This is a Phase I, IIa, Single-Arm, interventional, open label, treatment study to evaluate the safety and tolerability of ICG318 CAR-T (BCMA-CD19-IL-15/IL15sushi cCAR T cells) in patients with relapsed and/or refractory inflammatory bowel disease.
Inflammatory bowel disease (IBD) is a chronic, immune-mediated disease of the gastrointestinal (GI) tract. IBD may result in GI lesions as well as extraintestinal manifestations affecting the joints, skin, eyes, and biliary system. IBD is driven by humoral immune cells including B cells, plasma cells and long-lived plasma cells. ICG318 CAR-T, the investigational agent in this clinical trial, is an armored, compound chimeric antigen receptor (cCAR) composed of two independently functioning CARs that target the CD19 surface antigen and the BCMA surface antigen on B cells and plasma/long-lived plasma cells, respectively. This study is being conducted to evaluate the safety and efficacy of ICG318 CAR-T in patients with refractory IBD. A single dose of ICG318 CAR-T will be evaluated after cyclophosphamide and fludarabine lymphodepletion.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Anti-BCMA, Anti-CD19 Compound CAR-T cells
Zhongshan people's hospital
Zhongshan, Guangdong, China
Number of Adverse Events (AEs) after ICG318 CAR-T infusion.
Number of participants with AEs, Serious Adverse Events (SAEs), Treatment Emergent Adverse Events (TEAEs), Adverse Events of Special Interest (AESI), and Dose Limiting Toxicities (DLTs).
Time frame: Starting day 0 and up to 2 years after ICG318 CAR-T infusion.
Determine the recommended phase 2 dose (RP2D) regimen.
The protocol is based on cohort schema with dose escalation from 1×10\^6/kg to 4×10\^6/kg.
Time frame: Starting day 0 and assessed 2 years after ICG318 CAR-T infusion.
The proportion of subjects who achieved drug-free remission.
Clinical, endoscopic, and histological remission maintained without any IBD-directed therapy.
Time frame: At 6 months, 12 months, 24 months after ICG318 CAR-T infusion.
Fecal calprotectin levels.
Time frame: 28 days, 2 months, 3 months, 6 months, 9 months, 12 months, 18 months, 24 months after ICG318 CAR-T infusion.
Cmax
Maximum serum concentration of ICG318 CAR-T.
Time frame: Assessed as per schedule of events up to 2 years after ICG318 CAR-T infusion.
Tmax
Time to maximum serum concentration of ICG318 CAR-T.
Time frame: Assessed as per schedule of events up to 2 years after ICG318 CAR-T infusion.
T1/2
Half-life of ICG318 CAR-T serum concentration.
Time frame: Assessed as per schedule of events up to 2 years after ICG318 CAR-T infusion.
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AUC
Plasma ICG318 CAR-T concentration versus time. Total systemic exposure to ICG318 CAR-T over time.
Time frame: Assessed as per schedule of events up to 2 years after ICG318 CAR-T infusion.
Rate of B cell elimination and naïve B-Cell recovery
B cell subsets will be assessed by flow cytometry panels and B-Cell receptor sequencing.
Time frame: Assessed as per schedule of events up to 2 years after ICG318 CAR-T infusion.
Recovery of immunoglobulins
Immunoglobulins IgG, IgM and IgA levels.
Time frame: Assessed as per schedule of events up to 2 years after ICG318 CAR-T infusion.
The proportion of subjects who achieved clinical remission from Crohn's Disease (CD)
CD activity index (CDAI) remission
Time frame: 3 months, 6 months, 12 months, 18 months, 24 months after ICG318 CAR-T infusion.
The proportion of subjects who achieved clinical response from CD
CDAI reduction
Time frame: 3 months, 6 months, 12 months, 18 months, 24 months after ICG318 CAR-T infusion.
The proportion of subjects who achieved endoscopic remission from CD
SES-CD remission.
Time frame: 12 months, 24 months after ICG318 CAR-T.
The proportion of subjects who achieved endoscopic response from CD
SES-CD reduction
Time frame: 12 months, 24 months after ICG318 CAR-T.
Histological Remission from CD
Absence of inflammation on tissue samples collected from endoscopic biopsy.
Time frame: 12 months, 24 months after ICG318 CAR-T.
The proportion of subjects who achieved clinical remission from Ulcerative Colitis (UC)
Adapted Mayo score remission.
Time frame: 3 months, 6 months, 12 months, 18 months, 24 months after ICG318 CAR-T infusion.
The proportion of subjects who achieved clinical response from UC
Adapted Mayo score response.
Time frame: 3 months, 6 months, 12 months, 18 months, 24 months after ICG318 CAR-T infusion.
The proportion of subjects who achieved endoscopic remission from UC
Mayo Endoscopic Subscore (MES) remission.
Time frame: 12 months, 24 months after ICG318 CAR-T infusion.
The proportion of subjects who achieved endoscopic response from UC
MES response.
Time frame: 12 months, 24 months after ICG318 CAR-T infusion.
Histological remission from UC
Nancy Histological Index (NHI) scoring. Evaluation performed on tissue samples collected from endoscopic biopsy.
Time frame: 12 months, 24 months after ICG318 CAR-T infusion.