Treatment of nonhealing diabetic foot ulcers with a platelet-derived growth factor gene-activated matrix (GAM501): results of a phase 1/2 trial

Wound Repair Regen. 2009 Nov-Dec;17(6):772-9. doi: 10.1111/j.1524-475X.2009.00541.x. Epub 2009 Oct 12.

Abstract

The results from a Phase 1/2 study of a replication-defective adenovirus encoding human platelet-derived growth factor (PDGF)-B formulated in a bovine collagen (Ad-5PDGF-B; 2.6% collagen; GAM501) gel for nonhealing neuropathic diabetic foot ulcers is reported. The primary objectives of the study were to evaluate the safety, maximum-tolerated dose, and preliminary biological activity of GAM501. Fifteen patients enrolled into the study with chronic, nonhealing ulcers received either a single administration of GAM501 at one of three dose levels, or up to four administrations of GAM501 at 1-week intervals. All patients received standard of care treatment including debridement and were required to wear an off-loading shoe. GAM501 was found to be safe and well tolerated with no evidence of systemic or local toxicity at all doses so no maximum-tolerated dose was reached. Serum antibody titers to platelet-derived growth factor-B homodimer and collagen were negative and adenoviral DNA was not detected in the blood. In the 12 patients that completed the study, ulcer closure was observed by Month 3 in 10 patients, seven of whom received a single application of GAM501. In conclusion, GAM501 did not appear to have any toxicity at doses that showed biological activity. GAM501 holds promise as a potentially effective treatment for nonhealing diabetic foot ulcers.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenoviruses, Human / genetics
  • Adenoviruses, Human / immunology
  • Administration, Topical
  • Adult
  • Aged
  • Bandages, Hydrocolloid
  • Debridement
  • Diabetic Foot / drug therapy*
  • Diabetic Foot / surgery
  • Drug Dosage Calculations
  • Female
  • Gels
  • Genetic Therapy*
  • Humans
  • Male
  • Middle Aged
  • Proto-Oncogene Proteins c-sis / administration & dosage*
  • Proto-Oncogene Proteins c-sis / adverse effects
  • Proto-Oncogene Proteins c-sis / genetics*
  • Wound Healing*

Substances

  • Gels
  • Proto-Oncogene Proteins c-sis