#2-20E. CAR T Cell Revolution: Targeting BCMA in Refractory Lupus Nephritis (ARD, 2025)

Conventional treatments for refractory lupus nephritis (LN) often fall short, leaving patients vulnerable to relapses and long-term morbidity. How can we achieve deep, durable, and potentially drug-free remission for those who fail standard immunosuppression? This open-label, single-arm clinical trial evaluated the safety and efficacy of anti-B cell maturation antigen (BCMA)-targeting chimeric antigen receptor (CAR) T cells in seven patients with biopsy-confirmed refractory LN. The therapy successfully eliminated peripheral B cells and induced profound clinical improvement. The most critical finding is that BCMA-only CAR T cell therapy effectively induced and maintained disease remission, achieving DORIS complete remission in five out of seven patients and demonstrating the potential for long-term drug-free status. This is a crucial step for managing treatment-resistant humoral autoimmune disorders, but clinicians must carefully consider that the findings are currently limited by the small sample size and the single-arm design. This study is highly relevant to practicing physicians as it indicates a groundbreaking, targeted strategy that could become a novel, curative option for patients struggling with treatment-refractory LN.

Citation: Hu Z, et al. BCMA-targeted CAR T cell therapy can effectively induce disease remission in refractory lupus nephritis. Annals of the Rheumatic Diseases. 2025. DOI: 10.1016/j.ard.2025.06.2128

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