First in Human Study: LIS1, an Induction Treatment in Kidney Transplanted Patients

NCT ID: NCT04431219

Last Updated: 2022-08-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 10 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-11-26
• Study Completion Date: 2022-03-28

Brief Summary

This first in human study aims at evaluating LIS1, a stabilized solution of purified anti-T lymphocytes polyclonal glyco-humanized swine IgG with immunosuppressive activity, in regards of safety, T cell depletion, and pharmacokinetics / pharmacodynamics in 10 kidney transplant recipients.

Conditions

Kidney Transplant

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SEQUENTIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Ascending Dose Cohort

The AD cohort will be first recruited and will include 5 patients: 1 patient per dose, sequentially recruited, the recruitment of the next dose level patient will be assessed by Data Safety Monitoring Board :

• Patient 1: 0.6 mg/Kg/day
• Patient 2: 1 mg/Kg/day
• Patient 3: 3 mg/Kg/day
• Patient 4: 6 mg/Kg/day
• Patient 5: 8 mg/Kg/day

Once the 5 AD patients complete LIS1 treatment, the sponsor and the DSMB will rule on the LIS1 dose to obtain an optimal CD3+ cells depletion, with a good safety profile and will determine the therapeutic dose.

Group Type: EXPERIMENTAL

LIS1

Intervention Type: BIOLOGICAL

LIS1 is an induction treatment on top of maintenance immunosuppressive regimen. All patients from AD and TD cohort will receive the conventional immunosuppressive regimen: tacrolimus (0.2 mg/kg) / mycophenolic acid (MMF, 2x1000 mg) / prednisone (20 mg from day 2). This conventional treatment should be started and monitored for all patients independently of their participation in the clinical trial. Methylprednisolone 500 mg / 100 mL saline / 30 minutes will be administered before reperfusion during the surgery and on post operation day 1 just before LIS1 administration.

Therapeutic Dose Cohort

The TD cohort will be recruited once the therapeutic dose is defined. This cohort will be divided in 2 subgroups of respectively 2 and 3 patients sequentially recruited.

DSMB will review the safety and efficacy profile of the first 2 patients (Subgroup1) and decide:

• To continue at the same dose and recruit the next 3 patients of Subgroup 2
• To recruit the next 3 patients with a lower dose, estimated from AD as bringing efficient depletion
• To recruit the next patient with a higher dose (+2 mg/kg), if the depletion is not considered satisfactory and if the safety profile is considered acceptable
• To end the trial if LIS1 toxicity is too important vs its efficacy in CD3+ depletion.

If the decision to increase the dose after the first two TD patients is made, an additional DSMB review will be planned after patient 8. The DSMB will decide to maintain the dose for the last 2 patients or to get back to the previous dose

Group Type: EXPERIMENTAL

LIS1

Intervention Type: BIOLOGICAL

LIS1 is an induction treatment on top of maintenance immunosuppressive regimen. All patients from AD and TD cohort will receive the conventional immunosuppressive regimen: tacrolimus (0.2 mg/kg) / mycophenolic acid (MMF, 2x1000 mg) / prednisone (20 mg from day 2). This conventional treatment should be started and monitored for all patients independently of their participation in the clinical trial. Methylprednisolone 500 mg / 100 mL saline / 30 minutes will be administered before reperfusion during the surgery and on post operation day 1 just before LIS1 administration.

Interventions

LIS1

LIS1 is an induction treatment on top of maintenance immunosuppressive regimen. All patients from AD and TD cohort will receive the conventional immunosuppressive regimen: tacrolimus (0.2 mg/kg) / mycophenolic acid (MMF, 2x1000 mg) / prednisone (20 mg from day 2). This conventional treatment should be started and monitored for all patients independently of their participation in the clinical trial. Methylprednisolone 500 mg / 100 mL saline / 30 minutes will be administered before reperfusion during the surgery and on post operation day 1 just before LIS1 administration.

Intervention Type: BIOLOGICAL

Eligibility Criteria

Inclusion Criteria

• Participants must be listed for kidney transplantation,
• AD cohort participants: First transplantation, Panel Reactive Antibody (PRA) < 20%, negative Donor Specific Antibody (DSA), no anti-HLA antibodies, Epstein-Barr Virus positive (EBV+) serology,
• TD cohort participants: First transplantation, 0-50 % PRA, negative DSA, negative flow cytometry crossmatch (FCXM) for any patients with anti-HLA antibodies on screening is mandatory, Epstein-Barr Virus positive (EBV+) serology
• Participants must weigh at least 50 kg and have a Body Mass Index (BMI) 18.0 ≤ BMI < 35.0 kg/m2,
• White Blood Cells > 3000/mm3, platelets > 75000/mm3,
• Female participants (WOCBP) must have a negative pregnancy test at screening and use a highly effective birth control until 90 days after the last administration of study drug,
• Non-vasectomized male subjects having a female partner of childbearing potential must agree to the use of a highly effective method of contraception until 90 days after the last administration of study drug,
• Participants must be capable of giving signed informed consent.

Exclusion Criteria

• Patients with an active cancer or a history of kidney cancer,
• Patients who have previously been exposed to other anti-lymphocyte globulins,
• Patients with previous organ transplantation,
• Patients with a history of specific viral infection that would contraindicate depleting antibody therapy (Hepatitis B and C, HIV),
• Patients with a positive HIV and/or Hepatitis B and C tests
• Patients who have uncontrolled concomitant bacterial or viral infections (unresolved during screening), mycosis and/or parasitosis,
• Patients with a significant liver function impairment: enzyme (AST and/or ALT) values must not exceed 1.5 times upper limit of normal,
• Patients with positive testing for tuberculosis (using QuantiFERON-TB test), Patients with CMV D+/R- constellation at transplant,
• Patients with seronegative EBV prior to transplantation,
• Patients who have previously been exposed to antibodies of swine origin,
• Expanded Criteria Donor (ECD) defined as donor older than 60 years,
• Participants who have participated in another research study involving an investigational product in the previous 3 months,
• Patients with cardiovascular or severe respiratory comorbidities (severe chronic respiratory failure, severe pulmonary fibrosis, obesity-ventilation syndrome, severe idiopathic pulmonary arterial hypertension) not allowing general anesthesia,
• Patients with type 1 diabetes,
• Participants who are pregnant, breast feeding or planning pregnancy during the study,
• Participants who have any form of substance abuse (drug, alcohol…), any other health abnormalities (psychiatric disorders) or condition that according to the investigator's opinion might endanger patient during his/her participation in the study.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Xenothera SAS

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Dr Ondrej Viklicky

Role: PRINCIPAL_INVESTIGATOR

Institut klinické a experimentální medicíny, Praha 4, Czech Republic

Locations

Institut klinické a experimentální medicíny

Prague, , Czechia

Countries

Czechia

References

Viklicky O, Slatinska J, Janousek L, Rousse J, Royer PJ, Toutain PL, Cozzi E, Galli C, Evanno G, Duvaux O, Bach JM, Soulillou JP, Giral M, Vanhove B, Blancho G. First-in-human Study With LIS1, a Next-generation Porcine Low Immunogenicity Antilymphocyte Immunoglobulin in Kidney Transplantation. Transplantation. 2024 Jul 1;108(7):e139-e147. doi: 10.1097/TP.0000000000004967. Epub 2024 Feb 29.

Reference Type: DERIVED

PMID: 38421879 (View on PubMed)

Other Identifiers

XT-1901

Identifier Type: -

Identifier Source: org_study_id