Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

CD4^LVFOXP3 i deltagere med IPEX

2. november 2026 opdateret af: Jessie L. Alexander, MD, Bacchetta, Rosa, MD

Fase 1 undersøgelse af autolog CD4^LVFOXP3 hos deltagere med immun dysregulering polyendokrinopati enteropati X-linked (IPEX) syndrom

This first-in-human, Phase 1 clinical trial will test the feasibility of the manufacturing and the safety of the administration of CD4^LVFOXP3 in up to 30 evaluable human participants with IPEX and evaluate the impact of the CD4^LVFOXP3 infusion on the disease.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Treatment with CD4^LVFOXP3 is expected to replace the defective Treg cells of the participants, and restore control of the immune system and therefore ameliorate symptoms of IPEX.

We expect to learn the following from this study:

  1. That CD4^LVFOXP3 can be consistently produced and be of expected quality to be used in humans,
  2. That CD4^LVFOXP3 are safe in children and young adults with IPEX, and determine its effects, both good and bad,
  3. That CD4^LVFOXP3 can improve overall health and allow reduction of medication/s.

This Phase 1 (feasibility and safety) trial will gather data about CD4^LVFOXP3 in vivo persistency and early signs of impact on symptoms of IPEX.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

16

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • California
      • Palo Alto, California, Forenede Stater, 94305
        • Lucile Packard Children's Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

4 måneder til 35 år (Barn, Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Han

Beskrivelse

Inclusion Criteria:

  • Body weight greater than 8 kg, unless assessed as able to tolerate leukapheresis
  • FOXP3 gene mutation
  • Medical history of progressive symptoms of IPEX with persistency of some symptoms and/or signs requiring immune suppressive medication. The participant may or may not be on immunosuppression at time of starting the study.
  • Uncontrolled IPEX disease but unable to tolerate immune suppressive medication
  • Recurrent IPEX symptoms, requiring immune suppressive medications, in participants who have had prior allogeneic (allo) blood stem cell transplantation (HSCT).
  • ≥ 50% Performance rating on Lansky/Karnofsky Scale
  • Organ and marrow function within acceptable levels of function
  • Absence of ongoing infections
  • Must be able to consent if an adult

Exclusion Criteria:

  • Medical instability
  • Less than 6 months life expectancy
  • Inability to meet limits for steroid dosing
  • Eligible for an HLA matched sibling or matched unrelated donor blood stem cell transplant, and be willing to undergo transplant.
  • Unrelated or comorbid disease
  • Allergy to any study medication, product, or intervention
  • Currently receiving another experimental treatment
  • History of malignancy, unless disease free for at least 2 years, with the exception of non melanoma skin cancer or carcinoma in situ

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Cohort A (≥12 years)

The first participant in Dose Level 1 will be administered 1.0 x 10^6 CD4^LVFOXP3 /kg (± 20%).

If there is no toxicity observed in the first participant, the following participants in Dose Level 1 will be administered the same dose of 1.0 x 10^6 CD4^LVFOXP3 /kg (± 20%).

If there is no toxicity observed in any participants in Dose Level 1, participants will be enrolled into Dose Level 2 and administered 3 x 10^6 CD4^LVFOXP3 /kg (± 20%).

If there is no toxicity observed in any participants in Dose Level 2, participants will be enrolled into Dose Level 3 and administered 10 x 10^6 CD4^LVFOXP3 /kg (± 20%).

If in any dose level 1 of 2 participants show toxicity, that dose level will be expanded to 6 participants.

If there is no toxicity observed in any participants in Dose Level 3, participants will then be administered 10 x 10^6 CD4^LVFOXP3 /kg (± 20%) at two time points 21-42 days apart.

Infusion of autologous CD4+ T cells that have undergone lentiviral-mediated gene transfer of:

i) healthy human FOXP3 gene leading to persistent high FOXP3 expression and acquisition of Treg-like cell function; and ii) human CD271 surface marker gene that allows tracking and quantification of the CD4^LVFOXP3 in the blood.

Andre navne:
  • CD4^LVFOXP3 Treg-lignende celler
Eksperimentel: Cohort B (<12 years)

Participants in Cohort B will always follow treatment of participants in Cohort A for the same dose level.

Cohort B will start at Dose Level 2 and be administered 3 x 10^6 CD4^LVFOXP3 /kg (± 20%).

If there is no toxicity observed in any participants in Dose Level 2, participants will be enrolled into Dose Level 3 and administered 10 x 10^6 CD4^LVFOXP3 /kg (± 20%).

If in any dose level 1 of 2 participants show toxicity, that dose level will be expanded to 6 participants.

If there is no toxicity observed in any participants in Dose Level 3, participants will then be administered 10 x 10^6 CD4^LVFOXP3 /kg (± 20%) at two time points 21-42 days apart.

Infusion of autologous CD4+ T cells that have undergone lentiviral-mediated gene transfer of:

i) healthy human FOXP3 gene leading to persistent high FOXP3 expression and acquisition of Treg-like cell function; and ii) human CD271 surface marker gene that allows tracking and quantification of the CD4^LVFOXP3 in the blood.

Andre navne:
  • CD4^LVFOXP3 Treg-lignende celler

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Meet target cell number for dose manufacturing
Tidsramme: Time at release from manufacturing (by Day 0 [infusion day] for each participant)

No more than two products fail the target cell dose and established release criteria.

Time at release from manufacturing (by Day 0 [infusion day] for each participant)
Find the safe maximum tolerated dose
Tidsramme: Up to 60 days post-infusion for each participant

No more than 1 out of 6 participants may experience a related dose limiting toxicity or treatment emergent adverse events.

Up to 60 days post-infusion for each participant

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Ændring i aldersspecifikke højdepercentiler
Tidsramme: Baseline (op til 60 dage før infusion af CD4^LVFOXP3) gennem post-infusion (måned 12)
Baseline (op til 60 dage før infusion af CD4^LVFOXP3) gennem post-infusion (måned 12)
Ændring i aldersspecifikke percentiler af kropsvægt
Tidsramme: Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 1, 2, 3, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9, 12)
Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 1, 2, 3, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9, 12)
Ændring i bilirubinniveauer
Tidsramme: Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Ændring i leverenzym - Alanin Transaminase (ALT)
Tidsramme: Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Ændring i leverenzym - aspartattransaminase (AST)
Tidsramme: Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Ændring i leverenzym - alkalisk fosfatase (ALP)
Tidsramme: Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Ændring i leverenzym - Gamma Glutyltranspeptidase (GGT)
Tidsramme: Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Baseline (op til 60 dage før infusion af CD4^LVFOXP3), præ-infusion gennem post-infusion (dag 2, uge ​​1, 2, 3, 4; måned 2, 3, 6, 9 og 12)
Ændring i C-peptid - Type 1 diabetes Pre-debut
Tidsramme: Baseline taget 60-30 dage før infusion af CD4^LVFOXP3; Post-infusion (uge 4, måned 3, 6 og 12).
Baseline taget 60-30 dage før infusion af CD4^LVFOXP3; Post-infusion (uge 4, måned 3, 6 og 12).
Ændring i HbA1c - Type 1 diabetes Pre-debut
Tidsramme: Baseline taget 60-30 dage før infusion af CD4^LVFOXP3; Post-infusion (uge 4, måned 3, 6 og 12).
Baseline taget 60-30 dage før infusion af CD4^LVFOXP3; Post-infusion (uge 4, måned 3, 6 og 12).
Ændring i PedsQL General Well-Being Scale - Livskvalitet
Tidsramme: Præ-infusion; Måned 6, 12
Præ-infusion; Måned 6, 12
Ændring i PedsQL Generic Core Scale - Livskvalitet
Tidsramme: Præ-infusion; Måned 6, 12
Præ-infusion; Måned 6, 12
Change in Diarrhea incidence
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (daily for the first month followed by monthly at Month 2, 3, 6, 9, 12)

Stool Diary records - extent of diarrhea as measured by frequency and volume of stools, and the presence or absence of blood and/or mucus, and stool studies at specified time points (for all ages).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (daily for the first month followed by monthly at Month 2, 3, 6, 9, 12)
Change in GI Symptoms - Gastrointestinal Symptoms Rating Scale
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3) through post-infusion (Week 4, Month 6, Month 12)

Gastrointestinal Symptoms Rating Scale (GSRS) (for patients ≥12 years old).

Baseline (up to 60 days before infusion of CD4^LVFOXP3) through post-infusion (Week 4, Month 6, Month 12)
Change in Body Mass Index (BMI)
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3, Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)

BMI measured as kg/m^2.

Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3, Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)
Change in INR level
Tidsramme: Baseline/screening (up to 60 days before infusion of CD4^LVFOXP3) through post-infusion (Week 4; Month 3, 6, 12)

International normalized ratio (INR) to determine prothrombin time.

Baseline/screening (up to 60 days before infusion of CD4^LVFOXP3) through post-infusion (Week 4; Month 3, 6, 12)
Skin Disease (EASI) - Changes from Baseline/ Pre-infusion
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)

Scoring of areas of involvement in each anatomical region (area), calculation of intensity using Eczema Area and Severity Index (EASI).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)
Skin Disease (POEM) - Changes from Baseline/ Pre-infusion
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)

Scoring of areas of involvement in each anatomical region (area), calculation of intensity using Patient oriented eczema measure (POEM).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)
Skin Disease (PASI) - Changes from Baseline/ Pre-infusion
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)

Changes in the extent (%) and severity of skin lesions and their complications (i.e. infections, atrophy, itching) using Psoriasis Area and Severity Index (PASI).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)
Skin Disease (MTLSS) - Changes from Baseline/ Pre-infusion
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)

Changes in the extent (%) and severity of skin lesions and their complications (i.e. infections, atrophy, itching) using Modified Total Lesional Sign Score (MTLSS).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)
Change in skin barrier function
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)

Biophysical Skin Evaluation: Skin measurement of transepidermal water loss to monitor skin barrier function and erythema

Baseline (up to 60 days before infusion of CD4^LVFOXP3), through post-infusion (Day 1; Week 1, 2, 3, 4; Month 3, 6 and 12)
Change in Hemolytic Anemia (RBC)
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)

Measurement of the number of red blood cells (Complete Blood Counts with Differential [CBCD]).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)
Change in Hemolytic Anemia (Reticulocyte)
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)

Measurement of the number of reticulocytes.

Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)
Change in Thrombocytopenia
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)

Measure the number of platelets (Complete Blood Counts with Differential (CBCD)).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)
Change in Neutropenia
Tidsramme: Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)

Measure the number of neutrophils (Complete Blood Counts with Differential [CBCD]).

Baseline (up to 60 days before infusion of CD4^LVFOXP3), pre-infusion through post-infusion (Day 1, 2, 3; Week 1, 2, 3, 4; Month 2, 3, 6, 9, 12)
Change in Daily insulin requirement - Type 1 diabetes monitoring
Tidsramme: Baseline taken 60-30 days before infusion of CD4^LVFOXP3 and post-infusion (over 7 consecutive days preceding each study visit);

Mean daily insulin use recorded over 7 consecutive days preceding each evaluation timepoint for patients with Type 1 Diabetes.

Baseline taken 60-30 days before infusion of CD4^LVFOXP3 and post-infusion (over 7 consecutive days preceding each study visit);
Change in hyper-/hypo-glycemic events - Type 1 diabetes monitoring
Tidsramme: Baseline taken 60-30 days before infusion of CD4^LVFOXP3 and post-infusion (over 7 consecutive days preceding each study visit);

Continuous glucose monitoring (CGM) metrics to log episodes of hyper/hypoglycemic events.

Baseline taken 60-30 days before infusion of CD4^LVFOXP3 and post-infusion (over 7 consecutive days preceding each study visit);
Change in Autoantibody Profile
Tidsramme: Screening/ Baseline, Post-infusion (Month 6 and 12)

Measure autoantibodies to organs involved in the disease (participant-specific): anti-insulin (IAA), anti-islet antigens (IA), anti-glutamic acid decarboxylase (GAD), anti-zinc transporter8 (ZNT8), anti-islet cells (ICA), anti-liver kidney microsome (LKM), anti-thyroperoxidase (TPO), anti-thyroglobulin (TG), anti-enterocytes, anti-SMA

Screening/ Baseline, Post-infusion (Month 6 and 12)
Change in Creatinine as a measure of Kidney Function
Tidsramme: Baseline taken 60-30 days before infusion of CD4^LVFOXP3, Pre-infusion, Week 1, 2, 3, 4; Month 2, 3, 6, 9 and 12

Measure kidney functional parameters, i.e., creatinine, in the blood and urine.

Baseline taken 60-30 days before infusion of CD4^LVFOXP3, Pre-infusion, Week 1, 2, 3, 4; Month 2, 3, 6, 9 and 12
Change in PedsQL Gastrointestinal Symptoms Scale - Quality of Life
Tidsramme: Pre-Infusion; Month 6, 12

Measured with Gastrointestinal Symptoms Scale: minimum value = 0 (never a problem), maximum value = 4 (almost always a problem). Higher scores mean a worse outcome.

Pre-Infusion; Month 6, 12
Disease-free Survival - Changes from Baseline
Tidsramme: Up to 15 years

The length of time from cell infusion to the point at which the participant survives without any new or worsening of existing signs or symptoms of disease. The data will be compared with historical disease-free survival probability. Probability of disease-free survival will be computed with the use of Kaplan-Meier estimator.

Up to 15 years
Overall Survival - Changes from Baseline
Tidsramme: Up to 15 years

Participant survival

Up to 15 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Jessie Alexander, MD, Stanford University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

22. marts 2022

Primær færdiggørelse (Anslået)

1. december 2026

Studieafslutning (Anslået)

1. oktober 2027

Datoer for studieregistrering

Først indsendt

12. januar 2022

Først indsendt, der opfyldte QC-kriterier

4. februar 2022

Først opslået (Faktiske)

15. februar 2022

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • IRB-63373
  • DRU-2020-7764 (Anden identifikator: FDA Office of Orphan Products Development)
  • RPD-2020-470 (Anden identifikator: FDA Office of Orphan Products Development)
  • CLIN2-13259 (Andet bevillings-/finansieringsnummer: California Institute of Regenerative Medicine (CIRM))
  • 1R01FD007540 (U.S. FDA-tilskud/-kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .