- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT04565665
Cellule staminali mesenchimali derivate dal sangue del cordone ombelicale per il trattamento della sindrome da distress respiratorio acuto correlato a COVID-19
Studio delle cellule staminali mesenchimali derivate dal sangue cordonale per il trattamento della sindrome da distress respiratorio acuto
This is a phase I trial followed by a phase II randomized trial. The purpose of phase I study is the feasibility of treating patients with acute respiratory distress syndrome (ARDS) related to COVID-19 infection (COVID-19) with cord blood-derived mesenchymal stem cells (MSC). The purpose of the phase II trial is to compare the effect of MSC with standard of care in these patients. MSCs are a type of stem cells that can be taken from umbilical cord blood and grown into many different cell types that can be used to treat cancer and other diseases. The MSCs being used for infusion in this trial are collected from healthy, unrelated donors and are stored and grown in a laboratory. Giving MSC infusions may help control the symptoms of COVID-19 related ARDS.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
PRIMARY OBJECTIVE:
1. To assess the safety of administering cord blood derived mesenchymal stem cell (CB-MSC) infusions for treatment of moderate, severe or critical pneumonia.
SECONDARY OBJECTIVES:
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In the group of participants who present intubated on ventilator support, assess the proportion that are able to be successfully extubated.
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In the group of participants who present requiring supplemental oxygen but otherwise breathing without assistance, assess the rate of progression to intubation.
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Estimate the survival rate at day 30 post treatment separately by group.
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Determine the treatment effect on clinical parameters, oxygenation and respiratory parameters:
- Resolution of fever
- Changes in oxygen demand (increased oxygen saturation at similar FiO2 or decreased FiO2 requirement)
- Progression to mechanical ventilation
- Length of Mechanical ventilation
- Decrease in PEEP in intubated participants
- Decrease in FiO2 in intubated participants
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Determine the treatment effect on laboratory markers:
- Complete blood count
- CRP
- Ferritin
- D Dimer
- Procalcitonin
- Cytokine levels
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Estimate hospitalization and ICU stay.
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Report on study related adverse events.
OUTLINE:
Currently not shipping cells outside of MD Anderson Cancer Center in Houston.
PILOT STUDY: Patients receive MSCs intravenously (IV) over 1-2 hours on day 1. participants may receive a second infusion of MSCs within 7 days after the first infusion per physician discretion.
PHASE II STUDY: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive MSCs IV over 1-2 hours on day 1. Patients may receive a second infusion of MSCs within 7 days after the first infusion per physician discretion.
ARM II: Patients receive standard of care.
After completion of study treatment, patients are followed up at days 7, 14, 30, 60, and months 6 and 12.
Tipo di studio
Iscrizione (Stimato)
Fase
- Fase 2
- Fase 1
Contatti e Sedi
Luoghi di studio
-
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Texas
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Houston, Texas, Stati Uniti, 77030
- M D Anderson Cancer Center
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-
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Age greater than or equal 18 years.
- Participants with chest x-ray findings concerning for pneumonia from any cause, with clinical signs suggestive of at least moderate illness such as respiratory rate >20 breaths per minute or with oxygen saturation less than 93% on room air**
- Participants with COVID-19 associated pneumonia must meet baseline categorization of Moderate, Severe or Critical COVID-19 per FDA Guidance for Industry COVID-19: Developing Drugs and Biologics Products for Treatment or Prevention, February 2021.
- Negative pregnancy test in a woman with childbearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization.
- Participant or legally authorized representative consent. Participants with diminished mental capacity may be allowed on to enroll on the study.
- Because of the nature of COVID-19, participants enrolled on this study with COVID-19 associated pneumonia may have been previously enrolled in other IND trials for their cancer diagnosis or for COVID-19. These enrollments will not exclude them from enrollment to this study.
Exclusion Criteria:
- Moribund participants not expected to survive up to 48 hours
- Participants with severe chronic liver disease (Childs-Pugh score > 10)
- Pregnant and/or lactating women
- Participants on extracorporeal membrane oxygenation
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Sperimentale: Phase II Arm I (mesenchymal stem cells)
Patients receive MSCs as in the Pilot study. |
Given IV
Altri nomi:
|
|
Comparatore attivo: Phase II Arm II (standard of care)
Patients receive standard of care. |
Receive standard of care
Altri nomi:
|
|
Sperimentale: Pilot study (mesenchymal stem cells)
Patients receive MSCs IV over 1-2 hours on day 1. Patients may receive a second infusion of MSCs within 7 days after the first infusion per physician discretion. |
Given IV
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Pazienti vivi senza tossicità infusionale di grado 3, 4 (Fase II)
Lasso di tempo: Al giorno 30 dopo l'infusione di MSC
|
Al giorno 30 dopo l'infusione di MSC
|
|
|
Pazienti vivi con tossicità infusionale di grado 3 o 4 (Fase II)
Lasso di tempo: Al giorno 30 dopo l'infusione di MSC
|
Al giorno 30 dopo l'infusione di MSC
|
|
|
Pazienti non vivi (Fase II)
Lasso di tempo: Al giorno 30 dopo l'infusione di MSC
|
Al giorno 30 dopo l'infusione di MSC
|
|
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Incidence of composite serious adverse events (Phase I)
Lasso di tempo: Within 30 days of the first mesenchymal stem cell (MSC) infusion
|
Serious adverse events with be comprised of grade 3 or 4 graft versus host disease or death and will be estimated and reported overall and by group, along with 95% confidence intervals. |
Within 30 days of the first mesenchymal stem cell (MSC) infusion
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Degenza ospedaliera (Fase I)
Lasso di tempo: Fino al giorno 30 dopo l'infusione di MSC
|
Fino al giorno 30 dopo l'infusione di MSC
|
|
|
Degenza in Terapia Intensiva (Fase I)
Lasso di tempo: Fino al giorno 30 dopo l'infusione di MSC
|
Fino al giorno 30 dopo l'infusione di MSC
|
|
|
Proportion of successfully extubated patients who present intubated on ventilator support (Phase I)
Lasso di tempo: Up to day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
Up to day 30 post MSC infusion
|
|
Rate of successful progression to intubation in patients who require supplemental oxygen but who are otherwise able to breathe without assistance (Phase I)
Lasso di tempo: Up to day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
Up to day 30 post MSC infusion
|
|
Overall survival rate (Phase I)
Lasso di tempo: At day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
At day 30 post MSC infusion
|
|
Survival rate in patients who present intubated on ventilator support (Phase I)
Lasso di tempo: At day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
At day 30 post MSC infusion
|
|
Survival rate in patients who require supplemental oxygen but who are otherwise able to breathe without assistance (Phase I)
Lasso di tempo: At day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
At day 30 post MSC infusion
|
|
Clinical parameters (Phase I)
Lasso di tempo: Up to day 30 post MSC infusion
|
The effect of MSCs on clinical parameters will be assessed. Continuous clinical parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
|
Oxygenation parameters (Phase I)
Lasso di tempo: Up to day 30 post MSC infusion
|
The effect of MSCs on oxygenation parameters will be assessed. Continuous oxygenation parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
|
Respiratory parameters (Phase I)
Lasso di tempo: Up to day 30 post MSC infusion
|
The effect of MSCs on respiratory parameters will be assessed. Continuous respiratory parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
|
Laboratory markers (Phase I)
Lasso di tempo: Up to day 30 post MSC infusion
|
The effect of MSCs on laboratory markers will be assessed. Continuous laboratory parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
|
Incidence of infusion-related adverse events (Phase I)
Lasso di tempo: Up to day 30 post MSC infusion
|
All grades of infusion-related adverse events will be summarized by grade and type. |
Up to day 30 post MSC infusion
|
Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: Amanda Olson, M.D. Anderson Cancer Center
Pubblicazioni e link utili
Collegamenti utili
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Stimato)
Completamento dello studio (Stimato)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Neoplasie per sede
- Neoplasie
- Infezioni delle vie respiratorie
- Infezioni
- Infezioni da virus a RNA
- Malattie virali
- Malattie delle vie respiratorie
- Malattie polmonari
- Malattie ematologiche
- Polmonite, virale
- Polmonite
- Infezioni da coronavirus
- Infezioni da Coronaviridae
- Infezioni da Nidovirus
- Malattie emiche e linfatiche
- COVID-19
- Neoplasie ematologiche
- Amministrazione dei servizi sanitari
- Qualità, accesso e valutazione dell'assistenza sanitaria
- Qualità dell'assistenza sanitaria
- Indicatori di qualità, assistenza sanitaria
- Linee guida come argomento
- Assicurazione della qualità, assistenza sanitaria
- Standard di cura
- Pratica le linee guida come argomento
Altri numeri di identificazione dello studio
- 2020-0365
- 2020-0365 (Altro identificatore: M D Anderson Cancer Center)
- NCI-2020-06741 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .