Under the leadership of Dr. Saira Sheikh, UNC’s established multidisciplinary team has expertise in cell therapy clinical trials focused on lupus, myositis and other autoimmune diseases. The group recently co-authored a key perspectives article titled, “When too late is too late: timing of CAR T-cell therapy in SLE & lupus nephritis,” published in Frontiers in Immunology advocating for earlier use of CD19 CAR T-cell therapy for high-risk patients with moderate to severe systemic lupus erythematosus (SLE) and lupus nephritis (LN).
At UNC, similar to published reports, CD19 CAR T-cell therapy has demonstrated the capacity to induce deep, drug-free remissions in patients with severe, refractory lupus, including those with LN. These observations challenge long-standing assumptions about the reversibility of autoimmune disease and raise a critical question: whether CAR T-cell therapy should remain a therapy of last resort or if trials could investigate use earlier in the disease course, when its disease-modifying potential may be greatest. When CAR T-cell therapy is administered late in the disease course, its true biologic effect may be underestimated, and clinical nonresponse may be misattributed to lack of therapeutic activity rather than to persistent damage and fibrosis. Given the potential for a durable disease-free, drug free remission, the team proposes investigating use of CAR T-cell therapy in clinical trials for early severe SLE and LN. The current positioning as a refractory/salvage therapy late in the treatment algorithm may limit its impact for patients with SLE at high risk of irreversible organ damage.
To read more: https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1914091/full