A Trial to Determine the Safety and Tolerability of Transplanted Stem Cell Derived Dopamine Neurons to the Brains of Individuals With Parkinson's Disease

NCT05635409 | Active Not Recruiting Phase 1 DMC

• 2 other identifiers: CCTU02632021-001366-38
• Study Type: interventional
• Target: 8
• Locations: 2 countries
• Sites: 2

Brief Summary

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

Conditions

Parkinson Disease

Outcome Measures

Primary Outcomes (2)

• The number and nature of adverse events and serious adverse events in the first 12 months following transplantation

  Adverse events are recorded from the point of participant informed consent and at every trial visit

  12 months following transplantation

• Absence of space occupying masses on cranial MRI in the first 12 months following transplantation

  Magnetic resonance imaging (MRI) scans

  12 months following transplantation

Secondary Outcomes (24)

• Changes in clinical effects at 36 months following transplantation compared to baseline; emergence of new neurological features,

  36 months following transplantation

• Changes in clinical effects at 36 months following transplantation compared to baseline; global cognitive changes assessed using the Montreal Cognitive Assessment (MoCA)

  36 months following transplantation

• Changes in clinical effects at 36 months following transplantation compared to baseline; global cognitive changes assessed using the Hopkins verbal learning task-revised (HVLT-R)

  36 months following transplantation

• Changes in clinical effects at 36 months following transplantation compared to baseline; global cognitive changes assessed using semantic (animal naming) fluency

  36 months following transplantation

• Changes in clinical effects at 36 months following transplantation compared to baseline; global cognitive changes assessed using the stroop test

  36 months following transplantation

Other Outcomes (10)

• Exploratory outcome: changes in F-DOPA uptake and dopamine transporter (DAT) binding at 6 months post transplantation on PET imaging with F-DOPA and PE2i compared to PET imaging performed pre-transplant.

  6 months post transplant

• Exploratory outcome: changes in F-DOPA uptake and dopamine transporter (DAT) binding at 12 months post transplantation on PET imaging with F-DOPA and PE2i compared to PET imaging performed pre-transplant.

  12 months post transplant

• Exploratory outcome: changes in F-DOPA uptake and dopamine transporter (DAT) binding at 24 months post transplantation on PET imaging with F-DOPA and PE2i compared to PET imaging performed pre-transplant.

  24 months post transplant

Study Arms (2)

Dose 1

EXPERIMENTAL

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.

Biological: STEM-PD

Dose 2

EXPERIMENTAL

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.

Biological: STEM-PD

Interventions

STEM-PD 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 1; Dose 2

Eligibility Criteria

• Age: 50 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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
• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Region Skane: lead
• Lund University: collaborator
• Cambridge University Hospitals NHS Foundation Trust: collaborator
• University of Cambridge: collaborator

Study Sites (2)

Region Skåne - Skåne University Hospital

Lund, 214 28, Sweden

Location

Cambridge University Hospitals NHS Foundation Trust

Cambridge, Cambridgeshire, CB2 0QQ, United Kingdom

Location

Related Publications (46)

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  PMID: 41469040 DERIVED

Related Links

• World's first clinical trial to treat Parkinson's disease with stem cells
• Surgical instrument for implantation

MeSH Terms

Conditions

Parkinson Disease

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Study Officials

• Roger Barker

  Cambridge University Hospitals NHS Foundation Trust & University of Cambridge

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This is a multicentre, single arm, dose escalation, first in human advanced therapy investigational medicinal product (ATIMP) trial.

Study Record Dates

• First Submitted: November 15, 2021
• First Posted: December 2, 2022
• Study Start: November 30, 2022
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): November 1, 2027
• Last Updated: December 17, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will share

Locations

GB (1); SE (1)