A Phase 1/2, Open-label, Safety and Dosing Study of Autologous CART Cells (Desmoglein 3 Chimeric Autoantibody Receptor T Cells [DSG3-CAART] or CD19-specific Chimeric Antigen Receptor T Cells [CABA-201]) in Subjects With Active, Pemphigus Vulgaris (RESET-PV)

Purpose

A phase 1/2, open-label, safety and dosing study of autologous CART cells (desmoglein 3 chimeric autoantibody receptor T cells [DSG3-CAART] or CD19-specific Chimeric Antigen Receptor T cells [CABA-201]) in subjects with active, pemphigus vulgaris

Condition

  • Pemphigus Vulgaris

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

for DSG3-CAART: Closed to enrollment - Confirmed diagnosis of mPV by prior or screening biopsy and prior positive anti- DSG3 antibody ELISA - mPV inadequately managed by at least one standard immunosuppressive therapies - Active mPV at screening - Anti-DSG3 antibody ELISA positive at screening Inclusion Criteria for CABA-201 sub-study: Open to enrollment - Age ≥18 - Confirmed diagnosis of PV by prior or screening biopsy and prior positive DSG3 ELISA, IIF, and/or DIF - PV inadequately managed by at least one standard immunosuppressive therapy - Active PV at screening - DSG3 ELISA positive at screening

Exclusion Criteria

  • Active cutaneous lesions associated with PV that indicates mucocutaneous rather than mucosal-dominant disease - Rituximab in last 12 months unless PV symptoms have recently worsened or anti-DSG3 antibody titers have recently increased - Prednisone > 0.25mg/kg/day - Other autoimmune disorder requiring immunosuppressive therapies - Investigational treatment in last 3 months Exclusion Criteria for CABA-201 sub-study - Have paraneoplastic pemphigus or active malignancy (not including non-melanoma skin cancer) or malignancy diagnosed within the previous 5 years - Have received rituximab or other anti-CD20 or anti-CD19 therapies in last 12 months unless anti-DSG3 antibody titers have recently increased or PV symptoms have recently worsened - Prednisone > 0.25mg/kg/day - Other autoimmune disorder requiring immunosuppressive therapies - Treatment with any investigational agent within 4 weeks or 5 half-lives, whichever is longer.

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Sequential Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
DSG3-CAART
Single or multiple intravenous infusion(s) of DSG3-CAART at varying dose levels. This study is now closed to enrollment.
  • Biological: DSG3-CAART
    Intravenous infusions of DSG3-CAART alone at different doses and different fractionations, with or without intravenous immunoglobulin, cyclophosphamide, and/or fludarabine.
Experimental
CABA-201
Infusion of CABA-201 with or without cyclophosphamide and fludarabine preconditioning, or with or without cyclophosphamide preconditioning. This sub-study is open to enrollment.
  • Biological: CABA-201
    Single intravenous infusion of CABA-201 at escalating doses, with or without preconditioning.

Recruiting Locations

Brigham and Women's Hospital
Boston 4930956, Massachusetts 6254926 02115
Contact:
Rita Gyurko
617-278-6903
rgyurko1@bwh.harvard.edu

More Details

Status
Recruiting
Sponsor
Cabaletta Bio

Study Contact

Cabaletta Bio
+1 267 759 3100
clinicaltrials@cabalettabio.com

Detailed Description

Pemphigus vulgaris (PV) is a B-cell mediated autoimmune disorder in which painful blisters are formed on the skin or mucosal membrane, including the mouth, nose, throat, eyelids, anus, and genitals. This phase 1/2 study is being conducted in two parts. The first part is the main study conducted to find the maximum tolerated dose and optimal fractionated infusion schedule of an investigational cell therapy, DSG3-CAART, that can be given to patients with mucosal PV who are inadequately managed by standard therapies. This study is closed to enrollment. The second part is a sub-study is being conducted to investigate if CABA-201, also called resecabtagene autoleucel, or "rese-cel", can be safely administered while achieving clinical responses without the need for preconditioning in mucosal-dominant PV (mPV) and mucocutaneous PV (mcPV) patients. This sub-study is open to enrollment. DSG3-CAART or CABA-201 may potentially lead to complete and durable remission of disease.