- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04673266
Using Romiplostim to Treat Low Platelet Counts During Chemotherapy in People With Lymphoma
August 21, 2023 updated by: Memorial Sloan Kettering Cancer Center
Romiplostim for Prevention of Severe Chemotherapy Induced Thrombocytopenia in Lymphoma Patients - Phase II Study
The purpose of this study is to see if the study drug, romiplostim, helps low platelet count caused by standard chemotherapy treatment for lymphoma.
This study will also look at whether romiplostim can prevent the need for chemotherapy dose delays, chemotherapy dose reductions, and platelet transfusions.
In addition, we will determine how safe it is to give romiplostim to people with lymphoma who have low platelet count from chemotherapy.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
11
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
-
-
Florida
-
Miami, Florida, United States, 33136
- University of Miami - Sylvester Comprehensive Cancer Center
-
-
New Jersey
-
Basking Ridge, New Jersey, United States, 07920
- Memorial Sloan Kettering Basking Ridge (All Protocol Activites)
-
Middletown, New Jersey, United States, 07748
- Memorial Sloan Kettering Monmouth (All Protocol Activities)
-
Montvale, New Jersey, United States, 07645
- Memorial Sloan Kettering Bergen (All Protocol Activities)
-
-
New York
-
Commack, New York, United States, 11725
- Memorial Sloan Kettering Commack (All protocol activities)
-
Harrison, New York, United States, 10604
- Memorial Sloan Kettering Westchester (All Protocol Activities)
-
New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center (All Protocol Activities)
-
Uniondale, New York, United States, 11553
- Memorial Sloan Kettering Nassau (All Protocol Activities)
-
-
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
Description
Inclusion Criteria:
- Adult patients ≥ 18 years old diagnosed with any type of lymphoma.
- Receiving chemotherapy-based treatment known to cause thrombocytopenia. Eligibility is limited to regimens with a 21-day cycle. Previous single-agent anti-CD20 antibody or radiotherapy will not count as a line of treatment. Eligible regimens include those based on a platinum backbone (e.g. ICE, DHAX, DHAP, GemOx, GDP, ESHAP), those based on a doxorubicin backbone (e.g. CHOP, CDOP, HyperCVAD, BEACOPP) or on a high-dose cytarabine backbone (e.g.HiDAC). Of note, treatment programs which involve sequential administration of two or more regimens (e.g. CHOP->ICE or CHOP-DHAX) are eligible as long as the patient is planned for at least two more cycles of the regimen on which the CIT was initially observed. Regimens with inherent dose-adjustments by blood counts (e.g. da-EPOCH) are ineligible unless the treating oncologist is not planning to increase treatment doses on subsequent cycles.
History of a severe treatment-related thrombocytopenia during the most recent cycle of treatment, as defined by one or more of the following criteria:
- PLT < 50,000 on day 1 (- 2 days) of the subsequent treatment cycle.
- Grade 4 thrombocytopenia, defined as PLT <25,000 cells/mcl and/or transfusion for thrombocytopenia or bleeding. Need for PLT transfusion in order to meet minimal PLT criteria for invasive procedures will not count for eligibility.
- Patient is planned for at least one more cycle of chemotherapy.
- ECOG Performance Status of ≤ 2 (Karnofsky ≥50%, see Appendix A - ECOG/Karnofsky performance status scale).
Patients must have normal organ function as defined below on day 1 of the prior cycle:
- Absolute neutrophil count ≥ 1,000/mcL - use of gCSF is acceptable for eligibility
- Hemoglobin ≥ 7 g/dL - transfusion support is acceptable for eligibility
- Total bilirubin ≤ 3x the institutional ULN
- AST and ALT ≤ 3x institutional upper limit of normal
- Human immunodeficiency virus (HIV)-infected patients on effective antiretroviral therapy with undetectable viral load are eligible for this trial, provided there are no anticipated interactions between antiretroviral treatment and the study drug.
- Women of child-bearing potential (WOCBP) and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation.
- Ability to understand and the willingness to sign a written informed consent document prior to participation in the study and any related procedures being performed. Legally Authorized Representatives are permitted.
Exclusion Criteria:
- History of or concurrent hematological malignancy other than lymphoma (acute or chronic leukemia, myelodysplastic syndrome [MDS], myeloproliferative neoplasm, multiple myeloma). Patient with composite/concurrent lymphoma or Richter's transformation are eligible.
- History of allogeneic hematopoietic stem cell transplantation (SCT). Patients with a prior autologous SCT or CAR-T treatment are eligible.
- Patients with history of symptomatic venous thrombotic event (VTE), such as deep vein thrombosis (DVT) or pulmonary embolism (PE) who is unable to tolerate anticoagulation. Patients who have completed their indicated course of anticoagulation prior to enrollment or are tolerating ongoing anticoagulation are eligible. Patients with VTE associated with central venous catheter are eligible.
- Patients with history of symptomatic arterial thrombotic events such as myocardial infarction, ischemia cerebral vascular accident, or transient ischemic attack within 4 months prior to enrollment.
- Patients who have thrombocytopenia related to pre-existing ITP.
- Major surgery within 26 days prior to enrollment, or minor surgery within 3 days prior to enrollment.
- Solid-tumor malignancy metastatic or locally-advanced unresectable within the last 5 years that could adversely affect subject safety or longevity, create the potential for drug-drug interactions, or compromise the interpretation of study results.
- Concurrent therapy with other investigational agents.
- Within 4 months prior to enrollment, any history of active congestive heart failure (New York Heart Association [NYHA] Class III to IV), symptomatic ischemia, uncontrolled arrhythmias, clinically significant electrocardiogram (ECG) abnormalities, screening ECG with corrected QT (QTc) interval of > 470 msec, pericardial disease, or myocardial infarction.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, renal failure requiring hemodialysis, or psychiatric illness/social situations that would limit compliance with study requirements. These include abnormal laboratory values, that could cause unacceptable safety risks or compromise compliance with the protocol.
- Patients are excluded from this study if pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 180 days after the last dose of trial treatment.
- Patient has acute viral hepatitis (typically defined by elevated AST/ALT), or a history of chronic or active HBV or HCV infection (HBcAb or HBsAg positive and detectable serum/plasma HBV DNA, or HCV Ab positive and detectable serum/plasma HCV RNA).
- Patients with any significant history of non-compliance to medical regimens or unwilling or unable to comply with the instructions given to him/her by the study staff.
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: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: romiplostim
Romiplostim will be administered from the beginning of the next chemotherapy cycle with a starting dose of 3 mcg/kg subcutaneously.
Dose will be titrated based on nadir of the platelet counts during the prior cycle.
The maximum dose of romiplostim will be 6 mcg/kg.
|
All patients will begin weekly (+/- 2 days) romiplostim at 3 mcg/kg subcutaneously.
The romiplostim dose will be titrated, based on weekly CBC/platelet counts.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
measure of incidence of indication for dose delays
Time Frame: 1 year
|
defined as PLT < 50,000 cells/mcl) at the end of cycle 1 (C1D21±2d); presence of grade 4 thrombocytopenia (<25,000 cells/mcl) at any time throughout the treatment cycle; or indication for a PLT transfusion for thrombocytopenia or for bleeding at any time throughout the treatment cycle.
|
1 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Zachary Epstein-Peterson, MD, Memorial Sloan Kettering Cancer Center
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.
Helpful Links
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 (Actual)
December 14, 2020
Primary Completion (Estimated)
December 1, 2025
Study Completion (Estimated)
December 1, 2025
Study Registration Dates
First Submitted
December 14, 2020
First Submitted That Met QC Criteria
December 14, 2020
First Posted (Actual)
December 17, 2020
Study Record Updates
Last Update Posted (Actual)
August 22, 2023
Last Update Submitted That Met QC Criteria
August 21, 2023
Last Verified
August 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20-492
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
Memorial Sloan Kettering Cancer Center supports the international committee of medical journal editors (ICMJE) and the ethical obligation of responsible sharing of data from clinical trials.
The protocol summary, a statistical summary, and informed consent form will be made available on clinicaltrials.gov
when required as a condition of Federal awards, other agreements supporting the research and/or as otherwise required.
Requests for deidentified individual participant data can be made beginning 12 months after publication and for up to 36 months post publication.
Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals.
Requests may be made to: crdatashare@mskcc.org.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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.
Clinical Trials on Thrombocytopenia
-
Weill Medical College of Cornell UniversityColumbia University; New York Presbyterian HospitalCompletedAlloimmune Thrombocytopenia | Fetal Alloimmune ThrombocytopeniaUnited States
-
Sylvia ElzekUnknownThrombocytopenia Neonatal
-
Central Hospital, Nancy, FranceRecruitingHeparin-induced ThrombocytopeniaFrance
-
Centre Hospitalier Universitaire de BesanconNot yet recruitingHeparin-induced Thrombocytopenia
-
University of ArizonaAmerican College of Clinical PharmacyRecruitingHeparin-induced ThrombocytopeniaUnited States
-
Veralox TherapeuticsCelerionCompletedHeparin-induced ThrombocytopeniaUnited States
-
Aspen Global IncorporatedTerminatedHeparin-induced ThrombocytopeniaUnited States, Bosnia and Herzegovina, Canada, France, Germany, Italy, Poland, Russian Federation, Serbia
-
Marshall UniversityUnknownHeparin-induced ThrombocytopeniaUnited States
-
Ottawa Hospital Research InstituteUnknownHeparin-induced Thrombocytopenia (HIT)Canada
-
Assistance Publique Hopitaux De MarseilleWithdrawnNeonatal Thrombocytopenia Isoimmunization Maternal-fetalFrance
Clinical Trials on Romiplostim
-
Assistance Publique - Hôpitaux de ParisCompletedPersistent Thrombocytopenia Following Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)France
-
Kyowa Kirin China Pharmaceutical Co., Ltd.CompletedImmune ThrombocytopeniaChina
-
AmgenCompletedMyelodysplastic Syndromes | Thrombocytopenia | MDS
-
AmgenCompletedImmune ThrombocytopeniaUnited States, Canada, Belgium, Czechia, Mexico, Turkey, Australia, Spain, France, Israel, Hungary, South Africa, Poland, Russian Federation, United Kingdom, Brazil, Switzerland
-
Federal Research Institute of Pediatric Hematology...CompletedWiskott-Aldrich SyndromeRussian Federation
-
Samsung Medical CenterUnknown
-
Kyowa Kirin China Pharmaceutical Co., Ltd.CompletedImmune Thrombocytopenia (ITP)China
-
Memorial Sloan Kettering Cancer CenterAmgenCompletedMultiple Myeloma | Hodgkin Lymphoma | Non-Hodgkin Lymphoma | HDT-AHCTUnited States
-
Memorial Sloan Kettering Cancer CenterTerminatedSolid Tumor | Solid Carcinoma | Solid Tumor, ChildhoodUnited States
-
Memorial Sloan Kettering Cancer CenterAmgenCompletedIsolated Chemotherapy-induced ThrombocytopeniaUnited States