Experience With a Subretinal Cell-based GossMark Therapy in Patients With Geographic Atrophy Secondary to Age-related Macular Degeneration

PURPOSE: To evaluate the safety and tolerability of and clinical response to a single, subretinal dose of human umbilical tissue derived cells (palucorcel [CNTO-2476]) in the eyes of adults aged >= 50 years with bilateral geographic atrophy (GA) secondary to age-related macular degeneration (AMD). DESIGN: Phase 1/2a, multicenter, open-label, dose escalation, fellow-eye controlled study. METHODS: In the phase 1 portion, eyes were assigned to receive a single, subretinal dose of palucorcel (ranging from 6.0 x 10(4) to 5.6 x 10(5) viable cells). In the phase 2a portion, eyes were assigned to one of 2 palucorcel doses (6.0 x 10(4) or 3.0 x 10(5) cells) determined during the phase 1 portion. The intervention eye was the eye with worse baseline visual acuity. RESULTS: A total of 35 eligible subjects underwent at least a partial surgical procedure. Palucorcel was administered in 33 eyes. Overall, 17.1% (6/35) of subjects experienced retinal detachments and 37.1% (13/35) experienced retinal perforations. No episodes of immune rejection or tumor formation were observed. At 1 year, 1.0- and 15-letter gains in best-corrected visual acuity were observed in 34.5% (10/29) and 24.1% (7/29) of eyes receiving palucorcel, respectively, and in 3.3% (1/30; for both) of fellow eyes. CONCLUSIONS: The subretinal delivery procedure in this study was associated with a high rate of retinal perforations (n = 13) and retinal detachments (n = 6). When cells were sequestered in the subretinal space, palucorcel was well tolerated and may be associated with improvements in visual acuity. Larger randomized controlled studies are required to confirm these results. Future studies would require a modified surgical approach. (C) 2017 The Author(s). Published by Elsevier Inc.