CorestemChemon's autologous mesenchymal stem cell therapy Neuronata-R has demonstrated meaningful efficacy signals in a subgroup of amyotrophic lateral sclerosis (ALS) patients with slow disease progression, according to final results from the company's Phase 3 ALSummit trial. The South Korean biotech company announced that the therapy showed statistically significant improvements across multiple clinical measures and consistent reductions in neurofilament light chain (NfL) biomarker levels, positioning it for potential FDA accelerated approval by mid-2026.
The findings represent a strategic pivot for CorestemChemon after the overall Phase 3 trial failed to meet its primary endpoint in December 2024. However, post hoc analysis conducted after full data collection revealed significant clinical improvements in patients with slower disease progression, prompting the company to pursue a targeted regulatory pathway similar to that used for Tofersen's recent FDA approval.
Subgroup Analysis Reveals Targeted Efficacy
The final Clinical Study Report confirmed that Neuronata-R demonstrated statistically significant improvements in key efficacy endpoints among participants with slow disease progression. CorestemChemon stratified participants into slow and fast progressors, recognizing the potential efficacy of the therapy in early-stage ALS.
Among slow progressors, Neuronata-R showed statistically significant improvements across multiple measures including the primary composite endpoint CAFS (Combined Assessment of Function and Survival), functional outcomes assessed by ALSFRS-R scores, and respiratory function measured by slow vital capacity (SVC).
At Month 6, participants in Group 1 (two-dose arm) receiving Neuronata-R showed statistically significant improvement in CAFS with an LS Mean of 20.95 versus 13.66 for placebo (95% CI; p<0.024). Group 2 (five-dose arm) also demonstrated improvement with an LS Mean of 24.78 versus 17.92 for placebo (95% CI; p<0.041).
The five-dose treatment arm demonstrated statistically significant improvement in ALSFRS-R scores beginning at Month 9 post-treatment, one month earlier than the two-dose arm, which reached significance at Month 10. In Group 2, significant divergence in SVC compared to the control group emerged from Month 8 post-treatment, suggesting a potential effect in delaying disease progression.
NfL Biomarker Reduction Supports Regulatory Strategy
CorestemChemon highlighted the reduction in NfL levels, a biomarker that served as the basis for FDA accelerated approval in ALS, including the recent decision on Tofersen. In both treatment arms, NfL levels consistently declined over time. In Group 2, NfL levels were significantly lower than placebo at both Month 4 and Month 10, suggesting a potential dose-dependent effect.
"This subgroup analysis lends strong support to a biomarker-driven approval strategy," a company official said. "The consistency of our internal analysis with external CRO validation adds credibility to the dataset and provides a concrete basis for regulatory discussions with the MFDS."
The consistency between the company's internal analysis and validation by an independent CRO strengthens the reliability of the dataset, which has been incorporated into the final Clinical Study Report.
Regulatory Timeline and Market Strategy
The company views these findings as strategically significant, particularly given their alignment with the precedent set by Tofersen, where the FDA granted accelerated approval based on NfL reduction rather than survival benefit. CorestemChemon plans to request a Pre-BLA or Type C meeting with the FDA in Q3 2025, with the goal of submitting a biologics license application by Q4 2025 and targeting regulatory approval by mid-2026.
CorestemChemon will finalize its submission package in collaboration with a global CRO and actively engage with regulatory agencies to pursue worldwide market entry for Neuronata-R.
Mechanism of Action and Safety Profile
Neuronata-R utilizes mesenchymal stem cells derived from a patient's own bone marrow to modulate inflammation, protect motor neurons, and alter the neurodegenerative microenvironment through paracrine signaling. These cells exert anti-inflammatory and immunomodulatory effects and secrete trophic factors, cytokines, and extracellular vesicles that modulate the microenvironment and reduce neuroinflammation.
The therapy has been administered to more than 400 commercial patients and 190 clinical trial participants with no treatment-related serious adverse events reported. Neuronata-R holds Orphan Drug Designation from both the U.S. FDA (2018) and the EMA (2019).
CorestemChemon began ALS research in 2002 and obtained MFDS approval for Neuronata-R in 2014. The company completed a Phase 2 trial in 2014 and its Phase 3 trial in 2024, with the final Clinical Study Report submitted to the MFDS.
