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NCT06193889PHASE2, PHASE3Recruiting

KYSA-6: A Study of Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy, in Patients With Generalized Myasthenia Gravis

Kyverna Therapeutics

Start Date

8/28/2024

Completion Date

9/1/2028

Summary

A Study of the Anti-CD 19 Chimeric Antigen Receptor T Cell Therapy for Patients with Myasthenia Gravis

Detailed Description

Myasthenia gravis (MG) is a chronic autoimmune disease that affects the neuromuscular junction and is characterized by muscle weakness. B cells play a role in MG, and the disease is characterized by the presence of autoantibodies such as anti-AChR and anti-MuSK antibodies. CD-19 target chimeric antigen receptor (CAR) T cells harness the ability of cytotoxic T cells to directly and specifically lyse target cells to effectively deplete both normal and autoreactive B cells in the circulation as well as impacted lymphoid and potentially non-lymphoid tissues. KYV-101 (mivocabtagene autoleucel \[miv-cel\])), a fully human anti-CD19 CAR T-cell therapy, will be investigated in adult subjects with myasthenia gravis (MG).

Eligibility Criteria

Age Range: 18 years to 75 years

Key Inclusion Criteria 1. Presence of autoantibodies to AChR or MuSK 2. Myasthenia Gravis Foundation of America (MGFA) Class II-IV 3. MG-Activities of Daily Living (MG-ADL) total score of ≥6 at screening and confirmed at baseline visit 4. QMG total score of ≥11 at screening an confirmed at baseline visit 5. Failed treatment with 2 or more immunosuppressive/immunomodulatory therapies, or failed at least 1 immunosuppressive therapy and required chronic plasmapheresis, or IVIG (or subcutaneous or intramuscular Ig) to control symptoms 6. On a stable dose of glucocorticoids and/or other immunotherapies for ≥1 month prior to screening. For patients treated with azathioprine, a stable dose for ≥2 months prior to screening is required 7. No change in dose of acetylcholinesterase inhibitors for ≥2 weeks prior to screening 8. No use of intravenous immune globulin (IVIG) or plasmapheresis (PLEX) within 4 weeks of screening or pre-dose baseline (unless this is part of their SOC treatment regimen) 9. No use of rituximab (or any other anti-CD20 or CD19 monoclonal antibody) within 12 weeks prior to screening 10. Able and willing to attend the necessary visits to the study site Key Exclusion Criteria 1. Unable to washout or interrupt autoimmune disease therapy prior to apheresis and/or baseline if required 2. Co-occurring neurological autoimmune disease (ie, Lambert-Eaton Myasthenic Syndrome) or any disease affecting the neuromuscular junction or muscle causing weakness (eg, myositis, myopathy, motor neuropathy) 3. History of stroke (with residual sequalae and/or risk for recurrence), seizure (even if well controlled on antiepileptics), neurodegenerative disease, altered mental status (unexplained and/or recent/current), or uncontrolled/severe psychiatric disease 4. Any serious and/or uncontrolled medical condition that, in the investigator's judgment, would cause unacceptable safety risk, interfere with study procedures or results, or compromise compliance with the protocol, including but not limited to, clinically significant cardiac or pulmonary disease 5. History of primary immunodeficiency, organ or allogeneic bone marrow transplant, or splenectomy 6. Active, uncontrolled, viral, bacterial, or systemic fungal infection or recent history of repeated infections 7. Thymectomy \<12 months of screening or planned during the study 8. Prior treatment with gene therapy product or cellular immunotherapy (eg, CAR T) requiring vector integration and directed at any target 9. Patients requiring chronic anticoagulation therapy that cannot be discontinued for medical procedures

Interventions

DRUG

Standard of Care Treatment

DRUG

Standard lymphodepletion regimen

BIOLOGICAL

KYV-101

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Conditions

Myasthenia GravisGeneralized Myasthenia Gravis

Locations

Ronald Reagan UCLA Medical Center

Los Angeles, California 90095

United States

University of California, Irvine

Orange, California 92868

United States

Stanford University Medical Center

Palo Alto, California 94305

United States

University of Miami

Miami, Florida 33149

United States

Indiana University Health

Indianapolis, Indiana 46202

United States

University of Missouri

Columbia, Missouri 65212

United States

Oregon Health & Science University

Portland, Oregon 97239

United States

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania 19107

United States

Houston Methodist Hospital

Houston, Texas 77030

United States

Intermountain Medical Center

Murray, Utah 84107

United States

Westmead Institute for Medical Research

Westmead,

Australia

Hospital Israelita Albert Einstein

São Paulo,

Brazil

Charite- Universitätsklinikum Berlin

Berlin,

Germany

Universitätsklinikum der Ruhr-Universität Bochum

Bochum,

Germany

Universitätsklinikum Hamburg-Eppendorf

Hamburg,

Germany

Medizinische Hochscule Hannover

Hanover,

Germany

Friedrich-Schiller-Universität Jena

Jena,

Germany

Universitätsklinik Magdeburg

Magdeburg,

Germany

Technical University Munich, Klinikum Rechts der Isar

Munich,

Germany

King's Faisal Specialist Hospital and Research Center

Riyadh, Kindom of Saudi Arabia

Saudi Arabia

Cambridge University Hospital, Addenbrooke's Hospital

Cambridge,

United Kingdom

King's College Hospital

London,

United Kingdom