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Study to Evaluate Hepatic Artery Injection of Autologous Human Bone Marrow-Derived MSCs in Patients With Alcoholic LC

Primary Purpose

Alcoholic Liver Cirrhosis

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cellgram™ (Bone marrow-derived MSCs)
Sponsored by
Pharmicell Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcoholic Liver Cirrhosis focused on measuring Alcoholic, Liver, Cirrhosis, Liver Disease

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Alcoholic liver cirrhosis as diagnosed by clinical, biochemical, radiological, or histological evidence.
  2. Male or female, 18 to 70 years of age, inclusive.
  3. Child-Pugh class B (7 to 9 points)
  4. Capable, in the Investigators opinion, of undergoing hepatic artery catheterization.
  5. No consumption of alcohol or other potentially hepatotoxic substances considered clinically relevant in the opinion of the Investigator, within 6 months prior to screening and throughout the study.
  6. Provision of informed consent by the patient (or their legal representative) to participate in the clinical study.
  7. Able, in the Investigator's opinion, to comply with the requirements of the protocol (including the follow-up period).
  8. Females of childbearing potential must test negative on standard urine pregnancy test and must be willing to practice appropriate contraceptive methods for the duration of the study. Highly effective methods of birth control include hormonal birth control, intrauterine devices (IUDs), or any double-barrier method (sponges, female condoms) used by the woman in addition to contraception used by their male partner such as vasectomy or condom supplemented with spermicide.

Exclusion Criteria:

  1. Current diagnosis of malignant hematologic disease (e.g., acute myeloid leukemia, acute lymphoblastic leukemia, non-Hodgkin's lymphoma, Hodgkin's lymphoma, multiple myeloma).
  2. Etiology other than alcohol for underlying liver cirrhosis.
  3. Baseline creatinine >1.7 mg/dL and/or estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2
  4. Clinical history of a solid cancer within 5 years prior to screening or current diagnosis of a solid cancer (including hepatocellular carcinoma assessed by ultrasonography and elevated AFP level) and currently receiving cancer treatment.

    Continuous use of a clinically relevant amount of steroids or antibiotics within 1 month prior to screening. Clinical relevance will be determined by the Investigator.

  5. Model for End-Stage Liver Disease score >20.
  6. International normalized ratio >3.0 and/or platelet counts <30,000/mm3
  7. Major operation within 3 months prior to screening.
  8. Presence of extrahepatic biliary stricture.
  9. Participant has undergone transjugular intrahepatic portosystemic shunt.
  10. Active hepatic artery or portal vein thrombosis.
  11. Presence of advanced hepatic encephalopathy Stages 3-4 (West Haven criteria) at the time of screening.
  12. Active variceal bleeding during the last 6 months before screening.
  13. Severe cardiac, renal, or respiratory failure.
  14. Positive serological test results for human immunodeficiency virus (HIV), HCV, hepatitis B surface antigen (HBsAg) and/or syphilis.
  15. Patient is pregnant or breast feeding, or planning to become pregnant while enrolled in the study, up to the EOS visit.
  16. Positive urine pregnancy test at Screening.
  17. Drug abuse within the past 2 years (as confirmed by patient disclosure or a urine drug screen conducted at Screening).
  18. Participation in an interventional clinical study within 30 days prior to screening.

Sites / Locations

  • University of UtahRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cellgram™ (Bone marrow-derived MSCs)

Arm Description

Infusion Cellgram™(Bone marrow-derived MSCs). Single dose administration of approximately 5 x 10^7 cells/10 mL (range: 4.5 x 10^7 to 5.5 x 10^7 cells/10 mL) via the hepatic artery.

Outcomes

Primary Outcome Measures

Incidence of Serious Adverse Events
An SAE suggests a significant hazard, contraindication, side-effect, or precaution. With respect to human clinical experience, this includes any event that: Results in death. Is life-threatening.* Requires in-patient hospitalization or prolongation of existing hospitalization. Results in persistent or significant disability/incapacity. Is a congenital anomaly/birth defect. Other medically important condition Life-threatening in the definition of a SAE or adverse reaction refers to an event in which the patient was at risk of death at the time of event; it does not refer to an event, which hypothetically might have caused death if it were more severe.

Secondary Outcome Measures

Number of patients with Hepatocellular carcinoma (primary liver cancer) development
assessed via ultrasonography and alpha fetoprotein [AFP] analysis
Incidence of Adverse Events
Incidence of Adverse Events as assessed by vital signs, physical examination, safety laboratory tests, and patient reporting
Liver stiffness measurement
with transient elastography (i.e., FibroScan®)
How well the Liver is functioning
by tests including: serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, albumin, gamma glutamyl transpeptidase (GGT) and creatinine. Units of Measure: AST will be report in U/L. ALT will be report in U/L. GGT will be report in U/L. Bilirubin will be report in mg/dL. creatinine will be report in mg/dL. Albumin will be report in g/dL
Chronic liver disease as assessed by the Child-Pugh score
The Child-Pugh Score will be used to determine the prognosis, required strength of treatment and the necessity of liver transplantation. The score employs 5 clinical measures of liver disease (total bilirubin, serum albumin, INR, ascites and hepatic encephalopathy). Each parameter is scored 1 to 3, with 3 indicating the most severe derangement.
Model for End-Stage Liver Disease (MELD) Score
MELD uses the patient's values for serum bilirubin, serum creatinine, and the INR for PT to predict survival. It is calculated according to the following formula defined by Kamath et al (2001): MELD = 3.78×ln[serum bilirubin (mg/dL)] + 11.2×ln[INR] + 9.57×ln[serum creatinine (mg/dL)] + 6.43
Overall survival
defined as the time from infusion until death from any cause during the study period.
Quality of life as assessed by 36-Item Short Form Survey (SF-36) Questionnaire
The Short Form-36 Quality Of Life questionnaire will be recorded for each patient. The 8 subscales of the SF-36 (Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health) and 2 summary component measures (Physical Component Summary, Mental Component Summary) will be calculated and summarized.

Full Information

First Posted
January 7, 2019
Last Updated
October 20, 2020
Sponsor
Pharmicell Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03838250
Brief Title
Study to Evaluate Hepatic Artery Injection of Autologous Human Bone Marrow-Derived MSCs in Patients With Alcoholic LC
Official Title
A Phase I, Open-Label, Single-Dose Study to Evaluate the Safety and Efficacy of Hepatic Artery Injection of Autologous Human Bone Marrow-Derived Mesenchymal Stem Cells (Cellgram™) in Patients With Alcoholic Liver Cirrhosis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 20, 2019 (Actual)
Primary Completion Date
March 2021 (Anticipated)
Study Completion Date
June 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pharmicell Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is to evaluate the safety and efficacy of a single dose of Cellgram™ delivered via hepatic artery in patients with decompensated alcoholic liver cirrhosis.
Detailed Description
After providing written informed consent, subjects will return to the study center for further evaluation and to have their Bone marrow harvested by an experienced hematologist or interventional radiologist. Within approximately 1 month (30 ± 7 days) after Bone marrow aspiration, study participants will be admitted to the study center on Day 1. At the study center, the participant will undergo hepatic artery catheterization by an interventional radiologist who will inject a single dose of Cellgram™. Participants will remain as in-patients and be observed for 24 hours post-infusion. Following discharge, participants will periodically return to the study center for study assessment visits over a period of 1 year. When a suitable candidate is identified by the Investigator, the Investigator or designated healthcare professional will ask the patient about his/her willingness to be included in the clinical study. Following this, patients will be allowed sufficient time, in their own opinion, to consider study entry, and will be offered the opportunity to ask any further questions prior to signing the informed consent form.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcoholic Liver Cirrhosis
Keywords
Alcoholic, Liver, Cirrhosis, Liver Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
A single-dose injection of autologous bone marrow-derived mesenchymal stem cells (Cellgram™) will be administered to the patient by an experienced interventional radiologist.
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cellgram™ (Bone marrow-derived MSCs)
Arm Type
Experimental
Arm Description
Infusion Cellgram™(Bone marrow-derived MSCs). Single dose administration of approximately 5 x 10^7 cells/10 mL (range: 4.5 x 10^7 to 5.5 x 10^7 cells/10 mL) via the hepatic artery.
Intervention Type
Biological
Intervention Name(s)
Cellgram™ (Bone marrow-derived MSCs)
Intervention Description
Approximately 15 to 30 mL of bone marrow is aspirated from the posterior iliac crest of patients under local anesthesia. Approximately 30 days (±7 days) after BM aspiration, the participant will return to the study center for admission and for the infusion Cellgram™ (Bone marrow-derived MSCs).
Primary Outcome Measure Information:
Title
Incidence of Serious Adverse Events
Description
An SAE suggests a significant hazard, contraindication, side-effect, or precaution. With respect to human clinical experience, this includes any event that: Results in death. Is life-threatening.* Requires in-patient hospitalization or prolongation of existing hospitalization. Results in persistent or significant disability/incapacity. Is a congenital anomaly/birth defect. Other medically important condition Life-threatening in the definition of a SAE or adverse reaction refers to an event in which the patient was at risk of death at the time of event; it does not refer to an event, which hypothetically might have caused death if it were more severe.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Number of patients with Hepatocellular carcinoma (primary liver cancer) development
Description
assessed via ultrasonography and alpha fetoprotein [AFP] analysis
Time Frame
12 months
Title
Incidence of Adverse Events
Description
Incidence of Adverse Events as assessed by vital signs, physical examination, safety laboratory tests, and patient reporting
Time Frame
12 months
Title
Liver stiffness measurement
Description
with transient elastography (i.e., FibroScan®)
Time Frame
12 months
Title
How well the Liver is functioning
Description
by tests including: serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, albumin, gamma glutamyl transpeptidase (GGT) and creatinine. Units of Measure: AST will be report in U/L. ALT will be report in U/L. GGT will be report in U/L. Bilirubin will be report in mg/dL. creatinine will be report in mg/dL. Albumin will be report in g/dL
Time Frame
12 months
Title
Chronic liver disease as assessed by the Child-Pugh score
Description
The Child-Pugh Score will be used to determine the prognosis, required strength of treatment and the necessity of liver transplantation. The score employs 5 clinical measures of liver disease (total bilirubin, serum albumin, INR, ascites and hepatic encephalopathy). Each parameter is scored 1 to 3, with 3 indicating the most severe derangement.
Time Frame
12 months
Title
Model for End-Stage Liver Disease (MELD) Score
Description
MELD uses the patient's values for serum bilirubin, serum creatinine, and the INR for PT to predict survival. It is calculated according to the following formula defined by Kamath et al (2001): MELD = 3.78×ln[serum bilirubin (mg/dL)] + 11.2×ln[INR] + 9.57×ln[serum creatinine (mg/dL)] + 6.43
Time Frame
12 months
Title
Overall survival
Description
defined as the time from infusion until death from any cause during the study period.
Time Frame
12 months
Title
Quality of life as assessed by 36-Item Short Form Survey (SF-36) Questionnaire
Description
The Short Form-36 Quality Of Life questionnaire will be recorded for each patient. The 8 subscales of the SF-36 (Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health) and 2 summary component measures (Physical Component Summary, Mental Component Summary) will be calculated and summarized.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Alcoholic liver cirrhosis as diagnosed by clinical, biochemical, radiological, or histological evidence. Male or female, 18 to 70 years of age, inclusive. Child-Pugh class B (7 to 9 points) Capable, in the Investigators opinion, of undergoing hepatic artery catheterization. No consumption of alcohol or other potentially hepatotoxic substances considered clinically relevant in the opinion of the Investigator, within 6 months prior to screening and throughout the study. Provision of informed consent by the patient (or their legal representative) to participate in the clinical study. Able, in the Investigator's opinion, to comply with the requirements of the protocol (including the follow-up period). Females of childbearing potential must test negative on standard urine pregnancy test and must be willing to practice appropriate contraceptive methods for the duration of the study. Highly effective methods of birth control include hormonal birth control, intrauterine devices (IUDs), or any double-barrier method (sponges, female condoms) used by the woman in addition to contraception used by their male partner such as vasectomy or condom supplemented with spermicide. Exclusion Criteria: Current diagnosis of malignant hematologic disease (e.g., acute myeloid leukemia, acute lymphoblastic leukemia, non-Hodgkin's lymphoma, Hodgkin's lymphoma, multiple myeloma). Etiology other than alcohol for underlying liver cirrhosis. Baseline creatinine >1.7 mg/dL and/or estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 Clinical history of a solid cancer within 5 years prior to screening or current diagnosis of a solid cancer (including hepatocellular carcinoma assessed by ultrasonography and elevated AFP level) and currently receiving cancer treatment. Continuous use of a clinically relevant amount of steroids or antibiotics within 1 month prior to screening. Clinical relevance will be determined by the Investigator. Model for End-Stage Liver Disease score >20. International normalized ratio >3.0 and/or platelet counts <30,000/mm3 Major operation within 3 months prior to screening. Presence of extrahepatic biliary stricture. Participant has undergone transjugular intrahepatic portosystemic shunt. Active hepatic artery or portal vein thrombosis. Presence of advanced hepatic encephalopathy Stages 3-4 (West Haven criteria) at the time of screening. Active variceal bleeding during the last 6 months before screening. Severe cardiac, renal, or respiratory failure. Positive serological test results for human immunodeficiency virus (HIV), HCV, hepatitis B surface antigen (HBsAg) and/or syphilis. Patient is pregnant or breast feeding, or planning to become pregnant while enrolled in the study, up to the EOS visit. Positive urine pregnancy test at Screening. Drug abuse within the past 2 years (as confirmed by patient disclosure or a urine drug screen conducted at Screening). Participation in an interventional clinical study within 30 days prior to screening.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
JIYEOUN JEONG, CCRP, Bachelor
Phone
82-02-3496-0134
Email
jyjeong@pharmicell.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Juan Gallegos-Orozco, Ph.D
Organizational Affiliation
University of Utah
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juan Gallegos-Orozco, Ph.D
Phone
801-581-7878
Email
juan.gallegos@hsc.utah.edu

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Study to Evaluate Hepatic Artery Injection of Autologous Human Bone Marrow-Derived MSCs in Patients With Alcoholic LC

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