Cette page a été traduite automatiquement et l'exactitude de la traduction n'est pas garantie. Veuillez vous référer au version anglaise pour un texte source.

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

6 juillet 2026 mis à jour par: 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.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Intervention / Traitement

Description détaillée

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.

Type d'étude

Interventionnel

Inscription (Estimé)

5

Phase

  • Phase 2
  • La phase 1

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

  • Nom: Marina CAVAZZANA, MD, PhD
  • Numéro de téléphone: + 33 01 44 49 50 68
  • E-mail: m.cavazzana@aphp.fr

Sauvegarde des contacts de l'étude

  • Nom: Aline DECHANET, Project Manager
  • Numéro de téléphone: +33 01 44 38 17 11
  • E-mail: aline.dechanet@aphp.fr

Lieux d'étude

  • France
    • Île-de-France Region
      • Paris, Île-de-France Region, France, 75015
        • Department of Biotherapy, Hopital Necker Enfants malades
        • Contact:
          • Marina CAVAZZANA, MD, PHD
          • Numéro de téléphone: +33 01 44 49 50 68
          • E-mail: m.cavazzana@aphp.fr

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant
  • Adulte

Accepte les volontaires sains

Non

La description

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 d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 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.
Génétique: FOXP3-T4 drug product
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)
Médicament: ILT-101
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)
Autres noms:
  • Adeleuskin or IL2

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Frequency of clinical AEs and pathological variations of laboratory parameters
Délai: 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
Délai: 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
Délai: 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
Délai: 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)
Délai: Up to 24 months post-infusion
Up to 24 months post-infusion
Persistence of recirculating LNGFR+among CD4+ T cells
Délai: at 3 months post-infusion
Percentage of LNGFR+ among CD4+ T cells
at 3 months post-infusion

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Persistence of FOXP3-T4 Cells
Délai: Up to 24 months post-infusion
Persistence of recirculating LNGFR among CD4+ T cells
Up to 24 months post-infusion
Phenotyping
Délai: 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
Délai: 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
Délai: Beyond 3 months to 24 months post-infusion
Beyond 3 months to 24 months post-infusion
TCR repertoire
Délai: 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
Délai: 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
Délai: Up to 24 months post-infusion
Diminution of the skin lesions severity
Up to 24 months post-infusion
Organ-Specific Remission: Skin disease
Délai: 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
Délai: 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
Délai: Up to 24 months post-infusion
Reduction of insulin dose administrered
Up to 24 months post-infusion
Organ-Specific Remission: Endocrine System Function
Délai: Up to 24 months post-infusion
Reduction of HBA1C
Up to 24 months post-infusion
Organ-Specific Remission: Renal function
Délai: 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
Délai: Up to 24 months post-infusion months
Improvement of proteinuria
Up to 24 months post-infusion months
Organ-Specific Remission: Renal function
Délai: Up to 24 months post-infusion months
Improvement of tubular effect
Up to 24 months post-infusion months
Organ-Specific Remission: Digestive System
Délai: Up to 24 months post-infusion months
Change in the weight curve
Up to 24 months post-infusion months
Organ-Specific Remission: Digestive System
Délai: Up to 24 months post-infusion months
Change in diarrhea incidence
Up to 24 months post-infusion months
Organ-Specific Remission: Digestive System
Délai: Up to 24 months post-infusion months
Decrease of fecal calprotectin
Up to 24 months post-infusion months
Organ-Specific Remission: Musculoskeletal System
Délai: 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
Délai: 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
Délai: 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
Délai: Up to 24 months post-infusion months
Presence of autoimmune hemolytic anemia
Up to 24 months post-infusion months
Organ-Specific Remission: Blood count
Délai: Up to 24 months post-infusion months
Presence of thrombocytopenia
Up to 24 months post-infusion months
Organ-Specific Remission: Eye
Délai: 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
Délai: Up to 24 months
Reduction of corticosteroid therapy or immunosuppressive treatment
Up to 24 months

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Assistance Publique - Hôpitaux de Paris

Collaborateurs

URC-CIC Paris Descartes Necker Cochin

Les enquêteurs

  • Chaise d'étude: Emmanuelle SIX, MD, PhD, Institut Imagine

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

1 septembre 2026

Achèvement primaire (Estimé)

1 septembre 2028

Achèvement de l'étude (Estimé)

1 janvier 2029

Dates d'inscription aux études

Première soumission

20 avril 2026

Première soumission répondant aux critères de contrôle qualité

6 juillet 2026

Première publication (Réel)

13 juillet 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

13 juillet 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

6 juillet 2026

Dernière vérification

1 juin 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • APHP251137
  • 2025-523305-15-00 (Ctis)

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

S'abonner