Overview
This is an investigator-initiated, open-label, single-arm, dose-escalation study designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics (PD), and preliminary efficacy of an in vivo circular RNA chimeric antigen receptor T cell in adult participants with R/R B-cell malignancies.
Description
This is an investigator-initiated, open-label, single-arm, dose-escalation study designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics (PD), and preliminary efficacy of an in vivo circular RNA chimeric antigen receptor T cell in adult participants with R/R B-cell malignancies.
Investigational product (IP)will be explored across four dose levels (as described in the table below) in adult participants with R/R B-cell malignancies, including diffuse large B-cell lymphoma \[DLBCL\], follicular lymphoma \[FL\], mantle cell lymphoma \[MCL\], chronic lymphocytic leukemia \[CLL\]/small lymphocytic lymphoma \[SLL\], Waldenström macroglobulinemia \[WM\], and marginal zone lymphoma (MZL).
The study consists of three periods: screening period, treatment period, and post-treatment follow-up period.
Eligibility
Inclusion Criteria:
- Age ≥ 18 years, any gender.
- Able to provide written informed consent.
- Confirmed diagnosis of relapsed/refractory (R/R) CD19-positive B-cell malignancy, including:
- Diffuse large B-cell lymphoma (DLBCL)
- Follicular lymphoma (FL)
- Mantle cell lymphoma (MCL)
- Small lymphocytic lymphoma (SLL)/chronic lymphocytic leukemia (CLL)
- Waldenström macroglobulinemia (WM)
- Marginal zone lymphoma (MZL)
- ECOG performance status 0 or 1.and have archival tumor biopsy tissue and pathology report from the most recent relapse, or at least one palpable superficial tumor lesion at screening, and agree to biopsy/resection before the first dose of IP for disease confirmation.
- Disease refractory to or relapsed after ≥ 2 prior lines of standard therapy, including required agents per disease subtype (e.g., anti-CD20, BTK inhibitors, chemotherapy, or ASCT if applicable).
- Measurable disease per Lugano 2014 or iwCLL 2018 criteria.
- LVEF ≥ 40% by echocardiogram.
- For patients with prior CD19-targeted therapy, confirmed CD19 positivity at screening.
- Women of childbearing potential (WOCBP) must have a negative serum pregnancy test and agree to use effective contraception during the study and for 6 months after last treatment.
- Male patients with female partners must agree to use condoms, and partners must use effective contraception, during the study and for 6 months after last treatment.
Exclusion Criteria:
- Prior anticancer therapy-related toxicities unresolved to baseline or ≤ Grade 1 (alopecia and peripheral neuropathy excepted).
- Central nervous system (CNS) involvement by lymphoma.
- Need for urgent treatment due to tumor mass effect or spinal cord compression.
- Known hypersensitivity to any component of IP, including mRNA/LNP-based products.
- History of another primary malignancy within the past 3 years, except adequately treated basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma in situ.
- Active hepatitis B (HBsAg-positive with detectable HBV DNA) or hepatitis C (HCV RNA-positive) infection.
- Active or prior HIV infection.
- Uncontrolled active systemic infection requiring IV therapy within 1 week before dosing.
- Active or history of acute/chronic GVHD.
- Inadequate hematologic function (ANC \<1.0×10⁹/L, Hb \<70 g/L, PLT \<50×10⁹/L, lymphocytes ≤0.5×10⁹/L) or coagulation abnormalities (INR/APTT ≥1.5×ULN).
- Hepatic impairment (ALT/AST \>2×ULN, or \>3×ULN with hepatic involvement; bilirubin \>2×ULN, unless Gilbert syndrome).
- Renal impairment (CrCl \<50 mL/min by Cockcroft-Gault).
- Uncontrolled ischemic heart disease, NYHA Class III-IV heart failure, or baseline QTcF ≥450 ms (male) / ≥470 ms (female).
- Severe psychiatric disorder history.
- Pregnancy or breastfeeding.
- Received prohibited treatments within 4 weeks before dosing, including high-dose corticosteroids (\>20 mg prednisone equivalent daily), chemotherapy, immunosuppressive therapy, prior CAR-T or other gene/cell therapy, or T-cell engagers.
- Participation in another clinical study with investigational therapy within 3 months before dosing, or prior participation in cell/gene therapy trials.
- Planned radiotherapy within 6 weeks after screening (unless only non-irradiated PET-positive lesions remain eligible).
- Planned allogeneic HSCT within 90 days after screening.
- Significant comorbidities or unstable medical conditions deemed by the investigator to compromise safety or study compliance.


