Intracerebral Transplantation of Neural Stem Cells for the Treatment of Ischemic Stroke
Primary Purpose
Ischemic Motor Stroke, Chronic
Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
NSI-566
Sponsored by
About this trial
This is an interventional treatment trial for Ischemic Motor Stroke, Chronic focused on measuring chronic stroke, neural stem cell, transplant, paralysis
Eligibility Criteria
Inclusion Criteria:
- Have the ability to understand the requirements of the study, provide written informed consent, understand and provide written authorization for the use and disclosure of Protected Health Information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) Privacy Ruling] and comply with the study procedures
- Men and women 30-65 years old
- Women must have a negative serum pregnancy test and practice an acceptable method of contraception or be of non-childbearing potential (post-menopausal for at least 2 years or who have undergone hysterectomy or oophorectomy or surgical sterilization)
- At least 3 months but no more than 24 months from time of stroke, with a motor neurological deficit
- Documented history of completed ischemic stroke in subcortical region of MCA or lenticulostriate artery with or without cortical involvement, with correlated findings by MRI
- Modified Rankin Score of 2, 3 or 4
- FMMS score of 55 or less;
- Two evaluations at approximately 3 weeks apart prior to surgery with less than +/- 4 point change in the NIHSS
- Able and willing to meet all follow-up requirements
- Able and willing to undergo post-physical therapy/rehabilitation
Exclusion Criteria:
- Any disabling psychological or psychiatric disorders which may confound the study
- History of more than one symptomatic stroke, TIAs allowed
- History of another major neurological disease or injury
- Cerebral infarct size >8cm in any one measurement
- Myocardial infarction within the prior 3 months
- History of seizures or current use of antiepileptic medication
- Receipt of any investigational drug or device within 30 days
- Receipt of any cell infusion other than blood transfusion
Any concomitant medical disease or condition noted below:
- Coagulopathy with INR > 1.4 at the time of surgery
- Panel Reactive Antibodies (PRA) > 20% at initial screen
- Active infection at the time of surgery
- Active hypotension requiring vasopressor therapy
- Skin breakdown over the site of surgery
- Active or history of malignancy
- Primary or secondary immune deficiency
- Persistent MRI artifact that would prevent imaging pre and post-operation or unable to undergo MRI
- Creatinine >115μmol/L, liver function tests (SGOT/SGPT, Bilirubin, Alk Phos) > 2x upper limit of normal, hematocrit/hemoglobin < 30/10, total WBC < 4000/mm3,platelet count <100,000/mm3, uncontrolled hypertension (systolic > 180mmHg or diastolic> 100mmHg) or uncontrolled diabetes (defined as hemoglobin A1C>8%), evidence of GI bleeding by hemoccult test,positive tuberculosis (TB test: PPD/Mantoux), hepatitis B or C, or human immunodeficiency virus (HIV)
Presence of any of the following conditions:
- Current drug abuse or alcoholism
- Unstable medical conditions
- Unstable psychiatric illness including psychosis and untreated major depression
- Any condition that the Investigator or primary physician feels may interfere with participation in the study or may endanger the subject
- Any condition that the surgeon feels may pose complications for the surgery
- Known hypersensitivity to tacrolimus or methylprednisolone
- Unable or unwilling to participate in physical and/or occupational therapy or return to clinic for follow up examinations as scheduled
- Inability to provide informed consent as determined by screening protocol.
- Use of antiplatelet drugs less than 2 weeks before surgery
Sites / Locations
- Ba Yi Brain Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
NSI-566 neural stem cell implantation
Arm Description
Outcomes
Primary Outcome Measures
Adverse Events
Secondary Outcome Measures
Clinical improvement using NIH Stroke Scale
Clinical improvement using Modified Rankin Scale
Clinical improvement using Fugl-Meyer Motor Score
Clinical Improvement using Mini-mental State Examination
Full Information
NCT ID
NCT03296618
First Posted
September 22, 2017
Last Updated
October 3, 2017
Sponsor
Suzhou Neuralstem Biopharmaceuticals
1. Study Identification
Unique Protocol Identification Number
NCT03296618
Brief Title
Intracerebral Transplantation of Neural Stem Cells for the Treatment of Ischemic Stroke
Official Title
Phase I Clinical Study of Intracerebral Transplantation of Neural Stem Cells for the Treatment of Ischemic Stroke
Study Type
Interventional
2. Study Status
Record Verification Date
October 2017
Overall Recruitment Status
Unknown status
Study Start Date
June 2012 (undefined)
Primary Completion Date
May 2018 (Anticipated)
Study Completion Date
May 2018 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Suzhou Neuralstem Biopharmaceuticals
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The study is to determine the safety of human neural stem cell transplantation for the treatment of paralysis and related symptoms due to chronic motor stroke and to determine the maximum tolerated dose.
Detailed Description
This is a Phase I study of human neural stem cell transplantation for the treatment of chronic motor stroke. This single-site, Phase I, open-label study may enroll up to 18 patients across 5 cohorts of ascending doses of human neural stem cells to define maximal tolerated dose.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ischemic Motor Stroke, Chronic
Keywords
chronic stroke, neural stem cell, transplant, paralysis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
NSI-566 neural stem cell implantation
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
NSI-566
Intervention Description
Dosing will consist of a one-time stereotactic, intracranial injection of a hNSC line, NSI-566, ranging from 1.2×107 cells to 8×107 cells, as tolerated.
Primary Outcome Measure Information:
Title
Adverse Events
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Clinical improvement using NIH Stroke Scale
Time Frame
12 months
Title
Clinical improvement using Modified Rankin Scale
Time Frame
12 months
Title
Clinical improvement using Fugl-Meyer Motor Score
Time Frame
12 months
Title
Clinical Improvement using Mini-mental State Examination
Time Frame
12 months
Other Pre-specified Outcome Measures:
Title
MRI analysis of transplant site
Time Frame
12 months
Title
PET analysis of transplant site
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Have the ability to understand the requirements of the study, provide written informed consent, understand and provide written authorization for the use and disclosure of Protected Health Information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) Privacy Ruling] and comply with the study procedures
Men and women 30-65 years old
Women must have a negative serum pregnancy test and practice an acceptable method of contraception or be of non-childbearing potential (post-menopausal for at least 2 years or who have undergone hysterectomy or oophorectomy or surgical sterilization)
At least 3 months but no more than 24 months from time of stroke, with a motor neurological deficit
Documented history of completed ischemic stroke in subcortical region of MCA or lenticulostriate artery with or without cortical involvement, with correlated findings by MRI
Modified Rankin Score of 2, 3 or 4
FMMS score of 55 or less;
Two evaluations at approximately 3 weeks apart prior to surgery with less than +/- 4 point change in the NIHSS
Able and willing to meet all follow-up requirements
Able and willing to undergo post-physical therapy/rehabilitation
Exclusion Criteria:
Any disabling psychological or psychiatric disorders which may confound the study
History of more than one symptomatic stroke, TIAs allowed
History of another major neurological disease or injury
Cerebral infarct size >8cm in any one measurement
Myocardial infarction within the prior 3 months
History of seizures or current use of antiepileptic medication
Receipt of any investigational drug or device within 30 days
Receipt of any cell infusion other than blood transfusion
Any concomitant medical disease or condition noted below:
Coagulopathy with INR > 1.4 at the time of surgery
Panel Reactive Antibodies (PRA) > 20% at initial screen
Active infection at the time of surgery
Active hypotension requiring vasopressor therapy
Skin breakdown over the site of surgery
Active or history of malignancy
Primary or secondary immune deficiency
Persistent MRI artifact that would prevent imaging pre and post-operation or unable to undergo MRI
Creatinine >115μmol/L, liver function tests (SGOT/SGPT, Bilirubin, Alk Phos) > 2x upper limit of normal, hematocrit/hemoglobin < 30/10, total WBC < 4000/mm3,platelet count <100,000/mm3, uncontrolled hypertension (systolic > 180mmHg or diastolic> 100mmHg) or uncontrolled diabetes (defined as hemoglobin A1C>8%), evidence of GI bleeding by hemoccult test,positive tuberculosis (TB test: PPD/Mantoux), hepatitis B or C, or human immunodeficiency virus (HIV)
Presence of any of the following conditions:
Current drug abuse or alcoholism
Unstable medical conditions
Unstable psychiatric illness including psychosis and untreated major depression
Any condition that the Investigator or primary physician feels may interfere with participation in the study or may endanger the subject
Any condition that the surgeon feels may pose complications for the surgery
Known hypersensitivity to tacrolimus or methylprednisolone
Unable or unwilling to participate in physical and/or occupational therapy or return to clinic for follow up examinations as scheduled
Inability to provide informed consent as determined by screening protocol.
Use of antiplatelet drugs less than 2 weeks before surgery
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xu Ruxiang, M.D
Organizational Affiliation
BaYi Brain Hospital, Army General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ba Yi Brain Hospital
City
Beijing
Country
China
12. IPD Sharing Statement
Citations:
PubMed Identifier
22415942
Citation
Glass JD, Boulis NM, Johe K, Rutkove SB, Federici T, Polak M, Kelly C, Feldman EL. Lumbar intraspinal injection of neural stem cells in patients with amyotrophic lateral sclerosis: results of a phase I trial in 12 patients. Stem Cells. 2012 Jun;30(6):1144-51. doi: 10.1002/stem.1079.
Results Reference
background
PubMed Identifier
22158518
Citation
Boulis NM, Federici T, Glass JD, Lunn JS, Sakowski SA, Feldman EL. Translational stem cell therapy for amyotrophic lateral sclerosis. Nat Rev Neurol. 2011 Dec 13;8(3):172-6. doi: 10.1038/nrneurol.2011.191.
Results Reference
background
PubMed Identifier
21905078
Citation
Lunn JS, Sakowski SA, Hur J, Feldman EL. Stem cell technology for neurodegenerative diseases. Ann Neurol. 2011 Sep;70(3):353-61. doi: 10.1002/ana.22487.
Results Reference
background
PubMed Identifier
21391854
Citation
Lunn JS, Sakowski SA, Federici T, Glass JD, Boulis NM, Feldman EL. Stem cell technology for the study and treatment of motor neuron diseases. Regen Med. 2011 Mar;6(2):201-13. doi: 10.2217/rme.11.6. Erratum In: Regen Med. 2011 Jul;6(4):536.
Results Reference
background
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Intracerebral Transplantation of Neural Stem Cells for the Treatment of Ischemic Stroke
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