Table 2. Ongoing and planned clinical trials of cell therapies for the treatment of PD. TBD, to be determined.
Trial | Transeuro182 NCT01898390 | ISCO183 NCT02452723 | CiRA125 | Chinese Academy of Sciences184 NCT03119636 | American multicentre case report185 | Summit for PD (in set up)59 | NYSTEM-PD186 (in set up) | European STEM-PD187(in set up) |
---|---|---|---|---|---|---|---|---|
Cell source | Foetal ventral mesencephalona | Parthenogenetic neural stem cellsb | Allogenic iPSCsc | Parthenogenetic embryonic stem cell derived neural precursorsd | Autologous iPSCse | Autologous iPSCsf | H9 embryonic stem cellsg | RC17 embryonic stem cellsh |
Cryopreservation of the cell product | No | Yes | No | Data not available | Yes | Yes | Yes | Yes |
Screening of cell product for genetic variance/quality control | None | Yes, flow cytometry and RT- PCR to assess markers of pluripotency. | Yes, sequencing for genes of interest | Data not available | Whole genome sequencing | Whole genome sequencing | Yes, Karyotype analysis by G- banding. Viral testing. Genetic testing TBD. | Yes, flow cytometry and RT- PCR to assess markers of pluripotency and midbrain dopaminergic progenitors. Genetic testing TBD |
Functional testing | Structural and functional MRI 18F-Dopa PET 11C-PE2I PET 11C-DASB PET | MRI 18F-DOPA PET | MRI 18F-FLT-PET | MRI DAT-SPECT | 18F-DOPA PET MRI CT scan | 18F-DOPA PET DAT- SPECT 18F-FLT PET | 18F-DOPA PET 11C-PE2I PET MRI | MRI 18F-DOPA PET 11C-PE2I PET |
Immunosuppression | Cyclosporine, Azathioprine and Prednisolone | Yes, but unclear | Tacrolimus | Data not available | None | None | Tacrolimus, mycophenalate, basiliximab, prednisolone. | TBD |
MHC Matching? | No | No | Yes | Two groups - one HLA matched one mismatched | Autologous transplant | N/A | No | No |
Patient cohort | 30-68y/o early- stage PD patients | 30-70y/o moderate to severe PD patients | 50-70y/o moderate PD patients | 50-80 y/o moderate PD patients | One 69 y/o PD patient | 45-70 y/o moderate PD patients. | 40-70y/o moderate PD patients. | Moderate stage PD patients 40- 70y/o |
Date of first-in-human transplant | 2015 | 2016 | 2018 | 2017 | 2018 | TBD | TBD | TBD |
aGrafting of foetal ventral mesencephalic tissue has previously demonstrated efficacy in PD animal models and patients27,55,57,188. bNSCs grafted into the brains of rodents and non-human primates was safe but with minimal clinical efficacy65,67,68.
cClinical grade iPSC-derived dopaminergic progenitors have demonstrated safety and efficacy in rodent and non-human primate PD models62.
dClinical grade ESC-derived neural precursors significantly improved motor dysfunction in some MPTP lesioned non-human primates, in the absence of tumour formation for up to 2 years184.
ePD patient-derived iPSC-derived dopaminergic precursors significantly reversed motor deficits in 6OHDA lesioned rats, without tumour formation185. Results were corroborated in one PD patient, who demonstrated clinical benefit up to 2 years after grafting, without the onset of serious adverse events185.
fData pertaining to the safety and efficacy of autologous iPSC-derived dopaminergic neurons is underway. 10 patient-derived iPSC lines have been successfully generated64.
gClinical grade H9 ESC-derived dopaminergic progenitors have demonstrated safety and efficacy in preclinical PD models135,150.
hClinical grade ESC-derived dopaminergic progenitors have demonstrated safety and efficacy in preclinical PD models84,88.