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Dead Mesenchymal Stem Cells for Radiation Lung Injury

Primary Purpose

Radiation Lung Injury

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Death mesenchymal stem cell
Sponsored by
Sichuan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Radiation Lung Injury focused on measuring Dead Mesenchymal Stem Cells, Radiation Lung Injury, Treatment

Eligibility Criteria

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

Inclusion Criteria: Received chest radiotherapy; EOCG PS score of 0 to 3 points; Diagnosis of radiation lung injury by the attending physician, grade 2 to 3 (according to the CTCAE v5.0 standards); Main organs function is normal, that meet the following criteria: blood routine examination (within 7 days of unused hematopoietic growth factors and blood transfusion) : ANC ≥ 1.5 x 10^9 / L, PLT ≥ 80 x 10^9 / L, HGB ≥ 80 g/L;Biochemical examination: TBil ≤ 1.5 x ULN (upper limit of normal);ALT or AST ≤ 2.5 x ULN; Creatinine clearance ≥ 60 mL/min (Cockcroft - Gault formula); Blood coagulation function: INR or PT ≤ 1.5 x ULN, if the subjects are receiving anticoagulant therapy, as long as the scope of PT in anticoagulant drugs for it. Heart function examination, electrocardiogram (ECG) normal or abnormal ECG (by the researchers to determine the clinical significance). Heart doppler ultrasound assessment: LVEF ≥ 50%; Radiation lung injury lasts less than 2 months; Survival expectation ≥6 months; Signed and dated written informed consent Exclusion Criteria: Pregnant or lactating women, men and women of childbearing age who are unwilling or unable to take effective contraceptive measures; People with a history of chronic bronchitis, emphysema, or cor pulmonale; History of lung resection surgery; Tumor progression; People with severe lung infection; Uncontrollable severe systemic diseases (e.g., central nervous system, cardiovascular system, blood system, digestive system, endocrine system, respiratory system, genitourinary system, immune system, etc.) and psychosis; Serious cardiovascular events: a period of 6 months in heart failure (NYHA class III level IV), myocardial infarction, unstable angina, severe arrhythmia, cerebral infarction, cerebral hemorrhage; Abnormal liver and kidney function: AST and ALT exceed the upper limit of normal by 2.5 times. Serum creatinine is greater than 1.5 mg/dl in men and 1.4 mg/dl in women; Co-infection with HIV, Treponema pallidum, tuberculosis, influenza virus, adenovirus and other respiratory infections; Hemorrhage or thrombosis, bleeding or anticoagulant drugs; Combined with cachexia or other organ failure (requiring organ support); Shock or invasive ventilation; Combined with pulmonary interstitial pneumonia caused by other reasons or damage, or lung imaging showed radioactive lung injury diagnosed with pulmonary interstitial pneumonia or damage before; Patients who have participated in clinical studies of stem cells; The investigators believed that there were other reasons why participants were not suitable for the study.

Sites / Locations

  • West China HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Death mesenchymal stem cell therapy plus standard treatment for radiation pneumonia

Arm Description

Subjects (n=3) received a standard treatment regimen combined with a pre-specified starting dose of dead mesenchymal stem cells (2.0×10^7 for 60kg patient), infusion every 3 days, continuous infusion 4 times, treatment duration is 4~6 weeks. . If dose-limiting toxicity (DLT) does not occur within 30 days of the first administration, the dose is escalated by three times.

Outcomes

Primary Outcome Measures

The number of adverse events
The number of adverse events occurring within a given time frame will be reported according to CTCAE v5.0 to assess overall safety.

Secondary Outcome Measures

Chest contrast-enhanced CT will be used to assess changes in lung injury after treatment
Chest contrast-enhanced CT will be performed at 1, 2, 3, 6, and 12 months after completion of dead mesenchymal stem cell injection, and the change in the proportion of total lesions to total lung volume will be calculated, i.e., (proportion of total lesions to total lung volume - proportion of total lesions to total lung volume at baseline) / proportion of total lesions to total lung volume at baseline.
Blood gas analysis will be performed after 1 month of dead mesenchymal stem cell injection.
At 1 month after completion of the injection of dead mesenchymal stem cells, changes in blood gas analysis will be observed to assess lung function.
Pulmonary function test will be performed after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
At after 1, 2, 3, 6, 12month completion of the injection of dead mesenchymal stem cells, pulmonary function test will be performed to assess recovery of lung function.
6-minute walking tests will be performed after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
At 1, 2, 3, 6 and 12 months after the completion of dead mesenchymal stem cell therapy, 6-minute walking tests will be performed to evaluate the recovery of the subjects' cardiopulmonary condition.
St. George's Respiratory Questionnaire will be completed to estimate the quality of life after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
At 1, 2, 3, 6 and 12 months after the completion of dead mesenchymal stem cell therapy, St. George's Respiratory Questionnaire will be completed to evaluate the subjects' quality of life.

Full Information

First Posted
June 24, 2023
Last Updated
August 31, 2023
Sponsor
Sichuan University
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1. Study Identification

Unique Protocol Identification Number
NCT06021067
Brief Title
Dead Mesenchymal Stem Cells for Radiation Lung Injury
Official Title
Dead Mesenchymal Stem Cells for the Treatment of Radiation Lung Injury
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 10, 2023 (Anticipated)
Primary Completion Date
September 10, 2024 (Anticipated)
Study Completion Date
September 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sichuan University

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 aim of this single center, single arm and prospective study is to explore the safety and efficacy of hDMSCs in the treatment of radiation pneumonitis.
Detailed Description
As a single-center, single-arm, prospective clinical trial, this study aims to explore the safety and efficacy of hDMSCs in the treatment of radiation pneumonia. This study will include patients who have received chest radiation therapy and are diagnosed with radiation lung injury based on clinical manifestations and changes in chest CT imaging. The degree of lung injury is graded according to CTCAE v5.0 criteria, and the corresponding standard treatment is received according to its grade. Using the 3+3 design for dose climbing, according to the order of patient inclusion, the first 3 patients (cohort 1) are treated with a standard treatment regimen combined with a pre-specified starting dose of dead mesenchymal stem cells (this study does not set up a live MSC group as a control). There are currently no relevant research results of previous human trials. The starting dose is obtained by our preclinical research. The mouse dose is 1×10^5/pc/30g, that is, the effective dose of mice is 3.3×10^6/kg. The dose of mice is 10 times that of humans, and the effective dose of humans is 3.3×10^5/kg. Therefore, the clinical effective dose of 60kg patients is 2.0×10^7, infusion every 3 days, continuous infusion 4 times, treatment duration of 4~6 weeks. During the dose-limited toxicity (DLT) observation period (30 days), observe the number of cases of DLT in 3 patients to determine whether to maintain the current dose group or adjust the dose group. If the dose of dead mesenchymal stem cells needs to be increased, the dose is ramped up by 3 times the starting dose (i.e., the second gradient dose is 6.0×10^7) until the number of patients in either dose group reaches 6 or the dose group adjustment is not possible. To determine the optimal therapeutic dose for the treatment of radiation lung injury using death mesenchymal stem cells in combination with standard therapy. A total of 15 patients were planned to be included in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Radiation Lung Injury
Keywords
Dead Mesenchymal Stem Cells, Radiation Lung Injury, Treatment

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
one-arm study
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Death mesenchymal stem cell therapy plus standard treatment for radiation pneumonia
Arm Type
Experimental
Arm Description
Subjects (n=3) received a standard treatment regimen combined with a pre-specified starting dose of dead mesenchymal stem cells (2.0×10^7 for 60kg patient), infusion every 3 days, continuous infusion 4 times, treatment duration is 4~6 weeks. . If dose-limiting toxicity (DLT) does not occur within 30 days of the first administration, the dose is escalated by three times.
Intervention Type
Biological
Intervention Name(s)
Death mesenchymal stem cell
Intervention Description
A standard treatment regimen combined with a pre-specified starting dose of dead mesenchymal stem cells (2.0×10^7 for 60kg patient), infusion every 3 days, continuous infusion 4 times, treatment duration is 4~6 weeks.
Primary Outcome Measure Information:
Title
The number of adverse events
Description
The number of adverse events occurring within a given time frame will be reported according to CTCAE v5.0 to assess overall safety.
Time Frame
up to 1 year
Secondary Outcome Measure Information:
Title
Chest contrast-enhanced CT will be used to assess changes in lung injury after treatment
Description
Chest contrast-enhanced CT will be performed at 1, 2, 3, 6, and 12 months after completion of dead mesenchymal stem cell injection, and the change in the proportion of total lesions to total lung volume will be calculated, i.e., (proportion of total lesions to total lung volume - proportion of total lesions to total lung volume at baseline) / proportion of total lesions to total lung volume at baseline.
Time Frame
up to 1 year
Title
Blood gas analysis will be performed after 1 month of dead mesenchymal stem cell injection.
Description
At 1 month after completion of the injection of dead mesenchymal stem cells, changes in blood gas analysis will be observed to assess lung function.
Time Frame
up to 1 year
Title
Pulmonary function test will be performed after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
Description
At after 1, 2, 3, 6, 12month completion of the injection of dead mesenchymal stem cells, pulmonary function test will be performed to assess recovery of lung function.
Time Frame
up to 1 year
Title
6-minute walking tests will be performed after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
Description
At 1, 2, 3, 6 and 12 months after the completion of dead mesenchymal stem cell therapy, 6-minute walking tests will be performed to evaluate the recovery of the subjects' cardiopulmonary condition.
Time Frame
up to 1 year
Title
St. George's Respiratory Questionnaire will be completed to estimate the quality of life after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
Description
At 1, 2, 3, 6 and 12 months after the completion of dead mesenchymal stem cell therapy, St. George's Respiratory Questionnaire will be completed to evaluate the subjects' quality of life.
Time Frame
up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Received chest radiotherapy; EOCG PS score of 0 to 3 points; Diagnosis of radiation lung injury by the attending physician, grade 2 to 3 (according to the CTCAE v5.0 standards); Main organs function is normal, that meet the following criteria: blood routine examination (within 7 days of unused hematopoietic growth factors and blood transfusion) : ANC ≥ 1.5 x 10^9 / L, PLT ≥ 80 x 10^9 / L, HGB ≥ 80 g/L;Biochemical examination: TBil ≤ 1.5 x ULN (upper limit of normal);ALT or AST ≤ 2.5 x ULN; Creatinine clearance ≥ 60 mL/min (Cockcroft - Gault formula); Blood coagulation function: INR or PT ≤ 1.5 x ULN, if the subjects are receiving anticoagulant therapy, as long as the scope of PT in anticoagulant drugs for it. Heart function examination, electrocardiogram (ECG) normal or abnormal ECG (by the researchers to determine the clinical significance). Heart doppler ultrasound assessment: LVEF ≥ 50%; Radiation lung injury lasts less than 2 months; Survival expectation ≥6 months; Signed and dated written informed consent Exclusion Criteria: Pregnant or lactating women, men and women of childbearing age who are unwilling or unable to take effective contraceptive measures; People with a history of chronic bronchitis, emphysema, or cor pulmonale; History of lung resection surgery; Tumor progression; People with severe lung infection; Uncontrollable severe systemic diseases (e.g., central nervous system, cardiovascular system, blood system, digestive system, endocrine system, respiratory system, genitourinary system, immune system, etc.) and psychosis; Serious cardiovascular events: a period of 6 months in heart failure (NYHA class III level IV), myocardial infarction, unstable angina, severe arrhythmia, cerebral infarction, cerebral hemorrhage; Abnormal liver and kidney function: AST and ALT exceed the upper limit of normal by 2.5 times. Serum creatinine is greater than 1.5 mg/dl in men and 1.4 mg/dl in women; Co-infection with HIV, Treponema pallidum, tuberculosis, influenza virus, adenovirus and other respiratory infections; Hemorrhage or thrombosis, bleeding or anticoagulant drugs; Combined with cachexia or other organ failure (requiring organ support); Shock or invasive ventilation; Combined with pulmonary interstitial pneumonia caused by other reasons or damage, or lung imaging showed radioactive lung injury diagnosed with pulmonary interstitial pneumonia or damage before; Patients who have participated in clinical studies of stem cells; The investigators believed that there were other reasons why participants were not suitable for the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhen-Yu Ding, Prof
Phone
86-028-85423609
Email
dingzhenyu@scu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhen-Yu Ding, Prof
Organizational Affiliation
Sichuan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
West China Hospital
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhen-Yu Ding, Prof
Phone
0086288542357
Email
dignzhenyu@scu.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No
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Dead Mesenchymal Stem Cells for Radiation Lung Injury

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