Pioneering Cell Transplants for the Treatment of Spinal Cord Injury
Contributed by Lineage Cell Therapeutics
Each year, spinal cord injury (SCI) affects an estimated 18,000 individuals in the United States, with less than 1% of those experiencing complete neurologic recovery upon hospital discharge. Current treatments primarily focus on rehabilitation, assistive devices, medications, and surgery; however, these only provide benefits in mitigating symptoms, improving mobility, stabilizing the spine, and reducing pain.
At Lineage Cell Ther
apeutics (Lineage), our mission is to pioneer a new branch of medicine, based on the transplant of fully-functional “replacement” cells for people impacted by serious conditions, including SCI. Lineage is developing OPC1, an investigational cell transplant, for the treatment of SCI. OPC1 is comprised of a population of neuronal cells which are intended to replace and restore the function of the cells which were damaged in SCI. Specifically, OPC1 contains oligodendrocyte progenitor cells (OPCs), which are naturally-occurring precursors to the cells which provide electrical insulation to nerve axons in the form of a myelin sheath.
Cell transplants like OPC1, offer patients the opportunity to receive healthy replacement cells (grown in a laboratory) to replace their existing cells that may be dysfunctional, damaged, or destroyed, such as in the case of persons affected by spinal cord injuries.
The OPC1 transplant is designed to replace or support cells that are absent or dysfunctional due to traumatic injury, with a goal to help improve the quality of life and restore or augment functional activity in persons suffering from traumatic cervical or thoracic SCIs, through a combination of possible mechanisms.
To date, 5 patients with thoracic spinal cord injuries and 25 patients with cervical spinal cord injuries have been enrolled in clinical trials of OPC1, with results from both studies published in the Journal of Neurosurgery Spine. The clinical development of OPC1 has been partially funded by a $14.3 million grant from the California Institute for Regenerative Medicine.
In a phase 1 clinical trial of OPC1 for the treatment of thoracic SCI, all subjects were followed for at least 10 years: there were no unexpected serious adverse events attributable to the OPC1 cell transplant and no evidence of neurological decline, enlarging masses, further spinal cord damage or syrinx formation. In a Phase 1/2a clinical trial of OPC1 for the treatment of cervical SCI, all subjects were evaluated for at least 2 years: there were no unexpected serious adverse events related to the OPC1 cell transplant, no enrolled patients had worsening of neurological function and there was an indication of functional benefit compared to best available matched control (32% gained two or more levels of function within 12 months based on ISNCSCI scores).
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OPC1 is currently in long-term follow-up from the Phase 1/2a multicenter clinical trial for cervical SCI. Some individual patient perspectives are available here: Chris’ s story and Jake’s story.
On February 13, 2024, Lineage announced the clearance by the U.S. Food and Drug Administration (FDA) of its Investigational New Drug amendment (INDa) to enable clinical testing for the OPC1 program to continue. Pursuant to the IND, Lineage has initiated activities to open its first clinical site in the DOSED (Delivery of Oligodendrocyte Progenitor Cells for Spinal Cord Injury: Evaluation of a Novel Device) clinical study, to evaluate the safety and utility of a novel spinal cord delivery device in subacute, and for the first time, chronic SCI patients.
“With so few opportunities for SCI patients to participate in clinical trials, it is a privilege to engage with the SCI community as part of our efforts to improve outcomes for individuals with a debilitating condition for which there currently are no FDA-approved treatments. The clearance of our INDa and the initiation of OPC1 clinical testing under our sponsorship represents a significant milestone for this program, and highlights our commitment to developing modern cell therapy product candidates. We are excited by the opportunity to build upon the promising results achieved with OPC1 in previous trials, and to continue to seek improvements in how our therapy is prepared and administered. The DOSED clinical study is intended to evaluate the safety and performance of a new delivery device, which is compatible with our forthcoming off-the-shelf “immediate-use” formulation, and which does not require cessation of patient ventilation during administration. We believe these improvements can lead to a safer surgical procedure for surgeons and patients. This study also will mark the first time that OPC1 is administered to chronic SCI patients, and we will be collecting efficacy assessments in addition to the primary outcome measures of safety,” stated Brian M. Culley, Lineage CEO.
All presentations and panels from the 2023 SCI Investor Symposium can be viewed here. Be sure to follow the Reeve Foundation and Lineage for updates on the 2nd annual SCI Symposium.
You can learn more about Lineage here, or by following the Company on Twitter @LineageCell. Our commitment is to continue pioneering in this field, with the hope of bringing life-changing treatments to those affected by SCI.