Caspofungin Maximum Tolerated Dose in Patients With Invasive Aspergillosis

July 25, 2013 updated by: Oliver Cornely, MD, University of Cologne

A Phase II Dose Escalation Study of Caspofungin in Patients With Invasive Aspergillosis

This study investigates the safety and tolerability as well as the efficacy and pharmacokinetics of caspofungin in four escalating dosages in adult patients with hematologic malignancies and proven or probable invasive aspergillosis.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Due to its efficacy and a broad antifungal spectrum against relevant fungal pathogens, lack of cross-resistance to azoles and amphotericin B, documented efficacy against human Aspergillus infections, favorable pharmacokinetic properties, and excellent tolerability according to the current data, caspofungin is a highly promising candidate for improving the results of treatment of invasive fungal infections.

Preclinical and clinical data indicate a dose dependent antifungal efficacy of caspofungin as well as of other echinocandins such as micafungin and anidulafungin. Thus it appears reasonable to investigate the impact of higher doses of caspofungin to improve the results already achieved with this component so far.

The maximum tolerated dose (MTD) of caspofungin and the distribution of the drug in patients following administration of doses of 70 mg or more are not yet known. We therefore investigate the safety, tolerability and pharmacokinetics of caspofungin in rising doses in a dose escalation study in adult patients with proven or probable invasive aspergillosis.

Study Type

Interventional

Enrollment (Actual)

46

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Belgium
      • Leuven, Belgium, 3000
        • University Hospital Gasthuisberg
  • Germany
      • Berlin, Germany, 12200
        • Charite - Campus Benjamin Franklin
      • Köln, Germany, 50924
        • Klinikum der Universität zu Köln
      • Münster, Germany, 48149
        • Universitatsklinikum Munster

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Immunocompromised due to hematologic malignancies, bone marrow failure syndromes, hematopoietic stem cell transplantation, solid organ transplantation, other conditions resulting in severe neutropenia, HIV infection, prolonged corticosteroid therapy, treatment with other immunosuppressive medications, or other immunocompromising conditions that place patients at risk for invasive fungal infections.
  • Evidence of proven or probable invasive aspergillosis, by modified EORTC criteria

Exclusion Criteria:

  • Concomitant other systemic antifungal agents are not permitted on study.
  • Chronic invasive fungal infection, defined as signs/symptoms of invasive fungal infection present for > 4 weeks preceding entry into study
  • Prior systemic therapy of ≥ 4 days with any polyene anti-fungal agent within 14 days of study enrollment
  • Prior systemic therapy of ≥ 4 days with non-polyenes for the current, documented IFI.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 1st cohort
70mg caspofungin 1x/day
Drug: caspofungin
i.v.
Other Names:
  • cancidas
Experimental: 2nd cohort
100mg caspofungin 1x/day
Drug: caspofungin
i.v.
Other Names:
  • cancidas
Experimental: 3rd cohort
150mg caspofungin 1x/day
Drug: caspofungin
i.v.
Other Names:
  • cancidas
Experimental: 4th cohort
200mg caspofungin 1x/day
Drug: caspofungin
i.v.
Other Names:
  • cancidas

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Safety and Tolerability of Caspofungin in Four Escalating Dosages in Adult Patients With Hematologic Malignancies and Proven or Probable Invasive Aspergillosis
Time Frame: End of caspofungin treatment, treatment duration varied between 3 and 29 days (mean: 20.5; median: 24.5)
Endpoints of safety and tolerability are the number of toxicity-related study therapy discontinuations and grade III and IV clinical and laboratory events, as evaluated on the basis of current NCI criteria.
End of caspofungin treatment, treatment duration varied between 3 and 29 days (mean: 20.5; median: 24.5)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Efficacy of Caspofungin in Four Escalating Dosages in the Treatment of Proven or Probable Invasive Aspergillosis.
Time Frame: End of caspofungin treatment; 4 weeks follow-up; 12 weeks follow-up

Numbers of patients in each dose cohort according to invasive aspergillosis (IA) outcome at end of protocol treatment (EOT), 4 weeks follow-up (4w FU) and 12 weeks follow-up (12w FU), respectively. 12w FU was only required for patients with a CR or PR at the 4w FU.

Definitions:

CR: resolution of all attributable symptoms, signs, and radiographic or bronchoscopic abnormalities.

PR: clinically meaningful improvement in attributable symptoms, signs, and radiographic (min. 50% decrease) or bronchoscopic abnormalities.

Stable disease (SD): no improvement in attributable symptoms, signs, and radiographic or bronchoscopic abnormalities.

Failure: deterioration in attributable clinical or radiographic abnormalities necessitating alternative antifungal therapy or resulting in death.

Relapse: reemergence of IA after EOT following CR, PR or SD or early withdrawal.
End of caspofungin treatment; 4 weeks follow-up; 12 weeks follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Cologne

Investigators

  • Principal Investigator: Oliver A. Cornely, MD, Klinikum der Universität zu Köln

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2006

Primary Completion (Actual)

October 1, 2009

Study Completion (Actual)

October 1, 2009

Study Registration Dates

First Submitted

November 24, 2006

First Submitted That Met QC Criteria

November 24, 2006

First Posted (Estimate)

November 27, 2006

Study Record Updates

Last Update Posted (Estimate)

July 31, 2013

Last Update Submitted That Met QC Criteria

July 25, 2013

Last Verified

July 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Uni-Koeln-687
  • 2006-001936-30 (EudraCT Number)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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