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Phase I/IIa Clinical Trial of Human Umbilical Cord Mesenchymal Stem Cell Injection in the Treatment of Idiopathic Pulmonary Fibrosis (IPF)

Primary Purpose

Idiopathic Pulmonary Fibrosis

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Human umbilical cord mesenchymal stem cell injection
Sponsored by
Shanghai Life Science & Technology
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Idiopathic Pulmonary Fibrosis focused on measuring Idiopathic pulmonary fibrosis, IPF

Eligibility Criteria

50 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • (1) Age 50~75 years old (including the threshold), regardless of gender;

    (2) IPF was diagnosed according to the diagnostic guidelines for idiopathic pulmonary fibrosis jointly issued by the American Thoracic Society (ATS), the European Respiratory Society (ERs), the Japanese Respiratory Society (JRS) and the Latin American Thoracic Association (ALAT) in 2018;

    (3) Subjects with typical imaging manifestations of IPF (honeycomb, stretch bronchiectasis or bronchiectasis (mainly in ground glass shadow and fine mesh shadow) on HRCT within 12 months before screening;

    (4) Within 3 months before administration, the researcher determined that the disease was stable. The pulmonary carbon monoxide diffusion volume (DLCO) was 30% - 79% of the predicted value (corrected by HB value), or FVC was 50% - 80% of the predicted value;

    (5) Blood biochemical examination should meet the following standards: alanine aminotransferase (ALT) ≤ 1.5uln, aspartate aminotransferase (AST) ≤ 1.5uln, total bilirubin (TBIL) ≤ 1.5uln, direct bilirubin (DBIL) ≤ 1.5uln, blood creatinine (CR) ≤ 1.5uln;

    (6) Expected survival ≥ 12 months;

    (7) Subjects who have good compliance, can understand and cooperate with the completion of pulmonary function examination, are willing to take drugs according to the requirements of the protocol and receive follow-up examination on time;

    (8) Subjects who voluntarily participated in the trial, understood and signed the informed consent form.

Exclusion Criteria:

  • (1) Have previously received stem cell therapy, or are intolerant to cell therapy, or have taken drugs that may cause or aggravate pulmonary fibrosis (such as amiodarone, bleomycin or methotrexate);

    (2) Suffering from interstitial lung disease (ILD) other than IPF, including but not limited to: any other type of interstitial pneumonia; Lung disease related to exposure to fibroblasts or other environmental toxins or drugs; Other types of occupational lung disease; Granulomatous pulmonary disease; Pulmonary vascular disease; Systemic diseases, including vasculitis, infectious diseases (i.e. tuberculosis) and connective tissue diseases;

    (3) Those who need oxygen therapy at present (oxygen therapy time 15h/d);

    (4) Those who used or planned to use nidanib during the study 1 month before screening;

    (5) Subjects with a history of mechanical ventilation or complicated with infectious pneumonia and asthma within 1 month before screening;

    (6) Patients with malignant tumors within 5 years before screening;

    (7) Those who have been hospitalized for 3 times or more due to acute exacerbation of IPF or other respiratory diseases within 1 year before screening;

    (8) There is evidence that the subjects currently have digestive, urinary, cardiovascular, cerebrovascular, hematological, nervous, mental and metabolic diseases that may affect safety, such as type 2 diabetes with poor blood glucose control (fasting blood glucose ≥ 10.0mmol/l or HbA1c ≥ 8.0%), hypertension with poor blood pressure control (≥ 160/100mmhg), etc;

    (9) Have a history of psychotropic drug abuse and drug abuse;

    (10) People with known history of immune system (such as thymus disease and systemic lupus erythematosus);

    (11) Patients with positive serum Virology (HBsAg, HCV antibody, HIV antibody, Treponema pallidum antibody), including hepatitis B virus carriers, patients with stable hepatitis B after drug treatment (DNA titer ≤ 500iu/ml or copy number < 1000copies/ml) and cured patients with hepatitis C (HCV RNA test negative) can be enrolled after being judged to be qualified by the researcher;

    (12) People who are allergic to human albumin, narcotic drugs or their ingredients;

    (13) Subjects who participated in any other clinical trials within the first 3 months of screening;

    (14) Subjects who cannot tolerate bronchoscopy (including but not limited to the following conditions: active massive hemoptysis; severe hypertension and arrhythmia; myocardial infarction or history of unstable angina pectoris within 4-6 weeks before screening; severe cardiopulmonary dysfunction; uncorrectable bleeding tendency (platelet count < 60 × 109/l), such as severe coagulation dysfunction, uremia and severe pulmonary hypertension; Severe superior vena cava obstruction syndrome; Suspected aortic aneurysm; Multiple pulmonary bullae; General condition (extreme failure);

    (15) The researchers judged that the risk of general anesthesia / local anesthesia was higher;

    (16) Human chorionic gonadotrophin in pregnancy or lactation, or screening β ( β- HCG) positive, or unable and unwilling to take effective non drug contraceptives during the study period and 6 months after the end of the study;

    (17) Other circumstances that the researcher believes are not suitable for entering this test.

Sites / Locations

  • Shanghai Sixth People's HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dose escalation

Arm Description

Four different doses were set, and three subjects in each dose plan received human umbilical cord mesenchymal stem cell injection successively. Each subject received a single dose of 6.0*10^6, 3.0*10^7, 6.0*10^7, and 9.0*10^7 cells / person.

Outcomes

Primary Outcome Measures

Tolerance of patients with idiopathic fibrosis to human umbilical cord mesenchymal stem cell injection
Incidence and severity of adverse events according to CTCAE5.0
Dose exploration of patients with idiopathic fibrosis to human umbilical cord mesenchymal stem cell injection
The maximum tolerable dose (MTD) of a single administration depends on whether dose limiting toxicity (DLT) occurs within 4 weeks after the first administration, for example (1) Hematological toxicity of grade 3 and above caused by the treatment of human umbilical cord mesenchymal stem cell injection, (2) There are grade 3 and above non hematological toxic reactions caused by the treatment of human umbilical cord mesenchymal stem cell injection, except for the following cases, (3) Any other toxicity related to cell therapy that is higher than the baseline level is judged as clinically significant and / or unacceptable by the investigator and the sponsor, (4) There are acute exacerbations and serious adverse events (SAE) of IPF related to the treatment of human umbilical cord mesenchymal stem cell injection (which may be related, likely to be related and definitely related)

Secondary Outcome Measures

Preliminary efficacy evaluation
Changes from baseline in St. George's respiratory questionnaire SGRQ, dyspnea score, cough score and 6-minute walk test (grade and distance)in the treatment of idiopathic pulmonary fibrosis (IPF), and to recommend the appropriate dose of cell therapy for subsequent clinical studies
Preliminary efficacy evaluation
Changes in lung function (FVC, DLCO sb) compared with baseline

Full Information

First Posted
July 12, 2022
Last Updated
April 10, 2023
Sponsor
Shanghai Life Science & Technology
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1. Study Identification

Unique Protocol Identification Number
NCT05468502
Brief Title
Phase I/IIa Clinical Trial of Human Umbilical Cord Mesenchymal Stem Cell Injection in the Treatment of Idiopathic Pulmonary Fibrosis (IPF)
Official Title
An Open Clinical Study to Explore the Safety, Tolerance and Preliminary Efficacy of Human Umbilical Cord Mesenchymal Stem Cell Injection in the Treatment of Idiopathic Pulmonary Fibrosis (IPF)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 10, 2022 (Actual)
Primary Completion Date
August 2023 (Anticipated)
Study Completion Date
August 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai Life Science & Technology

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Main purpose -To explore the safety and tolerance of human umbilical cord mesenchymal stem cells in the treatment of idiopathic pulmonary fibrosis (IPF). Secondary purpose To explore the preliminary efficacy of human umbilical cord mesenchymal stem cells in the treatment of idiopathic pulmonary fibrosis (IPF), and to recommend the appropriate dose of cell therapy for subsequent clinical studies. To explore the immunogenicity of human umbilical cord mesenchymal stem cell injection in the treatment of idiopathic pulmonary fibrosis (IPF). This study adopts a clinical research design of multi center, single dose and increasing dose. 18 qualified IPF subjects will be included in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Idiopathic Pulmonary Fibrosis
Keywords
Idiopathic pulmonary fibrosis, IPF

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
Dose escalation
Arm Type
Experimental
Arm Description
Four different doses were set, and three subjects in each dose plan received human umbilical cord mesenchymal stem cell injection successively. Each subject received a single dose of 6.0*10^6, 3.0*10^7, 6.0*10^7, and 9.0*10^7 cells / person.
Intervention Type
Drug
Intervention Name(s)
Human umbilical cord mesenchymal stem cell injection
Intervention Description
Different doses of human umbilical cord mesenchymal stem cell injection were infused to the focus of patients with idiopathic pulmonary fibrosis through bronchoscope, and the tolerance of subjects to different doses of human umbilical cord mesenchymal stem cell injection was observed, and the curative effect was preliminarily observed.
Primary Outcome Measure Information:
Title
Tolerance of patients with idiopathic fibrosis to human umbilical cord mesenchymal stem cell injection
Description
Incidence and severity of adverse events according to CTCAE5.0
Time Frame
From the first administration to 4 weeks after administration
Title
Dose exploration of patients with idiopathic fibrosis to human umbilical cord mesenchymal stem cell injection
Description
The maximum tolerable dose (MTD) of a single administration depends on whether dose limiting toxicity (DLT) occurs within 4 weeks after the first administration, for example (1) Hematological toxicity of grade 3 and above caused by the treatment of human umbilical cord mesenchymal stem cell injection, (2) There are grade 3 and above non hematological toxic reactions caused by the treatment of human umbilical cord mesenchymal stem cell injection, except for the following cases, (3) Any other toxicity related to cell therapy that is higher than the baseline level is judged as clinically significant and / or unacceptable by the investigator and the sponsor, (4) There are acute exacerbations and serious adverse events (SAE) of IPF related to the treatment of human umbilical cord mesenchymal stem cell injection (which may be related, likely to be related and definitely related)
Time Frame
From the first administration to 4 weeks after administration
Secondary Outcome Measure Information:
Title
Preliminary efficacy evaluation
Description
Changes from baseline in St. George's respiratory questionnaire SGRQ, dyspnea score, cough score and 6-minute walk test (grade and distance)in the treatment of idiopathic pulmonary fibrosis (IPF), and to recommend the appropriate dose of cell therapy for subsequent clinical studies
Time Frame
The 4th, 12th, 24th and 48th week after administration
Title
Preliminary efficacy evaluation
Description
Changes in lung function (FVC, DLCO sb) compared with baseline
Time Frame
The 4th, 12th, 24th and 48th week after administration
Other Pre-specified Outcome Measures:
Title
Preliminary efficacy evaluation
Description
Changes in abnormal values of routine safety tests (blood routine, urine routine, blood biochemistry, 12 lead ECG, etc.) compared with baseline
Time Frame
The 4th, 12th, 24th and 48th week after administration
Title
Preliminary efficacy evaluation
Description
Changes in chest HRCT scores from baseline
Time Frame
The 12th, 24th and 48th week after administration
Title
Preliminary efficacy evaluation
Description
Changes of lung tumor markers from baseline
Time Frame
The 12th, 24th and 48th week after administration
Title
Preliminary efficacy evaluation
Description
Frequency and severity of acute exacerbations of IPF
Time Frame
Within 48 weeks after administration
Title
Immunogenicity of human umbilical cord mesenchymal stem cells
Description
Changes of specific immunoglobulin G (IgG) from baseline
Time Frame
The 1st and 4th weeks after administration
Title
Immunogenicity of human umbilical cord mesenchymal stem cells
Description
Cytokines (TNF- α、 IFN- γ、 Changes of IL-2, IL-4, IL-5 and IL-6) from baseline
Time Frame
The 1st and 4th weeks after administration

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: (1) Age 50~75 years old (including the threshold), regardless of gender; (2) IPF was diagnosed according to the diagnostic guidelines for idiopathic pulmonary fibrosis jointly issued by the American Thoracic Society (ATS), the European Respiratory Society (ERs), the Japanese Respiratory Society (JRS) and the Latin American Thoracic Association (ALAT) in 2018; (3) Subjects with typical imaging manifestations of IPF (honeycomb, stretch bronchiectasis or bronchiectasis (mainly in ground glass shadow and fine mesh shadow) on HRCT within 12 months before screening; (4) Within 3 months before administration, the researcher determined that the disease was stable. The pulmonary carbon monoxide diffusion volume (DLCO) was 30% - 79% of the predicted value (corrected by HB value), or FVC was 50% - 80% of the predicted value; (5) Blood biochemical examination should meet the following standards: alanine aminotransferase (ALT) ≤ 1.5uln, aspartate aminotransferase (AST) ≤ 1.5uln, total bilirubin (TBIL) ≤ 1.5uln, direct bilirubin (DBIL) ≤ 1.5uln, blood creatinine (CR) ≤ 1.5uln; (6) Expected survival ≥ 12 months; (7) Subjects who have good compliance, can understand and cooperate with the completion of pulmonary function examination, are willing to take drugs according to the requirements of the protocol and receive follow-up examination on time; (8) Subjects who voluntarily participated in the trial, understood and signed the informed consent form. Exclusion Criteria: (1) Have previously received stem cell therapy, or are intolerant to cell therapy, or have taken drugs that may cause or aggravate pulmonary fibrosis (such as amiodarone, bleomycin or methotrexate); (2) Suffering from interstitial lung disease (ILD) other than IPF, including but not limited to: any other type of interstitial pneumonia; Lung disease related to exposure to fibroblasts or other environmental toxins or drugs; Other types of occupational lung disease; Granulomatous pulmonary disease; Pulmonary vascular disease; Systemic diseases, including vasculitis, infectious diseases (i.e. tuberculosis) and connective tissue diseases; (3) Those who need oxygen therapy at present (oxygen therapy time 15h/d); (4) Those who used or planned to use nidanib during the study 1 month before screening; (5) Subjects with a history of mechanical ventilation or complicated with infectious pneumonia and asthma within 1 month before screening; (6) Patients with malignant tumors within 5 years before screening; (7) Those who have been hospitalized for 3 times or more due to acute exacerbation of IPF or other respiratory diseases within 1 year before screening; (8) There is evidence that the subjects currently have digestive, urinary, cardiovascular, cerebrovascular, hematological, nervous, mental and metabolic diseases that may affect safety, such as type 2 diabetes with poor blood glucose control (fasting blood glucose ≥ 10.0mmol/l or HbA1c ≥ 8.0%), hypertension with poor blood pressure control (≥ 160/100mmhg), etc; (9) Have a history of psychotropic drug abuse and drug abuse; (10) People with known history of immune system (such as thymus disease and systemic lupus erythematosus); (11) Patients with positive serum Virology (HBsAg, HCV antibody, HIV antibody, Treponema pallidum antibody), including hepatitis B virus carriers, patients with stable hepatitis B after drug treatment (DNA titer ≤ 500iu/ml or copy number < 1000copies/ml) and cured patients with hepatitis C (HCV RNA test negative) can be enrolled after being judged to be qualified by the researcher; (12) People who are allergic to human albumin, narcotic drugs or their ingredients; (13) Subjects who participated in any other clinical trials within the first 3 months of screening; (14) Subjects who cannot tolerate bronchoscopy (including but not limited to the following conditions: active massive hemoptysis; severe hypertension and arrhythmia; myocardial infarction or history of unstable angina pectoris within 4-6 weeks before screening; severe cardiopulmonary dysfunction; uncorrectable bleeding tendency (platelet count < 60 × 109/l), such as severe coagulation dysfunction, uremia and severe pulmonary hypertension; Severe superior vena cava obstruction syndrome; Suspected aortic aneurysm; Multiple pulmonary bullae; General condition (extreme failure); (15) The researchers judged that the risk of general anesthesia / local anesthesia was higher; (16) Human chorionic gonadotrophin in pregnancy or lactation, or screening β ( β- HCG) positive, or unable and unwilling to take effective non drug contraceptives during the study period and 6 months after the end of the study; (17) Other circumstances that the researcher believes are not suitable for entering this test.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Baowen Chen, CEO
Phone
086-13701662450
Email
glu@shlifestemcell.com
First Name & Middle Initial & Last Name or Official Title & Degree
Wang Kai, PM
Phone
086-17601600819
Email
kwang@shlifestemcell.com
Facility Information:
Facility Name
Shanghai Sixth People's Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200233
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ren Tao, Doctor of Medicine
Phone
021-64369181
Email
rentao305@163.com
First Name & Middle Initial & Last Name & Degree
Song Yuanlin, Doctor of Medicine
First Name & Middle Initial & Last Name & Degree
Li Feng, Doctor of Medicine

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Undecided: It is not yet known if there will be a plan to make IPD available.
Citations:
PubMed Identifier
27890713
Citation
Glassberg MK, Minkiewicz J, Toonkel RL, Simonet ES, Rubio GA, DiFede D, Shafazand S, Khan A, Pujol MV, LaRussa VF, Lancaster LH, Rosen GD, Fishman J, Mageto YN, Mendizabal A, Hare JM. Allogeneic Human Mesenchymal Stem Cells in Patients With Idiopathic Pulmonary Fibrosis via Intravenous Delivery (AETHER): A Phase I Safety Clinical Trial. Chest. 2017 May;151(5):971-981. doi: 10.1016/j.chest.2016.10.061. Epub 2016 Nov 24.
Results Reference
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PubMed Identifier
23855653
Citation
Tzouvelekis A, Paspaliaris V, Koliakos G, Ntolios P, Bouros E, Oikonomou A, Zissimopoulos A, Boussios N, Dardzinski B, Gritzalis D, Antoniadis A, Froudarakis M, Kolios G, Bouros D. A prospective, non-randomized, no placebo-controlled, phase Ib clinical trial to study the safety of the adipose derived stromal cells-stromal vascular fraction in idiopathic pulmonary fibrosis. J Transl Med. 2013 Jul 15;11:171. doi: 10.1186/1479-5876-11-171.
Results Reference
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PubMed Identifier
25039426
Citation
Chambers DC, Enever D, Ilic N, Sparks L, Whitelaw K, Ayres J, Yerkovich ST, Khalil D, Atkinson KM, Hopkins PM. A phase 1b study of placenta-derived mesenchymal stromal cells in patients with idiopathic pulmonary fibrosis. Respirology. 2014 Oct;19(7):1013-8. doi: 10.1111/resp.12343. Epub 2014 Jul 9.
Results Reference
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PubMed Identifier
19497992
Citation
Moodley Y, Atienza D, Manuelpillai U, Samuel CS, Tchongue J, Ilancheran S, Boyd R, Trounson A. Human umbilical cord mesenchymal stem cells reduce fibrosis of bleomycin-induced lung injury. Am J Pathol. 2009 Jul;175(1):303-13. doi: 10.2353/ajpath.2009.080629. Epub 2009 Jun 4.
Results Reference
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PubMed Identifier
21569606
Citation
Hass R, Kasper C, Bohm S, Jacobs R. Different populations and sources of human mesenchymal stem cells (MSC): A comparison of adult and neonatal tissue-derived MSC. Cell Commun Signal. 2011 May 14;9:12. doi: 10.1186/1478-811X-9-12.
Results Reference
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PubMed Identifier
21471066
Citation
Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, Colby TV, Cordier JF, Flaherty KR, Lasky JA, Lynch DA, Ryu JH, Swigris JJ, Wells AU, Ancochea J, Bouros D, Carvalho C, Costabel U, Ebina M, Hansell DM, Johkoh T, Kim DS, King TE Jr, Kondoh Y, Myers J, Muller NL, Nicholson AG, Richeldi L, Selman M, Dudden RF, Griss BS, Protzko SL, Schunemann HJ; ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011 Mar 15;183(6):788-824. doi: 10.1164/rccm.2009-040GL.
Results Reference
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Phase I/IIa Clinical Trial of Human Umbilical Cord Mesenchymal Stem Cell Injection in the Treatment of Idiopathic Pulmonary Fibrosis (IPF)

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