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Umbilical Cord Blood Cell (MC001) Transplant Into Injured Spinal Cord Followed by the Locomotor Training

Primary Purpose

Spinal Cord Injuries

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Umbilical Cord Blood Mononuclear Cell
Locomotor Training
Sponsored by
StemCyte, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Cord Injuries focused on measuring Spinal Cord Injury, Umbilical Cord Blood, Injured Spinal Cord, MC001

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male and female subjects' ≥18 to ≤60 years.
  • Traumatic SCI at a neurological level (the lowest contiguous spinal cord segmental level that has intact motor and sensory score) between C5 and T11 by MRI.

Note: For the first three subjects at each study center, the neurological level of SCI will be limited to thoracic region (between T1 and T11).

  • Subjects with chronic SCI (defined as ≥ 12 months post- initial SCI surgery) with stable neurologic findings for at least six months and be able stand at least 1 hour/day using a standing frame, tilt table, or equivalent device.
  • Subjects with a current neurological status of ASIA impairment grade A (complete).
  • The injured site of the spinal cord is within three vertebral levels as confirmed by MRI scan.
  • Subject must be in good enough physical health to tolerate the surgery and participate in the intensive walking program.
  • Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Principal Investigator.
  • Both male and female subjects and their partners of childbearing potential must agree to use medically accepted methods of contraception.
  • Willing and able to participate in all aspects of the study, including completion of subjective evaluations, attendance at scheduled clinic visits, and compliance with all protocol requirements as evidenced by providing written informed consent.
  • At least one frozen HLA-matched (≥4:6 to a specific patient) CBU identified for each subject.

Exclusion Criteria:

  • Clinically significant renal, cardiovascular, hepatic and psychiatric diseases or other conditions that may increase risk of complications during or after surgery or may reduce the ability of the patient to participate in intense locomotor training based on the medical judgment of the investigator.
  • Presence of any clinically significant medical condition(s) or infection (including but not limited to the carrier of hepatitis B virus or HIV) that, in the opinion of the Investigator, could interfere with the treatment or participation in the study.
  • Subjects with flaccid paralysis with absence of deep tendon reflexes in the legs, severe atrophy of the lower limbs, or other evidence of lumbosacral injury, peripheral nerve injury, and motoneuronal loss.
  • Fracture of weight-bearing bones and joints. These include fractures of femur, tibia, and fibula, as well as the ankle, knee, or hip joints. If such fractures have healed, the patient can be included in the trial.
  • Injury to brain, peripheral nerve, or muscle that may interfere with neurologic or walking assessment.
  • Pregnant or lactating woman.
  • Unavailability of HLA-matched umbilical cord blood cells.
  • Any contraindication of laminectomy operation or locomotor training includes:

    • Patient with active infection diseases.
    • Patient with wound infection on or near the implantation site.
    • Patient with severe deformity of spine on or near the implantation site.
    • Patient has immuno-compromised condition, or is with known autoimmune conditions or is human immunodeficiency virus (HIV) seropositive.
    • Patient has on-going moderate to severe organ impairment other than study.
  • Subject with abnormal renal function, cardiovascular disease, depression at screening will be excluded, if considered clinically significant and unstable by the Principal Investigator.
  • Subject who is currently participating in another investigational study or has been taking any investigational drug within the last 4 weeks before screening for this study.
  • Any other criteria, which, in the opinion of the investigator, suggests that the subject would not be compliant with the study protocol and/or would not be suitable to participate in this study.
  • Subject with low bone density (DEXA scan resulted T score < -4).

Sites / Locations

  • Mountainside Medical Center
  • Hualien Tzu Chi HospitalRecruiting
  • Taipei Medical University HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

MC001

No treatment

Arm Description

UCBMNC (MC001) transplant+Locomotor training

No surgery, no transplant, locomotor training only

Outcomes

Primary Outcome Measures

Walking Index of Spinal Cord Injury (WISCI II) Overall Measure
The primary endpoint for this study is mean change from baseline of the Walking Index of Spinal Cord Injury (WISCI II).

Secondary Outcome Measures

Walking Index of Spinal Cord Injury Measure (WISCI II) at Week 6 and 28
Mean change from baseline of the Walking Index of Spinal Cord Injury (WISCI II).
Spinal Cord Independence Measure (SCIM III)
Mean change from baseline of Spinal Cord Independence Measure (SCIM III)
Measure of American Spinal Injury Association (ASIA) Motor and Sensory Scores and AIS Grade
American Spinal Injury Association (ASIA) score has three components: (1) Sensory scores: There is a maximum total of 56 points each for light touch and pin prick (sharp/dull discrimination) modalities, for a total of 112 points per side of the body. (2) Motor scores: There is a maximum score of 25 for each extremity, totaling 50 for the upper limbs and 50 for the lower limbs. (3) ASIA Impairment Scale: Injuries are classified in general terms of being neurologically "complete" or "incomplete" based upon the sacral sparing definition.

Full Information

First Posted
June 3, 2019
Last Updated
August 22, 2023
Sponsor
StemCyte, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03979742
Brief Title
Umbilical Cord Blood Cell (MC001) Transplant Into Injured Spinal Cord Followed by the Locomotor Training
Official Title
A Randomized Controlled Phase II, Two-Arm Study of Umbilical Cord Blood Cell Transplant (MC001) Into Injured Spinal Cord Followed by the Locomotor Training for Patients With Chronic Complete Spinal Cord Injuries (SCI).
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 22, 2022 (Actual)
Primary Completion Date
August 22, 2026 (Anticipated)
Study Completion Date
March 31, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
StemCyte, Inc.

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
Umbilical cord blood mononuclear stem cells (UCBMSCs) transplant followed by the intensive locomotor training for up to 5±1 hours a day, 5±1 days a week, and for 3-6 months for treatment in patients with chronic, stable and complete spinal cord injury.
Detailed Description
This study is a randomized controlled, Phase II, two-arm study of Umbilical Cord Blood Mononuclear Cell (MC001) transplant into the injured spinal cord followed by the locomotor training for up to 5±1 hours a day, 5±1 days a week, for 3-6 months. A total of 18 subjects with chronic complete spinal cord injury (SCI) will be randomized to one of the two groups. The subjects assigned to Group A will receive 6.4 million UCBMNC (MC001) transplanted into the dorsal root entry zones above and below the injury site exposed by a laminectomy. Subjects in Group B will not have MC001 transplant or surgery. All subjects will receive 3-6 months of intensive locomotor training.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Cord Injuries
Keywords
Spinal Cord Injury, Umbilical Cord Blood, Injured Spinal Cord, MC001

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
18 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
MC001
Arm Type
Experimental
Arm Description
UCBMNC (MC001) transplant+Locomotor training
Arm Title
No treatment
Arm Type
Other
Arm Description
No surgery, no transplant, locomotor training only
Intervention Type
Biological
Intervention Name(s)
Umbilical Cord Blood Mononuclear Cell
Other Intervention Name(s)
MC001
Intervention Description
Active ingredients: Monocytes, CD34+, CD133+ cells Dose: 4 injections of 16-μliter (100,000 cells/μliter)
Intervention Type
Other
Intervention Name(s)
Locomotor Training
Intervention Description
Locomotor training for up to 6 hours a day, 6 days a week, and for 3-6 months
Primary Outcome Measure Information:
Title
Walking Index of Spinal Cord Injury (WISCI II) Overall Measure
Description
The primary endpoint for this study is mean change from baseline of the Walking Index of Spinal Cord Injury (WISCI II).
Time Frame
At Week 48.
Secondary Outcome Measure Information:
Title
Walking Index of Spinal Cord Injury Measure (WISCI II) at Week 6 and 28
Description
Mean change from baseline of the Walking Index of Spinal Cord Injury (WISCI II).
Time Frame
At Week 6 and 28.
Title
Spinal Cord Independence Measure (SCIM III)
Description
Mean change from baseline of Spinal Cord Independence Measure (SCIM III)
Time Frame
At Week 6, 28, and 48.
Title
Measure of American Spinal Injury Association (ASIA) Motor and Sensory Scores and AIS Grade
Description
American Spinal Injury Association (ASIA) score has three components: (1) Sensory scores: There is a maximum total of 56 points each for light touch and pin prick (sharp/dull discrimination) modalities, for a total of 112 points per side of the body. (2) Motor scores: There is a maximum score of 25 for each extremity, totaling 50 for the upper limbs and 50 for the lower limbs. (3) ASIA Impairment Scale: Injuries are classified in general terms of being neurologically "complete" or "incomplete" based upon the sacral sparing definition.
Time Frame
At Week 2, 6, 28, and 48.
Other Pre-specified Outcome Measures:
Title
Exploratory Endpoint - Kunming Locomotor Score (KLS) Measure
Description
Mean change from baseline of Kunming locomotor scores (KLS). Kunming Locomotor Scale (KLS) is a 10-grade Roman numeral locomotion scoring system describing ability to stand, ability to walk, and required support/devices.
Time Frame
At Week 6, 28, and 48.
Title
Exploratory Endpoint - Numerical Rating Scale (NRS) Measure
Description
Mean change from baseline of Numerical Rating Scale (NRS) for neuropathic pain. An 11-unit scale will be used, where 0 represents "No pain" and 10 represents the "Worst possible pain".
Time Frame
At Week 2, 6, 28, and 48.
Title
Exploratory Endpoint - LANSS Scale Measure
Description
Mean change from baseline of Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale. An 11-unit scale will be used, where 0 represents "No pain" and 10 represents the "Worst possible pain". The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale is an assessment tool used to analyze and classify pain. It is a simple bedside test, conducted in two parts .i.e. a patient-completed questionnaire and a brief clinical assessment. Out of the seven items in the LANSS Pain Scale, five are symptom related and two are examination items.
Time Frame
At Week 2, 6, 28, and 48.
Title
Exploratory Endpoint - SSEP and MEP Measure
Description
Percentage of subjects with positive change in Somatosensory evoked potential (SSEP) and Motor evoked potentials (MEP).
Time Frame
At week 48.
Title
Exploratory Endpoint - Long fiber bundles growth measure
Description
Percentage of subjects with Long fiber bundles growth crossing the injury site by Magnetic resonance diffusion tenor images (MR/DTI).
Time Frame
At Week 6, 28, and 48.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female subjects' ≥18 to ≤60 years. Traumatic SCI at a neurological level (the lowest contiguous spinal cord segmental level that has intact motor and sensory score) between C5 and T11 by MRI. Note: For the first three subjects at each study center, the neurological level of SCI will be limited to thoracic region (between T1 and T11). Subjects with chronic SCI (defined as ≥ 12 months post- initial SCI surgery) with stable neurologic findings for at least six months and be able stand at least 1 hour/day using a standing frame, tilt table, or equivalent device. Subjects with a current neurological status of ASIA impairment grade A (complete). The injured site of the spinal cord is within three vertebral levels as confirmed by MRI scan. Subject must be in good enough physical health to tolerate the surgery and participate in the intensive walking program. Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Principal Investigator. Both male and female subjects and their partners of childbearing potential must agree to use medically accepted methods of contraception. Willing and able to participate in all aspects of the study, including completion of subjective evaluations, attendance at scheduled clinic visits, and compliance with all protocol requirements as evidenced by providing written informed consent. At least one frozen HLA-matched (≥4:6 to a specific patient) CBU identified for each subject. Exclusion Criteria: Clinically significant renal, cardiovascular, hepatic and psychiatric diseases or other conditions that may increase risk of complications during or after surgery or may reduce the ability of the patient to participate in intense locomotor training based on the medical judgment of the investigator. Presence of any clinically significant medical condition(s) or infection (including but not limited to the carrier of hepatitis B virus or HIV) that, in the opinion of the Investigator, could interfere with the treatment or participation in the study. Subjects with flaccid paralysis with absence of deep tendon reflexes in the legs, severe atrophy of the lower limbs, or other evidence of lumbosacral injury, peripheral nerve injury, and motoneuronal loss. Fracture of weight-bearing bones and joints. These include fractures of femur, tibia, and fibula, as well as the ankle, knee, or hip joints. If such fractures have healed, the patient can be included in the trial. Injury to brain, peripheral nerve, or muscle that may interfere with neurologic or walking assessment. Pregnant or lactating woman. Unavailability of HLA-matched umbilical cord blood cells. Any contraindication of laminectomy operation or locomotor training includes: Patient with active infection diseases. Patient with wound infection on or near the implantation site. Patient with severe deformity of spine on or near the implantation site. Patient has immuno-compromised condition, or is with known autoimmune conditions or is human immunodeficiency virus (HIV) seropositive. Patient has on-going moderate to severe organ impairment other than study. Subject with abnormal renal function, cardiovascular disease, depression at screening will be excluded, if considered clinically significant and unstable by the Principal Investigator. Subject who is currently participating in another investigational study or has been taking any investigational drug within the last 4 weeks before screening for this study. Any other criteria, which, in the opinion of the investigator, suggests that the subject would not be compliant with the study protocol and/or would not be suitable to participate in this study. Subject with low bone density (DEXA scan resulted T score < -4).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Bobo Chen, PhD
Phone
886 2 2655 8558
Ext
300
Email
us105d@stemcyte.com.tw
Facility Information:
Facility Name
Mountainside Medical Center
City
Montclair
State/Province
New Jersey
ZIP/Postal Code
07042
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Hualien Tzu Chi Hospital
City
Hualien City
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shinn-Zong Lin, MD, PhD
Phone
886 975 661 719
Facility Name
Taipei Medical University Hospital
City
Taipei City
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yung-Hsiao Chiang
Phone
886 2 27372181
Ext
8016

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
All information supplied by StemCyte, Inc in connection with this study and not previously published, is considered confidential information. This information includes, but is not limited to, the Investigator's Brochure, clinical protocol, case report forms and other scientific data. All data collected during the study are confidential. This confidential information shall remain the sole property of StemCyte, Inc, shall not be disclosed to others without the written consent of StemCyte, Inc, and shall not be used except in the performance of this study.
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Umbilical Cord Blood Cell (MC001) Transplant Into Injured Spinal Cord Followed by the Locomotor Training

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