Systemic lupus erythematosus (SLE) is the most common systemic autoimmune disease in China. The kidneys are the organ most frequently affected in SLE and a major cause of mortality among SLE patients. Currently, cell-based therapy has emerged as an innovative treatment approach for SLE. CHT105 injection is an allogeneic chimeric antigen receptor T (CAR-T) cell product derived from healthy donors' T cells, which are transduced with a lentiviral vector encoding an anti-CD19/CD70 CAR. This engineered T-cell product effectively recognizes and eliminates immune cells expressing CD19 and/or CD70 antigens-including autoreactive T and B cells-and holds promise as a novel therapeutic option for patients with refractory lupus nephritis (LN). This study is a clinical trial evaluating the safety and preliminary efficacy of CHT105 injection-a CD19/CD70-targeting allogeneic CAR-T cell product-in adult patients with relapsed or refractory LN. Eligible participants will first undergo lymphodepleting preconditioning. Following confirmation of eligibility per standard infusion criteria, participants will receive a single intravenous infusion of CHT105 on Day 0 (D0). After CHT105 infusion, participants will undergo a 52-week short-term follow-up and up to a 15-year long-term follow-up.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
14
All subjects will receive fludarabine/cyclophosphamide lymphodepletion followed by CHT105 infusion.
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Nanjing, Jiangsu, China
Safety of CHT105 Injection in Subjects with Refractory Lupus Nephritis
* Types and incidence of dose-limiting toxicities (DLTs); * Types, severity, and frequency of adverse events (AEs); * Incidence and grading of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).
Time frame: From enrollment to the end of treatment at 52 weeks
Complete Renal Response (CRR)
Evaluated only in participants with lupus nephritis; participants meeting all the following criteria are considered to have achieved CRR: Urinary protein excretion \<0.5 g/24 h or urine protein-to-creatinine ratio (UPCR) \<0.5 g/g; Estimated glomerular filtration rate (eGFR) decline ≤10-15% from baseline or eGFR ≥60 mL/min/1.73 m²; No use of rescue medications exceeding protocol-specified thresholds prior to assessment.
Time frame: at Week 24 after CHT105 infusion.
Partial Renal Response (PRR)
Evaluated only in participants with lupus nephritis; participants meeting all the following criteria are considered to have achieved PRR: eGFR decline ≤10-15% from baseline or eGFR ≥60 mL/min/1.73 m²; Improvement in 24-hour UPCR: * For participants with baseline UPCR ≤3.0 g/g: UPCR \<1.0 g/g; * For participants with baseline UPCR \>3.0 g/g: \>50% reduction from baseline and UPCR \<3.0 g/g; No use of rescue medications exceeding protocol-specified thresholds prior to assessment.
Time frame: At at Week 24 after CHT105 infusion.
Primary Efficacy Renal Response (PERR)
Evaluated only in participants with lupus nephritis; participants meeting all the following criteria are considered to have achieved PERR: UPCR ≤0.7 g/g; eGFR decline ≤20% from baseline or eGFR ≥60 mL/min/1.73 m²; No use of rescue medications exceeding protocol-specified thresholds prior to assessment.
Time frame: At at Week 24 after CHT105 infusion.
Overall Renal Response (ORR)
Evaluated only in participants with lupus nephritis, encompassing those achieving either complete renal response (CRR) or partial renal response (PRR).
Time frame: At at Week 24 after CHT105 infusion.
CRR, PRR, or PERR, and overall response rate
percentage of participants achieving CRR, PRR, or PERR, and overall response rate (i.e., percentage achieving either CRR or PRR)
Time frame: At each follow-up visit between the first dose and Week 52.
the Systemic Lupus Erythematosus Responder Index-4 (SRI-4) criteria
Trial participants who meet all of the following criteria are considered to have achieved the SRI response: * A reduction of ≥4 points in the SLEDAI-2K score from baseline; * No new BILAG A-grade organ involvement and no new BILAG B-grade involvement in two or more organs, as assessed by the BILAG-2004 index relative to baseline; * No worsening in the Physician's Global Assessment (PGA), defined as an increase of \<0.30 points on the Visual Analog Scale (VAS) from baseline; * No use of rescue medications exceeding protocol-specified thresholds prior to assessment.
Time frame: At each follow-up visit between the first dose and Week 52.
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