A phase II study of human allogeneic liver-derived progenitor cell therapy for acute-on-chronic liver failure and acute decompensation.

ACLF, acute-on-chronic liver failure AD, acute decompensation of liver cirrhosis AE, adverse event AESI, AE of special interest ATMP, advanced therapy medicinal product Alcoholic liver disease BW, body weight CRP, C-reactive protein EASL-CLIF, European Association for the Study of Chronic Liver Failure HALPC, human allogeneic liver-derived progenitor cells INR, international normalised ratio Liver regenerative medicine MELD, model for end-stage liver disease MSC, mesenchymal stem cells SAE, serious AE SAS, safety analysis set SUSAR, suspected unexpected serious adverse reaction Stem cell TEG, thromboelastography TGT, thrombin generation test i.v., intravenous

Journal

JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 22 09 2020
revised: 16 03 2021
accepted: 07 04 2021
entrez: 25 6 2021
pubmed: 26 6 2021
medline: 26 6 2021
Statut: epublish

Résumé

Human allogeneic liver-derived progenitor cells (HALPC, HepaStem®; Promethera Biosciences, Mont-Saint-Guibert, Belgium) are an advanced therapy medicinal product that could potentially alleviate systemic inflammation and ameliorate liver function in patients with acute-on-chronic liver failure (ACLF) or acute decompensation of cirrhosis (AD). This open-label phase II study was conducted in 9 centres in Belgium, Spain, and Bulgaria between 2016 and 2019. The primary objective was to assess the safety of HALPC therapy up to Day 28 and the secondary objectives were to assess its safety and preliminary efficacy up to Month 3. The 24 treated patients (mean age: 51 years) were mostly male with an alcoholic cirrhosis. On pre-infusion Day 1, 15 patients had ACLF and 9 patients had AD. Two of the 3 initial patients treated with high HALPC doses (∼5×10 The treatment of patients with ACLF or AD with up to 2 doses of 1.2×10 EudraCT 2016-001177-32. Patients with liver cirrhosis may suffer from the rapid onset of organ failure or multiple organ failure associated with a high risk of death in the short term. This clinical study of 24 patients suggests that an advanced therapy based on the intravenous infusion of low doses of human allogeneic liver-derived progenitor cells is safe and supports the next phase of clinical development of this type of therapy.

Sections du résumé

BACKGROUND & AIMS OBJECTIVE
Human allogeneic liver-derived progenitor cells (HALPC, HepaStem®; Promethera Biosciences, Mont-Saint-Guibert, Belgium) are an advanced therapy medicinal product that could potentially alleviate systemic inflammation and ameliorate liver function in patients with acute-on-chronic liver failure (ACLF) or acute decompensation of cirrhosis (AD).
METHODS METHODS
This open-label phase II study was conducted in 9 centres in Belgium, Spain, and Bulgaria between 2016 and 2019. The primary objective was to assess the safety of HALPC therapy up to Day 28 and the secondary objectives were to assess its safety and preliminary efficacy up to Month 3.
RESULTS RESULTS
The 24 treated patients (mean age: 51 years) were mostly male with an alcoholic cirrhosis. On pre-infusion Day 1, 15 patients had ACLF and 9 patients had AD. Two of the 3 initial patients treated with high HALPC doses (∼5×10
CONCLUSIONS CONCLUSIONS
The treatment of patients with ACLF or AD with up to 2 doses of 1.2×10
CLINICAL TRIALS REGISTRATION BACKGROUND
EudraCT 2016-001177-32.
LAY SUMMARY BACKGROUND
Patients with liver cirrhosis may suffer from the rapid onset of organ failure or multiple organ failure associated with a high risk of death in the short term. This clinical study of 24 patients suggests that an advanced therapy based on the intravenous infusion of low doses of human allogeneic liver-derived progenitor cells is safe and supports the next phase of clinical development of this type of therapy.

Identifiants

pubmed: 34169246
doi: 10.1016/j.jhepr.2021.100291
pii: S2589-5559(21)00067-7
pmc: PMC8207211
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100291

Informations de copyright

© 2021 The Author(s).

Déclaration de conflit d'intérêts

NC-C, IS, NG, YV, SM, and VB are employees of Promethera Biosciences. MN is a founder, patent holder, and consultant of Promethera Biosciences and employee of UCLouvain. ES is a founder, patent holder, consultant and board member of Promethera Biosciences and employee of UCLouvain. TG is an advisory board member for Promethera Biosciences and for Goliver Therapeutics, and is a recipient of a grant from Gilead Sciences Inc. FN, P-FL, LL, LH, VV, DL, and AA report no conflicts of interest. Please refer to the accompanying ICMJE disclosure forms for further details.

Références

N Engl J Med. 2020 May 28;382(22):2137-2145
pubmed: 32459924
PLoS One. 2012;7(8):e42819
pubmed: 22900053
Cell Transplant. 2007;16(7):717-28
pubmed: 18019361
J Crit Care. 2018 Feb;43:54-60
pubmed: 28843665
Front Immunol. 2019 Mar 19;10:476
pubmed: 30941129
Ann Hepatol. 2013 Sep-Oct;12(5):713-24
pubmed: 24018489
Stem Cells Dev. 2015 Oct 1;24(19):2269-79
pubmed: 26192403
Nat Rev Dis Primers. 2016 Jun 09;2:16041
pubmed: 27277335
Transplantation. 2017 Aug;101(8):1845-1851
pubmed: 28738402
Stem Cells. 2018 Nov;36(11):1778-1788
pubmed: 30063804
J Immunol Res. 2019 Sep 12;2019:8250584
pubmed: 31612154
Gastroenterology. 2013 Jun;144(7):1426-37, 1437.e1-9
pubmed: 23474284
Cell Transplant. 2012;21(10):2241-55
pubmed: 22525602
Stem Cells Transl Med. 2012 Oct;1(10):725-31
pubmed: 23197664
Trends Mol Med. 2019 Feb;25(2):149-163
pubmed: 30711482
Hepatology. 2017 Jul;66(1):209-219
pubmed: 28370357
Transplantation. 2019 Sep;103(9):1903-1915
pubmed: 30801523
Stem Cells Transl Med. 2017 Jun;6(6):1445-1451
pubmed: 28452204
Stem Cell Res Ther. 2020 Feb 7;11(1):51
pubmed: 32028991
Hepatol Int. 2015 Jul;9(3):355-9
pubmed: 25788183
J Hepatol. 2018 Aug;69(2):406-460
pubmed: 29653741
Hepatology. 2005 Mar;41(3):553-8
pubmed: 15726661
Stem Cells Int. 2017;2017:2679518
pubmed: 28491094
Hepatology. 2016 Dec;64(6):2165-2172
pubmed: 27696493
Lancet. 2008 May 10;371(9624):1579-86
pubmed: 18468541
Gut. 2010 Nov;59(11):1561-9
pubmed: 20675694
Hepatobiliary Surg Nutr. 2018 Oct;7(5):331-344
pubmed: 30498709
Hematology Am Soc Hematol Educ Program. 2015;2015:243-9
pubmed: 26637729
Sci Rep. 2016 May 05;6:25487
pubmed: 27146801
Stem Cell Res Ther. 2017 Jun 5;8(1):131
pubmed: 28583205
Gastroenterology. 2008 May;134(5):1360-8
pubmed: 18471513
Hepatology. 2013 Mar;57(3):1153-62
pubmed: 23213075
Stem Cells. 2014 Sep;32(9):2430-42
pubmed: 24805247
Crit Care Med. 2017 Oct;45(10):1616-1624
pubmed: 28640024
Hepatology. 2015 Jul;62(1):232-42
pubmed: 25800029
Gut. 2019 Oct;68(10):1872-1883
pubmed: 30580251
J Hepatol. 2020 Apr;72(4):688-701
pubmed: 31778751
Hepatology. 2019 May;69(5):2150-2163
pubmed: 30615211

Auteurs

Frederik Nevens (F)

Department of Gastroenterology and Hepatology, University Hospitals, KU Leuven, Belgium.

Thierry Gustot (T)

Department of Gastroenterology and Hepato-Pancreatology, C.U.B. Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Pierre-François Laterre (PF)

Intensive Care Unit, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.

Luc L Lasser (LL)

Gastroenterology Clinic, CHU Brugmann, Brussels, Belgium.
Department of Hepatogastroenterology, CHU Brugmann, Brussels, Belgium.

Lyudmil E Haralampiev (LE)

Department of Internal Diseases, Multiprofile Hospital for Active Treatment (MEDICA), Ruse, Bulgaria.

Victor Vargas (V)

Liver Unit, Hospital Vall d'Hebron, Universitat Autònoma Barcelona, CIBERehd, Barcelona, Spain.

Desislava Lyubomirova (D)

Department of Clinical Gastroenterology with Hepatology, Gastroenterology Clinic, University Multiprofile Hospital for Active Treatment "Georgi Stranski", Pleven, Bulgaria.

Agustin Albillos (A)

Gastroenterology and Hepatology, University Hospital Ramón y Cajal, Madrid, Spain.

Mustapha Najimi (M)

UCLouvain, Institute of Experimental and Clinical Research (IREC), Laboratory of Pediatric Hepatology and Cell Therapy (PEDI), Brussels, Belgium.

Sébastien Michel (S)

Promethera Biosciences, Mont-Saint-Guibert, Belgium.

Ivaylo Stoykov (I)

Promethera Biosciences, Mont-Saint-Guibert, Belgium.

Noelia Gordillo (N)

Promethera Biosciences, Mont-Saint-Guibert, Belgium.

Yelena Vainilovich (Y)

Promethera Biosciences, Mont-Saint-Guibert, Belgium.

Virginie Barthel (V)

Promethera Biosciences, Mont-Saint-Guibert, Belgium.

Nathalie Clerget-Chossat (N)

Promethera Biosciences, Mont-Saint-Guibert, Belgium.

Etienne M Sokal (EM)

UCLouvain, Institute of Experimental and Clinical Research (IREC), Laboratory of Pediatric Hepatology and Cell Therapy (PEDI), Brussels, Belgium.
Promethera Biosciences, Mont-Saint-Guibert, Belgium.
Cliniques Universitaires Saint-Luc, UCLouvain, Pediatric Hepatology & Gastroenterology Unit, Brussels, Belgium.

Classifications MeSH