This trial is an investigator-initiated, single-arm, open-label Phase Ib/II study to observe the safety, tolerability, PK/PD characteristics, immunogenicity, and the efficacy of SYS6020 injection in participants with relapsed/refractory multiple sclerosis. The study plans to enroll participants with progressive or relapsing multiple sclerosis. The recommended dosing regimen is as follows: a single administration dose of 45×10\^6 CAR-T cells/kg (allowing a fluctuation of ±20%), administered once a week for 6 consecutive doses. To ensure participant safety, this study will establish a Safety Monitoring Committee (SMC). A staggered enrollment and dosing strategy will be adopted in the early stage. Two early safety evaluation will be established (after the first 3 enrolled participants complete their first 3 infusions of SYS6020, and after the first 3 enrolled participants complete their first 6 infusions of SYS6020) for comprehensive assessment. The study plans to enroll 10-15 participants. Once the enrollment of 10-15 participants is complete, a comprehensive assessment may be conducted based on the actual progress of the study and combined with existing data. This will fully evaluate the safety, preliminary efficacy, and PK/PD/ADA data of the enrolled participants. If the overall safety of the participants is manageable, preliminary efficacy shows a positive trend, and there are value and necessity for further exploration, expanding the number of participants may be considered (up to a maximum of 25 participants in total).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
25
SYS6020 injection is an injection of autologous CAR-T cells that have been temporarily transfected with LNP-mRNA targeting BCMA. The eligible participants will receive a single administration dose of 45×10\^6 CAR-T cells/kg (allowing a fluctuation of ±20%), administered once a week for 6 consecutive doses
Tongji Hospital, Tongji Medical College of Hust
Wuhan, Hubei, China
Safety and tolerability
Incidence, severity, and relationship of adverse events and serious adverse events, and incidence of clinically significant laboratory abnormalities.
Time frame: From informed consent through Month 24
Time to 12-Week Confirmed Disability Progression (CDP) in Participants with Progressive Multiple Sclerosis
Time to protocol-defined worsening in Expanded Disability Status Scale (EDSS) score sustained for at least 12 weeks in participants with SPMS or PPMS
Time frame: Month 24
Annualized Relapse Rate (ARR) in Participants with Relapsing Multiple Sclerosis
Number of protocol-defined relapses divided by total participant-years of follow-up
Time frame: Time Frame: Month 24
Change from Baseline in EDSS(Expanded Disability Status Scale) Score
The EDSS ranges from 0 to 10, with higher scores indicating greater neurological disability.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Proportion of Participants with an Improvement of at Least 1.0 Point in EDSS(Expanded Disability Status Scale) Score
The EDSS ranges from 0 to 10, with higher scores indicating greater neurological disability.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Proportion of Participants Without Confirmed Disability Progression
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
RMS: Proportion of Participants Who Remain Relapse-Free
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in Timed 25-Foot Walk(T25FW)
Measured in seconds. A longer completion time indicates worse walking performance.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in Nine-Hole Peg Test(9HPT)
Measured in seconds. A longer completion time indicates worse upper-extremity and manual dexterity performance.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in Multiple Sclerosis Functional Composite (MSFC) Score Description
The MSFC score has no fixed minimum or maximum value, and higher scores indicate better neurological function.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in Modified Fatigue Impact Scale (MFIS) Score
The 21-item MFIS total score ranges from 0 to 84, with higher scores indicating a greater impact of fatigue on daily functioning.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in VAS (Visual Analog Scale) Score
Scores range from 0 to 10. Higher scores indicate greater pain severity.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in Multiple Sclerosis Quality of Life-54 (MSQOL-54) Score
Scores range from 0 to 100, with higher scores indicating better quality of life.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in 36-Item Short Form Health Survey Score (SF-36)
The SF-36 includes eight domains. Each domain score ranges from 0 to 100, with higher scores indicating better health status.
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Change from Baseline in T2-Weighted Lesion Volume
Time frame: Baseline and Months 3, 6, 12, 18, and 24
PMS: Brain Volume Loss from Baseline
Time frame: Baseline and Months 3, 6, 12, 18, and 24
Number of New or Enlarging T2-Weighted Lesions
Time frame: Baseline and Months 3, 6, 12, 18, and 24
RMS: Gadolinium-Enhancing Lesion Outcomes
Time frame: Baseline and Months 3, 6, 12, 18, and 24
PK: BCMA CAR Transgene Copy Number in Peripheral Blood
Quantified using quantitative polymerase chain reaction (qPCR)
Time frame: Before and immediately after the first, second, third, and fifth infusions; at 1, 2, 6, 24, 48, and 72 hours after the first and second infusions; and at 1 and 2 hours after the third and fifth infusions, as protocol specified.
PK:BCMA CAR-Positive Cells in Peripheral Blood
The absolute count and percentage of circulating BCMA CAR-positive cells in peripheral blood will be measured using flow cytometry
Time frame: Before and immediately after, and at 1 and 2 hours after the first, second, third, and fifth infusions.
PK: BCMA CAR Transgene Copy Number in Cerebrospinal Fluid
Quantified using qPCR
Time frame: At screening and within 1 to 3 hours after the fifth infusion
Change from Baseline in Peripheral Blood B-Cell Subsets
Time frame: Baseline and Day 15, Months 1, 3, 9, 18, and 24
Change from Baseline in Immunoglobulin Levels
Time frame: Baseline and Months 1, 3, 6, 9, 12, 18, and 24
Incidence of Anti-CAR Antibodies
Time frame: Baseline and Day 15, Months 1, 3, 6, 9, 12, 18, and 24
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