Autologous Muscle-Derived Cell Therapy for Swallowing Impairment in Patients Following Treatment for Head and Neck Cancer

Objectives/Hypothesis To evaluate the safety and potential efficacy of autologous muscle-derived cells (AMDCs) for the treatment of swallowing impairment following treatment for oropharynx cancer. Study Design Prospective, phase I, open label, clinical trial. Methods Oropharynx cancer survivors disease free >= 2 years post chemoradiation were recruited. All patients had swallowing impairment but were not feeding tube dependent (Functional Oral Intake Scale [FOIS] >= 5). Muscle tissue (50-250 mg) was harvested from the vastus lateralis and 150 x 10(6) AMDCs were prepared (Cook MyoSite Inc., Pittsburgh, PA). The cells were injected into four sites throughout the intrinsic tongue musculature. Participants were followed for 24 months. The primary outcome measure was safety. Secondary endpoints included objective measures on swallowing fluoroscopy, oral and pharyngeal pressure, and changes in patient-reported outcomes. Results Ten individuals were enrolled. 100% (10/10) were male. The mean age of the cohort was 65 (+/- 8.87) years. No serious adverse event occurred. Mean tongue pressure increased significantly from 26.3 (+/- 11.1) to 31.8 (+/- 9.5) kPa (P = .017). The mean penetration-aspiration scale did not significantly change from 5.6 (+/- 2.1) to 6.8 (+/- 1.8), and the mean FOIS did not significantly change from 5.4 (+/- 0.5) to 4.6 (+/- 0.7). The incidence of pneumonia was 30% (3/10) and only 10% (1/10) experienced deterioration in swallowing function throughout 2 years of follow-up. The mean eating assessment tool (EAT-10) did not significantly change from 24.1 (+/- 5.57) to 21.3 (+/- 6.3) (P = .12). Conclusion Results of this phase I clinical trial demonstrate that injection of 150 x 10(6) AMDCs into the tongue is safe and may improve tongue strength, which is durable at 2 years. A blinded placebo-controlled trial is warranted. Level of Evidence Level 3 Laryngoscope, 2021