Jeffrey Cohen, MD

"Both are important. We knew that, from the outset, this was going to be a relatively small study. Our primary goal was to confirm the feasibility of the procedures and safety, and then to get some preliminary indications that the cells were biologically active.”

Autologous cellular therapy has not only recently emerged as a credible and practical option for cancer and other highly debilitating diseases, but a potential option for patients with progressive multiple sclerosis (PMS). A phase 2 study that evaluated the use of autologous mesenchymal stromal cells secreting neurotrophic factors (MSC-NTF) cells in this patient population found it to be a safe approach to treatment, with preliminary evidence of efficacy and relevant cerebrospinal fluid biomarker outcomes.

37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)

, showed that 14% and 13% of patients had 25% improvement on Timed 25-Foot Walk and 9-Hole Peg Test, respectively. There are currently no FDA-approved autologous cell therapy options for MS, and the therapeutic landscape of options for those with PMS remains limited.

The primary end point of the study was safety, with secondary efficacy end points that included T25W, 9HPT, Low Contrast Letter Acuity, Symbol Digit Modalities Test, 12 item MS Walking Scale, as well as cerebrospinal fluid, and blood biomarkers. Cohen, director, Mellen Center for MS Treatment and Research, 

, sat down to discuss whether observing a mechanistic effect is more valuable than achieving efficacy end points at this stage of the treatment’s pipeline.

Videos

The director of the Mellen Center for MS Treatment and Research at Cleveland Clinic provided context on whether efficacy outcomes should be weighed more than mechanistic action when evaluating MSC-NTF cell therapies. [WATCH TIME: 3 minutes]

Grading Valuable Aspects of Mesenchymal Cell Activity in Progressive MS: Jeffrey Cohen, MD

"Progressive MS represents a major unmet need in the field. We think that the therapies that are going to be effective will probably have different actions than our currently available therapies. They will have neuroprotective activity or that they promote. Several aspects of mesenchymal stem cell function meet those needs."

, October 13-15, investigators presented key data from a phase 2 study that evaluated autologous mesenchymal stromal cells secreting neurotrophic factors (MSC-NTF) cells in patients with progressive multiple sclerosis (MS). These cells are induced to increase secretion of neuroprotective and immunomodulatory molecules and may address compartmentalized central nervous system inflammation. The trial featured 18 patients with progressive MS who had mean Expanded Disability Status Scale scores of 5.4.

At the conclusion of the 28-week treatment period, 14% and 13% of treated patients showed 25% improvements in timed 25-foot walk and 9-Hole Peg Test. In comparison, no patients from the Comprehensive Longitudinal Investigation of Multiple Sclerosis, or CLIMB, registry (n = 48), the study’s matched cohort, achieved these outcomes during comparable follow-up. The therapy also demonstrated relevant cerebrospinal fluid biomarker outcomes as well.

, director, Mellen Center for MS Treatment and Research, 

, and president, Americas Committee for Treatment and Research in Multiple Sclerosis, sat down with 

to discuss the presentation. He provided context on the need for alternative therapies for patients with progressive MS, and why the mechanistic action of MSC-NTF cells pose as an intriguing option.

Cohen J, Lublin F, Lock C, Pelletier D, et al. Phase 2 safety and efficacy study of intrathecal MSC-NTF cells in progressive multiple sclerosis. Presented at ECTRIMS 2021.

The director of the Mellen Center for MS Treatment and Research at Cleveland Clinic discussed the use of MSC-NTF cells in progressive MS and the data backing this approach. [WATCH TIME: 3 minutes]

Benefits to Treating Progressive MS With Mesenchymal Stem Cells: Jeffrey Cohen, MD

“What was interesting about [the Kenneth P. Johnson Memorial Lecture and the National Multiple Sclerosis Society Barancik Award Presentation and Talk] is that they emphasized novel interactions between the immune system and the myelin-forming cells. Dr. [Benjamin] Segal talked about some novel leukocyte populations—some immune cell populations that are involved not only in the damage that’s caused by MS, but also in stimulating the repair that naturally happens.”

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021

 included a variety of presentations and talks focused on the meeting’s theme of the “Spectrum of Multiple Sclerosis” (MS). This was very prevalent in the 2 opening talks: the Kenneth P. Johnson Memorial Lecture, delivered this year by 

, and the National MS Society Barancik Award Presentation and Talk, delivered by Dwight E. Bergles, PhD.

For ACTRIMS president Jeffrey Cohen, MD, these talks were very reflective of the state of the science in MS research and a few novel bits of information. Segal focused on the understanding of progressive MS and the role that immune cells play in disease progression and repair, while Bergles spent time on the interactions that oligodendrocytes have with the immune system and the axons. Both, ultimately, displaying the new understandings that are being researched in MS currently.

Additionally, Cohen, who is also the director of the Mellen Center for MS Treatment and Research at Cleveland Clinic, shared his thoughts on the impact of COVID-19 with 

 in this interview. He spoke to the COVID-themed presentations given in the Cutting Edge sessions, and how the virus affected the normal relaying of phase 2 and 3 clinical trial data at this year’s meeting.

For more coverage of ACTRIMS Forum 2021, 

The president of the Americas Committee for Treatment and Research in MS shared his perspective on the impact of COVID and the top talks at the ACTRIMS Forum 2021.

The COVID Focus and the Top Talks at ACTRIMS 2021: Jeffrey Cohen, MD

“We put on the large, combined meeting with ECTRIMS in the fall—MS Virtual 2020—so we learned a lot of lessons from that.”

For a year now, medical organizations and societies around the world have been forced to shift to a virtual format for their annual meetings, adjusting from the normal ebbs and flows on the exhibit hall floors to an all-digital, on-demand style. For the major multiple sclerosis (MS) groups like the 

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS)

 and its Forum 2021, this was no different.

This year’s meeting ran from February 25-27, with a theme focused on the spectrum of MS, and was granted a distinct advantage regarding its planning, as Jeffrey Cohen, MD, president, ACTRIMS, and director, Mellen Center for MS Treatment and Research, Cleveland Clinic, told 

. Specifically, ACTRIMS had fortunately already in-part run a virtual meeting—the joint meeting with its European counterpart, ECTRIMS. Conversely, the 2020 meeting was one of the final in-person conferences of the year.

In this interview, Cohen offers his perspective on the forum in this new format. He shared his thoughts the impact of missing the personal interactions that are so vital to the experience, such as hallway conversations and discussions over coffee, and how ACTRIMS tried to re-create those experiences. Additionally, he spoke to what he envisions the future of the ACTRIMS Forum to look like as future meetings take on a hybrid nature.

The president of the Americas Committee for Treatment and Research in MS discusses his takeaways from this year’s virtual forum.

Jeffrey Cohen, MD

Articles

Grading Valuable Aspects of Mesenchymal Cell Activity in Progressive MS: Jeffrey Cohen, MD

Benefits to Treating Progressive MS With Mesenchymal Stem Cells: Jeffrey Cohen, MD

The COVID Focus and the Top Talks at ACTRIMS 2021: Jeffrey Cohen, MD

ACTRIMS 2021 Post-Conference Expert Perspective: Jeffrey Cohen, MD