Golden State Milestone: Stem Cell Agency Announces its First Phase Two Clinical Trial

The California stem cell agency today scored a first with the announcement that one of its projects – a heart disease therapy -- has now advanced to a phase two clinical trial after successfully completing a phase one safety trial.

In a press release, Jonathan Thomas, chairman of the $3 billion research effort, hailed the Allstar trial by Capricor Therapeutics, Inc., of Beverly Hills. He declared,

"This is a highly significant announcement for us at CIRM as it's the first time we have funded a therapy into a Phase 2 clinical trial.

"Heart disease claims around 600,000 American lives every year, so clearly there is a huge need for new approaches and more effective therapies. We are hopeful this is the first of many treatments to turn the tide against this disease, and that this will be the first of many projects we are funding to get to a Phase 2 trial."

The adult stem cell therapy “uses unrelated donor-derived stem cells, called cardiosphere-derived cells, that are then infused into a patient’s artery with the aim of reducing scarring caused by heart attacks,” CIRM said.

Capricor Therapeutics, which has its roots in Cedars-Sinai in Los Angeles, describes itself as as “a diversified heart failure biotechnology company.” It came into being last summer as the result of the merger of Capricor and Niles Therapeutics. The company has benefited from about $27 million in support from the stem cell agency, including $6.9 million for early work by one of its founders Eduardo Marbán at Cedars-Sinai.

The company's stock price closed at $2.48 today, down 17 cents. Its 52-week range is from $2.48 to $2.65.

The firm's CEO, Linda Marbán, said the move into phase two was a “giant leap” for the firm and the heart therapy field.

The executive chairman of the firm is Frank Litvack, a heart surgeon who was the only other candidate for chairmanship of the stem cell agency when Thomas won the job in 2011.

The announcement today is a milestone for the stem cell agency, which is aggressively seeking results that will help to generate financial support after 2017, when its current state funding runs out.

The CIRM news release said,

“The next phase will involve an estimated 300 patients who have had heart attacks, and they will be evaluated in a double-blind, randomized, placebo-controlled trial.  This will be further broken down into two groups: one will include patients 30-90 days post attack, the second will be 91 days to one year after the incident.”

The phase two trial is to determine the therapy's effectiveness and further study its safety. If successful, it can move into a phase three trial to confirm its effectiveness, monitor side effects, compare it to common treatments and collect information that will allow the drug or treatment to be used safely.

Here is a CIRM video in which Eduardo Marbán discusses some of the issues involved in the therapy. Here is a link to a 2011 presentation to the CIRM governing board about the early research – a presentation that generated some excitement on the board.

Cost-saving Stem Cell Cuts Puzzle California Scientists

Jeanne Loring, the head of the Scripps stem cell program, reflected last week on the move by the $3 billion California stem cell agency to scuttle a program that she and other scientists believe is critical to the research effort.

Writing on ipscell.com, she discussed the effort to save the “shared” labs program at 17 institutions around the state. Continuation of the program was axed by directors last week in a cost-saving move. The agency is down to its last $600 million or so, and the governing board was feeling the pressure last week of having to deal with competing interests.

The board has 29 members, but only six in attendance could vote on the program because of the board's longstanding conflict-of-interest problems. Four approved the recommendation by CIRM staff and its Scientific Advisory Board to halt the lab program. That was all it took – the votes of four directors out of 29.

Loring and 11 other scientists attended last week's board meeting in an unsuccessful effort to the save the labs. She later wrote,

“We are back home now, but still puzzled about why CIRM would destroy one of its most successful programs.  The irony is that the board would like to continue to support training.  The training is done in the shared labs.  There are no more courses without the shared labs. 

“We aren’t giving up; we’re just taking some time to think.  Meanwhile, the positive side:  we did an amazing thing:  we are normally very competitive with each other, but on Wednesday we came together from all over California to support a single cause that is dear to our hearts.  That will remain a high point for me, even though I also feel a profound sense of loss.”

Bad Link Repaired

A bad link in the "$61 Million" item has been fixed, thanks to an anonymous reader who called it to our attention. The link is to the list of all the applications in that round.

Wish List on Criteria for New President of $3 Billion California Stem Cell Agency

Directors of the $3 billion California stem cell agency today moved closer to possibly selecting a non-scientist as the new president of the nine-year-old research enterprise.

On a unanimous voice vote with no discussion, they approved criteria that did not make it mandatory that a scientist fill the position being vacated by Alan Trounson, a noted IVF researcher who is returning to Australia.

Instead, the governing board decided that candidates should have “experience with and personal commitment to medical and scientific research including familiarity with stem cell research.”

In terms of academic credentials, the criteria state that the new president have either or both an M.D. or Ph.D. degree or “equivalent industry experience or similar body of knowledge developed in professional roles.”

The criteria that was approved was not available to the public today on the CIRM Web site prior to board action. It had been altered on Tuesday night from an earlier version that was posted on the Web site.

Here is the text of what appear to be the only alterations (all additions) in the new criteria.

• "Comfort working in the public sector, including an awareness of the need to comply with the laws that govern them, such as transparency, conflict of interest, and public accountability laws." 
• "Experience dealing with, and commitment to, diversity and gender equality in the workplace."

It is ironic that the addition of the need for awareness of the need for transparency was added but the document was not available to the public prior to board approval.

CIRM Chairman Jonathan Thomas said yesterday that the agency is on verge of signing a contract with a search firm, Korn Ferry, to help in finding the new president. Directors have been emphatic about the need for speed in finding the new president.

Trounson has agreed to stay on for an unspecified period, but he could leave at any point. If he leaves before a new president is chosen, presumably Ellen Feigal, senior vice president at the agency, would pick up his duties temporarily, as she did earlier this year for three months.

She is also likely to be a candidate for the top spot, and if she is not selected after serving again on an interim basis, she might well decide to look for opportunities elsewhere.

California Stem Cell Agency Board Quits for the Day

The governing board of the California stem cell agency adjourned its two-day meeting in Los Angeles at 2:40 p.m. PST today. We will have an item coming up shortly on approval of the criteria for selection of the new president. The board approved a revised criteria that was not available to the public prior to board action. It is unclear whether any of the changes were substantive.

Stem Cell Agency Identifies Grant Recipients

The California stem cell agency has posted its press release on this week's meeting of its governing board. The press release includes the identities of the grant recipients. All of the recipients are affiliated with institutions represented on the CIRM board. Here is a link to the press release.

$61 Million Approved for Stem Cell Clinical Trials

Directors of the California stem cell agency today handed out $61 million in its ambitious disease team program that is designed to push stem cell research into clinical trials.

Action on the six awards followed yesterday's move by the board to set aside $200 million to beef up its efforts for stage one and two clinical trials. The agency is focusing ever more intently on commercializing its research.

The $3 billion program is expected to run out of cash for new grants in 2017. Its efforts to develop a new stream of funding depend a great deal on showing results that resonate with the public and possible funding sources.

This grant round was originally budgeted for $100 million, but directors today were loath to approve additional funding. They noted that the agency is now living an era of financial limits.

Today's awards are aimed at cancer (three grants), sickle cell anemia, macular degeneration and severe airway obstruction. Size of the awards ranges from $20 million to $4.4 million. Terms range up to four years.

The agency did not immediately release the names of the winners, in keeping with its policy of secrecy until after the board votes. However, the names of the applicants could be determined by a knowledgeable person searching articles in the various fields. A CIRM news release is expected shortly with the names of the researchers and institutions. (Here is a link to the press release. All of the recipients are employed at institutions represented on the governing board.)

Thirteen applications, including one from a business, were considered by reviewers.

Here are links to the information provided by CIRM staff on the grant applications: summaries of the grant reviews, staff justification for funding tier two applications, Power Point presentations to be made to directors on the applications, including the range of scores on individual applications. However, the range of scores on the rejected applications was not provided.

Stem Cell Board Nixes $13.4 Million to Help Cure Cartilage Disorders

Directors of the California stem cell agency today rejected a $13.4 million proposal that would have been the first disease team research that it has backed that would deal with cartilage disorders.

The project would have built on earlier research funded by CIRM. The agency staff cited work at UC Davis  by Kyriacos Athanasiou and at Scripps by Peter Schultz. Funding of the application was supported by the CIRM staff, which did not identify the applicant.

However,  the governing board, however, went along, on a 10-1 vote, with arguments by Director Jeff Sheehy and others that the agency had finite resources and had to make difficult decisions. He noted that many alternative treatments exist for cartilage problems. Sheehy said,

"We are here to make progress on serious diseases and conditions."  

Former Chairman Robert Klein, in an unusual appearance as a member of the public, urged approval of the grant. He said that it would address conditions "very prevalent in the older population."  Klein told the board that the research would be a "very important milestone that will help you get more money in the future."

While Klein did not mention it, older persons participate in elections to a much greater degree than younger persons. They would be an important group in winning support for another bond issue to fund CIRM, which runs out of cash for new grants in 2017.

$13.9 Million Approved for Sickle Cell Research at UCLA

The California stem cell agency today effectively approved a $13.9 million grant involving UCLA to develop stem cell gene therapy for sickle cell anemia.

CIRM directors acted on a staff recommendation to place the grant in a category that is automatically approved by the board.

(Here is a press release that was issued later by UCLA. The investigator is Donald Kohn.)

CIRM Directors Reject $16 Million Eye Research Application

Directors of the California stem cell agency today rejected a $16 million application from Cedars-Sinai for research involving retinitis pigmentosa.

The action came on a split vote despite a personal appearance by the principal investigator, Kent Small, and a patient advocate.

CIRM staff had recommended rejecting the grant because the agency is funding a number of other eye research projects. The vote was 7-4 to approve the staff recommendation.

Small and Clive Svendsen, also of Cedars-Sinai, noted that other diseases have many grants from CIRM and have not been subjected to the same sort of objection. They noted that the eye is a particularly good target for stem cell therapy compared to other areas of the body.

$4.4 Million Grant Approved for Severe Airway Obstruction

The governing board of the California stem cell agency today effectively approved a $4.4 million grant for research involving severe airway obstruction.

The board approved a staff recommendation to place the grant in a category that the board automatically votes to fund. Names of the applicant and employer have not been released by the agency.

Disease Team Applications Under Discussion

The $100 million disease team round applications are under discussion currently at today's meeting of the governing board of the California stem cell agency.

CIRM Chairman Jonathan Thomas outlined the appeal process prior to the discussion and cautioned rejected applicants in the audience that the board is not the first avenue of appeals.

The board has revised its appeal process in the last year to discourage appeals directly to the board.  Over the last couple of years, the appeals have often involved emotional presentations by patient advocates seeking to support applications.

Nonetheless, under state law, any person has a right to address the board on any subject.

CIRM Board Meeting Begins in Los Angeles

Directors of the California stem cell agency opened their meeting at 9:08 a.m. PST today with a presentation on the annual audit.

Live Coverage Upcoming of CIRM Board Meeting: Presidential Selection, $100 Million in Grants on Table

The California Stem Cell Report will provide live coverage of today's meeting of the governing board of the $3 billion California stem cell agency beginning at 9 a.m. PST.

Directors are scheduled to approve criteria for selection of a new president and award roughly $100 million in their ambitious disease team program, which is aimed at pushing stem cell research closer to the marketplace.

Here is a link to the agenda, which has background material on most of the items.

Sharp Exchanges as Stem Cell Board Tables Future Funding Proposal

A plan to finance the California stem cell agency after its $3 billion runs out in 2017 was shunted aside today after it ran into sharp opposition and questions from several of the agency's governing board members.

Vice chairman Art Torres attacked the preparation of the report as "offensive" because none of the patient advocates on the board, of which he is one, were consulted in its preparation. He said the CIRM staff should have prepared the $150,000 report -- not a consultant. Torres said the issue of sustained funding for the agency is the responsibility of the Chairman Jonathan Thomas, not the outgoing President Alan Trounson.

Torres' heated remarks drew a sharp retort from Trounson, who summarized the report for the board and said it was part of his management goals. Trounson said that he considered Torres' remarks an "attack on me," an assertion that Torres denied.

Other board members, including Thomas, said the report requires further thought and testing. They said the new president, who will replace Trounson, should be involved. CIRM Director Jeff Sheehy, another patient advocate, moved to table the report and put it in the hands of Thomas with the proviso that no further funds be spent on it pending further action. Sheehy's motion was approved on a voice vote.

The report was aimed at dealing with the loss of state bond funding for the agency.  The report called for private-public partnerships that would mean closer ties to industries. The funding would undoubtedly be considerably less than the $300 million or so that the agency currently hands out annually.

The proposal would also mean a considerable change in the nature of CIRM's program, likely focusing even more on research that is close to the marketplace.

Another bond issue for funding the agency has not been ruled out by the agency. But taking it to the voters is difficult politically and financially. The initiative campaign in 2004 that created the stem cell agency cost more than $30 million.  Stem cell scuttlebutt has it that former CIRM Chairman Robert Klein is talking up another bond election and perhaps even raising campaign funds.

Here is a link to Trounson's Power Point presentation today.

New Funding Plan for Stem Cell Agency Coming Up Shortly

Next up before the California stem cell agency board of governors is the proposal for a public-private funding plan to carry the research forward after 2017, when its current funding runs out. The board is on a short break and will resume in about five minutes.

Stem Cell Lab Program Nixed in California

Directors of the California stem cell agency today eliminated future funding for a $72 million "shared" labs program that supporters said was a key to successful stem cell research in the Golden State.

The action came on a 4-0 vote with two abstentions following a presentation by 20 stem cell scientists that the labs were vital to research and needed for the training of scientists. Jeanne Loring, head of the Scripps stem cell program, told the board today that the labs have evolved to become the place "where all of the research for CIRM takes place." She later said in an email that each lab is currently receiving only $200,000 a year.

The agency's Scientific Advisory Board recommended no further funding of the labs, saying their original justification was no longer "compelling." CIRM staff agreed, saying alternatives to shared labs were available.

CIRM President Alan Trounson said the agency had a finite number of dollars and "sometimes we have to cut off some these things." He said that the labs are "probably not as important as some other things" and that the labs are a "luxury."

The labs have another six to 12 months of remaining funding. Steve Juelsgaard, a CIRM board member, said the labs should have been planning for a loss of funding from the agency.

Only seven of the 29 members of the agency governing board could participate in the discussion or vote because of conflicts of interest. One of the seven was absent from the meeting. The other members of the board are tied to institutions that operate shared labs.

The program was begun in 2007 and has been funded to the tune of $72 million since then. Loring later said in an email to the California Stem Cell Report,

"You should mention that each of the shared labs was getting $200,000 a year…that's it. That's what they decided to cut.  We have leveraged that money 10-fold from NIH, but NIH will not support cores directly."

(Loring's comments in her email were added following publication of the original version of this story.)

California Stem Cell Agency: $200 Million Approved to Speed Up Stem Cell Cures

The California stem cell agency today set aside $200 million to accelerate research into early stage clinical trials over the next several years.

The plan was unanimously approved as directors considered ways to generate therapeutic results as they strive to fulfill promises made to California voters in 2004 when they approved creation of the $3 billion research effort.

Ellen Feigal, senior vice president for research and development for the agency, told directors that about 14 existing projects would be examined for acceleration with possibly up to six to eight ultimately selected. The grants review group would consider the projects, and its recommendations would be brought to the governing board for final approval. One key criteria would be the likelihood that the trial would demonstrate proof of concept by 2017. (See here for her presentation and full criteria for selection.)

The $200 million set aside would go for possible phase two clinical trials. Some directors said more money was needed because costs generally rise. Additionally stem cell research is a new field and is likely to be more expensive than conventional research. The agency would also beef up support for the projects with more advice from external advisers and CIRM staff.

Funding for the agency is set to expire in 2017, and the agency is seeking results that will support a drive to raise additional cash.

California Stem Cell Meeting: CIRM Directors Decide to Press Harder on Therapy Development

Directors of the California stem cell agency today voted to intensify their focus on a handful of projects most likely to advance through clinical trials despite concerns that other efforts by the agency could suffer as a result.

On a unanimous roll call vote, the board approved a motion to create a priority system as recommended by its new Scientific Advisory Board.

"It is time for us to be brutal," said CIRM Director Sherry Lansing, a former Hollywood studio chief and former chair of the University of California board of regents. She said,

"Unless we have a home run in something...it will be extremely difficult to get more funding."

The agency is expected to run out of cash for new grants in 2017. It is in the process of trying to devise a plan for some sort of private-public financial partnership. Discussion at the meeting also made it clear that another bond ballot measure has not been ruled out by some directors, who emphasized the need to show results to voters.

Several directors expressed concern that by making a decision to establish priorities the agency would be forgoing efforts to create "the strongest possible foundation" for stem cell science. They questioned whether the agency should behave like a business "trying to hit a home run." However, no votes were registered in opposition to setting priorities.

During this morning's meeting in Los Angeles, CIRM staff briefed directors on the status of CIRM research. The governing board was told that six to eight projects could be selected out of 23 with the goal of accelerating them into phase one and phase two clinical trials.

A figure of $200 million was mentioned as a possible set aside to help the projects move ahead, but the directors this morning did not approve a specific amount. That may come later today.

Several directors commented that today's meeting on priorities and future funding plans may well be the most significant in years.

The board is now at lunch.

California Stem Cell Meeting Resumes

Directors of the California stem cell agency have returned from their break following repairs to their audiocast on the Internet. Discussion of the priorities of the agency is continuing.