Trial reportNature medicine2026
CD19 CAR-T cells for treatment-refractory autoimmune diseases: the phase 1/2 CASTLE basket trial.
Trial report in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06347718 (CAR-T Cells in Systemic B Cell Mediated Autoimmune Disease), which is not on this map. Cited by 32 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
CAR-T Cells in Systemic B Cell Mediated Autoimmune Disease
Who cites it
32 citing papers in PubMed.
- Chimeric antigen receptor T-cell therapy in systemic lupus erythematosus: From B cell depletion to immune reprogramming.Journal of translational autoimmunity · 2026Review
- Article
- Resetting immunometabolic set points in autoimmune disease.Journal of translational autoimmunity · 2026Review
- Next-generation immune cell engagers for B cell depletion in autoimmune diseases.Nature reviews. Drug discovery · 2026Review
- Persistence of mucosal CAR-T cells and inflammatory remodeling in enterocolitis associated with BCMA CAR-T cell therapy.Nature medicine · 2026Article
- Point-of-care CAR-T cell manufacturing as a path to equity in cancer immunotherapy in a middle-income country.Molecular therapy. Oncology · 2026Article
- Vaccination considerations in autoimmune rheumatic diseases.Nature reviews. Rheumatology · 2026Review
- New treatments in myositis on the horizon.EULAR rheumatology open · 2026Review
- T Cell Thoughts.Immunological reviews · 2026Review
- Management of systemic lupus erythematosus and antiphospholipid syndrome during CAR-T therapy: insights from two clinical cases.Immuno-oncology technology · 2026Article
- Review
- CD19 CAR T cell therapy for treatment-refractory seropositive rheumatoid arthritis: a phase 1 trial.Nature medicine · 2026Article
- The why, what, who and when of B cell depletion in systemic lupus erythematosus: biological rationale, patient stratification and evolving therapeutic modalities.Rheumatology (Oxford, England) · 2026Review
- [From CAR-T to T-cell engagers : New T-cell-based treatment in rheumatology].Zeitschrift fur Rheumatologie · 2026Review
- Expansion and safety profile of CD28-costimulated anti-CD19 CAR T cells in B-cell lymphoma versus autoimmune disease.HemaSphere · 2026Article
- Progress and promise of CAR-T cell treatment in autoimmune diseases.PLoS medicine · 2026Review
- Review
- Challenges and opportunities: CAR-T cell therapy in autoimmune diseases.Cell insight · 2026Review
- Deep phenotyping of skin tissue remodeling in patients with systemic sclerosis treated with CD19-CAR T cells.Nature communications · 2026Article
- Defective B cell tolerance in SLE lymph nodes underpins VHmedRxiv : the preprint server for health sciences · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
34 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chimeric antigen receptor (CAR)-T cells are considered a powerful therapeutic tool to reset the immune system in patients with autoimmune diseases. Innovative trial designs are needed to allow feasible testing of the safety and efficacy of CAR-T cells in clinical studies. CASTLE (CAR-T cells in systemic B cell mediated autoimmune disease) is a phase 1/2a two-stage optimal design basket study that investigated the safety and efficacy of zorpocabtagene autoleucel (Zorpo-cel, also known as MB-CART19.1), an autologous CD19 CAR-T cell product, in patients with treatment-resistant systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and idiopathic inflammatory myopathies (IIM). The primary safety outcome was the rate of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). The secondary clinical efficacy outcomes were remission of SLE according to DORIS criteria, no progression of interstitial lung disease in SSc and American College of Rheumatology (ACR) major/moderate response in IIM after 24 weeks. A total of 24 patients were enrolled (10 with SLE, 9 with SSc and 5 with IIM), all receiving a single infusion of Zorpo-cel after stopping immunosuppressive treatments and receiving standard lymphodepletion with cyclophosphamide and fludarabine. Primary and secondary endpoints of CASTLE were met. Regarding safety, no CRS higher than grade 2 and no ICANS occurred. Regarding efficacy, 22 of the 24 patients achieved predefined efficacy endpoints, with 9 out of 10 patients with SLE reaching DORIS remission, 9 out of 9 patients with SSc showing no disease progression, and 4 out of 5 patients with IIM reaching ACR major/moderate response. Furthermore, all patients remained free of glucocorticoids and any other immunosuppressive treatment over the entire observation period of 24 weeks. CASTLE suggests the feasibility, safety and efficacy of Zorpo-cel in three different autoimmune diseases and paves the way for conducting a pivotal study. ClinicalTrials.gov identifier: NCT06347718 , EudraCT identifier: 2022-001366-35 .
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