학술논문
Cell Therapy for Chronic TBI: Interim Analysis of the Randomized Controlled STEMTRA Trial.
Document Type
article
Author
Kawabori, Masahito; Weintraub, Alan H; Imai, Hideaki; Zinkevych, Laroslav; McAllister, Peter; Steinberg, Gary K; Frishberg, Benjamin M; Yasuhara, Takao; Chen, Jefferson W; Cramer, Steven C; Achrol, Achal S; Schwartz, Neil E; Suenaga, Jun; Lu, Daniel C; Semeniv, Ihor; Nakamura, Hajime; Kondziolka, Douglas; Chida, Dai; Kaneko, Takehiko; Karasawa, Yasuaki; Paadre, Susan; Nejadnik, Bijan; Bates, Damien; Stonehouse, Anthony H; Richardson, R Mark; Okonkwo, David O
Source
Neurology. 96(8)
Subject
Language
Abstract
ObjectiveTo determine if chronic motor deficits secondary to traumatic brain injury (TBI) can be improved by implantation of allogeneic modified bone marrow-derived mesenchymal stromal/stem cells (SB623).MethodsThis 6-month interim analysis of the 1-year double-blind, randomized, surgical sham-controlled, phase 2 STEMTRA trial (NCT02416492) evaluated safety and efficacy of the stereotactic intracranial implantation of SB623 in patients with stable chronic motor deficits secondary to TBI. Patients in this multi-center trial (N = 63) underwent randomization in a 1:1:1:1 ratio to 2.5 × 106, 5.0 × 106, 10 × 106 SB623 cells or control. Safety was assessed in patients who underwent surgery (N = 61), and efficacy in the modified intent-to-treat population of randomized patients who underwent surgery (N = 61; SB623 = 46, control = 15).ResultsThe primary efficacy endpoint of significant improvement from baseline of Fugl-Meyer Motor Scale score at 6 months for SB623-treated patients was achieved. SB623-treated patients improved by (LS mean [SE]) +8.3 (1.4) vs +2.3 (2.5) for control at 6 months, the LS mean difference was 6.0 (95% CI: 0.3-11.8); p = 0.040. Secondary efficacy endpoints improved from baseline, but were not statistically significant vs control at 6 months. There were no dose-limiting toxicities or deaths, and 100% of SB623-treated patients experienced treatment-emergent adverse events vs 93.3% of control patients (p = 0.25).ConclusionsSB623 cell implantation appeared to be safe and well tolerated, and patients implanted with SB623 experienced significant improvement from baseline motor status at 6 months compared to controls.Classification of evidenceThis study provides Class I evidence that implantation of SB623 was well tolerated and associated with improvement in motor status.