RecruitingPhase 1

A Study of Anti-CD19 Chimeric Antigen Receptor T-Cell ( CAR-T) Therapy in Subjects With Non-relapsing and Progressive Forms of Multiple Sclerosis

A Phase 1, Open-Label, Single Center Study of KYV-101, an Autologous Fully-Human Anti-CD19 Chimeric Antigen Receptor T-Cell (CD19 CAR T) Therapy in Subjects With Non-relapsing and Progressive Forms of Multiple Sclerosis

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years to 65 Years
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

Not stated in the study description — ask the study team about visits and procedures.

Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests anti-CD19 CAR-T therapy, a treatment that uses changed immune cells. It is for adults ages 18 to 65 with progressive multiple sclerosis (MS), which gets worse over time, without relapses.

A Study of Anti-CD19 Chimeric Antigen Receptor T Cell Therapy in Subjects with Non-relapsing and Progressive Forms of Multiple Sclerosis

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Be 18 to 65 years old and have a confirmed diagnosis of progressive MS.
  • Have antibodies to Epstein-Barr virus (EBV), which are proteins that show a past immune response.
  • Have antibodies to the chickenpox/shingles virus, or have at least one Shingrix vaccine dose at least 4 weeks before treatment.
  • Meet the study’s blood count and immune protein levels, and have good enough kidney, liver, lung, and heart function.
  • Complete required infection tests and meet the study’s rules for negative results.
  • Have a negative pregnancy test if you can become pregnant. If you can become pregnant or father a child, use highly effective birth control from enrollment through 12 months after the CAR-T infusion.
  • Be able to understand the study and sign a consent form.
  • Meet the study’s limits for blood pressure, pulse, breathing rate, and temperature. High blood pressure must be controlled as required.

Who can't join

  • Have certain brain, spinal cord, or nerve diseases other than MS, including NMOSD or MOGAD, which can resemble MS.
  • Have certain blood or clotting disorders, an inherited immune weakness, or take blood thinners or medicines that keep platelets from forming clots.
  • Have an uncontrolled infection or an infection needing hospital care or IV treatment within 4 weeks of screening. Some simple infections responding to treatment are allowed. Active HIV or hepatitis B or C is excluded; past hepatitis may be allowed if no virus is detected.
  • Have liver scarring, certain serious heart problems, or a cancer history that does not meet the study’s exceptions. Crohn’s disease, rheumatoid arthritis, or lupus needing ongoing immune-suppressing treatment within the past 2 years also excludes you.
  • Have had an organ transplant, a stem cell transplant using your own cells, cell-based immune therapy such as CAR-T, gene therapy, radiation to the lymph system, or mitoxantrone treatment.
  • Have used an experimental treatment too recently, anti-CD20 treatment within 9 months, or certain MS drugs without the required 30- or 60-day break. Starting a new MS disease-modifying treatment between cell collection and preparatory chemotherapy is not allowed.
  • Have had a severe immediate allergic reaction or another reason you cannot safely receive a study drug or one of its ingredients.
  • Have a health condition, mental health concern, or life situation that the study team believes makes treatment unsafe, affects study testing, or prevents you from completing required visits and procedures.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria: 1. Patient is ≥ 18 years old, and ≤65 years of age, at time of screening visit. 2. Diagnosis of MS according to the 2017 McDonald Criteria. 3. Progressive MS by 2014 Lublin MS phenotypic criteria. 4. Presence of varicella-zoster virus (VZV) antibodies, or completion of at least one dose of the varicella zoster glycoprotein E (gE) Shingrix vaccine at least four weeks prior to treatment. 5. Presence of anti EBV antibodies. 6. Organ and Marrow Function * Absolute neutrophil count (ANC) ≥ 2000/uL. * Platelet count ≥ 150,000/uL. * Absolute lymphocyte count ≥ 1000/uL. * Serum immunoglobulin G (IgG) ≥ 500mg/dL. * Hemoglobin ≥ 9 g/dL. * Adequate renal, hepatic, pulmonary and cardiac function defined as: * Creatinine ≤ 2mg/dL or creatinine clearance (as estimated by Cockcroft Gault Equation) ≥ 60 mL/min. * Serum alanine transaminase (ALT)/aspartate aminotransferase (AST) ≤ 3 upper limit of normal (ULN). * Total bilirubin ≤ 1.5 mg/dl, except in subjects with Gilbert's syndrome * Cardiac ejection fraction ≥ 40%, no evidence of physiologically significant pericardial effusion as determined by an ECHO, and no clinically significant ECG findings. * Baseline oxygen saturation \> 94% on room air. 7. Testing for * Hepatitis B core antibody (HBc Ab) * Hepatitis C antibody (HCV Ab) * Hepatitis B surface antigen (Hep B surf. AG) * HIV 1\&2 Ab * Syphilis Screen * Human T-cell lymphotropic virus (HTLV) Ab I \& II * Nucleic acid test multiplex (NAT MPX) for HIV, HCV, HBV * Herpes Simplex Virus 1 \& 2 IgG panel * Varicella-Zoster (VZ) IgG * Cytomegalovirus (CMV) Total Ab Must be seronegative for HIV-1 RNA polymerase chain reaction (PCR); HIV 1 and HIV 2 Ab (antibody); HTLV-1 and HTLV-2 Ab; PCR+ or negative surface antigen for hepatitis B; negative for the Treponema pallidum antibody Syphilis screen; and negative for HIV-1 and hepatitis C by nucleic acid testing (NAT) within 40 days of apheresis procedures. 8. Females of childbearing potential have a negative serum or urine pregnancy test because of the potentially dangerous/unknown effects on the fetus. Females who have undergone hysterectomy or who have been postmenopausal for at least 2 years are not considered to be of childbearing potential. 9. Contraception: Subjects of child-bearing or child-fathering potential must be willing to practice highly effective birth control from the time of enrollment on this study and for the entire study period which is 12 months after receiving the CAR T cell infusion. 10. Ability to understand and the willingness to sign a written informed consent document. Patients must have signed informed consent to participate in the trial. 11. Adequate vital sign criterion with acceptable numerical ranges of: * Systolic Blood Pressure (mmHg) ≥ 100 and ≤ 150 * Diastolic Blood pressure (mmHg) ≥ 60 and ≤ 90 * To ensure subject safety and stability, any subject who is noted to have a BP \> 150/90 mm Hg should be stable on anti-hypertensive medications with repeated BP ≤150/90 for at least one month prior to enrollment in the study * Heart Rate ≥ 60 and ≤ 100 bpm * Oral Temperature ≤ 37.7 C/afebrile * Respiratory rate ≥ 12 and ≤ 20bpm Exclusion Criteria: 1. History of neuromyelitis optica spectrum disorder (NMOSD) or MOG antibody associated disease (MOGAD). 2. Prior treatment with any investigational agent within 3 months, or 5 half-lives, whichever is longer. Agents authorized by the FDA for prevention or treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are not considered investigational. 3. Initiation of any DMT between the completion of apheresis and start of lymphodepletion (LD) chemotherapy. The use of methylprednisolone for bridging therapy between apheresis and start of LD chemotherapy will be allowed. 4. History of CNS or spinal cord tumor, metabolic or infectious cause of myelopathy, genetically inherited progressive CNS disorder, sarcoidosis or non-MS progressive neurologic condition affecting ability to perform study assessments. 5. History of cytopenia consistent with the diagnosis of myelodysplastic syndrome (MDS). 6. History of sickle cell anemia or other hemoglobinopathy. 7. Coagulation abnormalities defined by: international normalized ratio (INR) \> 1.5, prothrombin time (PT) \> 14 seconds, partial thromboplastin time (PTT) \> 45 seconds to the exclusion criteria. Patients with positive antiphospholipid antibodies, including anti-cardiolipin, or lupus anticoagulant. 8. Presence of fungal, bacterial, viral, or other infection that is not controlled and/ or requiring hospitalization or treatment with IV antimicrobials within 4 weeks of screening. Simple urinary tract infection (UTI) and uncomplicated bacterial pharyngitis are permitted if responding to active treatment. 9. Psychiatric disorder(s) or psychosocial circumstance(s) which in the opinion of the Stanford Transplant team caring for this potential patient would place the patient at an unacceptable risk. 10. Presence or history of liver cirrhosis. 11. History of malignancy other than non-melanoma skin cancer or carcinoma in situ (e.g. cervix, bladder, breast) unless disease free for at least 3 years 12. Active infection with HIV, hepatitis B (HBsAg positive) or hepatitis C virus (anti-HCV positive) as the immunosuppression contained in this study may pose unacceptable risk. A prior history of hepatitis B or hepatitis C is permitted providing the viral load is undetectable per quantitative PCR and/or nucleic acid testing. Hepatitis B surface antibody following hepatitis B immunization is not considered to be evidence of past infection. 13. Central nervous system (CNS) disorder such as cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease unrelated to MS that in the judgment of the investigator may impair the ability to evaluate neurotoxicity. 14. History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac disease (uncontrolled congestive heart failure) within 4 months of enrollment. Subjects with stable cardiac disease fulfilling inclusion criteria are allowed. 15. Subjects receiving anticoagulation therapy or subjects with concomitant use of antiplatelet agents. 16. History of Crohn's, rheumatoid arthritis, systemic lupus that required continued systemic immunosuppression/systemic disease modifying agents within the 2 years prior to trial enrollment. 17. A primary immune deficiency disease 18. In the investigator's judgment, the subject is unlikely to complete protocol-required study visits or procedures, including follow-up visits, or comply with the study requirements for participation. 19. History of severe immediate hypersensitivity reaction to any of the agents used in this study. This includes contraindications or life-threatening allergies, hypersensitivity, or intolerance to KYV-101 or its excipients, including dimethyl sulfoxide; Bendamustine; or tocilizumab. 20. Any medical condition that in the judgement of the investigator is likely to interfere with assessment of safety or efficacy of study treatment. 21. Prior treatment with total lymphoid irradiation or mitoxantrone exceeding 36 mg/m2 cumulative dose 22. Prior treatment with autologous hematopoietic stem cell transplantation, or prior history of cellular immunotherapy (eg. CAR T) or gene therapy directed at any target. 23. Prior treatment with anti-CD20+ monoclonal antibody therapy within 9 months of trial initiation. A 30-day washout will be required for prior treatment with glatiramer acetate, interferon-beta, and fumarates. A 60-day washout will be required for sphingosine-i-phosphate modulators and natalizumab. Excluded will be patients who received prior treatment with mitoxantrone regardless of prior cumulative dose. 24. Prior history of solid organ transplantation 25. Impaired cardiac function or clinically significant cardiac disease including: * a. Unstable angina or myocardial infarction or coronary artery bypass graft (CABG) within 6 months prior to apheresis. * b. New York Heart Association (NYHA) stage III or IV congestive heart failure. * c. History of clinically significant cardiac arrhythmia (eg, ventricular tachycardia), complete left bundle branch block, high-grade atrioventricular (AV) block. * d. History of severe nonischemic cardiomyopathy. * e. Left ventricular ejection fraction (LVEF) \<45% as assessed by echocardiogram (ECHO) or multi-gated acquisition (MUGA) scan (performed ≤8 weeks of apheresis). * f. Active, current cardiac manifestations of systemic lupus erythematosus (SLE) including pericarditis, pericardial effusion, and myocarditis. 26. Prior history of splenectomy 27. History of moderate or worse than moderate asthma or chronic obstructive pulmonary disease (COPD) 28. Corrected QT interval (QTc) \>450msec in males or \>470msecs in females 29. Subjects with valvular heart disease (regurgitation, stenosis or atresia 30. Moderate or worse renal impairment using criteria * Stage 1: Kidney damage with normal or increased GFR (\>90 mL/min/1.73 m\^2). * Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m\^2). * Stage 3a: Moderate reduction in GFR (45-59 mL/min/1.73 m\^2). * Stage 3b: Moderate reduction in GFR (30-44 mL/min/1.73 m\^2). * Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m\^2). * Stage 5: Kidney failure (GFR \< 15 mL/min/1.73 m\^2 or dialysis) 31. Previously received Mavenclad, yet drug washout is ≤9 months. 32. History of a seizure disorder even if the seizure disorder is well controlled with anti-epileptics 33. Prior history of treatment with cellular immunotherapy (e.g. CAR T) gene therapy product directed as any target.

Study sites (1)

CA

  • Stanford Multiple Sclerosis Center · Palo Alto, CA 94304Emma Martinez, BA · Study contact · 650-387-5907 · eam1@stanford.eduJeffrey Dunn, MD · Principal investigatorEverett Meyer, MD · Sub-investigatorRobert Lowsky, MD · Sub-investigatorMore trials in Palo Alto