search
Back to results

Open Label Phase I hCT-MSC in Toddlers With Autism Spectrum Disorder (TACT)

Primary Purpose

Autism Spectrum Disorder

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
hCT-MSC infusion
Sponsored by
Duke University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Autism Spectrum Disorder focused on measuring Autism Spectrum Disorder, ASD, Autism, PDD

Eligibility Criteria

18 Months - 48 Months (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age ≥ 18 months to ≤ 48 months (48 months, 29 days) at the time of consent
  2. Confirmed clinical DSM-5 diagnosis of Autism Spectrum Disorder using the DSM-5 Checklist as informed by the Autism Diagnostic Observation Schedule - 2.
  3. Fragile X testing performed and negative; CMA and/or whole exome sequencing performed and results not linked to autism diagnosis
  4. Stable on current psychoactive medication regimen (dose and dosing schedule) for at least 2 months prior to infusion of study product
  5. Normal absolute lymphocyte count (≥1500/uL)
  6. Participant and parent/guardian are English speaking
  7. Able to travel to Duke University for two multi-day visits (baseline and six months) and parent/guardian is able to participate in interim surveys and interviews
  8. Parental consent

Exclusion Criteria:

  1. General:

    1. Review of medical records indicates ASD diagnosis not likely
    2. Screening data suggests that participant would not be able to comply with the requirements of the study procedures as assessed by the study team
    3. Family is unwilling or unable to commit to participation in all study-related assessments, including protocol follow up
    4. Sibling is enrolled in this (Duke hCT-MSC) study
  2. Genetic:

    1. Records indicate that child has a known genetic syndrome such as (but not limited to) Fragile X syndrome, neurofibromatosis, Rett syndrome, tuberous sclerosis, PTEN mutation, cystic fibrosis, muscular dystrophy or a genetic mutation known to be associated with ASD
    2. Known pathogenic mutation or copy number variation (CNV) associated with ASD (e.g., 16p11.2, 15q13.2, 2q13.3)
  3. Infectious:

    1. Known active CNS infection
    2. Evidence of uncontrolled infection based on records or clinical assessment
    3. Known HIV positivity
  4. Medical:

    1. Known metabolic disorder
    2. Known mitochondrial dysfunction
    3. History of unstable epilepsy or uncontrolled seizure disorder, infantile spasms, Lennox Gastaut syndrome, Dravet syndrome, or other similar chronic seizure disorder
    4. Active malignancy or prior malignancy that was treated with chemotherapy
    5. History of a primary immunodeficiency disorder
    6. History of autoimmune cytopenias (i.e., ITP, AIHA)
    7. Coexisting medical condition that would place the child at increased risk for complications of study procedures
    8. Concurrent genetic or acquired disease or comorbidity(ies) that could require a future stem cell transplant
    9. Significant sensory (e.g., blindness, deafness, uncorrected hearing impairment) or motor (e.g., cerebral palsy) impairment
    10. Impaired renal or liver function as determined by serum creatinine >1.5mg/dL or total bilirubin >1.3mg/dL, except in patients with known Gilbert's disease
    11. Significant hematologic abnormalities defined as: Hemoglobin <10.0 g/dL, WBC < 3,000 cells/mL, ALC <1000/uL, Platelets <150 x 10e9/uL
    12. Known clinically relevant physical dysmorphology associated with neurodevelopmental conditions.
  5. Current/Prior Therapy:

    a. History of prior cell therapy b. Current or prior use of IVIG or other anti-inflammatory medications with the exception of NSAIDs c. Current or prior immunosuppressive therapy i. No systemic steroid therapy that has lasted >2 weeks, and no systemic steroids within 3 months prior to enrollment. Topical and inhaled steroids are permitted.

Sites / Locations

  • Duke University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

hCT-MSC infusion

Arm Description

Outcomes

Primary Outcome Measures

Safety of hCT-MSC infusion as measured by incidence of infusion reactions
Safety of hCT-MSC infusion as measured by severity of infusion reactions
CTCAE is used to measure severity
Safety of hCT-MSC infusion as measured by incidence of product-related infections
Safety of hCT-MSC infusion as measured by severity of product-related infections
CTCAE is used to measure severity
Safety of hCT-MSC infusion as measured by evidence of alloimmunization via anit-HLA antibodies
Safety of hCT-MSC infusion as measured by incidence of graft vs. host disease
Safety of hCT-MSC infusion as measured by severity of graft vs. host disease
CTCAE is used to measure severity
Safety of hCT-MSC infusion as measured by incidence of unexpected adverse events
Safety of hCT-MSC infusion as measured by severity of unexpected adverse events
CTCAE is used to measure severity
Change in PDD Behavior Inventory Autism Composite Score (PDDBI)
Change in mean of the Socialization Subscale and Communication Subscale standard scores on the Vineland Adaptive Behavior Scales (VABS-3)
Change in Clinical Global Impression Scale (CGI)
Change in Communicative Development Inventories (CDI-2)
Change in attention abilities as assess via eye-tracking
Change in brain activity as measured by EEG

Secondary Outcome Measures

Full Information

First Posted
March 2, 2020
Last Updated
January 19, 2023
Sponsor
Duke University
Collaborators
The Marcus Foundation
search

1. Study Identification

Unique Protocol Identification Number
NCT04294290
Brief Title
Open Label Phase I hCT-MSC in Toddlers With Autism Spectrum Disorder
Acronym
TACT
Official Title
AN OPEN LABEL PHASE I STUDY OF hCT-MSC, AN UMBILICAL CORD-DERIVED MESENCHYMAL STROMAL CELL PRODUCT IN YOUNG CHILDREN WITH AUTISM SPECTRUM DISORDER
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
February 24, 2021 (Actual)
Primary Completion Date
August 17, 2022 (Actual)
Study Completion Date
August 17, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Duke University
Collaborators
The Marcus Foundation

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 is a single site, prospective study of one intravenous infusion of human umbilical cord tissue-derived mesenchymal stromal cells (hCT-MSC) in toddlers with autism spectrum disorder (ASD). Toddlers 18 to 48 months of age with a confirmed diagnosis of ASD will be eligible to participate. Diagnosis will be confirmed at the time of the eligibility visit at the Duke Center for Autism and Brain Development. All participants will receive a single intravenous dose of 2x106/kg hCT-MSC per kilogram at baseline. Assessments will be conducted at baseline and 6 months, with remote follow-up assessments at 12 months.
Detailed Description
The primary purpose of this study is to evaluate safety and feasibility. Safety assessments include monitoring of acute infusion reactions, adverse events, incidence of infections, and markers of alloimmunization. Clinical outcome measures will also be described. A key clinical outcome measeure is the change in social communication abilities from baseline to 6 months based on the Joint Engagement Rating Inventory (JERI), a commonly-used and well-validated coding system for rating the quality and quantity of social communication skills in toddlers with and without ASD.91 JERI coding rates social communication abilities on a 1 to 7 scale and factors in both the quantity and quality of skills. The total joint engagement score as well as ratings on all JERI subscales that comprise the total score will be described. Other clinical endpoints will include the PDD Behavior Inventory (PDDBI) autism composite score, the mean of the Socialization Subscale Standard Score and Communication Subscale Standard Score on the Vineland Adaptive Behavior Scales (VABS-3), the Clinical Global Impression Scale (CGI) - Severity and Improvement Scales, the Communicative Development Inventories (CDI-2): Words & Sentences subscales, attention abilities via eye-tracking, and brain activity. Exploratory clinical endpoints will include autism symptoms measured by an app that elicits and records autism symptoms on an iPad (SenseToKnow), Autism Diagnostic Observation Scale (ADOS-2) Calibrated Severity Score (overall, social affect, and repetitive behavior), PDD Behavior Inventory (PDDBI) Subscales, and VABS-3 Standard Score and age equivalent for the following subscales: Socialization, Communication, and Daily Living and the Standard Score and age equivalent for the VABS-3 Adaptive Behavior Composite. Safety and VABS-3 assessments will also be conducted remotely at three and 12 months. Duration of study participation will be 12 months from the time of the baseline infusion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autism Spectrum Disorder
Keywords
Autism Spectrum Disorder, ASD, Autism, PDD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
hCT-MSC infusion
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
hCT-MSC infusion
Intervention Description
This is a single site, phase I, open-label, prospective study of one intravenous infusion of human umbilical cord tissue-derived mesenchymal stromal cells (hCT-MSC) in 12 toddlers 18 to 48 months of age with autism spectrum disorder (ASD).
Primary Outcome Measure Information:
Title
Safety of hCT-MSC infusion as measured by incidence of infusion reactions
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by severity of infusion reactions
Description
CTCAE is used to measure severity
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by incidence of product-related infections
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by severity of product-related infections
Description
CTCAE is used to measure severity
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by evidence of alloimmunization via anit-HLA antibodies
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by incidence of graft vs. host disease
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by severity of graft vs. host disease
Description
CTCAE is used to measure severity
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by incidence of unexpected adverse events
Time Frame
1 year
Title
Safety of hCT-MSC infusion as measured by severity of unexpected adverse events
Description
CTCAE is used to measure severity
Time Frame
1 year
Title
Change in PDD Behavior Inventory Autism Composite Score (PDDBI)
Time Frame
Baseline, 6 months
Title
Change in mean of the Socialization Subscale and Communication Subscale standard scores on the Vineland Adaptive Behavior Scales (VABS-3)
Time Frame
baseline, 6 months
Title
Change in Clinical Global Impression Scale (CGI)
Time Frame
baseline, 6 months
Title
Change in Communicative Development Inventories (CDI-2)
Time Frame
baseline, 6 months
Title
Change in attention abilities as assess via eye-tracking
Time Frame
baseline, 6 months
Title
Change in brain activity as measured by EEG
Time Frame
baseline, 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Months
Maximum Age & Unit of Time
48 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 months to ≤ 48 months (48 months, 29 days) at the time of consent Confirmed clinical DSM-5 diagnosis of Autism Spectrum Disorder using the DSM-5 Checklist as informed by the Autism Diagnostic Observation Schedule - 2. Fragile X testing performed and negative; CMA and/or whole exome sequencing performed and results not linked to autism diagnosis Stable on current psychoactive medication regimen (dose and dosing schedule) for at least 2 months prior to infusion of study product Normal absolute lymphocyte count (≥1500/uL) Participant and parent/guardian are English speaking Able to travel to Duke University for two multi-day visits (baseline and six months) and parent/guardian is able to participate in interim surveys and interviews Parental consent Exclusion Criteria: General: Review of medical records indicates ASD diagnosis not likely Screening data suggests that participant would not be able to comply with the requirements of the study procedures as assessed by the study team Family is unwilling or unable to commit to participation in all study-related assessments, including protocol follow up Sibling is enrolled in this (Duke hCT-MSC) study Genetic: Records indicate that child has a known genetic syndrome such as (but not limited to) Fragile X syndrome, neurofibromatosis, Rett syndrome, tuberous sclerosis, PTEN mutation, cystic fibrosis, muscular dystrophy or a genetic mutation known to be associated with ASD Known pathogenic mutation or copy number variation (CNV) associated with ASD (e.g., 16p11.2, 15q13.2, 2q13.3) Infectious: Known active CNS infection Evidence of uncontrolled infection based on records or clinical assessment Known HIV positivity Medical: Known metabolic disorder Known mitochondrial dysfunction History of unstable epilepsy or uncontrolled seizure disorder, infantile spasms, Lennox Gastaut syndrome, Dravet syndrome, or other similar chronic seizure disorder Active malignancy or prior malignancy that was treated with chemotherapy History of a primary immunodeficiency disorder History of autoimmune cytopenias (i.e., ITP, AIHA) Coexisting medical condition that would place the child at increased risk for complications of study procedures Concurrent genetic or acquired disease or comorbidity(ies) that could require a future stem cell transplant Significant sensory (e.g., blindness, deafness, uncorrected hearing impairment) or motor (e.g., cerebral palsy) impairment Impaired renal or liver function as determined by serum creatinine >1.5mg/dL or total bilirubin >1.3mg/dL, except in patients with known Gilbert's disease Significant hematologic abnormalities defined as: Hemoglobin <10.0 g/dL, WBC < 3,000 cells/mL, ALC <1000/uL, Platelets <150 x 10e9/uL Known clinically relevant physical dysmorphology associated with neurodevelopmental conditions. Current/Prior Therapy: a. History of prior cell therapy b. Current or prior use of IVIG or other anti-inflammatory medications with the exception of NSAIDs c. Current or prior immunosuppressive therapy i. No systemic steroid therapy that has lasted >2 weeks, and no systemic steroids within 3 months prior to enrollment. Topical and inhaled steroids are permitted.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joanne Kurtzberg, MD
Organizational Affiliation
Duke Health
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Geraldine Dawson, PhD
Organizational Affiliation
Duke Health
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jessica Sun, MD
Organizational Affiliation
Duke Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Open Label Phase I hCT-MSC in Toddlers With Autism Spectrum Disorder

We'll reach out to this number within 24 hrs