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NCT Number: NCT04422912

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)

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

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

Stanford University, Dept. of Dermatology, Redwood City, California, United States

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About this study

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 in two parts. The first part is the main study 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. This study is closed to enrollment.

The second part is a sub-study is being conducted to investigate if CABA-201, also called resecabtagene autoleucel, or "rese-cel", can be safely administered while achieving clinical responses without the need for preconditioning in mucosal-dominant PV (mPV) and mucocutaneous PV (mcPV) patients. This sub-study is open to enrollment.

DSG3-CAART or CABA-201 may potentially lead to complete and durable remission of disease.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for DSG3-CAART: Closed to enrollment

  • 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: Open to enrollment

  • Age ≥18
  • 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) or malignancy diagnosed within the previous 5 years
  • 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
  • Treatment with any investigational agent within 4 weeks or 5 half-lives, whichever is longer.

Treatment and study plan

DSG3-CAART

Biological

Intravenous infusions of DSG3-CAART alone at different doses and different fractionations, with or without intravenous immunoglobulin, cyclophosphamide, and/or fludarabine.

CABA-201

Biological

Single intravenous infusion of CABA-201 at escalating doses, with or without preconditioning.

Primary outcomes

  1. Adverse events, including Dose Limit Toxicity

    Time frame: 3 months

    Incidence of adverse events that are related to DSG3-CAART therapy

  2. For CABA-201 Sub-study: To evaluate adverse events reported by subjects

    Time frame: Up to 28 days after CABA-201 infusion

    Incidence and severity of AEs

Secondary outcomes

  1. Percent of CAAR-transduced cells

    Time frame: Baseline

    Percent of total cells for infusion that are CAAR-transduced cells by flow cytometry

  2. Total DSG3-CAART positive cells

    Time frame: Baseline

    Total DSG3-CAART positive cells for each manufacturing run by flow cytometry

  3. Cellular kinetics profile of DSG3-CAART

    Time frame: Up to 36 months

    Cellular kinetics profile of DSG3-CAART assessed by quantitative polymerase chain reaction

  4. Change in DSG3 autoantibody titer

    Time frame: Up to 36 months

    Change in DSG3 autoantibody titer by ELISA compared to pre-infusion visit

  5. Serologic remission

    Time frame: Up to 36 months

    Proportion of subjects achieving serologic remission, determined by negative DSG3 ELISA titer

  6. Pemphigus Disease Area Index (PDAI)

    Time frame: Up to 36 months

    Change in PDAI compared to pre-infusion visit, scored on a 0-250 scale where a greater number represents more disease activity

  7. Clinical remission: complete remission off therapy and complete remission on minimal therapy

    Time frame: Up to 36 months

    Proportion of subjects achieving complete remission, determined by a PDAI activity score of 0 for at least 2 months, either off therapy or on minimal therapy

  8. Time to clinical remission and time to serologic remission

    Time frame: up to 36 months

    Time to clinical remission and time to serologic remission from the last infusion

  9. Duration of clinical remission and duration of serologic remission

    Time frame: up to 36 months

    Duration of clinical remission and duration of serologic remission sustained after achieving the initial remission

  10. For CABA-201 Sub-study: To evaluate adverse events reported by subjects

    Time frame: Up to 156 weeks after CABA-201 infusion

    Incidence and severity of AEs

  11. For CABA-201 Sub-study: To characterize the pharmacodynamics (PD)

    Time frame: Up to 156 weeks

    Levels of B cells in the blood

  12. For CABA-201 Sub-study: To characterize the pharmacokinetics (PK)

    Time frame: Up to 156 weeks

    Levels of CABA-201-positive T cells in the blood

  13. For CABA-201 Sub-study: To evaluate autoantibody -related biomarkers

    Time frame: Up to 156 Weeks

    Levels of serum anti-DSG3 and anti-DSG1 antibodies

  14. For CABA-201 Sub-study: To evaluate efficacy

    Time frame: Up to 156 Weeks

    Absolute and percent change in disease activity by Pemphigus Disease Area Index (PDAI)

Study contacts

Contact information is provided by the study sponsor or research team.

Cabaletta Bio

CONTACT

[email protected]

+1 267 759 3100 ext. 4444

Sponsors and collaborators

Lead sponsor

Cabaletta Bio

Industry

Registry information

Official study title

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

Important dates

Study start
2020
Primary completion
2029
Study completion
2029
First posted
Jun 9, 2020
Registry last updated
May 29, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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