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Industry-sponsored cardiovascular cell therapies. Some metrics.

Posted: May 27, 2012 at 3:57 pm

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Cell therapies for cardiovascular-related conditions is a closely watched, much studied, oft-discussed, and hotly contested segment of the cell therapy industry.


The data to-date are admittedly confusing.  From a clinical perspective, the studies for which we have data have been relatively small involving a mish-mash of indications, endpoints, eligibility criterion, methods and/or route of administration, as well as the time of administration relative to event or disease progression.


Further compounding any interpretation of the data, from a technical perspective, is the fact the products have been widely varied in terms of being autologous vs allogeneic, expanded and not, genetically modified and not, from a plethora of different sources, and utilizing a wide variety of cell types from skelatal myoblasts, cardiomyocytes, mesenchymal stromal cells, mononuclear cells, etc. 


All this makes it extremely difficult to draw any conclusions with respect to what's working and what's not.  We will not attempt to do so.


All we do below is attempt to give a snapshot of the industry-sponsored cell therapy trials currently ongoing for cardiovascular-related conditions.  So here it is:


Commercial:
Pharmicell's Heartcelligram is the only cell therapy to have received regulatory approval for commercial distribution for the treatment of a cardiac-related indication.  Heartcelligram is an autologous cell therapy approved in 2011 by the Korean Food and Drug Administration (KFDA) for the treatment of Acute Mycardial Infarction (AMI).  The price is reportedly $19,000 and the trial data behind the approval has not yet been published in a peer-reviewed journal.


Phase III or II/III:
There are currently only 3 active and recruiting cardiac-related, industry-sponsored cell therapy trials.  Interestingly they all involve autologous products, two involve devices, two involve centralized manufacturing, two involve bone marrow cells as a source, two are only in European clinical sites, and two are targeting ischemic-related conditions.

  • Baxter Therapeutics' Auto-CD34+ cells
  • Cytori
Two companies warrant particular mention at this stage as they appear to be in transition between phases II and III.

Cardio3 Biosciences initially designed a trial of their autologous C-Cure in heart failure secondary to ischemic cardiomyopathy to be a phase II/III trial enrolling 240 patients.  While the trial began in late 2008 and is still registered as active but no longer recruiting on ClinicalTrials.gov the entry has not been updated for almost a year.  

In 2010 the company announced that after enrolling 45 patients - of which 21 were in the treatment arm (24 in the control arm) - they decided to close the study to future enrollment and prepare for a phase III trial.  This decision was reportedly based on "very encouraging data". 

Dr. Christian Homsy, CEO of Cardio3 BioSciences provided the following guidance: “The highly promising data we report today build on the favourable safety profile we have observed through this Phase II trial and documents in patients our belief that we have with  C-Cure a product candidate with the potential to make a real difference in the treatment of heart failure... As noted in the company’s press release of 29 June 2010, with the Phase II stage completed and to allow for potential modifications to the trial protocol, Cardio3 BioSciences has not proceeded to Phase III recruitment into the trial but has continued to gather all data for the six month analysis. Through the Phase II trial, we gained significant  experience in working with a highly innovative stem cell therapy in a clinical setting, and we are using this acquired knowledge in the design of our planned Phase III programme."  The phase III trial of C-Cure is expected to commence in the second half of 2012.

Mesoblast has also announced with its strategic partner, Teva, that they are proceeding with plans to conduct a phase III study of its allogeneic cell therapy product, Revascor, in chronic heart failure.  Most anticipate this clinical trial application to be filed sometime in late 2012.


Phase I or II:
There are over 20 active, industry-sponsored earlier-stage trials (phase I, I/II or II) for cardiovascular-related conditions.  At least 5 of these are expected to have clinical readouts this year.   



Hope this is useful.

--

This post has been brought to you by your friends at CTG.  All cell therapy. All the time. 🙂  

-- Lee @celltherapy

p.s.  As always we welcome your feedback, comments, and corrections.  
























































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Posted in Regenerative Medicine | Comments Off on Industry-sponsored cardiovascular cell therapies. Some metrics.

Psychiatry's "Bible" Gets an Overhaul (preview)

Posted: May 27, 2012 at 3:57 pm

Editor's Note: Read our blog series on psychiatry's new rulebook, the DSM-5.

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A Look at the 'Son of CIRM' Proposal on the June California Ballot

Posted: May 27, 2012 at 3:56 pm


In the last couple of weeks, two
well-respected Los Angeles Times columnists have visited what
might be called the "Son of CIRM" initiative on the
June ballot in California. It is aimed at fighting cancer by spending
$800 million or so annually on research with the money coming from a
$1-a-pack tax on cigarettes.

One of the columnists, Michael
Hiltzik
, said the measure, Proposition 29, is another
example of why California is a world leader in "paving the road to hell with good intentions." The other writer, George
Skelton, said,

"Prop. 29 would increase cancer
research. Reduce smoking. Save lives. Hurt the lying tobacco
companies. Good plan."

In his work at the Times, Hiltzik deals primarily with business
and financial news. He has written from time to time critically about
the $3 billion California stem cell agency.  Skelton is a longtime
observer of the Califorrnia political scene and has been around since
Pat Brown was governor.
In a column slated for publication
Sunday, Hiltzik said that the drafters of the cancer measure closely
examined Proposition 71, which created the stem cell agency in
2004, and "managed to reproduce the earlier measure's worst
features."
He said the Proposition 71 "retired
the trophy for doing the wrong thing in the wrong way for what sounds
like the right reasons." Hiltzik wrote,

"Proposition 71, you may recall, was sold to a gullible
public via candy-coated images of Christopher Reeve walking
again and Michael J. Fox cured of Parkinson's.
The implication was that these miracles would happen if voters
approved a $3-billion bond issue for stem cell research. Who could be
against that? 

 "As it turned out, the stem cell
measure created an unwieldy bureaucracy and etched conflicts of
interest into the state Constitution. By last count about 85% of the
$1.3 billion in grants handed out by the program, or some $1.1
billion, has gone to institutions with representatives on the stem
cell board. The program is virtually immune to oversight by the
Legislature or other elected officials. For these reasons and others,
it has grappled with only mixed success with changes in stem cell
science and politics that have called its original rationale into
question."

Hiltzik continued,

"Proposition
29, similarly, places most spending from the tobacco tax in the hands
of a nine-member board that must comprise one cardiovascular
physician affiliated with a California academic medical center; the
chancellors of UC Berkeley, UC San Francisco and UC
Santa Cruz
; two representatives of lobbying groups devoted to
tobacco-related illness (including one who has been treated for such
a disease); and three representatives from National Cancer
Institute
-designated cancer centers in the state. There are
10 of the latter, including five UC campuses and the City of Hope.
Plainly, every member of the board will represent an employer that
thinks it's in line for some of the money."

Skelton took a different approach on May 14. Using the words of a federal judge,
he lambasted the tobacco industry for its "a
certified history of deception, distortion and lying. And let's not
forget fraud and racketeering."
Skelton dealt with the current TV ads
being aired in California against the initiative. They criticize the
measure for its conflicts of interest and also say that the money
would be spent out of state.
Skelton wrote,

"The anti-29 side is hitting this
hard: that the research money generated in California could be spent
out of state. And the politest thing possible to say about that claim
is that it's disingenuous. It's stretching something that's
conceivable into a virtual certainty."

Skelton continued,

"The anti-29 camp charges that
(the structure of the board) would allow a conflict of interest in
awarding contracts. But there are state laws that protect against
such conflicts.

"Anyway, the tobacco crowd can't have it
both ways: complaining that the money could be spent outside
California and also griping when the system is set up to practically
guarantee that it will be spent in California."

Our take:
Ballot box budgeting – which is at
the heart of both the stem cell and cancer initiatives -- is one of the
reasons that California is staggering from one year to the next in a
perennial financial mess. Initiatives also sometimes create nasty
blowback that can damage the effort that they ostensibly serve. Such
is the case with the California stem cell agency, which suffers from
management and other minutia embedded in Proposition 71 that is virtually
politically impossible to change.
Hiltzik wrote,

"Gov. Brown's latest budget
proposal calls for cuts of $1.2 billion in Medi-Cal and
$900 million in CalWorks (a relief program for families with
children) and steep cuts in financial aid for college students and in
court budgets. The University of California and Cal State systems are
becoming crippled by 20 years of cutbacks in state funding,
leading to soaring tuition charges. Tobacco-related illnesses create
some of the burden on Medi-Cal and other public healthcare programs,
yet a minimal portion of Proposition 29 revenue, if any, would go to
helping taxpayers carry that burden. 

"With the overall state budget gap
approaching $16 billion, how can anyone make the case for diverting a
huge chunk of $800 million a year in new revenue to long-term
scientific research, whether in California or not? Even if you
believe that case can be made, the proper place to make it is in the
Legislature, where all these demands on the budget can be weighed and
balanced against one another — not at the ballot box, where the
only choice is to spend it the way the initiative's drafters choose
or not to raise it at all."

The California Stem Cell Report agrees
wholeheartedly.
(A personal disclosure: I worked for
Skelton when he was bureau chief for United Press International in
Sacramento some decades ago and consider him a friend. I am also
acquainted with Hiltzik but have not known him as long. I hold both
men in high regard.)

Source:
http://californiastemcellreport.blogspot.com/feeds/posts/default?alt=rss

Posted in Stem Cells, Stem Cell Therapy | Comments Off on A Look at the 'Son of CIRM' Proposal on the June California Ballot

Thin Coverage of California Stem Cell Board Meeting

Posted: May 27, 2012 at 3:56 pm


Media coverage of yesterday's $69
million in research awards and other matters involving the California
stem cell agency was nearly non-existent today.
That is not unusual, however, since the
$3 billion enterprise is not within the attention span of the
mainstream press and electronic outlets.
The California Stem Report could find
only two stories involving yesterday's actions. One by Ron Leuty
appeared in the San Francisco Business Times and was a look at the grant awards. The other appeared on Nature's website.
Unfortunately, Nature's lead was incorrect.
It said,

 "The California Institute of Regenerative Medicine
(CIRM)
voted on 24 May to accept a new strategic planwhich
shrinks or eliminates support for basic research, facilities and
training, while funneling more of its funds toward clinical
development."

The CIRM governing board actually put
off until at least July decisions on which programs to cut and which
to expand. Basic research is not likely, however, to take a major
hit, for a variety of reasons.

Source:
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'Sun Never Sets on CIRM' – California Agency Awards $69 Million to Researchers

Posted: May 27, 2012 at 3:56 pm


The California stem cell agency today
awarded $69 million in grants, including the first involving a collaboration with researchers in China, but none of the awards went to California
biotech businesses.
The awards were made in the agency's
third translational round, which funds projects that are in the
initial stage of identifying drugs or cell types that could become
drug therapies.
CIRM originally allocated $95 million
for the round, but CIRM spokesman Kevin McCormack said that grant
reviewers determined that no applications beyond $69 million were
worthy of funding.
The CIRM governing board overturned a negative
reviewer decision on one grant after the scientist – W. Douglas
Boyd
of UC Davis -- filed an appeal. The appeals of two other
researchers, including one from a San Diego business, were not successful (see here
and here).
CIRM did not disclose the number of
applications from businesses. The agency has been sharply
criticized for failing to fund businesses in a substantial way.
The approved grants involve
collaboration with researchers in Australia and Germany as well as
China. The collaborations are based on agreements worked out earlier
by CIRM with overseas groups, which fund their own countries' researchers. No CIRM cash is involved, according to the agency.
CIRM President Alan Trounson, a native
of Australia and researcher there until joining the stem cell agency,
said in a press release,

"The sun now never sets on the
CIRM collaborative projects..."

The news release also said,

 "The
Chinese Ministry of Science and Technology has committed roughly
$850,000 in collaboration with a team at UCSF to study liver failure.
This is the stem cell agency’s first joint effort with scientists
in China, which is home to a fast-growing stem cell research
community."

The UCSF liver team is led by Holger
Willenbring
, whose goal is "to develop a source of autologous
therapeutic cells for patients with liver disease who otherwise would
require a liver transplant," according to the CIRM review summary.
The agency did not spell out the details of how the collaboration
would work.
All of the winning applicants, with the
exception of a Salk researcher, work for institutions linked to at
least one of the 29-members of the CIRM governing board. CIRM
directors, however, are barred from voting or even discussing applications in which CIRM attorneys have determined there is a conflict
of interest.
You can find the names of all the successful applicants in the CIRM news release.    

Source:
http://californiastemcellreport.blogspot.com/feeds/posts/default?alt=rss

Posted in Stem Cells, Stem Cell Therapy | Comments Off on 'Sun Never Sets on CIRM' – California Agency Awards $69 Million to Researchers

Stem Cell Agency Board Sticks with More Financial Disclosure

Posted: May 27, 2012 at 3:56 pm


The governing board of the $3 billion
California stem cell agency today rejected a proposal that would have
restricted transparency surrounding the financial interests of its
directors and top executives.

On a unanimous voice vote, the board
decided it would stick with the more complete disclosure rules that it
has operated under since 2005. CIRM staff had offered changes that would have narrowed the amount of economic
information that the board members and the executives would have been
required to disclose.
The directors' Governance Subcommittee, however, on May 3 rejected the plan. Sherry Lansing, a former
Hollywood film studio CEO and chair of the subcommittee, said at the time,

"I personally feel strongly that
because of CIRM's unique mission and the agency's incredibly
long-standing commitment to transparency, i believe that we should
continue to set an example by requiring the broadest disclosure for
members of the board and high level staff."

Retention of existing disclosure
rules comes at a time when more conflicts may arise. The agency is
moving to engage the biotech industry more closely as it pushes to
develop stem cell therapies. Already one case of conflict has arisen this
year dealing with industry. It involves a "special advisor"
to CIRM who was nominated to become director of a firm sharing in a
$14.5 million grant. She also was working for the firm. (See here and
here.)
The CIRM board also has built-in
conflicts of interest, written into the law by Proposition 71, which
created the agency. About 92 percent of the $1.3 billion awarded so
far has gone to institutions tied to members of the CIRM governing
board. Board members are not permitted, however, to vote on or
discuss grants to their institutions. But it is fair to say that if
California voters had foreseen that nearly all of the grants would
have gone to directors' institutions, they would not have
approved creation of the stem cell agency.
As the California Stem Cell Report remarked earlier, it is a good
move for CIRM to retain more transparency rather than less. As one of
the Moss Adams staffers said today – in a different context –
during the presentation of the first-ever performance audit of CIRM,

"When people have to fill a void
in information, they assume the worst."

Source:
http://californiastemcellreport.blogspot.com/feeds/posts/default?alt=rss

Posted in Stem Cells, Stem Cell Therapy | Comments Off on Stem Cell Agency Board Sticks with More Financial Disclosure

California Stem Cell Agency Launches Five-Year Push for Cures

Posted: May 27, 2012 at 3:56 pm


The $3 billion California stem cell
today officially embarked on a course that will mean closer ties to
the biotech industry in hopes of fulfilling the campaign promises to voters to
turn stem cells into cures.

On a unanimous voice vote, directors approved
changes in the seven-year-old agency's strategic plan. The action
will likely mean less money for some activities that enjoyed more cash in the past,  but directors put off action until at least late July.  The plan also sets the course for what may be the last years of life
for the unprecedented state research program. Authorization to borrow
more money (state bonds) for its grants will run out in about 2017.

During a brief discussion of the plan, which has been debated for some months, CIRM Director Jeff Sheehy noted that the agency has now entered "the realm of trade-offs."  Ellen Feigal, CIRM's senior vice president for research and development, told the board that the plan will require hard decisions and sharp focus on priorities. 

Among other things, for first time CIRM overtly set a goal of creating 20 programs that include outside
investment that focus on products. Another five-year goal explicitly calls for financing at least 10 therapies in early-phase
clinical trials, affecting at least five diseases. Overall, the plan seeks to achieve clinical proof-of-concept for stem cell therapies.

In contrast to the Proposition 71
campaign rhetoric, CIRM's strategic plan acknowledges that developing therapies takes a very long time,
often decades.
Two scenarios were presented to the
board for spending the agency's remaining $836 million for grants and
loans. One would allocate $506 million for development research, $195
for translational research and $135 million for basic research, but
nothing for training and "facilities/core resources."
The other scenario calls for $486
million for development research, $160 million for translational
research, $105 for basic research, $60 million for training and $25
million for "facilities/core resources."

The first scenario would mean a $85 million cut in training and shared lab programs – cash that helps to finance researchers and that benefits the many institutions that have representation on the CIRM board.

The board put off action on either scenario after CIRM President Alan Trounson said he wanted more time to prepare a complete analysis of the scenarios. 

The plan also calls for creation of a
platform to enable grantees, disease foundations, venture capitalists
and others to purse CIRM's mission when its state bond funding runs
out. The possibility exists that another bond measure would be submitted to voters. But in either case, CIRM will need a solid record to attract support. 

Source:
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CIRM Directors Pleased with Performance Audit Findings

Posted: May 27, 2012 at 3:56 pm


The $3 billion California stem cell
agency received a "very favorable" performance audit report
compared to other government agencies, CIRM directors were told
today.

Representatives of Moss Adams, which
was paid $234,944 by CIRM for the study, made the comments during a
presentation today to the agency's 29 directors. During their
comments, CIRM executives and directors focused on the favorable
aspects of the findings of the six-month study.
CIRM Chairman J.T. Thomas said the
report showed that CIRM is "doing better than being on the right
track." Co-vice chairman Art Torres said,

 "Comparatively we
have done very well."

The report praised the professionalism
of the CIRM staff – "a high caliber group" – and noted
the seven-year-old agency is both "ramping up and ramping down"
at the same time – a reference to the end of state bond funding for
CIRM in 2017.
Prior to the presentation, CIRM
President Alan Trounson said the staff would review the findings and
come up with a plan for the board at its July meeting. The agency is
already implementing some of the recommendations.
The audit was required by a recent
state law that also allowed CIRM to hire more than 50 persons, a cap
imposed by Proposition 71, which created the agency. The audit found a need for improvement in 27 areas and made recommendations. Of the 20 recommendations with the highest priority,
half involved how CIRM manages its information, much of which is
needed for good decision-making. The audit did not assess the
scientific performance of the agency.
The Moss Adams report, performed by the
Seattle firm's San Francisco office, said,

"CIRM board members and senior
management do not receive regularly updated, enterprise-level
performance information. The ability to evaluate performance against
strategic goals is critical to effective leadership and program
monitoring, evaluation, and reporting. CIRM does not currently have a
formal performance reporting program."

In addition to decision-making
information, Moss Adams called for improvements in the agency's
long-troubled grants management system, better grant outcome
tracking, development of a results-based communications plan,
creation of a comprehensive, formal business development plan,
formulation of a comprehensive information technology plan that would
include steps to establish clear responsibility for CIRM's website
and improved monitoring of invention disclosure forms from grantee
institutions.
Last week, in a long overdue move, the
agency hired a director for information technology, who is expected
to solve many of the problems cited in the audit.
State law requires another performance audit in a few years. 

Source:
http://californiastemcellreport.blogspot.com/feeds/posts/default?alt=rss

Posted in Stem Cells, Stem Cell Therapy | Comments Off on CIRM Directors Pleased with Performance Audit Findings

Live Coverage of Tomorrow's California Stem Cell Meeting

Posted: May 27, 2012 at 3:56 pm


The California Stem Cell Report will
provide live coverage of tomorrow's meeting of the governing board of
the $3 billion California stem cell agency. Directors are expected to
make major decisions about the agency's future direction, hear the results
of the first-ever performance audit and award about $95 million in
grants or loans.

The meeting will be held near the San
Francisco airport with another public teleconference location at UC
San Francisco
. Los Angeles will also have two public teleconference
locations. Another will be in La Jolla.
The meeting will be audiocast live on
the Internet, which the California Stem Cell Report will monitor from its
base in Panama near the Pacific entrance to the Panama Canal.
Instructions for listening in on the
audiocast can be found on the agenda along with specific addresses
for the public teleconference locations. The meeting is scheduled to
begin at 9 a.m. PDT.  

Source:
http://californiastemcellreport.blogspot.com/feeds/posts/default?alt=rss

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Michael J. Fox Backs Away From Stem Cell Cure for Parkinson's

Posted: May 27, 2012 at 3:56 pm


It was not exactly a case of "Back
to the Future,
" the hit movie starring Michael J. Fox,
but it did offer a reflection on the past.

It involves the actor's
changing views on stem cell research in connection with Parkinson's
disease, which he has had since the 1990s.
Fox's 2004 Ad
Early on, Fox was well-known for his
support of human embryonic stem cell research. ABC News
recently described him as having become "one of the country’s
most visible advocates for stem cell research." In California, Fox was a prominent promoter of the ballot initiative, Proposition 71,
that created the $3 billion California stem cell agency in 2004. "
He filmed a TV commercial that was
aired widely during the 2004 campaign to create the stem cell agency,
declaring,

 "It could save the life of someone you love."

Today he is considerably less
confident. In an interview last week with ABC, he cited "problems
along the way." Fox said,

“It’s not so much that [stem cell
research has] diminished in its prospects for breakthroughs as much
as it’s the other avenues of research have grown and multiplied and
become as much or more promising. So, an answer may come from stem
cell research but it’s more than likely to come from another area.”

Source:
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