ClinicalTrials.gg
RecruitingNCT04220190Updated Sep 29, 2026

RAPA-501 Therapy for ALS

A Phase 2/3 interventional study of RAPA-501 Autologous T stem cells in Amyotrophic Lateral Sclerosis, sponsored by Rapa Therapeutics LLC. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-29.

Sponsored by Rapa Therapeutics LLC · Phase 2/3, Interventional, and Treatment

From the registry’s dates

  • Started Jan 2025; still recruiting 1 year 10 months later.
Updated Sep 29, 2026Primary completion movedStudy completion moved+1 moreGo to Updates ↓
Phase
Phase 2/3
Study type
Interventional
Enrollment
41
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

RAPA-501-ALS is a phase 2/3 expansion cohort study of RAPA-501 autologous hybrid TREG/Th2 cells in patients living with amyotrophic lateral sclerosis (pwALS).

Read the detailed description

This is an open-label, non-randomized, multi-center phase 2/3 study evaluating RAPA-501 T stem cell therapy in pwALS on an expansion cohort. Amyotrophic lateral sclerosis (ALS) is a rare disease that is also considered an orphan disease according to the Orphan Drug Act.

After a subject consents to the study, an apheresis procedure will be performed to collect cells to manufacture the investigational product, RAPA-501 T stem cells. RAPA-501 T stem cells are manufactured ex vivo using epigenetic reprogramming to yield a T stem cell population that is enriched for a dual anti-inflammatory phenotype based on hybrid TREG and Th2 differentiation. RAPA-501 cells express both the TREG and Th2 transcription factors FOXP3 and GATA3, are enriched for expression of the ATP ectonucleotidase molecules CD39 and CD73, are enriched for the T cell homing molecule CD103, and suppress both effector T cell inflammatory molecules and CNS microglial cell inflammatory molecules.

This study consists of a phase 2/3 expansion cohort that is evaluating RAPA-501 T stem cell therapy at the dose of 80 x 10EE6 cells per infusion, with up to 4 infusions separated by six weeks between doses (infusion at time 0, and then after week 6, 12, and 18). Study subjects are then followed at the treatment site at 24 weeks and 30 weeks on-study. The primary objective in the expansion cohort is to determine the feasibility and safety of the highest established safe dose of RAPA-501 (80 x 10EE6 cells per infusion) in patients with standard-risk ALS (as defining by study entry values of: SVC greater than or equal to 70% of predicted normal; time interval since first ALS symptom, 24 months or less; and ALSFRS-R score between 34 and 45). Secondary study objectives relate to assessing the potential efficacy of RAPA-501 therapy through monitoring of ALSFRS-R scores, SVC values, time to King's stage transition, and survival.

02

Conditions studied

  • Amyotrophic Lateral Sclerosis

Keywords

  • Amyotrophic Lateral Sclerosis
  • RAPA-501
  • Autologous TREG/Th2 T stem cell therapy
  • Orphan Disease
  • rare disease
03

In context

Amyotrophic Lateral Sclerosis

978 studies on the registry are indexed under Amyotrophic Lateral Sclerosis; 277 are open to participants now.

This study's planned enrollment of 41 is close to the median of 38 across 662 interventional studies indexed under Amyotrophic Lateral Sclerosis.

Browse Amyotrophic Lateral Sclerosis studies →

Lead sponsor

Rapa Therapeutics LLC is the lead sponsor of 6 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Male or female patients ≥ 18 years of age.
  2. Patients with sporadic or familial amyotrophic lateral sclerosis (ALS) diagnosed as laboratory-supported possible, probable, or definite according to World Federation of Neurology El Escorial Criteria.
  3. . Less than or equal to 24 months since ALS symptom onset.
  4. Total ALSFRS-R score between 34 and 45.
  5. Must have a source of autologous T cells potentially sufficient to manufacture RAPA-501 cells, as defined by a peripheral CD3+ T cell count ≥ 500 cells per μl.
  6. Patients may continue riluzole (Rilutek®), and/or edaravone (Radicava®), and/or sodium phenylbutyrate/taurusodial (Relyvrio™) if on a stable dose for at least 30 days prior to the screening visit.
  7. Patients must be ≥ 2 two weeks removed from major surgery or therapy.
  8. Patients must have recovered from clinical toxicities ([resolution of (v5) [version 5] toxicity to a value of ≤ 2].).
  9. Serum creatinine ≤ less than or equal to 2.0 mg/dL.
  10. (AST) and alanine aminotransferase (ALT) ≤ 3 x (ULN).
  11. ≤ 1.5 (except if due to Gilbert's disease).
  12. Pulmonary slow vital capacity (SVC) ≥ 70% of predicted normal.
  13. No history of abnormal bleeding tendency.
  14. Voluntary written consent must be given before performance of any study related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient participant at any time without prejudice to future medical care.

Exclusion criteria

Exclusion Criteria:

  1. Active uncontrolled infection.
  2. Hypertension not adequately controlled by ≤ 3 medications.
  3. History of documented pulmonary embolus within 6 months of enrollment.
  4. cardiac pathology, as defined by: myocardial infarction within 6 months prior to enrollment, Class III or IV heart failure according to , uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities.
  5. Patients with history of coronary artery bypass grafting or angioplasty will receive a cardiology evaluation and be considered on a case-by-case basis.
  6. , , or seropositive.
  7. Pregnancy or breastfeeding patients.
  8. Patients of Subjects of childbearing age, or males who have a partner of , who are unwilling to practice .
  9. Patients Subjects may be excluded at the Principal Investigator discretion of the PI or if it is deemed that allowing participation would represent an unacceptable medical or psychiatric risk.
Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
41 participants (estimated)

Study arms

  • Experimental
    RAPA-501 Autologous T stem cells

    Phase 2/3 Expansion Cohort, Single-agent RAPA-501 T stem cells 80 x 10EE6 cells per infusion (no host conditioning)

    Biological: RAPA-501 Autologous T stem cells

Interventions

  • BiologicalRAPA-501 Autologous T stem cells

    Experimental: Phase 2/3 Expansion Cohort, Single-agent RAPA-501 T stem cells 80 x 10EE6 cells per infusion (no host conditioning)

    Also known as: RAPA-501 cells

06

What researchers measure

Primary outcomes

  1. In the expansion cohort enrolling standard-risk pwALS, determine the feasibility and safety of the highest established safe dose of RAPA-501 (80 x 10^6 cells per infusion).

    Time frame: Through 30 Weeks On-Study

Secondary outcomes

  1. Characterize immune system parameters pre- and post-therapy.

    Specifically, relative to pretreatment patient peripheral blood values, determine whether study interventions: (a) increase circulating Th2 and TREG cells; (b) reduce circulating Th1 cells; (c) increase T cell expression of programmed death-1 (PD-1); and (d) reduce inflammatory cytokines IL-1-beta, IL-6, and TNF-alpha.

    Time frame: Through 30 Weeks On-Study

  2. Relative to pretreatment values, characterize the potential effect of RAPA-501 therapy on serum markers of neurodegeneration (neurofilament light, NfL).

    Time frame: Through 30 Weeks On-Study

  3. Relative to pretreatment values, characterize the potential effect of RAPA-501 therapy on pulmonary function, as measured by slow vital capacity measurements (SVC, percent of predicted normal).

    Time frame: Through 30 Weeks On-Study

  4. Relative to pretreatment values, characterize the potential effect of RAPA-501 therapy on hand grip strength using hand-held dynamometry.

    Time frame: Through 30 Weeks On-Study

07

Study locations

1 of 1 sites recruiting
08

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jan 2025 (actual). Primary completion is estimated for Jul 2027, 29 months after the start.

Of 22 phase 2/3 interventional studies under Amyotrophic Lateral Sclerosis, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 18 and three quarters within 109. This study's planned 29 months is above that.

Since we started tracking on Sep 25, 2026, the dates moved once, on Sep 29, 2026: primary completion Jul 2026 → Jul 2027 and completion Jun 2027 → Jul 2028.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Jan 3, 2020
First posted
Jan 7, 2020
StartActual
Jan 2, 2025
Primary completionEst.
Jul 1, 2027was Jul 2026
CompletionEst.
Jul 1, 2028was Jun 2027
Last update
Sep 29, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Primary completion
Jul 1, 2026→Jul 1, 2027
Sep 29, 2026
Study completion
Jun 1, 2027→Jul 1, 2028
Sep 29, 2026
Contact
Study contact changed: j•••@rapatherapeutics.com→j•••@rapatherapeutics.com. See the current contact
Sep 29, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • Massachusetts General Hospital · Boston, United StatesContact m•••@mgh.harvard.edu→r•••@mgb.orgContact removed s•••@mgh.harvard.edu · •••4968
Sep 29, 2026
Show all 1 update
  1. Sep 29, 2026
    Primary completion Jul 1, 2026→Jul 1, 2027
    Study completion Jun 1, 2027→Jul 1, 2028
    Contact Study contact changed: j•••@rapatherapeutics.com→j•••@rapatherapeutics.com. See the current contact
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Massachusetts General Hospital · Boston, United StatesContact m•••@mgh.harvard.edu→r•••@mgb.orgContact removed s•••@mgh.harvard.edu · •••4968
    + 5 other changes: index terms, verification date, oversight details, description and data sharing statement

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT04220190
Lead sponsor
Rapa Therapeutics LLC
Responsible party
Sponsor
First posted
Jan 7, 2020
Start date
Jan 2, 2025
Primary completion
Jul 1, 2027 (estimated)
Completion
Jul 1, 2028 (estimated)
Last update
Sep 29, 2026

Study contacts

Daniel Fowler, M.D. Chief Medical Officer, RAPA Therapeutics, LLC
Contact
dan@rapatherapeutics.com
(301) 518-3104
Jennifer Sunga, M.S. Senior Regulatory Affairs Associate, RAPA Therapeutics, LLC
Contact
jsunga@rapatherapeutics.com
Daniel Fowler, M.D.
study director · Rapa Therapeutics LLC

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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