EMBOLD
What it found
The trial was stopped early because the treatment was not working.
Reason given: Study was terminated as primary endpoint was not achieved
What was tested
Treatment tested
- Evruleucel
Placebo or sham
- Placebo
What it measured
Main measures
Part 1: Incidence of adverse events
At 12 months after the first dose of study drug
SafetyPart 1: Incidence of clinically significant changes in laboratory tests, electrocardiograms (ECGs), and vital signs
At 12 months after the first dose of study drug
SafetyPart 1: Recommended Part 2 dose of ATA188 monotherapy
Day 1 to Day 35 of Cycle 1 for each participant in dose escalation part (approximately 1 year)
Part 2: Percentage of participants with confirmed expanded disability status scale (EDSS) improvement at 12 months
At 12 months after the first dose of study drug
Disability progression
Other measures (5)
Part 1: Change from baseline in EDSS score
At 12 months after the first dose of study drug
Disability progressionPart 2: Percentage of participants with confirmed EDSS improvement at 15 months
At 15 months after the first dose of study drug
Disability progressionPart 2: Percentage of participants with sustained disability improvement (SDI; ie, confirmed EDSS improvement or 20% decrease in timed 25-foot walk [T25W]) at 12 months
At 12 months after the first dose of study drug
Disability progressionWalking and mobilityPart 2: Percentage of participants with SDI at 15 months
At 15 months after the first dose of study drug
Part 2: Change from baseline in immunoglobulin G (IgG) index
At 9 months after the first dose of study drug
Who could take part
Progressive MS · 18 to 60
Inclusion Criteria: * For Part 1: History of progressive forms of MS (PPMS or SPMS), as defined by the 2010 Revised McDonald criteria for the diagnosis of MS * For Part 1: 18 to \< 66 years of age * For Part 1: EDSS scores of 3.0 to 7.0. Participants with EDSS scores of 6.5 to 7.0 must retain measurable upper limb function as assessed by the 9-hole Peg Test (9HPT). * For Part 2: Current diagnosis of a progressive form of MS (PPMS or SPMS) as defined by the 2017 Revised McDonald criteria * For Part 2:18 to \< 61 years of age * For Part 2:EDSS scores of 3.0 to 6.5 * Positive EBV serology * Willing and able to provide written informed consent Exclusion Criteria: * Clinical relapse as follows: For Part 1: Active clinical relapse between providing informed consent and the first dose of study drug. For Part 2: Documented clinical and/or radiological relapse for 2 years prior to screening, including gadolinium (Gd)-enhancing lesion(s) on any brain MRI scans available during this period (A participant will also be considered ineligible if any clinical and/or radiological relapse is reported between screening and the first dose of study drug.) * Concurrent serious uncontrolled or unresolved medical condition, such as infection, limiting protocol compliance or exposing the subject to unacceptable risk * Positive serology and/or nucleic acid testing (NAT) for human immunodeficiency virus (HIV), active hepatitis B virus (HBV) infection or carrier status for HBV, active hepatitis C virus (HCV) infection * For Part 1: Positive serology for syphilis or human T cell lymphotrophic virus I/II * Uncontrolled psychosis, uncontrolled depression or suicide risk, substance dependence, or any other psychiatric condition that may compromise the ability to participate in this trial * Clinically significant abnormalities of full blood count, renal function, or hepatic function * Any contraindication to MRI and/or Gd, eg., any object that is reactive to strong static magnetic, pulsed-gradient fields including any metallic fragments or foreign body (eg, aneurysm clip[s], pacemakers, electronic implants, shunts) * Any history of cancer (as exceptions, successfully treated non-melanoma skin cancer or carcinoma in situ of the cervix with a \< 5% chance of recurrence within 12 months of providing informed consent are allowed.) * Prior therapy with corticosteroids (within 2 weeks before Cycle 1 Day 1) * Prior therapy (30 days) B-cell depleting agent (eg, anti-CD20 agents such as ocrelizumab); participant must be progressing despite therapy to be eligible * For Part 1: Prior therapy (6 half-lives or 30 days whichever is longer) with cladribine, glatiramer acetate, interferon β, dimethyl fumarate, methotrexate, azathioprine, cyclosporine, fingolimod, natalizumab, teriflunomide, mitoxantrone, cyclophosphamide, any other immunosuppressant or cytotoxic therapy (other than steroids), antithymocyte globulin or similar anti-T-cell antibody therapy, or any other investigational product * For Part 1: Any previous treatment with alemtuzumab, ablative stem cell transplant, or EBV T-cell therapy * For Part 2: Prior therapy (6 half-lives or 30 days whichever is longer) with IV immunoglobin, plasmapheresis, Bruton's tyrosine kinase inhibitors, all sphingosine 1-phosphate receptor modulators (eg, fingolimod), glatiramer acetate, interferon β, nuclear factor (erythroid-derived 2)-like 2 (Nrf2) activators (eg, dimethyl fumarate), methotrexate, azathioprine, cyclosporine, natalizumab, teriflunomide, mitoxantrone, cyclophosphamide, any other immunosuppressant or cytotoxic therapy (other than steroids), antithymocyte globulin or similar anti-T-cell antibody therapy, or any other investigational product * For Part 2: Any previous treatment with cladribine, alemtuzumab, ablative stem cell transplant, or EBV T-cell therapy * Unresolved reactions from previous therapies that may, in the investigator's opinion, impact the safety of the participant or the conduct of this study * Unwilling to use protocol specified contraceptive methods * Women who are breastfeeding * Pregnancy * Inability or unwillingness to comply with study procedures
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
The purpose of this study is to evaluate the safety and tolerability of ATA188 as a monotherapy in Parts 1 and 2, to determine the recommended Part 2 dose (RP2D) of ATA188 as monotherapy in Part 1, and to evaluate the effect of ATA188 treatment on clinical disability, as assessed by confirmed Expanded Disability Status Scale (EDSS) improvement at 12 months in Part 2 in participants with progressive forms of multiple sclerosis (MS) (primary progressive multiple sclerosis [PPMS] and secondary progressive multiple sclerosis [SPMS]).
Papers
Results
Drosu N, Bjornevik K, Bilodeau PA, Yeh A, Lechner-Scott J, Hawkes CH, Giovannoni G, Levy M. In the era of antiviral trials for MS, the answer lies in the details. Mult Scler Relat Disord. 2024 Feb;82:105444. doi: 10.1016/j.msard.2024.105444. Epub 2024 Jan 12. No abstract available.Results
Giovannoni G, Hawkes CH, Lechner-Scott J, Levy M, Yeh EA. Emboldened or not: The potential fall-out of a failed anti-EBV trial in multiple sclerosis. Mult Scler Relat Disord. 2024 Jan;81:105364. doi: 10.1016/j.msard.2023.105364. Epub 2023 Dec 10. No abstract available.Background
Pender MP, Csurhes PA, Smith C, Beagley L, Hooper KD, Raj M, Coulthard A, Burrows SR, Khanna R. Epstein-Barr virus-specific adoptive immunotherapy for progressive multiple sclerosis. Mult Scler. 2014 Oct;20(11):1541-4. doi: 10.1177/1352458514521888. Epub 2014 Feb 3.Background
Pender MP, Csurhes PA, Burrows JM, Burrows SR. Defective T-cell control of Epstein-Barr virus infection in multiple sclerosis. Clin Transl Immunology. 2017 Jan 20;6(1):e126. doi: 10.1038/cti.2016.87. eCollection 2017 Jan.
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History
Started
Oct 2017
Main results due
Nov 2023
Finished
Jan 2024
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