Abstract: SA-PO1267
Beyond Conventional Immunosuppression: The Emerging Role of Chimeric Antigen Receptor-T Cell Therapy for Refractory Lupus Nephritis
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Salimiaghdam, Nasim, Capital Health Regional Medical Center, Trenton, New Jersey, United States
- Ebrahimi, Niloufar, Loma Linda University, Loma Linda, California, United States
- Abdi Pour, Amir, Loma Linda University, Loma Linda, California, United States
Background
Lupus nephritis (LN) causes 5-20% kidney failure within 10 years of diagnosis in patients with systemic lupus erythematosus (SLE). Persistent disease activity, treatment resistance, frequent relapses, and cumulative toxicity from long-term immunosuppression highlight an unmet need for novel therapies. Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a promising approach for refractory autoimmune diseases.
Methods
A review of preclinical and clinical evidence evaluating the role of CAR-T therapy in SLE and LN was conducted. Data were synthesized from lupus-prone animal models, human case reports, case series, and phase 1/2 clinical trials. Safety outcomes, immunologic responses, efficacy data, and trial endpoints were reviewed.
Results
Preclinical studies show that CD19-targeted CAR-T therapy induces sustained B-cell depletion, reduces autoantibody production, improves kidney histopathology, and prolongs survival. Early clinical experience in patients with refractory SLE and LN shows rapid induction of remission, normalization of serologic markers, and discontinuation of immunosuppression. In small cohorts, remission was achieved within about 3 months and sustained beyond 20 months despite B-cell reconstitution. Reports in LN describe resolution of proteinuria, improvement in kidney function, and, in select cases, dialysis discontinuation. Safety profiles are favorable, with mild cytokine release syndrome and low incidence of neurotoxicity. Long-term durability, optimal patient selection, and safety are being evaluated in ongoing trials.
Conclusion
CAR-T therapy represents a paradigm shift in the LN management by targeting the underlying immune dysregulation rather than providing chronic immunosuppression. Early evidence suggests the potential for durable remission and immune system reprogramming following a single treatment. Ongoing trials with long-term follow-up are essential to define efficacy and safety, patient selection, and determine whether CAR-T therapy can be integrated into standard clinical practice.
Selected Ongoing Clinical Trialas of CAR-T Therapy in SLE and LN