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Study Evaluating a Gene Therapy for IPEX Syndrome Through the Expression of FOXP3 on Deficient T Cells to Produce Tregs-like. (THERIPEX)

6 de julio de 2026 actualizado por: Assistance Publique - Hôpitaux de Paris

A Phase I/II Open-label, Non-randomized, Monocentric, Single-arm Study Evaluating the Safety and Efficacy of Induced CD4+ Treg by LV Vector Transduction Expressing the FOXP3 cDNA (FOXP3-T4) in Patients With IPEX Syndrome

The purpose of this study is to evaluate the safety and efficacy of FOXP3-T4 (an autologous gene therapy) alone or in combination with low-dose IL-2 for the treatment of IPEX syndrome. The therapy involves the transplantation of autologous CD4+ T-cells transduced ex vivo with the LV-EF1a-FOXP3-LNGFR lentiviral vector. The study follows a staggered approach: the first two patients will receive FOXP3-T4 monotherapy. Subsequent patients will receive FOXP3-T4 followed if needed by low-dose IL-2 treatment consisting of a daily dose for 5 days, then weekly administrations for 3 months.

The study aims to stabilize autoimmune manifestations and potentially cure the underlying disease, ultimately allowing for the discontinuation of ongoing immunosuppressive treatments.

Descripción general del estudio

Descripción detallada

IPEX syndrome is a primary immunodeficiency caused by hemizygous mutations in the gene FOXP3, which encodes an essential transcription factor required to maintain immunological tolerance by thymus-derived regulatory T (Treg) cells. The most common presentation suggestive of the diagnosis of IPEX syndrome is the classical triad of enteropathy, type I diabetes (TID), and eczema in neonatal onset. Still, it is now well established that IPEX syndrome comprises a broad spectrum of clinical manifestations with different degrees of severity and evolution.

Currently, the only curative treatment for the severe form is allogeneic hematopoietic stem cell transplantation (HSCT). However, because of its significant toxicity, it can be proposed only for more severe presentations and when an HLA identical donor is available. Moreover, the post-HSCT prognosis is also linked to prior disease activity and organ failures.

This clinical study aims to assess a new therapeutical strategy consisting of the conversion of the IPEX patient's CD4+T-cells into functional Treg-like cells by transducing them with an optimized bidirectional lentivirus vector expressing human FOXP3 and a truncated form of the low-affinity nerve growth factor receptor (ΔLNGFR) allowing the selection of the transduced cells. To favour Treg-like cells engraftment and expansion, the FOXP3-T4 infusion may be combined with subcutaneous injection of low-dose IL-2, if needed. Injecting FOXP3-T4 T-reg-like cells into IPEX patients is expected to stably improve the autoimmune manifestations and even cure the underlying disease, allowing the ongoing immunosuppressive treatments to be stopped.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

5

Fase

  • Fase 2
  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Marina CAVAZZANA, MD, PhD
  • Número de teléfono: + 33 01 44 49 50 68
  • Correo electrónico: m.cavazzana@aphp.fr

Copia de seguridad de contactos de estudio

  • Nombre: Aline DECHANET, Project Manager
  • Número de teléfono: +33 01 44 38 17 11
  • Correo electrónico: aline.dechanet@aphp.fr

Ubicaciones de estudio

    • Île-de-France Region
      • Paris, Île-de-France Region, Francia, 75015
        • Department of Biotherapy, Hopital Necker Enfants malades
        • Contacto:
          • Marina CAVAZZANA, MD, PHD
          • Número de teléfono: +33 01 44 49 50 68
          • Correo electrónico: m.cavazzana@aphp.fr

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Niño
  • Adulto

Acepta Voluntarios Saludables

No

Descripción

Inclusion Criteria:

  • Male patients only
  • Patients aged from 1 - 45 years of age (the first three patients will be aged between 10 - 45 years of age)
  • Patient with IPEX syndrome caused by mutation of the FOXP3 gene
  • Patients are eligible from the second line of treatment onward, even those under controlled disease
  • Patient with recurrent IPEX symptoms, under immune suppressive medications
  • Patient for whom HSCT is not feasible or when no suitable compatible donor is available
  • Patients who have had prior allogeneic blood stem cell transplantation (HSCT) with engraftment failure defined as no intake of donor cells
  • Patient or parental, guardian's patient signed informed consent
  • Male participants of reproductive potential with a partner of childbearing potential (WOCBP): willing to use an effective method of contraception during the trial and for at least 12 months post-infusion
  • Affiliation to a French or European social security scheme

Exclusion Criteria:

  • Unwillingness to return for follow-up during the 2-year study and during the 15 years of long term follow up study.
  • Patient with short life expectancy
  • Patient on AME (state medical aid) (unless exemption from affiliation).
  • Diagnosis of a significant psychiatric disorder of the patient that could seriously impede the ability to participate in the study.
  • Eligible for an HLA matched sibling or matched unrelated donor blood stem cell transplant (HLA 10/10) and be willing to undergo transplant.
  • Patients with uncontrolled or ongoing active infections.
  • HIV-1 or 2 or HTLV-1 infections.
  • Patients with severe IPEX clinical presentation needing a rapid allogeneic HSCT treatment within 3 months.
  • Patients with known history of hypersensitivity to IL-2 or any component of the formulation (mannitol, sodium lauryl sulfate, monosodium phosphate dehydrate, disodium phosphate dehydrate, glucose.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: FOXP3-T4 drug product
FOXP3-T4 is a genetically modified cell therapy product consisting of autologous CD4+ T-cells transduced ex vivo with a self-inactivating bidirectional lentiviral vector (LV-EF1a-FOXP3-LNGFR) expressing the FOXP3 and LNGFR cDNAs.
Each patient will receive a single IV infusion of FOXP3-T4, autologous gene-modified CD4+ T-transduced ex vivo with a self-inactivating lentiviral vector (LV-EF1a.FOXP3-LNGFR)
The first two patients included in the study will not receive IL-2 treatment. The others will receive the first injection the FOXP3-T4 treatment and if needed IL2-treatment. For IL2 treatment, patients will receive a daily dose for 5 days, followed by an administration per week for 3 months (ILT-101)
Otros nombres:
  • Adeleuskin or IL2

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Frequency of clinical AEs and pathological variations of laboratory parameters
Periodo de tiempo: Up to 24 months post-infusion
Number of clinical AEs
Up to 24 months post-infusion
Severity of clinical AEs and pathological variations of laboratory parameters
Periodo de tiempo: Up to 24 months post-infusion
Grading will be performed according to the CTCAE (Common Terminology Criteria for Adverse Events) current version. Severity is rated on a scale of Grade 1 (Mild) to Grade 5 (Death).
Up to 24 months post-infusion
Incidence of clinically detectable lymphoproliferation and abnormal clonal dominance
Periodo de tiempo: Up to 24 months post-infusion
This is measured via Vector Insertion Site Analysis (VISA)
Up to 24 months post-infusion
Incidence of clinically detectable lymphoproliferation and abnormal clonal dominance
Periodo de tiempo: Beyond 3 months to 24 months post-infusion
This is measured by proliferation of LNGFR+ cells
Beyond 3 months to 24 months post-infusion
Detection of Replication-Competent Lentivirus (RCL)
Periodo de tiempo: Up to 24 months post-infusion
Up to 24 months post-infusion
Persistence of recirculating LNGFR+among CD4+ T cells
Periodo de tiempo: at 3 months post-infusion
Percentage of LNGFR+ among CD4+ T cells
at 3 months post-infusion

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Persistence of FOXP3-T4 Cells
Periodo de tiempo: Up to 24 months post-infusion
Persistence of recirculating LNGFR among CD4+ T cells
Up to 24 months post-infusion
Phenotyping
Periodo de tiempo: Up to 24 months post-infusion
Deeper phenotyping of FOXP3-T4 (CD4+LNGFR+ CD25+ FOXP3+ CD127low)
Up to 24 months post-infusion
Vector Copy Number (VCN) Analysis
Periodo de tiempo: Up to 24 months post-infusion
Quantification of the transgene copy number (VCN) on drug product and on sorted T-CD4+
Up to 24 months post-infusion
Immunophenotyping T and B cells if no change is detected from the baseline (e.g. before treatment), the immunological phenotype
Periodo de tiempo: Beyond 3 months to 24 months post-infusion
Beyond 3 months to 24 months post-infusion
TCR repertoire
Periodo de tiempo: At 3 months, 12 months and 24 months, post-infusion
Evaluated by NGS before and after the treatment with FOXP3-T4
At 3 months, 12 months and 24 months, post-infusion
Autoantibodies dosage
Periodo de tiempo: At 3 months, 6 months, 12 months and 24 months post-infusion
At 3 months, 6 months, 12 months and 24 months post-infusion
Organ-Specific Remission: Skin disease
Periodo de tiempo: Up to 24 months post-infusion
Diminution of the skin lesions severity
Up to 24 months post-infusion
Organ-Specific Remission: Skin disease
Periodo de tiempo: Up to 24 months post-infusion
Diminution of inflammation in the skin biopsy
Up to 24 months post-infusion
Organ-Specific Remission: Endocrine System Function
Periodo de tiempo: Up to 24 months post-infusion
Evaluation of the functions of endocrine glands
Up to 24 months post-infusion
Organ-Specific Remission: Endocrine System Function
Periodo de tiempo: Up to 24 months post-infusion
Reduction of insulin dose administrered
Up to 24 months post-infusion
Organ-Specific Remission: Endocrine System Function
Periodo de tiempo: Up to 24 months post-infusion
Reduction of HBA1C
Up to 24 months post-infusion
Organ-Specific Remission: Renal function
Periodo de tiempo: Up to 24 months post-infusion months
Improvement of creatine and creatine clearance
Up to 24 months post-infusion months
Organ-Specific Remission: Renal function
Periodo de tiempo: Up to 24 months post-infusion months
Improvement of proteinuria
Up to 24 months post-infusion months
Organ-Specific Remission: Renal function
Periodo de tiempo: Up to 24 months post-infusion months
Improvement of tubular effect
Up to 24 months post-infusion months
Organ-Specific Remission: Digestive System
Periodo de tiempo: Up to 24 months post-infusion months
Change in the weight curve
Up to 24 months post-infusion months
Organ-Specific Remission: Digestive System
Periodo de tiempo: Up to 24 months post-infusion months
Change in diarrhea incidence
Up to 24 months post-infusion months
Organ-Specific Remission: Digestive System
Periodo de tiempo: Up to 24 months post-infusion months
Decrease of fecal calprotectin
Up to 24 months post-infusion months
Organ-Specific Remission: Musculoskeletal System
Periodo de tiempo: Up to 24 months post-infusion months
Improvement of arthritis evaluated by physical examination
Up to 24 months post-infusion months
Organ-Specific Remission: Respiratory Function
Periodo de tiempo: Up to 24 months post-infusion months
Improvement of asthma evaluated by physical examination
Up to 24 months post-infusion months
Organ-Specific Remission: General status
Periodo de tiempo: Up to 24 months post-infusion months
Improvement of performance status : Lansky and Karnofsky scores range from 100 to 10
Up to 24 months post-infusion months
Organ-Specific Remission: Blood count
Periodo de tiempo: Up to 24 months post-infusion months
Presence of autoimmune hemolytic anemia
Up to 24 months post-infusion months
Organ-Specific Remission: Blood count
Periodo de tiempo: Up to 24 months post-infusion months
Presence of thrombocytopenia
Up to 24 months post-infusion months
Organ-Specific Remission: Eye
Periodo de tiempo: Up to 24 months post-infusion months
Improvement of blepheratis evaluated by physical examination.
Up to 24 months post-infusion months
Reduction of Concomitant Therapy
Periodo de tiempo: Up to 24 months
Reduction of corticosteroid therapy or immunosuppressive treatment
Up to 24 months

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Silla de estudio: Emmanuelle SIX, MD, PhD, Institut Imagine

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de septiembre de 2026

Finalización primaria (Estimado)

1 de septiembre de 2028

Finalización del estudio (Estimado)

1 de enero de 2029

Fechas de registro del estudio

Enviado por primera vez

20 de abril de 2026

Primero enviado que cumplió con los criterios de control de calidad

6 de julio de 2026

Publicado por primera vez (Actual)

13 de julio de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

13 de julio de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

6 de julio de 2026

Última verificación

1 de junio de 2026

Más información

Términos relacionados con este estudio

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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