Trial of Bone-marrow Derived Mesenchymal Stromal Cells (MSC) for New Onset Chronic Lung Allograft Dysfunction (ASSIST-CLAD)

The University of Queensland

Status and phase

Completed

Phase 2

Conditions

Chronic Lung Allograft Dysfunction (CLAD)

Treatments

Drug: Placebo

Drug: Bone-marrow derived MSCs

Study type

Interventional

Funder types

Other

Identifiers

NCT02709343

ASSIST-CLAD

Details and patient eligibility

About

This study is designed for lung transplant patients who have developed chronic lung allograft dysfunction (CLAD). Consented patients will receive 4 intravenous doses of allogeneic, bone-marrow-derived MSCs (2*10^6 cells/kg/dose) or matching placebo over a period of 2 weeks with a 12 month follow up.

Full description

This is a phase 2, multi-center, randomized study (n=82, 1:1 MSC:placebo) where consented patients will receive 4 intravenous doses of IMP over a period of 2 weeks. Patients must provide written informed consent and meet the all Inclusion Criteria and none of the Exclusion Criteria to be eligible. Screening procedures include obtaining medical history, current medications, questionnaires, vital signs, Chest Xray, 6 Minute walk test and blood tests. Historical chest CT and full lung function from 12 weeks prior to screening may be used. Bronchoscopy with biopsy must have been performed no more than 6 months prior to screening. A bronchoscopy with bronchoalveolar lavage (BAL) is required, however will not need to be repeated if performed within 14 days prior to the baseline visit. Patients will then receive 4 infusions of MSC/placebo over a period of 2 weeks, with follow up at Week 3,6,10,14,28,41 and week 54.

Enrollment

64 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Bilateral lung transplant recipients aged ≥ 18 years and at least 6 months post-transplant. Patients with other organs transplanted (eg heart, liver, kidney) or those who have undergone lobar transplantation, or re-transplantation, are potentially eligible.
New-onset CLAD (defined as a persistent (3weeks apart) fall in FEV1 of at least 20% from the mean of the two best post-transplant values taken at least 3 weeks apart) in the 12 months prior to the screening visit. Other causes of a fall in FEV1 (acute cellular or humoral rejection, active infection, anastomotic stenosis etc.) must be excluded as per international guidelines.
Stable immunosuppression regimen, as assessed by the investigator, in the 8 weeks prior to the screening visit.
Available for all specified assessments at the study site through the completion of the study, including the protocol bronchoscopies.
Provision of written informed consent.

Exclusion criteria

Any condition that in the opinion of the Investigator may interfere with the safety of the patient, his / her completion of required follow-up visits or evaluation of the study objectives
Untreated cellular or humoral rejection
Clinically meaningful and untreated viral, bacterial or fungal infection
Use of azithromycin or another macrolide antibiotic, if commenced within 8 weeks of the screening visit
Intravenous pulsed methylprednisolone, within 4 weeks of the screening visit
Use of extracorporeal photopheresis, within 4 weeks of the screening visit
Use of total lymphoid irradiation, within 4 weeks of the screening visit
Poor functional status not expected to survive 6 months
Allergy to beef products
Women who are pregnant, breast-feeding or unwilling to use adequate contraception
Patients who are currently participating in another interventional clinical trial