This Phase 1 study evaluates the safety and tolerability of ATORM-C in patients with Crohn's disease. ATORM-C is an investigational product consisting of autologous adult stem cell-derived intestinal organoids. Participants will receive a single dose of ATORM-C applied directly to a target intestinal ulcer during colonoscopy. The study will also explore the effect of ATORM-C on intestinal ulcer healing.
This is an open-label, sequential dose-escalation Phase 1 study to evaluate the safety, tolerability, and exploratory efficacy of ATORM-C across three dose levels in patients with Crohn's disease. ATORM-C is manufactured by culturing and expanding autologous adult stem cell-derived intestinal organoids isolated from each participant's intestinal tissue. Participants will receive a single administration of ATORM-C directly applied to a target intestinal ulcer during colonoscopy. Primary evaluations will focus on safety and tolerability, with exploratory assessments of ATORM-C's effect on intestinal ulcer healing.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
18
ATORM-C is an investigational product consisting of autologous adult stem cell-derived intestinal organoids. Participants will receive a single administration of ATORM-C applied directly to the target intestinal ulcer during colonoscopy. ATORM-C is administered with fibrin glue (Greenplast-Q) to facilitate local application to the target ulcer.
Asan Medical Center
Seoul, South Korea
RECRUITINGDose-Limiting Toxicities (DLTs)
Occurrence of dose-limiting toxicities (DLTs). A DLT is defined as any Grade 3 or higher adverse reaction according to NCI CTCAE v5.0 that is assessed as possibly, probably, or certainly related to ATORM-C. CTCAE grades range from Grade 1 (mild) to Grade 5 (death related to an adverse event), with higher grades indicating greater severity.
Time frame: From ATORM-C administration through 4 weeks post-dose
Determination of Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D)
The MTD and RP2D of ATORM-C will be determined based on the occurrence of dose-limiting toxicities (DLTs) during the dose-escalation period and the overall safety and tolerability of ATORM-C.
Time frame: From ATORM-C administration through 24 weeks post-dose
Incidence of Adverse Events (AEs) and Adverse Events of Special Interest (AESIs)
Occurrence of treatment-emergent adverse events (TEAEs), adverse drug reactions (ADRs), serious adverse events (SAEs), serious adverse drug reactions (SADRs), adverse events of special interest (AESIs), and administration site local adverse events. Adverse events leading to discontinuation of study treatment or death will also be evaluated.
Time frame: From ATORM-C administration through 24 weeks post-dose
Changes in Clinical Laboratory Tests, Vital Signs, Physical Examinations, and 12-Lead Electrocardiograms (ECGs)
Changes from baseline in continuous safety parameters, including clinical laboratory tests and vital signs, evaluated at protocol-specified visits. Occurrence of clinically significant abnormalities (Abnormal CS) in clinical laboratory tests, physical examinations, and 12-lead electrocardiograms (ECGs) post-dose will also be evaluated.
Time frame: Baseline through 24 weeks post-dose, at protocol-specified visits
Change from Baseline in Target Ulcer Size
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Absolute change and percentage change from baseline in the size of the target ulcer, evaluated based on the longest diameter, shortest diameter, and total surface area measured during colonoscopy at protocol-specified time points.
Time frame: Baseline and Weeks 4, 12, and 24 post-dose
Change from Baseline in Modified Global Histologic Disease Activity Score (Modified GHAS) of the Target Ulcer
Change from baseline in the Modified Global Histologic Disease Activity Score (Modified GHAS) based on histologic evaluation of mucosal biopsy specimens collected from the target ulcer. The regional Modified GHAS ranges from 0 to 12, with higher scores indicating greater histologic disease activity.
Time frame: Baseline and Week 24 post-dose
Change from Baseline in Simple Endoscopic Score for Crohn's Disease (SES-CD) of the Target Ulcer
Change from baseline in the Simple Endoscopic Score for Crohn's Disease (SES-CD) total score and ulcer size subscore evaluated specifically for the target ulcer via colonoscopy. The SES-CD assessed for the target ulcer evaluates 4 endoscopic variables, each scored from 0 to 3, yielding a target ulcer regional score ranging from 0 to 12. Higher scores indicate greater endoscopic disease activity.
Time frame: Baseline and Weeks 4, 12, and 24 post-dose
Proportion of Participants Achieving ≥50% Reduction from Baseline in SES-CD Score of the Target Ulcer
Percentage of participants who achieve a 50% or greater reduction from baseline in the Simple Endoscopic Score for Crohn's Disease (SES-CD) total score for the target ulcer at Week 24 post-dose. The regional target ulcer SES-CD ranges from 0 to 12, with higher scores indicating greater endoscopic disease activity.
Time frame: Baseline and Week 24 post-dose
Proportion of Participants Achieving Endoscopic Remission of the Target Ulcer
Percentage of participants achieving endoscopic remission of the target ulcer at Week 24 post-dose. Endoscopic remission is defined as a Simple Endoscopic Score for Crohn's Disease (SES-CD) total score of less than 2 (\<2) for the target ulcer. The regional target ulcer SES-CD ranges from 0 to 12, with higher scores indicating greater endoscopic disease activity.
Time frame: Baseline and Weeks 4, 12, and 24 post-dose