CLBS03

Phase 2 Product Candidate for Recent-Onset Type I Diabetes

Caladrius is currently focused on developing a T-regulatory (Treg) cell-based therapy (CLBS03) for the treatment of type 1 diabetes mellitus (T1DM), using the patient’s own numerically and functionally enhanced Tregs. At the time of T1DM diagnosis, up to 20% of the patient’s insulin producing beta cells remain in the pancreas and, if protected from immune destruction, can be salvaged and restored to function, thus regaining glycemic control and decreasing long-term risks of related complications1. Restoration of beta cells' viability and function can also potentially improve the T1DM patient’s quality of life by decreasing the patient’s dependence on exogenous insulin injections and risk for major hypoglycemia and long term micro- and macrovascular complications.

A Phase 1 open-label uncontrolled dose-escalating study conducted at UCSF and Yale2 provided evidence for safety and tolerability of autologous expanded polyclonal Treg cell therapy (product representative of CLBS03) in 14 adults with established T1DM. Infused Tregs were detected in peripheral circulation for more than 12 months, indicating sustainability post administration. In addition, a Polish Phase 1 open-label controlled study of autologous expanded polyclonal Treg cell therapy in 22 children aged 5-18 with new onset T1DM3 similarly demonstrated safety and tolerability while providing evidence of potential bioactivity, as fasting C-peptide level (an indicator of beta cell function) was maintained, and increased rates of remission and insulin independence were observed in the Treg treatment group. Based on these findings, Caladrius received FDA agreement to conduct a randomized, double-blind, placebo-controlled Phase 2 study to further investigate the CLBS03 therapy in adolescents with recent-onset T1DM. The FDA also granted CLBS03 Fast Track and Orphan Drug designation for the treatment of T1DM, making it the first known therapeutic candidate for treatment of T1DM to receive the Fast Track designation. In addition to these designations in the US, the European Medicines Agency granted CLBS03 Advanced Therapeutic Medicinal Product (ATMP) classification. These designations provide benefits and expedite the process toward commercialization.

The Sanford Project: T-Rex Study Phase 2 in adolescents with recent onset T1D

Description
  • Double-blind, placebo-controlled, randomized trial
  • Adolescent patients ages 12 to 17 with recent onset of T1DM
Key EndpointsPreservation of C-peptide level, insulin use, severe hypoglycemic episodes, glucose and hemoglobin A1c levels
Powering80% power to detect a 0.2 pmol/mL difference in AUC mean MMTT-stimulated C-peptide between active and placebo
Study Size
  • 111 patients planned
  • Approximately 12 sites expected in the USA
  • Supported by strategic collaboration with Sanford Research – The Sanford Project providing operational resources and capital
TreatmentSingle dose of CLBS03 (dose cohorts of 2.5 or 20 million cells/kg) or placebo infusion

For more information, please visit the trial at www.clinicaltrials.gov.

The Sanford Project: T-Rex Study Executive Steering Committee

References:
  1. Lernmark Å. (2013) Depleting t cells in newly diagnosed autoimmune (type 1) diabetes—are we getting anywhere? Diabetes, 62:3669-3670.
  2. Bluestone, J., et al. (2015) Type 1 diabetes immunotherapy using polyclonal regulatory T cells. Science Translational Medicine, 7 (315).
  3. Marek-Trzonkowsa, N., et al. (2014) Therapy of type 1 diabetes with CD4(+)CD25(high)CD127-regulatory T cells prolongs survival of pancreatic islets - results of one year follow-up. Clin Immunol., 7 (315): 315ra189. http://www.ncbi.nlm.nih.gov/pubmed/24704576