Bioengineered Penile Tissue Constructs for Irreversibly Damaged Penile Corpora
Primary Purpose
Urologic Diseases, Male Urogenital Diseases, Penile Diseases
Status
Not yet recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Autologous tissue engineered corpora
Sponsored by
About this trial
This is an interventional treatment trial for Urologic Diseases focused on measuring Autologous tissue engineered corpora
Eligibility Criteria
Inclusion Criteria:
- Males aged 18-60 years.
- Acquired structural abnormalities of the corpora cavernosum secondary to trauma, infection, inflammation, or fibromatosis. These abnormalities will be diagnosed by clinical examination, and/or ultrasound, and/or computerized tomography.
- Stable abnormalities - at least 6 months with no pain or changes in deformity.
- At least one failed attempt at management by conventional approaches at least 6 months prior to enrollment
- Deformities less than 5 cm in length.
- Written informed consent obtained prior to participation in the study.
- Patients must be available for all follow up visits.
- Ability to speak English.
Exclusion Criteria:
- Presence of untreated or incompletely treated urinary tract infection at the time of biopsy.
- Uncontrolled bleeding disorder or patients with a platelet count less than 50,000, hemophilia or patients routinely receiving blood products for bleeding disorders.
- Serum creatinine > 2.0 mg/dl or evidence of progressive renal disease.
- ALT or AST value >1.5 times the upper limit of normal.
- Albumin < 3.0 g/dL.
- Serum direct bilirubin >0.3 mg/dL OR total bilirubin > 1.4 mg/dL
- BM I>40 kg/m2
- Uncontrolled diabetes with HbA1C>9%. (Subjects with controlled diabetes must be under care of diabetologist with treatment goals consistent with ADA criteria).
- Unstable cardiac disorders within the past 6 months including angina, abnormal ECG, history of cardiac arrest, surgery and/or other interventional procedure.
- Unstable pulmonary disorders within the past 6 months including dyspnea on exertion, chronic productive cough, pneumonia, hemoptysis, asthma requiring nebulized therapy.
- Active tuberculosis (TB) requiring treatment in the past 3 years. Subjects with a current positive (≥5 mm induration for high-risk subjects; otherwise ≥10 mm of induration) purified protein derivative (PPD) test are excluded unless they have completed a full course of treatment for latent TB and have a negative chest x-ray film at enrollment.
- Known to be colonization with either methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE), or gentamicin-resistant organisms.
- Immunocompromised subjects or subjects receiving immunosuppressive agents.
- Any history of alcohol and/or drug abuse.
- Documented history of, or positive result of HIV, Hepatitis B or C, or any infectious disease. External signs, sequelae, or positive serology of sexually transmitted disease (including HPV). Patients with a history of systemic conditions, including but not limited to HIV, diabetes and chronic liver disease (including Hepatitis B or C), that the Investigator believes may jeopardize the safety of the patient to participate in the study.
- Concurrent participation in any other clinical investigation during the period of this investigation. Patients who have been treated with any other investigational drug or participated in any investigational study within 30 days prior to enrollment in this study.
- Any circumstance in which the investigator deems participation in the study is not in the subject's best interest.
- Inability to participate in all necessary study activities due to physical or mental limitations.
- Inability or unwillingness to return for all required follow-up visits, for instance life expectancy < 1 year, or subject who knows they will be moving out of the country and unable to return for follow-up visits.
- Inability or unwillingness to sign informed consent.
- Patients requiring concomitant use of or treatment with immunosuppressive agents
- Patients with neurological disorders (e.g., multiple sclerosis, Parkinson's disease).
Sites / Locations
- Wake Forest Institute for Regenerative Medicine
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Autologous tissue engineered corpora
Arm Description
All subjects enrolled will undergo a corpora cavernosum biopsy. Endothelial and smooth muscle cells will be isolated and expanded, then seeded onto a scaffold that will later be implanted into the subject.
Outcomes
Primary Outcome Measures
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
rate of adverse events reported for each patient
Secondary Outcome Measures
Number of participants with graft thrombosis or grant failures
lack of graft thrombosis or graft failure
Full Information
NCT ID
NCT03463239
First Posted
February 18, 2018
Last Updated
May 1, 2023
Sponsor
Wake Forest University Health Sciences
Collaborators
United States Department of Defense
1. Study Identification
Unique Protocol Identification Number
NCT03463239
Brief Title
Bioengineered Penile Tissue Constructs for Irreversibly Damaged Penile Corpora
Official Title
Phase 1 Pilot Study of Bioengineered Penile Tissue Constructs in Subjects With Irreversibly Damaged Penile Corpora
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 2023 (Anticipated)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
July 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University Health Sciences
Collaborators
United States Department of Defense
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
The primary objective of this clinical trial is to evaluate the safety of autologous engineered corpora cavernosa + albuginea constructs for treatment of complex penile deformities. Autologous endothelial and smooth muscle cells obtained from enrolled subjects' corpora cavernosa biopsy sample, will be culture expanded in vitro and used to seed decellularized corpora cavernosa + albuginea obtained from cadaveric-donors to create autologous bioengineered corpora cavernosa/albuginea constructs for repair of damaged penile tissues.
Detailed Description
Damage to penile tissue due to infection, inflammation or trauma often leads to structural deformity that may result in loss of sexual function that can profoundly affect quality of life. Traumatic injuries in civilians and battlefield related injuries in soldiers often require reconstructive procedures to restore the anatomy and functionality of the penis. However, these procedures are often limited by poor availability of functionally intact penile tissue. Various penile reconstructive procedures, such as penile prostheses and autograft implantation have been attempted. While cosmetic appearance may be improved, restoration of spontaneous and natural erectile function is usually not achieved. This is often due to critical defect of the corpora cavernosa, which are responsible for erectile function. Recently, the concept of a tissue engineering-based therapy has been proposed for reconstructing damaged penile corporal tissue.
The primary objective of this Armed Forces Institute for Regeneration Medicine (AFIRM II) sponsored clinical trial is to evaluate the safety of autologous engineered corpora cavernosa + albuginea constructs for treatment of complex penile deformities. The proposed study design is a prospective non-randomized and uncontrolled, multi-center investigation. Autologous endothelial and smooth muscle cells obtained from enrolled participants' corpora cavernosa biopsy sample, will be culture expanded in vitro and used to seed decellularized corpora cavernosa + albuginea obtained from cadaveric-donors to create autologous bioengineered corpora cavernosa/albuginea constructs for repair of damaged penile tissues.
A total of ten male patients, referred for the treatment of damages of albuginea and/or corpora cavernosum without concurrent urethral injury will be recruited for this study. The estimated duration of the study for each subject following treatment is 36 months. The study team anticipates a duration of approximately 48 to 60 months to complete all enrollment and follow up. Enrolled participants will undergo a corporal tissue biopsy as an out-patient surgical procedure. Autologous corporal smooth muscle cells and corporal endothelial cells will be isolated and then seeded on cadaveric decellularized corporal bodies. Approximately 3-4 weeks later, the engineered construct including corporal tissue with attached tunica will be transplanted into the surgically prepared site of penile injury. Participants will be followed through 36 months post-implantation to monitor for safety.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urologic Diseases, Male Urogenital Diseases, Penile Diseases, Corpus Callosum Malformation, Corpora Cavernosa; Inflammation, Trauma Injury
Keywords
Autologous tissue engineered corpora
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Autologous tissue engineered corpora
Arm Type
Experimental
Arm Description
All subjects enrolled will undergo a corpora cavernosum biopsy. Endothelial and smooth muscle cells will be isolated and expanded, then seeded onto a scaffold that will later be implanted into the subject.
Intervention Type
Biological
Intervention Name(s)
Autologous tissue engineered corpora
Intervention Description
penile tissue construct
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
rate of adverse events reported for each patient
Time Frame
monitored through 36 months post-treatment
Secondary Outcome Measure Information:
Title
Number of participants with graft thrombosis or grant failures
Description
lack of graft thrombosis or graft failure
Time Frame
monitored through 36 months post-treatment
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Males aged 18-60 years.
Acquired structural abnormalities of the corpora cavernosum secondary to trauma, infection, inflammation, or fibromatosis. These abnormalities will be diagnosed by clinical examination, and/or ultrasound, and/or computerized tomography.
Stable abnormalities - at least 6 months with no pain or changes in deformity.
At least one failed attempt at management by conventional approaches at least 6 months prior to enrollment
Deformities less than 5 cm in length.
Written informed consent obtained prior to participation in the study.
Patients must be available for all follow up visits.
Ability to speak English.
Exclusion Criteria:
Presence of untreated or incompletely treated urinary tract infection at the time of biopsy.
Uncontrolled bleeding disorder or patients with a platelet count less than 50,000, hemophilia or patients routinely receiving blood products for bleeding disorders.
Serum creatinine > 2.0 mg/dl or evidence of progressive renal disease.
ALT or AST value >1.5 times the upper limit of normal.
Albumin < 3.0 g/dL.
Serum direct bilirubin >0.3 mg/dL OR total bilirubin > 1.4 mg/dL
BM I>40 kg/m2
Uncontrolled diabetes with HbA1C>9%. (Subjects with controlled diabetes must be under care of diabetologist with treatment goals consistent with ADA criteria).
Unstable cardiac disorders within the past 6 months including angina, abnormal ECG, history of cardiac arrest, surgery and/or other interventional procedure.
Unstable pulmonary disorders within the past 6 months including dyspnea on exertion, chronic productive cough, pneumonia, hemoptysis, asthma requiring nebulized therapy.
Active tuberculosis (TB) requiring treatment in the past 3 years. Subjects with a current positive (≥5 mm induration for high-risk subjects; otherwise ≥10 mm of induration) purified protein derivative (PPD) test are excluded unless they have completed a full course of treatment for latent TB and have a negative chest x-ray film at enrollment.
Known to be colonization with either methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE), or gentamicin-resistant organisms.
Immunocompromised subjects or subjects receiving immunosuppressive agents.
Any history of alcohol and/or drug abuse.
Documented history of, or positive result of HIV, Hepatitis B or C, or any infectious disease. External signs, sequelae, or positive serology of sexually transmitted disease (including HPV). Patients with a history of systemic conditions, including but not limited to HIV, diabetes and chronic liver disease (including Hepatitis B or C), that the Investigator believes may jeopardize the safety of the patient to participate in the study.
Concurrent participation in any other clinical investigation during the period of this investigation. Patients who have been treated with any other investigational drug or participated in any investigational study within 30 days prior to enrollment in this study.
Any circumstance in which the investigator deems participation in the study is not in the subject's best interest.
Inability to participate in all necessary study activities due to physical or mental limitations.
Inability or unwillingness to return for all required follow-up visits, for instance life expectancy < 1 year, or subject who knows they will be moving out of the country and unable to return for follow-up visits.
Inability or unwillingness to sign informed consent.
Patients requiring concomitant use of or treatment with immunosuppressive agents
Patients with neurological disorders (e.g., multiple sclerosis, Parkinson's disease).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mary-Clare Day, RN, BSN
Phone
336-713-1343
Email
mday@wakehealth.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ryan P Terlecki, MD
Organizational Affiliation
Associate Professor
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest Institute for Regenerative Medicine
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mary-Clare Day, RN, BSN
Phone
336-713-1343
Email
mday@wakehealth.edu
First Name & Middle Initial & Last Name & Degree
James Yoo, MD
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Bioengineered Penile Tissue Constructs for Irreversibly Damaged Penile Corpora
We'll reach out to this number within 24 hrs