The aim of this single center, single arm and prospective study is to explore the safety and efficacy of hDMSCs in the treatment of radiation pneumonitis.
As a single-center, single-arm, prospective clinical trial, this study aims to explore the safety and efficacy of hDMSCs in the treatment of radiation pneumonia. This study will include patients who have received chest radiation therapy and are diagnosed with radiation lung injury based on clinical manifestations and changes in chest CT imaging. The degree of lung injury is graded according to CTCAE v5.0 criteria, and the corresponding standard treatment is received according to its grade. Using the 3+3 design for dose climbing, according to the order of patient inclusion, the first 3 patients (cohort 1) are treated with a standard treatment regimen combined with a pre-specified starting dose of dead mesenchymal stem cells (this study does not set up a live MSC group as a control). There are currently no relevant research results of previous human trials. The starting dose is obtained by our preclinical research. The mouse dose is 1×10\^5/pc/30g, that is, the effective dose of mice is 3.3×10\^6/kg. The dose of mice is 10 times that of humans, and the effective dose of humans is 3.3×10\^5/kg. Therefore, the clinical effective dose of 60kg patients is 2.0×10\^7, infusion every 3 days, continuous infusion 4 times, treatment duration of 4\~6 weeks. During the dose-limited toxicity (DLT) observation period (30 days), observe the number of cases of DLT in 3 patients to determine whether to maintain the current dose group or adjust the dose group. If the dose of dead mesenchymal stem cells needs to be increased, the dose is ramped up by 3 times the starting dose (i.e., the second gradient dose is 6.0×10\^7) until the number of patients in either dose group reaches 6 or the dose group adjustment is not possible. To determine the optimal therapeutic dose for the treatment of radiation lung injury using death mesenchymal stem cells in combination with standard therapy. A total of 15 patients were planned to be included in this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
A standard treatment regimen combined with a pre-specified starting dose of dead mesenchymal stem cells (2.0×10\^7 for 60kg patient), infusion every 3 days, continuous infusion 4 times, treatment duration is 4\~6 weeks.
West China Hospital
Chengdu, Sichuan, China
RECRUITINGThe number of adverse events
The number of adverse events occurring within a given time frame will be reported according to CTCAE v5.0 to assess overall safety.
Time frame: up to 1 year
Chest contrast-enhanced CT will be used to assess changes in lung injury after treatment
Chest contrast-enhanced CT will be performed at 1, 2, 3, 6, and 12 months after completion of dead mesenchymal stem cell injection, and the change in the proportion of total lesions to total lung volume will be calculated, i.e., (proportion of total lesions to total lung volume - proportion of total lesions to total lung volume at baseline) / proportion of total lesions to total lung volume at baseline.
Time frame: up to 1 year
Blood gas analysis will be performed after 1 month of dead mesenchymal stem cell injection.
At 1 month after completion of the injection of dead mesenchymal stem cells, changes in blood gas analysis will be observed to assess lung function.
Time frame: up to 1 year
Pulmonary function test will be performed after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
At after 1, 2, 3, 6, 12month completion of the injection of dead mesenchymal stem cells, pulmonary function test will be performed to assess recovery of lung function.
Time frame: up to 1 year
6-minute walking tests will be performed after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
At 1, 2, 3, 6 and 12 months after the completion of dead mesenchymal stem cell therapy, 6-minute walking tests will be performed to evaluate the recovery of the subjects' cardiopulmonary condition.
Time frame: up to 1 year
St. George's Respiratory Questionnaire will be completed to estimate the quality of life after 1, 2, 3, 6, 12month of dead mesenchymal stem cell injection.
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At 1, 2, 3, 6 and 12 months after the completion of dead mesenchymal stem cell therapy, St. George's Respiratory Questionnaire will be completed to evaluate the subjects' quality of life.
Time frame: up to 1 year