This is an open-label, single-arm, dose-escalation study designed to evaluate the safety, tolerability, recommended subsequent dose, pharmacokinetic profile, and preliminary efficacy of JCXH-213 in adult patients with primary immune thrombocytopenia (ITP) who are refractory or relapsed after treatment with corticosteroids and second-line therapies. The study consists of a screening period, treatment period, end-of-treatment visit, safety follow-up, and study withdrawal visit. Two dose groups are planned: 2 mg and 4 mg, with 2 patients to be enrolled in each dose group. During the treatment period, JCXH-213 at the assigned dose will be administered once every other day for a total of 7 doses. Assessments for safety and efficacy will be conducted according to the study schedule. After the last dose, patients will undergo an end-of-treatment visit and safety follow-up until the end of the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
4
An mRNA-LNP based in vivo CAR therapy
Safety and tolerability of JCXH-213
Number of participants with adverse events (AEs), serious adverse events (SAEs), with abnormal laboratory tests results, abnormal electrocardiogram (ECG) readings, and abnormal vital signs
Time frame: The DLT observation period is 14 days after the first infusion of JCXH-213 (Day1-Day14).
Platelet count over time
Platelet count measured at Weeks 1, 2, 4, 8, and Months 3 and 4 after the first JCXH-213 infusion. If platelet count remains ≥ 30 × 10⁹/L at Month 4, extended follow-up may be performed at the investigator's discretion.
Time frame: Baseline to Month 4 (or longer at investigator's discretion)
Time to platelet response
Time from first JCXH-213 infusion to first platelet count ≥ 30 × 10⁹/L with ≥ 2-fold increase from baseline, and time to first platelet count ≥ 50 × 10⁹/L.
Time frame: From first infusion to Day 120
Cumulative weeks of platelet response
Cumulative weeks with platelet count ≥ 30 × 10⁹/L and ≥ 2-fold increase from baseline, and cumulative weeks with platelet count ≥ 50 × 10⁹/L, from first infusion to Day 120.
Time frame: From first infusion to Day 120
Change in WHO bleeding score
Change in World Health Organization (WHO) bleeding score from baseline to Day 56. The WHO bleeding score ranges from 0 to 4, with higher scores indicating worse bleeding outcomes.
Time frame: Baseline to Day 56
Degree of disease control
Degree of disease control, defined as cumulative weeks with platelet count ≥ 50 × 10⁹/L over a specified period.
Time frame: From first infusion to Day 120
Changes in platelet autoantibodies
Changes in platelet autoantibodies after JCXH-213 infusion, including: (1) quantitative detection of platelet surface-associated immunoglobulins (IgA, IgG, IgM); and (2) qualitative detection of platelet-specific and histocompatibility antibodies.
Time frame: From first infusion to Day 120
Peripheral blood B-cell subset profiling
Peripheral blood B-cell subset distribution after JCXH-213 infusion, assessed by flow cytometry.
Time frame: From first infusion to Day 120
Changes in peripheral blood JCXH-213 mRNA levels
Changes in peripheral blood JCXH-213 mRNA levels after JCXH-213 infusion, assessed by quantitative PCR (qPCR)
Time frame: From within 1 hour before the first dose to 24 hours after the last dose (Day 14)
Changes in peripheral blood CD19 CAR-positive cells
Subset distribution and level changes of peripheral blood CD19 CAR-positive cells after JCXH-213 infusion, assessed by flow cytometry
Time frame: From within 1 hour before the first dose to 24 hours after the last dose (up to Day 14)
Changes in peripheral blood cytokine levels
Changes in peripheral blood cytokine levels, including interleukin-6 (IL-6), interferon-α (IFN-α), and interferon-γ (IFN-γ), after JCXH-213 infusion
Time frame: From within 1 hour before the first dose to 24 hours after the last dose (up to Day 14)
Changes in anti-drug antibodies (ADA)
Changes in peripheral blood anti-drug antibodies (ADA), including anti-CAR antibodies and anti-PEG antibodies, after JCXH-213 infusion
Time frame: From within 1 hour before the first dose to 24 hours after the last dose (up to Day 14)
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