy-related cytokines such as CRP at different time points.
Time frame: 3 months
The concentration of ferritin [PD parameter]
The serum concentration of CAR-T therapy-related cytokines such as ferritin at different time points.
Time frame: 3 months
The proportion of major B-cell subtypes
The proportion of major B-cell subtypes at each visit time point after infusion.
Time frame: 6 months
The correlation between the proportion of major B-cell subtypes and the reduction of disease activity
The correlation between the proportion of major B-cell subtypes at each visit time point after infusion and the reduction of disease activity relative to baseline.
Time frame: 6 months