Fate Therapeutics (Nasdaq: FATE) has dosed the first patient in RECLAIM-LN, its Phase II potentially registrational trial of FT819, an off-the-shelf iPSC-derived CD19-targeting CAR T-cell therapy, in refractory lupus nephritis — advancing the first allogeneic CAR T-cell candidate into a potentially registration-enabling study in an autoimmune indication.
The patient was treated in an outpatient setting and discharged the same day, a logistical feature Fate has positioned as central to its commercial thesis: that iPSC-derived CAR T cells can be delivered outside specialized academic centers. The trial design was developed through FDA interactions under FT819's Regenerative Medicine Advanced Therapy (RMAT) designation, and the program has also been selected for the FDA's Chemistry, Manufacturing, and Controls Development and Readiness Pilot (CDRP) program, which provides enhanced CMC communication for therapies on accelerated timelines.
RECLAIM-LN is a multicenter, open-label, single-arm study targeting approximately 53 patients with refractory moderate-to-severe systemic lupus erythematosus (SLE) with Class III or IV lupus nephritis, with or without concomitant Class V. Patients must have failed at least two prior systemic immunosuppressive therapies. Each receives a single 900 million-cell dose of FT819 following lymphodepletion with bendamustine alone — a less-intensive conditioning regimen that avoids the fludarabine/cyclophosphamide combination standard in most CAR T-cell programs. The primary endpoint is complete renal response (CRR) at Week 26. Fate said the company anticipates completing enrollment within 15 to 18 months, by the first half of 2028.
FT819 depletes CD19-expressing B cells, which drive autoantibody production and renal inflammation in lupus nephritis. The iPSC-derived manufacturing approach uses a clonal master cell bank as the starting material, enabling uniform, scalable production without relying on patient- or donor-sourced cells.
The Phase II study builds on preliminary Phase I data presented at EULAR in June from 21 SLE patients. Among 16 patients receiving less-intensive conditioning with either cyclophosphamide or bendamustine, Fate reported no dose-limiting toxicities, Grade ≥3 cytokine release syndrome, ICANS, graft-versus-host disease or deaths. Clinical disease measures improved following treatment, with Fate reporting deeper and more durable responses with bendamustine, supporting its selection for RECLAIM-LN. The company also reported sustained depletion of dominant B-cell clones and reductions in glucocorticoid use. Fate Therapeutics, Inc.