Testing a new treatment for frontotemporal dementia caused by progranulin mutations

A Phase 1/2 Ascending Dose Study to Evaluate the Safety and Effects on Progranulin Levels of LY3884963 in Patients With Fronto-Temporal Dementia With Progranulin Mutations (FTD-GRN)

This study is testing a new treatment for frontotemporal dementia linked to specific gene mutations to see if it is safe and effective for patients over five years.

Quick facts

• Phase: Phase1; Phase2
• Study type: Interventional
• Enrollment: 30 (estimated)
• Ages: 30 Years to 85 Years
• Sex: All
• Sponsor: Prevail Therapeutics (Industry-sponsored)
• Locations: 11 sites (Maitland, Florida and 10 other locations)
• Trial ID: NCT04408625 on ClinicalTrials.gov

What this trial studies

This clinical trial is a Phase 1/2, multi-center, open-label study designed to evaluate the safety and effects of LY3884963, administered via intra-cisternal injection, in patients with frontotemporal dementia associated with progranulin mutations. The trial will involve escalating doses to assess tolerability and efficacy over a total duration of five years, with the first year focused on safety and biomarker evaluation. Participants will be monitored for changes in clinical outcomes and selected biomarkers over the subsequent four years.

Who should consider this trial

Good fit: Ideal candidates are men and women aged 30 to 85 with symptomatic frontotemporal dementia and a confirmed pathogenic progranulin gene mutation.

Not a fit: Patients without progranulin mutations or those with other forms of dementia may not benefit from this treatment.

Why it matters

Potential benefit: If successful, this treatment could improve the management of frontotemporal dementia in patients with specific genetic mutations.

How similar studies have performed: While this approach is novel, similar gene therapy studies have shown promise in other neurodegenerative conditions.

Eligibility criteria

Inclusion Criteria:

* Men or women aged 30 to 85 years (inclusive), at the time of informed consent.
* Body weight range of ≥40 kg (88 lbs) to ≤110 kg (242 lb) and a BMI of 18 to 34 kg/m2.
* Has symptomatic frontotemporal dementia (FTD), including mild behavioral, cognitive, motor or language impairment per Investigator's assessment (behavioral-variant FTD, primary progressive aphasia-FTD, FTD with corticobasal syndrome, or a combination of syndromes are allowed for enrollment).
* Score ≥0.5 and ≤15 on CDR plus NACC FTLD sum of boxes.
* Stable use of background medications at least 8 weeks prior to LY3884963 dosing.
* Carrier of a pathogenic progranulin gene (GRN) mutation.
* Negative screening test for Mycobacterium tuberculosis (MTB) or documented negative MTB test within 1year prior to screening.
* Age- and gender-appropriate cancer screenings are up-to-date and completed.
* Patient and/or patient's legally authorized representative has the ability to understand the purpose and risks of the study, and provide written informed consent and authorization to use protected health information.
* Patient has a reliable study partner/informant (e.g. family member, friend) willing and able to participate in the study as a source of information on the patient's health status and cognitive and functional abilities.
* Patient is not dependent on a walker or wheelchair.
* Patient is living in the community (i.e. not in nursing home); some levels of assisted living may be permitted at the discretion of the investigator.
* Pneumococcal pneumonia and shingles vaccines are required within 10 years of Screening (allowed to be performed during Screening but must be given at least 4 weeks prior to initiation of immunosuppressant regimen).

Exclusion Criteria:

* Diagnosis of a significant CNS (central nervous system) disease other than frontotemporal dementia (FTD) that may cause FTD symptoms or confound study objectives.
* Brain or cervical spine magnetic resonance image (MRI)/MRA imaging showing clinically significant abnormality considered to prevent intracisternal magna (ICM) injection.
* Hypersensitivity or contraindications to corticosteroid, and/or sirolimus use.
* Clinical evidence of peripheral symmetric sensory polyneuropathy (stable sensory mononeuropathies and radiculopathies are not exclusionary).
* Concomitant disease or condition within 6 months of screening that could interfere with, or treatment of which might interfere with, the conduct of the study or that would, in the opinion of the investigator, pose an unacceptable safety risk to the patient or interfere with the patient's ability to comply with study procedures
* Clinically significant laboratory test result abnormalities assessed at screening.
* Participation within 3 months prior to screening in another therapeutic investigational drug or device study with purported disease-modifying effects on FTD, unless it can be documented that the patient received placebo only.
* Any type of prior gene or cell therapy.
* Live vaccines in the 4 weeks prior to Screening. NOTE: Pneumococcal vaccine and/or shingles vaccine administration is allowed at least 4 weeks prior to initiation of immunosuppressant regimen.
* Use of blood thinners in the 2 weeks prior to screening, or anticipated use of blood thinners during the study. Antiplatelet therapies are acceptable if the patient is medically able to temporarily stop 48 hours to 7 days (depending on the antiplatelet medication used) prior to and at least 48 hours after ICM injection and LP. Note: the use of blood thinners as part of prophylaxis or treatment of an emergent VTE or another AE during the study does not exclude the patient, unless there is a baseline high risk of thromboembolic events, and use of blood thinners is highly anticipated in the opinion of the Investigator.
* Contraindications or intolerance to imaging methods (MRA, MRI, and/or computed tomography \[CT\]), including claustrophobia and intolerance to contrast agents used for MRI, MRA, or CT (including, but not limited to, gadolinium contrast agents and iohexol).
* Contraindications to general anesthesia or deep sedation.
* Positive urine test for drugs of abuse (including opiates, amphetamines, cocaine, barbiturates, and phencyclidine) without prescription at Screening and on Day 1.

Other protocol-defined inclusion/exclusion criteria may apply

Where this trial is running

Maitland, Florida and 10 other locations

• k2 Medical Research-Maitland — Maitland, Florida, United States (Recruiting)
• PPD Phase 1 Clinic, 100 West Gore Street, Suite 202 — Orlando, Florida, United States (Completed)
• Hospital of the University of Pennsylvania, 3 West Gates Building, 3400 Spruce Street — Philadelphia, Pennsylvania, United States (Recruiting)
• Royal Prince Alfred Hospital, Brain & Mind Research Institute, 94 Mallet Street — Camperdown, New South Wales, Australia (Recruiting)
• UZ Leuven, Neurologie Herestraat 49 — Leuven, Belgium (Recruiting)
• AP-HM Hôpital de La Timone — Saint-Pierre, Marseille, France (Recruiting)
• Centre Mémoire de Ressources — Lille, France (Recruiting)
• Le Ber, Institut du Cerveau et de la Moelle Epinière — Paris, France (Recruiting)
• Hospital Clinic de Barcelona, Villaroel 170 Servicio de Neurología — Barcelona, Spain (Completed)
• Hospital Universitario de Donostia, Servicio De Neurologia, Consultas Externas Neurologia, San Sebastian, Guipúzcoa — San Sebastian, Spain (Completed)
• University College London,Queen Square, Dementia Research Building, London, — London, United Kingdom (Recruiting)

Study contacts

• Study coordinator: Prevail Therapeutics

Conditions Frontotemporal Dementia; Fronto-Temporal Dementia; Progranulin Mutations; FTD-GRN; Gene Therapy; Dementia Gene Therapy; AAV9