This is an investigator initiated trial to assess the safety and efficacy of BCT301 cell Injection (CAR-iT cells derived from chemically induced pluripotent stem cells) in patients with refractory/recurrent IgG4-related disease.
This is a single-arm, open-label, single-center clinical study in which all patients receive a unified treatment regimen. The primary objective is to evaluate the safety and tolerability of BCT301 Cell Injection in patients with refractory/recurrent IgG4-RD. Secondary objective is to evaluate the improvement in disease activity in patients with refractory/recurrent IgG4-RD treated with BCT301 Cell Injection. Six subjects with refractory/recurrent IgG4-RD meeting the inclusion/exclusion criteria are planned to be enrolled and will receive a single infusion of 1.8 × 10\^8 BCT301 Cell Injection to evaluate the safety, efficacy, and PK/PD characteristics following BCT301 Cell Injection infusion. The study flow consists of a screening period, a lymphodepletion pretreatment period, a treatment period, and a follow-up period. Patients without relapse or deterioration after BCT301 Cell Injection infusion and not requiring protocol-prohibited treatment will undergo a primary follow-up of up to 360 days.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
BCT301 Cell Injection are CAR-iT cells derived from chemically induced pluripotent stem cells. Six subjects with refractory/recurrent IgG4-RD meeting the inclusion/exclusion criteria are planned to be enrolled and will receive a single infusion of 1.8 × 10\^8 BCT301 Cell Injection to evaluate the safety, efficacy, and PK/PD characteristics following BCT301 Cell Injection infusion.
The safety and tolerability of BCT301 Cell Injection in patients with refractory/recurrent IgG4-RD.
The occurrence of cell-infusion-related adverse events within 28 days after BCT301 Cell Injection infusion, with special emphasis on cell-therapy-specific adverse reactions such as CRS and ICANS.
Time frame: 28 days after BCT301 Cell Injection infusion
The change in IgG4-RD RI from baseline at 180 days after BCT301 Cell Injection infusion.
This endpoint evaluates the absolute change in the IgG4-Related Disease Responder Index (IgG4-RD RI) score from baseline to Day 180 post-infusion. The IgG4-RD RI is a validated, disease-specific composite scoring system that quantifies organ involvement and disease activity across multiple domains (e.g., head/neck, chest, retroperitoneum, etc.). The change is calculated as the Day 180 score minus the baseline score; a negative value indicates improvement (reduction in disease activity), while a positive value indicates worsening. This continuous variable complements the binary response rate endpoint by providing a more granular assessment of the degree of clinical improvement or deterioration over time, and will be analyzed using descriptive statistics (mean, median, standard deviation) as well as inferential tests (e.g., paired t-test or Wilcoxon signed-rank test) for within-subject change.
Time frame: 180 days after BCT301 Cell Injection infusion.
IgG4-RD RI response rate (decrease ≥ 2 points from baseline) at 90 and 180 days after BCT301 Cell Injection infusion.
This endpoint measures the proportion of subjects achieving at least a 2-point reduction from baseline in the IgG4-Related Disease Responder Index (IgG4-RD RI) at Day 90 and Day 180 post-infusion. The IgG4-RD RI is a validated disease activity scoring system; a decrease of ≥2 points is considered clinically meaningful and indicates a partial response to treatment.
Time frame: 90, 180 days after BCT301 Cell Injection infusion.
IgG4-RD complete remission rate at 180 and 360 days after BCT301 Cell Injection infusion.
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This endpoint evaluates the proportion of subjects who achieve stringent complete remission at Day 180 and Day 360. Complete remission requires all three criteria to be met simultaneously: (1) IgG4-RD RI score of 0 (no active disease manifestations); (2) prednisone dose of 0 mg/day after Week 4 (excluding any short-term glucocorticoid pulse used specifically to manage cytokine release syndrome \[CRS\] or allogeneic immune reactions, which are not counted as maintenance therapy); and (3) no documented recurrence or flare of disease activity from baseline through the assessment time point.
Time frame: 180 and 360 days after BCT301 Cell Injection infusion.
Proportion of patients with relapse after remission at 90, 180, and 360 days after BCT301 Cell Injection infusion.
This endpoint measures the cumulative proportion of subjects who, having achieved any remission (partial or complete) after infusion, subsequently experience disease relapse at Day 90, Day 180, or Day 360. Relapse is specifically defined as an increase in IgG4-RD RI score during the follow-up period that necessitates additional therapeutic intervention not specified in the study protocol, thereby indicating loss of disease control.
Time frame: 90, 180, and 360 days after BCT301 Cell Injection infusion.
Changes in IgG4 levels at 90, 180, and 360 days after BCT301 Cell Injection infusion.
This endpoint assesses the absolute change from baseline in serum IgG4 concentration (measured in g/L) at Day 90, Day 180, and Day 360 post-infusion.
Time frame: 90, 180, and 360 days after BCT301 Cell Injection infusion.
Physician Global Assessment (PhGA) and Patient Global Assessment (PtGA) compared with baseline.
This endpoint evaluates the change from baseline in both the Physician Global Assessment (PhGA) and the Patient Global Assessment (PtGA), each measured using a single-item visual analogue scale (VAS) ranging from 0 to 100 mm, where 0 indicates no disease activity and 100 indicates the worst possible disease activity/symptoms. Higher scores indicate a worse outcome. Changes are assessed at predefined time points (consistent with other endpoints, e.g., 90, 180, and 360 days) to capture the treatment effect from both clinician and patient perspectives.
Time frame: 90, 180, and 360 days after BCT301 Cell Injection infusion.