The International Linked Clinical Trials (iLCT) programme is the brainchild of The Cure Parkinson's Trust's Dr Richard Wyse and is a collaborative effort between The Cure Parkinson's Trust (CPT) and the Van Andel Institute (VAI) primarily designed to repurpose existing medications that have potential to change the course of Parkinson’s progression. Year on year, the initiative goes from strength to strength as more clinical trials of potentially disease modifying drugs are launched within the programme. 

The iLCT meeting occurs only once each year, but preparations are ongoing year round. The process starts with the identification of biological pathways of interest in what we know about the underlying pathology associated with Parkinson's. We look for specific cellular networks that are affected or potentially involved in the condition. We then maintain a constant vigilance on research being published regarding these pathways - regardless of whether they are in brain research or other medical conditions. Of particular interest to us is the development of novel therapies targeting these pathways.

Once interesting drugs have been identified, we begin exploring their basic characteristics and what they do in the body. For example, in most cases it is vitally important that the drug can access the brain, which is surrounded by a protective membrane that limits most drugs from entering. It is also important to understand how well absorbed the drug is and how long it lasts in the body. In addition, the committee is focused on the safety and tolerability of the compounds being discussed as they do not want to prioritise a treatment that could potentially do harm.

Over the course of the year, CPT will be in discussions with various biotech companies and academic researchers building the case for each experimental therapy. During the months of June and July, the research team begins compiling the dossiers of the drugs that have demonstrated the most potential. The dossiers cannot be made publicly available as they often contain confidential information. In addition, CPT is concerned about the safety issues associated with potential self-experimentation. It is important to appreciate that these therapies are experimental, and in many cases very little is known about what they could potentially do in people with Parkinson's. 

This selection process forms the basis of how CPT decides which drugs should be clinically tested, and this rigorous process has resulted in a clinical trial programme that now involves 16 drugs in 17 clinical trials - some of which are about to start, some nearing completion and some, having completed, and are moving quickly on to the next phase. The iLCT programme is the fastest way that we can conceive of getting desperately needed novel therapies into the clinic for the Parkinson's community. Read more about the 2020 iLCT Meeting.

The drug selection process is governed and evaluated by a committee of world leading scientists, physicians and advocates, all experts in their field of Parkinson's research. As chair of the iLCT committee since the programme was created in 2012, Van Andel Institute’s Professor Patrik Brundin has been instrumental in its success and the two organisations' partnership has been a vital ingredient in this flourishing programme.

Professor Brundin explains the role of the iLCT committee:

The iLCT initiative is a collaborative effort primarily designed to repurpose existing medications that have potential for slowing or stopping Parkinson’s progression. It has an ambitious, unifying goal - move these drugs into clinical trials and if they are successful, change the standard of care for people with Parkinson’s.

To do this, iLCT harnesses the collective expertise of leading scientists, physicians and advocates from around the world who meet annually to discuss candidate medications and prioritise them for support. Each year we whittle down the list from around 30 compounds to three or four based on extensive evaluation of scientific evidence. We then work with a global network of collaborators to design, fund and launch clinical trials.

The mission of iLCT is an urgent one. Parkinson’s disease is a growing public health problem and there still is no therapy that slows the relentless progression of symptoms. It is a daunting challenge, but we hope that a transformative discovery will soon be on the horizon.

Professor Patrik Brundin is one of the top cited researchers in the field of neuroscience with more than 300 publications on Parkinson’s and related topics. He has 35 years of experience studying neurodegenerative diseases, and in addition to managing his laboratory at the Van Andel Research Institute (VARI) and serving as director of the institute’s Center for Neurodegenerative Science, he is the co-editor-in-chief of the Journal of Parkinson’s Disease; a member of the World Parkinson Coalition’s board of directors and chair of the iLCT committee. He is heavily involved in the Parkinson’s community and works closely with advocates to find ways to further research and to improve the quality of life for people with Parkinson’s.

In January 2019, the Australian Parkinson's Mission - an international collaboration between the Garvan Institute of Medical Research, Shake It Up Australia Foundation, Parkinson’s Australia, The Cure Parkinson’s Trust (CPT) and the Michael J. Fox Foundation for Parkinson’s - was awarded a A$30 million government grant to identify and fast-track better treatments for Parkinson's. This innovative Australian-led programme of research expands the global Linked Clinical Trials programme spearheaded by CPT and establishes a first step towards personalised medicine providing an opportunity to deliver multiple clinical trials that incorporate advanced genetic and biomarker studies in a way that has not been done before.


The iLCT Scientific Committee

Patrik Brundin, M.D., Ph.D. (Scientific Committee chair) -VARI Associate Director of Research, Professor and Director of the Center for Neurodegenerative Science, Jay Van Andel Endowed Chair in Parkinson’s Research

Further reading: Patrik Brundin - Life on the River - published in The Lancet : March 22, 2019 

Roger Barker, MBBS, MRCP, Ph.D. - Professor of Clinical Neuroscience, University of Cambridge, UK

Flint Beal, M.D. - University Professor, Professor of Neuroscience, Professor of Neurology, Cornell University, Ithaca, USA

Camille Carroll, M.D.M.D., Ph.D. Associate Professor and Honorary Consultant Neurologist, University of Plymouth Faculty of Health and University Hospitals Plymouth NHS Trust

Mark R. Cookson, Ph.D. - Senior Investigator, Laboratory of Neurogenetics, NIH, USA

Ted Dawson, M.D., Ph.D. - Leonard and Madlyn Abramson Professor of Neurodegenerative Diseases, Johns Hopkins University, Baltimore, USA

David Devos, Ph.D. - University of Lille Nord de France · Medical Pharmacology

Tim Greenamyre, M.D., Ph.D. - Professor & Vice-Chair of Neurology, Movement Disorders Division Director, Pittsburgh Institute for Neurodegenerative Diseases

Howard Federoff, M.D., Ph.D. - Vice Chancellor for Health Affairs, Dean School of Medicine, Professor Neurology, University California at Irvine, USA

Brian Fiske, Ph.D. - Senior Vice President, Research Programs, The Michael J Fox Foundation

Tom Folytnie, Ph.D. - Consultant Neurologist and Senior Lecturer at the National Hospital for Neurology & Neurosurgery, University College, London, UK

Karl Kieburtz, M.D., MPH - Robert J. Joynt Professor in Neurology, Director of Clinical and Translational Science Institute, University of Rochester Medical Center, University of Rochester, Rochester, USA

Dimitri Krainc, M.D. - Chair, Department of Neurology, Director, Center for Rare Neurological Diseases (CRND), Northwestern University Feinberg School of Medicine, Chicago, USA

Andrew Lees, F.R.C.P., FMedSci - Professor of Neurology, The National Hospital for Neurology and Neurosurgery, Queen’s Square, Emeritus Director, Reta Lila Weston Institute of Neurological Sciences, University College London Institute of Neurology, University College London, U.K.

Mark Mattson, Ph.D. - Chief, Laboratory of Neurosciences, National Institute on Aging, Professor of Neuroscience, Johns Hopkins University, Baltimore, USA

Michael Schwarzschild, M.D., Ph.D. - Professor of Neurology, Harvard Medical School, Director of the Molecular Neurobiology Lab, Massachusetts General Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard University, Boston, USA

David Simon, M.D.
Director, National Parkinson Foundation Center of Excellence Parkinson's Disease Center, Associate Professor of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, USA

David Sulzer, M.D.
Professor of Clinical Neurology, Pharmacology and Psychiatry, Research Laboratories for Parkinson's Disease, Columbia University, New York, USA

Caroline Tanner, M.D., Ph.D., F.A.A.N. - Director, Parkinson’s Disease Research Education and Clinical Center, San Francisco Veterans Affairs Medical Center, Professor of Neurology, University of California, San Francisco, USA

John Trojanowski, M.D. - William Maul Measey-Truman G. Schnabel Professor of Geriatric Medicine and Gerontology, University of Pennsylvania, Philadelphia, USA

Dr Richard Wyse, - Director of Research, The Cure Parkinson’s Trust, UK

Dr Simon Stott - Deputy Director of Research, The Cure Parkinson’s Trust, UK