Preclinical quality, safety, and efficacy of a human embryonic stem cell-derived product for the treatment of Parkinson's disease, STEM-PD

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Cell replacement therapies for Parkinson’s disease (PD) based on transplantation of pluripotent stem cell-derived dopaminergic neurons are now entering clinical trials. Here, we present quality, safety, and efficacy data supporting the first-in-human STEM-PD phase I/IIa clinical trial along with the trial design. The STEM-PD product was manufactured under GMP and quality tested in vitro and in vivo to meet regulatory requirements. Importantly, no adverse effects were observed upon testing of the product in a 39-week rat GLP safety study for toxicity, tumorigenicity, and biodistribution, and a non-GLP efficacy study confirmed that the transplanted cells mediated full functional recovery in a pre-clinical rat model of PD. We further observed highly comparable efficacy results between two different GMP batches, verifying that the product can be serially manufactured. A fully in vivo-tested batch of STEM-PD is now being used in a clinical trial of 8 patients with moderate PD, initiated in 2022.
OriginalsprogEngelsk
TidsskriftCell Stem Cell
Vol/bind30
Udgave nummer10
Sider (fra-til)1299-1314.e9
Antal sider17
ISSN1934-5909
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The research leading to these results has received funding from the New York Stem Cell Foundation (grant number #NYSCF-R-I37), EU (FP7 HEALTH-F4-2013-602278 Neurostemcellrepair, H2020 NSC-Reconstruct 874758 and Eurostars projekt E!10838, DOPALAM 2017-01484), the European Research Council (ERC grant agreement no. 771427), Novo Nordisk A/S, the Swedish Research Council (grant agreements 2016-00873, 2021-00661), The Swedish Parkinson's Association (Parkinsonfonden), the Swedish Brain Foundation (Hjärnfonden FO2019-0301), the Strategic Research Areas at Lund University MultiPark (Multidisciplinary research in Parkinson's disease) and StemTherapy/Lund Stem Cell Center, the Danish Innovation Fund, The Lundbeck Foundation (R303-2018-3058 and R211-2015-3784), Parkinsonforeningen, the Knut and Alice Wallenberg Foundation and the Novo Nordisk Foundation (NNF21CC0073729 and NNF18OC0030286). We would like to thank Ulla Jarl, Michael Sparennius, and Amalie Holm as well as the staff at the Aarhus University Hospital PET Centre (Aage Kristian Olsen Alstrup, David Brooks) and Center for Experimental Neuroscience (CENSE, Dariusz Orlowski) for assistance with the minipig study and Petra Johnels, Ulf Malmqvist, Lisbet Norlander, Sebastian Strunk Möller, Kristina Johansson for support on regulatory and ethical issues. We thank Josefina Dykes, Anette Malmberg, Sabine Apitzsch, and Anna Weddig for clinical and clean room support. We further thank Charlotte Bailey, Sharon Barkatullah, Regine Bergholdt, David Campard, Jeppe Dehli, Frederikke Bjergvang Flagstad, Constanze Hammerle, Kirsten Høstgaard-Jensen, Janne Jensen, Rikke Kaae Kirk, Kristian Kolind, Helle Frimer Larsen, Inge Holm Lauritzen, Karsten Nielsen, Anne Mette Nøhr, Gabriel Pemberton, Christian de Vos Petersen, Johannes Roubroeks, Jonas Lyng Thomsen, Alice Troy, Tanja Villumsen, Johanne Press Wegeberg, Tina Zinck, Anja Dahl Østergren, and Anya Østergård from Novo Nordisk A/S for guidance and support on CMC statistics, technical, and regulatory issues and Marie Jönsson for help with graphical abstract. The authors confirm contribution to the paper as follows: trial conception and design, A.K. J.N. D.B.H. N.R. H.B. N.N.C.T. A.M.L. J.C.S. O.L. T.v.V. A.B. B.M. B.H. E.C. H.W. G.P. R.A.B. and M.P.; performance of experiments, data collection, analysis, and interpretation of results, A.K. J.N. D.B.H. N.R. H.B. N.N.C.T. A.F. A.F.A. T.C. S.V. J.M. P.S. Y.Z. A.M.L. T.P.L. M.L. C.C. O.B. B.M. and M.P.; draft manuscript preparation, A.K. M.P. and R.A.B. All authors reviewed the results, gave input to the manuscript, and approved the final version of the manuscript. M.P. is the owner of Parmar Cells AB. A.K. is the owner of Kirkeby Cell Therapy APS. M.P. and A.K. are co-inventors on patents WO2016162747A2/A3 and WO2019016113A1. M.P. A.K. R.A.B. H.W. H.B. A.B. E.C. D.B.H. G.P. and B.H. have performed paid consultancy for Novo Nordisk A/S, and members of NNCT R&D are current or previous employees of Novo Nordisk A/S. T.C. A.F.A. Y.Z. S.V. and D.B.H. performed the work as employees of Lund University but are currently employed by Novo Nordisk A/S (T.C. A.F.A. and S.V.), Takara Bio (Y.Z.), and D.B.H. at Eli Lilly and Company, where she is also a minor share holder. Novo Nordisk A/S is developing the STEM-PD product for commercial use. We support inclusive, diverse, and equitable conduct of research.

Funding Information:
The research leading to these results has received funding from the New York Stem Cell Foundation (grant number # NYSCF-R-I37 ), EU ( FP7 HEALTH-F4-2013-602278 Neurostemcellrepair, H2020 NSC-Reconstruct 874758 and Eurostars projekt E!10838, DOPALAM 2017-01484 ), the European Research Council (ERC grant agreement no. 771427 ), Novo Nordisk A/S , the Swedish Research Council (grant agreements 2016-00873 , 2021-00661 ), The Swedish Parkinson's Association (Parkinsonfonden), the Swedish Brain Foundation (Hjärnfonden FO2019-0301 ), the Strategic Research Areas at Lund University MultiPark (Multidisciplinary research in Parkinson’s disease) and StemTherapy/Lund Stem Cell Center, the Danish Innovation Fund , The Lundbeck Foundation ( R303-2018-3058 and R211-2015-3784 ), Parkinsonforeningen, the Knut and Alice Wallenberg Foundation and the Novo Nordisk Foundation ( NNF21CC0073729 and NNF18OC0030286 ). We would like to thank Ulla Jarl, Michael Sparennius, and Amalie Holm as well as the staff at the Aarhus University Hospital PET Centre (Aage Kristian Olsen Alstrup, David Brooks) and Center for Experimental Neuroscience (CENSE, Dariusz Orlowski) for assistance with the minipig study and Petra Johnels, Ulf Malmqvist, Lisbet Norlander, Sebastian Strunk Möller, Kristina Johansson for support on regulatory and ethical issues. We thank Josefina Dykes, Anette Malmberg, Sabine Apitzsch, and Anna Weddig for clinical and clean room support. We further thank Charlotte Bailey, Sharon Barkatullah, Regine Bergholdt, David Campard, Jeppe Dehli, Frederikke Bjergvang Flagstad, Constanze Hammerle, Kirsten Høstgaard-Jensen, Janne Jensen, Rikke Kaae Kirk, Kristian Kolind, Helle Frimer Larsen, Inge Holm Lauritzen, Karsten Nielsen, Anne Mette Nøhr, Gabriel Pemberton, Christian de Vos Petersen, Johannes Roubroeks, Jonas Lyng Thomsen, Alice Troy, Tanja Villumsen, Johanne Press Wegeberg, Tina Zinck, Anja Dahl Østergren, and Anya Østergård from Novo Nordisk A/S for guidance and support on CMC statistics, technical, and regulatory issues and Marie Jönsson for help with graphical abstract.

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© 2023 The Authors

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