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 Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • 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 - 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) - 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 - Investigational treatment in last 3 months

Study Design

Phase
Phase 1
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
DSG3-CAART or CABA-201
Cohort A: Fractionated infusions of DSG3-CAART at increasing dose levels (6-9 groups) administered as a single cycle. Cohort B: Consolidation of infusion of DSG3-CAART to fewer fractionations than in Cohort A using the selected dose from Cohort A (1 group) administered as a single cycle. Cohort C: Infusion of final selected dose and fractionation of DSG3-CAART from Cohorts A and B (1 group) administered as a single cycle. OR CABA-201 Cohort: Single infusion of CABA-201.
  • Biological: DSG3-CAART or CABA-201
    Intravenous infusions of DSG3-CAART alone at different doses and different fractionations. Subjects may also receive varying doses of DSG3-CAART as part of a sub-study, which will employ pre-treatment with intravenous immunoglobulin, cyclophosphamide, and with or without fludarabine to potentially increase the in vivo expansion, persistence and activity of DSG3-CAART. OR CABA-201: Single intravenous infusion of CABA-201.

Recruiting Locations

Brigham and Women's Hospital
Boston, Massachusetts 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 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. A sub-study will be conducted to investigate if CABA-201 can be safely administered while achieving clinical responses without the need for preconditioning in PV patients. DSG3-CAART or CABA-201 may potentially lead to complete and durable remission of disease.