- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02730299
Stem Cell Transplantation With NiCord® (Omidubicel) vs Standard UCB in Patients With Leukemia, Lymphoma, and MDS
A Multicenter, Randomized, Phase III Registration Trial of Transplantation of NiCord®, Ex Vivo Expanded, UCB-derived, Stem and Progenitor Cells, vs. Unmanipulated UCB for Patients With Hematological Malignancies
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Successful blood and marrow transplantation (BMT) requires the infusion of a sufficient number of hematopoietic stem/progenitor cells (HSPCs), capable of both homing to the bone marrow and regenerating a full array of hematopoietic cell lineages with early and late repopulating ability in a timely fashion.
A major drawback of Umbilical Cord Blood (UCB) is the low stem cell dose available for transplantation, compared to mobilized peripheral blood (PB) or bone marrow. This low stem cell dose can compromise the chances of engraftment and contributes to delayed kinetics of neutrophil and platelet recovery, as well as other transplant outcomes.
The aim of ex vivo expansion of cord blood is to provide a graft with sufficient numbers of cells that have rapid and robust in vivo neutrophil and platelet producing potential to enable successful transplantation.
NiCord® is a stem/progenitor cell-based product composed of ex vivo expanded allogeneic cells from one entire unit of UCB. NiCord® utilizes the small molecule nicotinamide (NAM), as an epigenetic approach to inhibit differentiation and to increase the migration, bone marrow (BM) homing and engraftment efficiency of Hematopoietic Progenitor Cells (HPC) expanded in ex vivo cultures. The chief aim of the study is to compare the safety and efficacy of NiCord® single ex-vivo expanded cord blood unit transplantation to unmanipulated cord blood unit transplantation in patients with hematological malignancies following conditioning therapy.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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São Paulo, Brazil
- Hospital Israelita Albert Einstein
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Rio de Janeiro
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Rio de Janeiro, Rio de Janeiro, Brazil, 20230-130
- Instituto Nacional de Câncer José Alencar Gomes da Silva - INCA
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São Paulo
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São Paulo, São Paulo, Brazil, 05403-010
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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São Paulo, São Paulo, Brazil, 05403-010
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Pediatrics
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São Paulo, São Paulo, Brazil, 14048-900
- Hospital Das Clinicas Da Faculdade De Medicina De Ribeirao Preto da Universidade de Sao Paulo
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Paris, France, 75019
- Robert Debré
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Haifa, Israel
- Rambam
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Jerusalem, Israel
- Hadassah Medical Center
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Petah Tikva, Israel
- Rabin Medical Center, Beilinson Hospital
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Tel Aviv, Israel
- Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center
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Tel Aviv, Israel
- Tel-Aviv Sourasky Medical Center
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Tel Litwinsky, Israel
- Chaim Sheba Medical Center, The Edmond and Lily Safra Children's hospital
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Florence, Italy, 50134
- Careggi University Hospital
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Rome, Italy, 00165
- Ospedale Pediatrico Bambino Gesù
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Utrecht, Netherlands, 3503 AB
- University Medical Center Utrecht
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Utrecht, Netherlands, 3584 CS
- Prinses Maxima Centrum voor Kinderoncologie B.V.
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Lisbon, Portugal, 1099-023
- Instituto Português de Oncologia de Lisboa Francisco Gentil
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Singapore, Singapore, 169608
- Singapore General Hospital
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Singapore, Singapore, 119074
- National University Cancer Institute
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Barcelona, Spain
- Hospital de la Santa Creu i Sant Pau
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Barcelona, Spain, 08035
- University Hospital Vall d'Hebron
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Barcelona, Spain, 08035
- Hospital Universitari Vall d'Hebron pediatrics
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Barcelona, Spain, 08908
- ICO Bellvitge
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Barcelona, Spain, 08950
- Sant Joan de Deu
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Seville, Spain
- Hospital Universitario Virgen del Rocio
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Valencia, Spain, 46009
- Hospital Universitario La Fe
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Valencia, Spain
- Hospital Universitario y Politécnico La Fe (pediatric)
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Birmingham, United Kingdom, B15 2GW
- Queen Elizabeth Hospital
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Leeds, United Kingdom, LS9 7TF
- St James Hospital
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Manchester, United Kingdom, M13 9WL
- Manchester University NHS Foundation Trust
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Surrey
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Sutton, Surrey, United Kingdom, SM2 5PT
- The Royal Marsden NHS Foundation Trust
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California
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Los Angeles, California, United States, 90095
- UCLA
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Los Angeles, California, United States, 91010
- City of Hope
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Palo Alto, California, United States
- Stanford University Cancer Institute
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San Diego, California, United States, 92093
- UC San Diego Moores Cancer Center
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Colorado
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Denver, Colorado, United States, 80045
- Children's Hospital Colorado
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Illinois
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Evanston, Illinois, United States, 60208
- Northwestern University
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Maywood, Illinois, United States, 60153
- Loyola University, Cardinal Bernardin Cancer Center
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Kansas
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Westwood, Kansas, United States, 66205
- University of Kansas Cancer Center
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Maryland
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Baltimore, Maryland, United States, 21201
- The University of Maryland Medicine Center
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Dana-Farber Cancer Institute
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Boston, Massachusetts, United States, 02115
- Boston Children's Hospital
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Michigan
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Detroit, Michigan, United States
- Henry Ford Medical Center
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Minnesota
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Minneapolis, Minnesota, United States, 55455
- University of Minnesota Masonic Cancer Center
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New Jersey
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New Brunswick, New Jersey, United States, 08901
- Rutgers Cancer Institute of New Jersey
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University Medical Center
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Ohio
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic Children's
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Oregon
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Portland, Oregon, United States, 97239
- Oregon Health & Science University
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15224
- UPMC Children's Hospital of Pittsburgh
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Tennessee
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Germantown, Tennessee, United States, 38138
- West Cancer Clinic
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Texas
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Dallas, Texas, United States, 75235
- Children's Medical Center Of Dallas
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Virginia
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Charlottesville, Virginia, United States, 22903
- University of Virginia Cancer Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Applicable disease criteria
- Patients must have one or two partially HLA-matched CBUs
- Back-up stem cell source
- Adequate Karnofsky/Lansky Performance score
- Sufficient physiological reserves
- Signed written informed consent
Exclusion Criteria:
- HLA-matched donor able to donate
- Prior allogeneic HSCT
- Other active malignancy
- Active or uncontrolled infection
- Active/symptoms of central nervous system (CNS) disease
- Pregnancy or lactation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: NiCord® (omidubicel)
NiCord® is a cryopreserved stem/progenitor cell based product comprised of:
Both fractions, i.e. NiCord® CF and NiCord® NF, will be kept frozen until they are thawed and infused on the day of transplantation. |
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Active Comparator: Unmanipulated CBU(s)
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Cord blood unit
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Time to Neutrophil Engraftment
Time Frame: post-transplant up to 42 days
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The time to engraftment of neutrophils >500/μl was defined as per Center for International Blood and Marrow Transplant Research (CIBMTR) standards, requiring donor chimerism for neutrophil engraftment.
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post-transplant up to 42 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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First Grade 2/3 Bacterial or Invasive Fungal Infections by 100 Days Following Transplantation
Time Frame: 100 days post-transplant
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First Bacterial Infection Grades 2-3 or Invasive Fungal Infection by 100 Days following Transplantation for the Intent to Treat Population
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100 days post-transplant
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Days Alive and Out of Hospital in the First 100 Days Post-transplantation
Time Frame: 100 days post-transplantation
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Days alive and out of hospital in the first 100 Days post-transplantation for the Intent to Treat Population
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100 days post-transplantation
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Number of Participants With Platelet Engraftment by 42 Days Post-transplantation
Time Frame: 42 days post-transplantation
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Platelet engraftment defined as the first day of a minimum of three consecutive measurements on different days such that the patient has achieved a platelet count > 20 × 10^9/L with no platelet transfusions during the preceding seven days (counting day of engraftment as one of the preceding seven days) for the Intent to Treat Population
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42 days post-transplantation
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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LTF Chimerism
Time Frame: By 5 years post-transplant
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Kaplan Meier probability of donor chimerism <95%
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By 5 years post-transplant
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LTF Overall Survival
Time Frame: By 5 years post-transplant
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Kaplan Meier probability of overall survival
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By 5 years post-transplant
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LTF Disease Progression/Relapse
Time Frame: By 5 years post-transplant
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Number of patients with relapse during the long-term follow-up period
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By 5 years post-transplant
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LTF Chronic GvHD
Time Frame: By 5 years post-transplant
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Cumulative Incidence of Chronic GvHD
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By 5 years post-transplant
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Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Mitchell Horwitz, MD, Duke University
Publications and helpful links
General Publications
- Del Pozo Martin Y. 47th Annual Meeting of the EBMT. Lancet Haematol. 2021 May;8(5):e317-e318. doi: 10.1016/S2352-3026(21)00104-6. Epub 2021 Mar 31. No abstract available.
- Horwitz ME, Stiff PJ, Cutler C, Brunstein C, Hanna R, Maziarz RT, Rezvani AR, Karris NA, McGuirk J, Valcarcel D, Schiller GJ, Lindemans CA, Hwang WYK, Koh LP, Keating A, Khaled Y, Hamerschlak N, Frankfurt O, Peled T, Segalovich I, Blackwell B, Wease S, Freedman LS, Galamidi-Cohen E, Sanz G. Omidubicel vs standard myeloablative umbilical cord blood transplantation: results of a phase 3 randomized study. Blood. 2021 Oct 21;138(16):1429-1440. doi: 10.1182/blood.2021011719.
- Majhail NS, Miller B, Dean R, Manghani R, Shin H, Sivaraman S, Maziarz RT. Hospitalization and Healthcare Resource Utilization of Omidubicel-Onlv versus Umbilical Cord Blood Transplantation for Hematologic Malignancies: Secondary Analysis from a Pivotal Phase 3 Clinical Trial. Transplant Cell Ther. 2023 Dec;29(12):749.e1-749.e5. doi: 10.1016/j.jtct.2023.09.004. Epub 2023 Sep 12.
- Szabolcs P, Mazor RD, Yackoubov D, Levy S, Stiff P, Rezvani A, Hanna R, Wagner J, Keating A, Lindemans CA, Karras N, McGuirk J, Hamerschlak N, Lopez-Torija I, Sanz G, Valcarcel D, Horwitz ME. Immune Reconstitution Profiling Suggests Antiviral Protection after Transplantation with Omidubicel: A Phase 3 Substudy. Transplant Cell Ther. 2023 Aug;29(8):517.e1-517.e12. doi: 10.1016/j.jtct.2023.04.018. Epub 2023 Apr 28.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms by Site
- Neoplasms
- Chronic Disease
- Disease Attributes
- Immune System Diseases
- Neoplasms by Histologic Type
- Hematologic Diseases
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Leukemia, Myeloid
- Bone Marrow Diseases
- Leukemia, Lymphoid
- Leukemia
- Myeloproliferative Disorders
- Pathological Conditions, Signs and Symptoms
- Hemic and Lymphatic Diseases
- Leukemia, Myeloid, Acute
- Hematologic Neoplasms
- Lymphoma
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
- Myelodysplastic Syndromes
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Other Study ID Numbers
- GC P#05.01.020
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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