US Zamto-cel Autoimmune Diseases

Last updated: June 9, 2026
Sponsor: Miltenyi Biomedicine GmbH
Overall Status: Active - Recruiting

Phase

1

Condition

Connective Tissue Diseases

Lupus Nephritis

Kidney Disease

Treatment

Cyclophosphamide

Fludarabine

zamtocabtagene autoleucel

Clinical Study ID

NCT06708845
M-2024-423
  • Ages > 18
  • All Genders

Study Summary

AID is a phase I multi-cohort study to assess the safety and tolerability of zamtocabtagene autoleucel (zamto-cel) in patients with refractory autoimmune diseases (SLE-Non renal, SLE-LN, SSc/dcSSc) after receiving standard therapy.

Eligibility Criteria

Inclusion

General Key Inclusion/Exclusion Criteria Across All Cohorts

Inclusion Criteria:

•Confirmed diagnosis of autoimmune disease (SLE-Non-renal, SLE-LN, SSc/ dcSSc)

Exclusion

Exclusion Criteria:

  • Prior gene therapy treatment

  • Active malignancy within past 5 years

  • Significant active fungal or bacterial infection

  • History or presence of CNS lupus or other CNS disease

  • eGFR < 45 mL/min/1.73 m^2

  • Total bilirubin outside the normal range (unless congenital hyperbilirubinemia suchas Gilbert syndrome has been confirmed).

Systemic Lupus Erythematosus-Non-renal Key Inclusion/Exclusion Criteria

Inclusion Criteria:

  • Positive for at least 1 of the following autoantibodies at Screening: anti- doublestranded DNA or anti-Smith

  • Systemic Lupus Erythematosus Disease Activity Index-2000 score ≥ 8 AND at least 1British Isles Lupus Assessment Group (BILAG)-2004 Class A (severe manifestation)organ scores

  • Inadequate response to glucocorticoids and to at least 2 of the followingtreatments, used for at least 3 months each: cyclophosphamide, mycophenolic acid orits derivatives, belimumab, azathioprine, anifrolumab, methotrexate, rituximab, orobinutuzumab

Exclusion Criteria:

  • Subjects with neuropsychiatric SLE.

  • Drug-induced SLE.

Systemic Lupus Erythematosus - Lupus Nephritis Key Inclusion/Exclusion Criteria

Inclusion Criteria:

  • Positive for at least 1 of the following autoantibodies at Screening: anti- doublestranded DNA or anti-Smith

  • Confirmed LN diagnosis by kidney biopsy during screening or within the previous 6months, with severe active phase of the disease.

  • Progressing despite maintenance on maximally tolerated doses of renin- angiotensinsystem (RAS) blocking agents, unless allergic to or intolerant of ACE inhibitors andARBs

  • Inadequate response to glucocorticoids and hydroxychloroquine and at least 1 of thefollowing treatments, used for at least 3 months each: cyclophosphamide,mycophenolic acid derivatives, belimumab, azathioprine, methotrexate, rituximab,obinutuzumab, calcineurin inhibitor (cyclosporin, tacrolimus or voclosporin)

Exclusion Criteria:

•Evidence of Rapidly progressive glomerulonephritis (defined as a doubling of serum creatinine within 3 months prior to enrollment) or as determined by the study investigator.

Systemic Sclerosis/Diffuse Cutaneous Systemic Sclerosis Cohort Key Inclusion/ Exclusion Criteria

Inclusion Criteria:

  • Active disease defined as:

  • Modified Rodnan skin score (mRSS) ≥ 16 units, in the prior 6 months, with 1 or moreof the following:

  • Increase in mRSS by ≥ 3 units or 10%

  • Involvement of 1 new body area with increase in mRSS by ≥ 2 units

  • Involvement of 2 new body areas with increase by ≥ 1 mRSS unit OR

  • Progressive interstitial lung disease (ILD) defined as:

  • Worsening of respiratory symptoms and an increased extent of fibrosis evaluated byhigh-resolution computed tomography

  • Lack of response to standard therapy (e.g., failure of ≥ 2 immunosuppressivetherapies)

Exclusion Criteria:

  • "Active" gastric antral vascular ectasia, as evidenced by bleeding (ie, onesophagogastroduodenoscopy) in the past 6 months or as per Investigator'sassessment.

  • History of SSc renal crisis within 1 year prior to Screening; presence of kidneyimpairment due to conditions other than SSc

Study Design

Total Participants: 48
Treatment Group(s): 3
Primary Treatment: Cyclophosphamide
Phase: 1
Study Start date:
July 01, 2026
Estimated Completion Date:
July 31, 2028

Study Description

This is a Phase 1, multicohort, dose-finding study evaluating autologous T cells engineered to target dual CD19 and CD20 antigens in subjects with refractory autoimmune diseases following standard therapy. The investigational product, Zamto-cel, is a chimeric antigen receptor T-cell (CAR-T) therapy genetically engineered to enable subjects' T cells to express CARs on their surfaces.

Eligible subjects will undergo leukapheresis for the collection of cells required for manufacturing. Prior to infusion of the fresh CAR-T product, subjects will receive a lymphodepleting regimen consisting of cyclophosphamide and fludarabine. The CAR-T cell infusion will be administered intravenously at a dose of 2.5 x 10^6 or 1.0 x 10^6 CAR+ cells/kg body weight, based on the dose level assigned to the cohort.

The study will initially enroll 3 subjects per cohort in a staggered manner to evaluate safety. Upon confirmation of safety, the study will proceed to cohort-specific recommended Phase 2 dose (RP2D) and dose expansion phases. Subjects will be monitored for up to 1 year to assess safety, preliminary efficacy, and health-related quality of life (HRQoL). Additional long-term follow-up will be conducted under a separate long-term follow-up protocol.

Connect with a study center

  • Froedtert Hospital and the Medical College of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Active - Recruiting

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