RG6501 (OpRegen®) Phase 1/2a Clinical Results Support the Potential for OpRegen to Slow, Stop or Reverse Disease Progression in Geographic Atrophy Secondary to Age-Related Macular Degeneration
Lineage Cell Therapeutics (LCTX) presented positive results from their Phase 1/2a clinical study of OpRegen at the 2023 ARVO Annual Meeting. The study focused on patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Key findings include:
- 7.6 letter gain in visual acuity observed in Cohort 4 over 12 months.
- Long-term vision preservation noted up to 4 years in treated eyes.
- Improved retinal structures correlated with the extent of OpRegen bleb coverage.
CEO Brian Culley expressed optimism about ongoing collaborations with Genentech and Roche. The ongoing Phase 2a study has started enrolling patients, highlighting the potential of OpRegen to address unmet medical needs in this debilitating condition.
- 7.6 letter gain in visual acuity at 12 months for patients in Cohort 4.
- Long term vision preservation in treated eyes observed for up to 4 years.
- Improvement in retinal structure correlating with extensive OpRegen bleb coverage.
- Ongoing enrollment in Phase 2a study indicating continued progress.
- None.
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Preliminary Evidence of
Durable Anatomical and Functional Improvements Following Administration of OpRegen Cells - Extensive OpRegen Surgical Bleb Coverage of Areas of GA May Be Critical for Optimizing Patient Outcomes
- OCT Imaging With Segmentation Analysis is Advantageous in Assessment of Retinal Integrity Post-Treatment
RG6501 (OpRegen) is an allogeneic retinal pigment epithelial (RPE) cell therapy currently in development for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). It is being developed under an exclusive worldwide collaboration between Lineage, Roche and
“We are extremely pleased to see our observations of improved retinal structure in the initial clinical study of OpRegen are being reinforced by additional external and independent analyses of the images performed by
2023 ARVO Presentation Highlights
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Preliminary evidence of outer retinal structure and visual function improvements with OpRegen was observed in patients with GA and impaired vision (Cohort 4 [n=12]):
- Patients in Cohort 4 had an average 7.6 letter gain in visual acuity at 12 months in the study eye;
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Three patients in Cohort 4 (
25% ) had a 15 letter or greater gain in visual acuity at 12 months in the study eye.
- Long term vision preservation with outer retinal structure improvement observed in the OpRegen treated eye persisted for up to 4 years of follow-up.
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The extent of OpRegen bleb coverage over the area of atrophy may be important to optimize patient outcomes:
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In patients with extensive OpRegen bleb coverage, maintenance or improvement of outer retina structure was observed in treated eyes compared to worsening in fellow eyes:
- Five patients in Cohort 4 who had a surgically delivered bleb containing OpRegen that extensively covered their atrophic areas and the foveal center, experienced an average 12.8 letter gain in their study eye.
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Improvement in outer retinal layers also correlated with the extent of OpRegen bleb coverage:
- Slower rates of RPE and external limiting membrane (ELM) loss were observed in OpRegen treated eyes compared to fellow untreated eyes;
- Patients with extensive OpRegen bleb coverage of the atrophic area had maintenance or improvement of RPE and ELM layers compared to patients with limited OpRegen bleb coverage.
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Resolution of complete RPE and outer retinal atrophy (cRORA) near borders of baseline GA were observed in cases with extensive coverage:
- Signs of improvement in areas of cRORA included: greater hyperreflectivity at the level of RPE/ Bruch's membrane (BM); less choroidal hypertransmission; reduction of retinal subsidence, and greater continuity of outer retinal layers.
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OCT imaging with segmentation analysis may be advantageous in assessment of retinal integrity following OpRegen treatment:
- OCT enables quantitation of changes in RPE and outer retinal structure (such as ELM loss) not possible with FAF imaging following OpRegen subretinal delivery.
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In patients with extensive OpRegen bleb coverage, maintenance or improvement of outer retina structure was observed in treated eyes compared to worsening in fellow eyes:
- One patient in Cohort 4 maintained improvement in visual acuity at 4 years post-treatment in the study eye (+3 letters read), compared to losing 30 letters in the untreated eye.
- Overall, these data suggest that OpRegen RPE cells may provide support to the remaining retinal cells within atrophic areas by counteracting host RPE cell dysfunction and loss.
- Further assessment of the optimal disease stage for intervention and target delivery location of OpRegen in a larger clinical study is needed to confirm these preliminary findings.
- A Phase 2a study evaluating the success of OpRegen delivery to target areas of GA is currently enrolling patients (ClinicalTrials.gov: NCT05626114).
Dr. Banin’s presentation is now available on the Events and Presentations section of Lineage’s website.
The
About OpRegen®
OpRegen is a retinal pigment epithelial cell therapy in development for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration. Following subretinal delivery, OpRegen has the potential to counteract RPE cell loss in areas of GA lesions by supporting retinal structure and function. OpRegen is being developed under a worldwide collaboration between Lineage, Roche and
About the Phase 1/2a Study
The Phase 1/2a study is an open-label, single-arm, multi-center, dose-escalation trial evaluating a single administration of OpRegen delivered subretinally in patients with bilateral GA. Twenty-four patients were enrolled into 4 cohorts. The first 3 cohorts enrolled only legally blind patients with a best corrected visual acuity (BCVA) of 20/200 or worse. The fourth cohort enrolled 12 patients with impaired vision (BCVA from 20/65 to 20/250 with smaller mean areas of GA). Cohort 4 also included patients treated with a new “thaw-and-inject” formulation of OpRegen, which can be shipped directly to sites and used immediately upon thawing, removing the complications and logistics of having to use a dose preparation facility. The primary objective of the study was to evaluate the safety and tolerability of OpRegen as assessed by the incidence and frequency of treatment-emergent adverse events. Secondary objectives are to evaluate the preliminary activity of OpRegen treatment by assessing the changes in ophthalmological parameters measured by various methods of primary clinical relevance.
About Geographic Atrophy
Geographic atrophy (GA) is an advanced form of age-related macular degeneration (AMD) characterized by severe loss of visual function. GA is a leading cause of adult blindness in the developed world, affecting at least 5 million people globally. There are two forms of advanced AMD: neovascular AMD and GA. GA and neovascular AMD can occur simultaneously in the same eye, and patients treated for neovascular AMD may still go on to develop GA. GA typically affects both eyes.
About
Forward-Looking Statements
Lineage cautions you that all statements, other than statements of historical facts, contained in this press release, are forward-looking statements. Forward-looking statements, in some cases, can be identified by terms such as “believe,” “aim,” “may,” “will,” “estimate,” “continue,” “anticipate,” “design,” “intend,” “expect,” “could,” “can,” “plan,” “potential,” “predict,” “seek,” “should,” “would,” “contemplate,” “project,” “target,” “tend to,” or the negative version of these words and similar expressions. Such statements include, but are not limited to, statements relating to: the potential therapeutic benefits OpRegen in patients with GA secondary to AMD; the significance of clinical data reported to date from the Phase 1/2a study of OpRegen, including the findings of retinal tissue restoration and visual function improvements; and the potential utilization of OCT imaging to measure efficacy in a pivotal clinical trial of OpRegen. Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause Lineage’s actual results, performance or achievements to be materially different from future results, performance or achievements expressed or implied by the forward-looking statements in this press release, including, but not limited to, the following risks: that positive findings in early clinical and/or nonclinical studies of a product candidate may not be predictive of success in subsequent clinical and/or nonclinical studies of that candidate; that competing alternative therapies may adversely impact the commercial potential of OpRegen; that Roche and
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