Phase Ⅰ/Ⅱa Trial Evaluating Intravenous hUC-MSCs Injection for Safety, Tolerability and Efficacy in Patients With POI
Phase Ⅰ/Ⅱa Clinical Trial to Evaluate the Safety, Tolerability and Efficacy of Intravenous Injection of Human Umbilical Cord Mesenchymal Stem Cells (hUC-MSCs) in Patients With Premature Ovarian Insufficiency (POI)
A Phase I/IIa clinical study evaluating the safety, tolerability and efficacy of intravenously administered human umbilical cord mesenchymal stem cell (hUC-MSCs) injection in patients with premature ovarian insufficiency (POI).
The primary objective of the Phase I dose-escalation stage is to assess the safety and tolerability of intravenous infusion of hUC-MSCs injection for the treatment of POI, and to determine the recommended phase II dose (RP2D) for the Phase IIa clinical trial.
The primary objective of the Phase IIa dose-expansion stage is to evaluate the efficacy of intravenous infusion of hUC-MSCs injection in POI treatment, and to generate data to support pivotal/confirmatory clinical trials.
調査の概要
詳細な説明
Premature ovarian insufficiency (POI) is defined as ovarian dysfunction occurring in women before the age of 40, which is mainly characterized by menstrual abnormalities (amenorrhea, oligomenorrhea or polymenorrhea), elevated gonadotropin levels (FSH > 25 U/L), and fluctuating decline in estrogen levels. The incidence of POI is age-specific: 1 in 250 women develops POI before 35 years of age, and 1 in 100 women develops POI before 40 years of age. The incidence rate of POI in China is 2.8%, showing an upward trend year by year with a younger onset age.
hormone replacement therapy (HRT) relieves symptoms caused by low estrogen through estrogen supplementation. Sequential estrogen-progestogen therapy is recommended for POI patients with an intact uterus. Since patients with POI require long-term HRT, natural or nearly natural estrogens and progestogens can be selected to minimize adverse effects on the mammary gland, metabolism, cardiovascular system and other systems. Nevertheless, HRT still increases the risks of breast cancer, heart disease and stroke.
Studies have demonstrated that mesenchymal stem cells can home to ovarian stroma, regulate the balance of Th1/Th2 cytokines and the expression of endometrial natural killer cells, alleviate inflammatory responses, inhibit apoptosis of ovarian granulosa cells and reduce ovarian interstitial fibrosis, thereby improving the ovarian microenvironment. Meanwhile, these cells can secrete growth factors including VEGF, IGF-1 and HGF, promote proliferation of various ovarian cells and angiogenesis, repair ovarian structure and restore ovarian ovarian function. This study aims to evaluate the safety, tolerability and efficacy of intravenously administered hUC-MSCs in the treatment of patients with POI.
研究の種類
入学 (推定)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究連絡先
- 名前:Xiaohong Wang,MD
- 電話番号:+86 755 6683 5786
- メール:xiaohong@wingor.net
研究場所
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Beijing Municipality
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Beijing、Beijing Municipality、中国、100730
- 募集
- Peking Union Medical College Hospital
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コンタクト:
- Qi Yu, Prof.
- 電話番号:+86 10 6915 8621
- メール:yuqimd@163.com
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-
参加基準
適格基準
就学可能な年齢
- 大人
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Aged 18 to 40 years at the time of signing the informed consent form (exclusive of the boundary values);
- Meet the diagnostic criteria specified in the Expert Consensus on Clinical Diagnosis and Treatment of Premature Ovarian Insufficiency (2023 Edition): oligomenorrhea (menstrual cycle longer than 35 days) or amenorrhea for more than 4 months, with basal serum follicle-stimulating hormone (FSH) > 25 U/L (tested on Days 2-4 of the menstrual cycle or during amenorrhea, at least twice with an interval of ≥4 weeks);
Satisfy one of the following two criteria:
- Total number of antral follicles (AFC) with a diameter of 2-10 mm in bilateral ovaries < 5;
- Serum anti-Müllerian hormone (AMH) ≤ 7.85 pmol/L (equivalent to 1.1 ng/mL);
- Have received standardized hormone replacement therapy (HRT) at a stable dose for ≥3 months prior to drug administration with stable hormone levels, and maintain stable HRT per medical advice throughout the trial (within 24 weeks after enrollment);
- Have no fertility requirements;
- Agree to use effective contraceptive measures throughout the trial period (such as complete abstinence, condoms, cervical caps plus spermicides, intrauterine devices, etc.);
- Negative serum β-hCG test result during the screening period (to rule out pregnancy);
- Fully understand the trial information and sign the informed consent form.
Exclusion Criteria:
- Subjects with primary amenorrhea;
- Subjects with thyroid disorders (hypothyroidism/hyperthyroidism or thyroid malignant tumors) or resistant ovary syndrome (ROS);
- Subjects with abnormal female karyotypes (e.g., Turner syndrome, Fragile X syndrome);
- Positive serology tests (HBV antibody, HCV antibody, HIV antibody, syphilis). Exceptions: HBV carriers, patients with stable HBV after drug treatment (HBV DNA titer ≤500 IU/mL or copies <1000 copies/mL), and patients with cured HCV (negative HCV RNA test) may be enrolled if deemed eligible by the investigator;
- Subjects receiving or planning to use the following medications during the trial: oral or systemic corticosteroids, danazol, anticoagulants, Chinese herbal medicines or botanical supplements that may affect hormone levels or ovarian function;
- History of hypersensitivity to human serum albumin;
- Pregnant or breastfeeding subjects;
- Participation in another clinical trial within the past 3 months, or receipt of other cell therapies (excluding blood transfusion);
- History of malignant tumors;
- Subjects with contraindications or cautions for estrogen use, including known or suspected breast cancer, endometrial cancer, other known or suspected sex hormone-dependent malignancies, active venous or arterial thromboembolic diseases within the last 6 months, undiagnosed abnormal genital bleeding, severe hepatic or renal insufficiency [serum aspartate aminotransferase (AST) >3×ULN, serum alanine aminotransferase (ALT) >3×ULN, estimated glomerular filtration rate (eGFR) <60 mL/min], etc.;
- Uncontrolled diabetes, hypertension (>150/100 mmHg), heart disease, etc.;
- Any other conditions judged by the investigator to render the subject unsuitable for participation in this study.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Phase I, Dose Cohort 1
Human Umbilical Cord Mesenchymal Stem Cells Injection
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hUC-MSCs Injection, administered via intravenous infusion as a single dose on D0.
他の名前:
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実験的:Phase I, Dose Cohort 2
Human Umbilical Cord Mesenchymal Stem Cells Injection
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hUC-MSCs Injection, administered via intravenous infusion as a single dose on D0.
他の名前:
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実験的:Phase I, Dose Cohort 3
Human Umbilical Cord Mesenchymal Stem Cells Injection
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hUC-MSCs Injection, administered via intravenous infusion as a single dose on D0.
他の名前:
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実験的:Phase IIa, Medium-Dose Cohort
Human Umbilical Cord Mesenchymal Stem Cells Injection
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hUC-MSCs Injection, 3 infusions in total, dosing interval ≥7 days.
他の名前:
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実験的:Phase IIa, High-Dose Cohort
Human Umbilical Cord Mesenchymal Stem Cells Injection
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hUC-MSCs Injection, 3 infusions in total, dosing interval ≥7 days.
他の名前:
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プラセボコンパレーター:Phase IIa, Placebo Cohort
Multiple Electrolytes Injection
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3 infusions in total, dosing interval ≥7 days
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Phase I : Incidence and number of subjects with treatment-emergent adverse events and serious adverse events.
時間枠:48 weeks
|
In this Phase I stage, safety is the primary endpoint.
Types, frequencies, severities and causal relationships of all adverse events (AEs) and serious adverse events (SAEs) occurring from the first administration of study drug to the end of safety follow-up (48 weeks), assessed in accordance with the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 6.0; together with the proportion of adverse events judged by the investigator to be related to the study drug.
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48 weeks
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Phase II :FSH
時間枠:at Week 24 post-treatment
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To evaluate the changes from baseline in serum follicle-stimulating hormone (FSH) levels at Week 24 post-treatment.
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at Week 24 post-treatment
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Phase II :E2
時間枠:at Week 24 post-treatment
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To evaluate the changes from baseline in serum festradiol (E2) levels at Week 24 post-treatment.
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at Week 24 post-treatment
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Phase II :AMH
時間枠:at Week 24 post-treatment
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To evaluate the changes from baseline in serum anti-Müllerian hormone (AMH) levels at Week 24 post-treatment.
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at Week 24 post-treatment
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Phase I: FSH
時間枠:48 weeks
|
To evaluate the changes from baseline in serum follicle-stimulating hormone (FSH) levels.
|
48 weeks
|
|
Phase I :E2
時間枠:48 weeks
|
To evaluate the changes from baseline in serum estradiol (E2) levels
|
48 weeks
|
|
Phase I : AMH
時間枠:48 weeks
|
To evaluate the changes from baseline in serum anti-Müllerian hormone (AMH) levels.
|
48 weeks
|
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Phase II: Incidence and number of subjects with treatment-emergent adverse events and serious adverse events.
時間枠:48 weeks
|
In this Phase II stage, safety is the secondary endpoint.
Types, frequencies, severities and causal relationships of all adverse events (AEs) and serious adverse events (SAEs) occurring from the first administration of study drug to the end of safety follow-up (48 weeks), assessed in accordance with the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 6.0; together with the proportion of adverse events judged by the investigator to be related to the study drug.
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48 weeks
|
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Phase I/II: AFC
時間枠:48 weeks
|
Changes from baseline in antral follicle count (AFC) by transvaginal ultrasound.
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48 weeks
|
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Phase I/II: endometrial thickness
時間枠:48 weeks
|
Changes from baseline in endometrial thickness measured by transvaginal ultrasound.
|
48 weeks
|
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Phase I/II: menstrual recovery status
時間枠:48 weeks
|
Menstrual recovery status will be assessed via patient inquiry at each visit.
|
48 weeks
|
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Phase I/II:Modified Kupperman Index
時間枠:48 weeks
|
To evaluate the changes in the Modified Kupperman Index from baseline across all post-baseline follow-up visits. Modified Kupperman Index will be assessed through physician interview.The total score ranges from 0 to 63 points. Total score stratification: >30 points indicates severe symptoms, 16-30 points moderate symptoms, 6-15 points mild symptoms, and <6 points normal status. |
48 weeks
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- WG108-POI-I/IIa
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個々の参加者データ (IPD) を共有する予定はありますか?
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