A Trial to Determine the Safety and Tolerability of Transplanted Stem Cell Derived Dopamine Neurons to the Brains of Individuals With Parkinson's Disease
NCT ID: NCT05635409
Last Updated: 2025-12-17
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
ACTIVE_NOT_RECRUITING
Clinical Phase
PHASE1
Total Enrollment
8 participants
Study Classification
INTERVENTIONAL
Study Start Date
2022-11-30
Study Completion Date
2027-11-30
Brief Summary
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Parkinson's disease (PD) occurs when an area of the brain begins to lose nerve cells that produce a chemical called dopamine. Dopamine is an important chemical, and one of its functions is that it helps to regulate body movement. The loss of these nerve cells leads to a reduction of dopamine in the brain. Medications used to treat PD temporarily replace this lost dopamine, but they do not repair the underlying disease. One of the most promising PD therapies to date has been the transplantation of dopamine producing cells into the brain. Unlike current treatments, these therapies may be able to repair the damage caused in PD.
In this trial, the investigators will transplant a new stem cell therapy, called the STEM-PD product, into the area of the brain affected in people with PD. These stem cells can develop into many different cell types, including dopamine-producing nerve cells. The investigators will transplant the stem cells using a device that has been previously used for similar transplants in Lund. This is the first time that the STEM-PD product will be given to humans.
The trial aims to assess whether the STEM-PD product is safe to use in people with PD. The investigators will also be looking for preliminary signs of efficacy.
The trial will recruit participants with PD from the UK and Sweden. Eight participants will undergo the STEM-PD product transplant. Participants will receive a single dose of the STEM-PD product. Participants will attend for 25 visits primarily at their local recruiting hospital. For participants from the UK, some of the imaging will be performed at Invicro (London), and the surgery (including some visits before and after) and some imaging will be performed in Lund. All participants will be followed up for 36 months following surgery
In this trial, the investigators will transplant a new stem cell therapy, called the STEM-PD product, into the area of the brain affected in people with PD. These stem cells can develop into many different cell types, including dopamine-producing nerve cells. The investigators will transplant the stem cells using a device that has been previously used for similar transplants in Lund. This is the first time that the STEM-PD product will be given to humans.
The trial aims to assess whether the STEM-PD product is safe to use in people with PD. The investigators will also be looking for preliminary signs of efficacy.
The trial will recruit participants with PD from the UK and Sweden. Eight participants will undergo the STEM-PD product transplant. Participants will receive a single dose of the STEM-PD product. Participants will attend for 25 visits primarily at their local recruiting hospital. For participants from the UK, some of the imaging will be performed at Invicro (London), and the surgery (including some visits before and after) and some imaging will be performed in Lund. All participants will be followed up for 36 months following surgery
Detailed Description
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Conditions
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Parkinson Disease
Study Design
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Allocation Method
NON_RANDOMIZED
Intervention Model
SEQUENTIAL
This is a multicentre, single arm, dose escalation, first in human advanced therapy investigational medicinal product (ATIMP) trial.
Primary Study Purpose
TREATMENT
Blinding Strategy
NONE
Study Groups
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Dose 1
The starting dose of this trial is selected as a dose of cells that is likely to be the minimal therapeutic dose, i.e. 100,000 surviving DA neurons per putamen, obtained by transplanting 3.54 million STEM-PD cells per putamen.
Group Type
EXPERIMENTAL
STEM-PD
Intervention Type
BIOLOGICAL
STEM-PD is a cryopreserved cell product, consisting of ventral midbrain dopaminergic progenitor cells derived from the clinical-grade hESC line RC17. STEM-PD will be administered using a non-CE marked class III neurosurgical medical device, the Rehncrona-Legradi device, bilaterally in one surgical session to the putamen.
Dose 2
To ensure that the investigators are not using a potentially suboptimal cell dose, the investigators also plan to test a higher dose, which is double the dose of dose 1, i.e., 200,000 surviving DA neurons (= 7.08 million transplanted STEM-PD cells) per putamen.
The Data and Safety Monitoring Board (DSMB) for the trial will make a recommendation for the dosing once participants 1-4 have been dosed and data is available for imaging and clinical measurements, as well as safety reports, 6 months after the last patient has been grafted. The DSMB can recommend either to: i) remain at dose 1; ii) proceed to dose 2; or, iii) wait longer to collect more data. The final decision will be made by the clinical sub-group of the Trial Management Group, after receiving confirmation of the DSMB's recommendation.
Group Type
EXPERIMENTAL
STEM-PD
Intervention Type
BIOLOGICAL
STEM-PD is a cryopreserved cell product, consisting of ventral midbrain dopaminergic progenitor cells derived from the clinical-grade hESC line RC17. STEM-PD will be administered using a non-CE marked class III neurosurgical medical device, the Rehncrona-Legradi device, bilaterally in one surgical session to the putamen.
Interventions
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STEM-PD
STEM-PD is a cryopreserved cell product, consisting of ventral midbrain dopaminergic progenitor cells derived from the clinical-grade hESC line RC17. STEM-PD will be administered using a non-CE marked class III neurosurgical medical device, the Rehncrona-Legradi device, bilaterally in one surgical session to the putamen.
Intervention Type
BIOLOGICAL
Eligibility Criteria
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Inclusion Criteria
* Have given written informed consent to participate in the trial
* Diagnosed with PD as defined using Queens Square Brain Bank criteria
* Moderate disease as defined by having Hoehn and Yahr stage 2-3 in OFF state
* Disease duration \> 10 years
* Male or female, aged between 50 and 75 years (inclusive)
* Have a significant response to dopamine therapies as judged by the PI or other delegated clinician
* Have symptoms that are not appropriately controlled by existing oral anti-PD medications, as judged by the PI or other delegated clinician
* Ability to travel to Lund for surgery
* Followed up for at least 12 months prior to inclusion in this trial in the TransEUro observational study
* Be fluent in English/Swedish to enable completion of questionnaires as assessed by the PI or other delegated clinician at Cambridge/Lund, respectively
* Be approved by the TMG clinical sub-group for trial participation
* Diagnosed with PD as defined using Queens Square Brain Bank criteria
* Moderate disease as defined by having Hoehn and Yahr stage 2-3 in OFF state
* Disease duration \> 10 years
* Male or female, aged between 50 and 75 years (inclusive)
* Have a significant response to dopamine therapies as judged by the PI or other delegated clinician
* Have symptoms that are not appropriately controlled by existing oral anti-PD medications, as judged by the PI or other delegated clinician
* Ability to travel to Lund for surgery
* Followed up for at least 12 months prior to inclusion in this trial in the TransEUro observational study
* Be fluent in English/Swedish to enable completion of questionnaires as assessed by the PI or other delegated clinician at Cambridge/Lund, respectively
* Be approved by the TMG clinical sub-group for trial participation
Exclusion Criteria
* Tremor dominant disease, as assessed by the PI or other delegated clinician
* Significant drug induced dyskinesias as defined by a score of \> 2 in the Abnormal Involuntary Movement Scale (AIMS) dyskinesias rating scale, in any body part in the ON state
* Ongoing major medical or psychiatric disorders, including depression (MADRS \> 20) and psychosis, that make participation unsuitable, as judged by the PI or other delegated clinician
* Any contraindication to neurosurgery
* Unable to be imaged using MRI
* Extensive ventral striatal loss or normal findings on F-DOPA PET at screening
* Significant cognitive impairment indicative of an incipient dementia/established dementia or values consistent with MoCA score of ≤ 24
* Unable to perform normal copying of interlocking pentagons and/or a semantic fluency score for naming animals of less than 20 over 90 seconds
* Other concomitant treatment with neuroleptics (including atypical neuroleptics) and/or cholinesterase inhibitors
* Previous neurosurgery to the brain, or cell or organ transplantation, or recipient of repeated blood transfusions
* Any contraindication to immunosuppressive therapy, prophylactic antibiotics, and/or osteoporosis prophylaxis (refer to STEM-PD Trial Immunosuppressant Manual)
* High levels of pre-formed specific anti-HLA antibodies to the cell product
* Severely reduced TPMT activity (less than half of the lower normal TPMT activity level)
* History of documented severe/significant allergy requiring treatment
* Female who is pregnant or breastfeeding
* Received an investigational drug (including investigational vaccines) or used an invasive investigational medical device within 4 weeks of the screening visit, or is currently enrolled in an interventional investigational trial
* Female of childbearing potential or male unwilling to follow contraception requirements (see protocol section 12.15)
* Any other condition which, in the opinion of the investigator, makes the patient inappropriate for entry into the trial
* Significant drug induced dyskinesias as defined by a score of \> 2 in the Abnormal Involuntary Movement Scale (AIMS) dyskinesias rating scale, in any body part in the ON state
* Ongoing major medical or psychiatric disorders, including depression (MADRS \> 20) and psychosis, that make participation unsuitable, as judged by the PI or other delegated clinician
* Any contraindication to neurosurgery
* Unable to be imaged using MRI
* Extensive ventral striatal loss or normal findings on F-DOPA PET at screening
* Significant cognitive impairment indicative of an incipient dementia/established dementia or values consistent with MoCA score of ≤ 24
* Unable to perform normal copying of interlocking pentagons and/or a semantic fluency score for naming animals of less than 20 over 90 seconds
* Other concomitant treatment with neuroleptics (including atypical neuroleptics) and/or cholinesterase inhibitors
* Previous neurosurgery to the brain, or cell or organ transplantation, or recipient of repeated blood transfusions
* Any contraindication to immunosuppressive therapy, prophylactic antibiotics, and/or osteoporosis prophylaxis (refer to STEM-PD Trial Immunosuppressant Manual)
* High levels of pre-formed specific anti-HLA antibodies to the cell product
* Severely reduced TPMT activity (less than half of the lower normal TPMT activity level)
* History of documented severe/significant allergy requiring treatment
* Female who is pregnant or breastfeeding
* Received an investigational drug (including investigational vaccines) or used an invasive investigational medical device within 4 weeks of the screening visit, or is currently enrolled in an interventional investigational trial
* Female of childbearing potential or male unwilling to follow contraception requirements (see protocol section 12.15)
* Any other condition which, in the opinion of the investigator, makes the patient inappropriate for entry into the trial
Minimum Eligible Age
50 Years
Maximum Eligible Age
75 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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Lund University
OTHER
Sponsor Role
collaborator
Cambridge University Hospitals NHS Foundation Trust
OTHER
Sponsor Role
collaborator
University of Cambridge
OTHER
Sponsor Role
collaborator
Region Skane
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Roger Barker
Role: PRINCIPAL_INVESTIGATOR
Cambridge University Hospitals NHS Foundation Trust & University of Cambridge
Locations
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Region Skåne - Skåne University Hospital
Lund, , Sweden
Site Status
Cambridge University Hospitals NHS Foundation Trust
Cambridge, Cambridgeshire, United Kingdom
Site Status
Countries
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Sweden
United Kingdom
References
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Barker RA; TRANSEURO consortium. Designing stem-cell-based dopamine cell replacement trials for Parkinson's disease. Nat Med. 2019 Jul;25(7):1045-1053. doi: 10.1038/s41591-019-0507-2. Epub 2019 Jul 1.
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Witt K, Daniels C, Reiff J, Krack P, Volkmann J, Pinsker MO, Krause M, Tronnier V, Kloss M, Schnitzler A, Wojtecki L, Botzel K, Danek A, Hilker R, Sturm V, Kupsch A, Karner E, Deuschl G. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson's disease: a randomised, multicentre study. Lancet Neurol. 2008 Jul;7(7):605-14. doi: 10.1016/S1474-4422(08)70114-5. Epub 2008 Jun 4.
Reference Type
BACKGROUND
Lansing AE, Ivnik RJ, Cullum CM, Randolph C. An empirically derived short form of the Boston naming test. Arch Clin Neuropsychol. 1999 Aug;14(6):481-7.
Reference Type
BACKGROUND
Related Links
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https://sitn.hms.harvard.edu/flash/2018/worlds-first-clinical-trial-treat-parkinsons-disease-stem-cells/
World's first clinical trial to treat Parkinson's disease with stem cells
https://shorturl.at/qZoLQ
Surgical instrument for implantation
Other Identifiers
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2021-001366-38
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
CCTU0263
Identifier Type: -
Identifier Source: org_study_id