Mirdametinib bei histiozytären Erkrankungen
Eine Phase-II-Studie mit dem MEK-Inhibitor Mirdametinib bei histiozytären Erkrankungen
The purpose of this study is to see if treatment with mirdametinib in patients with Langerhans cell histiocytosis (LCH) or other histiocytic disorders will be better than current treatments and with fewer side effects.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Langerhans cell histiocytosis (LCH) is a rare blood disorder. Though affecting all ages, LCH occurs more often in children, with an increased incidence in children less than 1 year of age. The disease presents in various ways, with most children suffering bony lesions, and skin rashes. In some patients, LCH affects vital organs such as liver, spleen, bone marrow, and the central nervous system. This group of patients are at significant risk of serious illness and death and are thus said to have risk-organ-positive (RO+) LCH. Current treatments for LCH consist of chemotherapy combined with other medications. However, many patients, especially those with RO+ disease, do not respond to therapy. Of the patients that do respond, many suffer progression of disease after an initial response to therapy, or recurrence of disease after completion of therapy.
The purpose of this study is to see if treatment with mirdametinib in patients with LCH or other histiocytic disorders will be better than current treatments and with fewer side effects.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 2
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Monica Trapp
- Telefonnummer: (513) 803-8574
- E-Mail: monica.trapp@cchmc.org
Studieren Sie die Kontaktsicherung
- Name: Caitlin Cottrell
- Telefonnummer: (513) 803-7039
- E-Mail: Caitlin.Cottrell@cchmc.org
Studienorte
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-
Ohio
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Cincinnati, Ohio, Vereinigte Staaten, 45229
- Rekrutierung
- Cincinnati Children's Hospital Medical Center
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Kontakt:
- Monica Trapp
- E-Mail: Monica.Trapp@cchmc.org
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Hauptermittler:
- Ashish Kumar, MD, PhD
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Kontakt:
- Caitlin Cottrell
- E-Mail: caitlin.cottrell@cchmc.org
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
-
Subjects must be ≥ 2 years of age AND have a diagnosis of a histiocytic disorder that requires systemic therapy
- If patient has had a diagnostic biopsy, biopsy must be reviewed and confirmed by CCHMC pathologist as feasible
- If patient has had a biopsy but has not had molecular testing done, must have tissue available for mutational analysis
- If patient has isolated pituitary/CNS disease or situations where biopsy is not feasible, positive ddPCR blood test for mutation associated with histiocytic neoplasm with clinical features of histiocytosis is sufficient
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Must have measurable disease on PET scan or brain MRI
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Subjects must demonstrate adequate organ function as defined:
- Renal: maximum serum creatinine 2x the upper limit of normal (ULN) OR a creatinine clearance or radioisotope GFR ≥ 70ml/min/1.73 m2
- Liver: ALT ≤ 3x ULN AND normal INR (≤ 1.5)
- Hematologic: Hematology: Albumin ≥ 2.8 g/dL; Absolute neutrophil count ≥ 1.5 x 109/L; Platelets ≥ 100 x 109/L; Hemoglobin ≥ 9.0 g/dL
- Patients with organ function abnormalities outside of these thresholds deemed to be the result of histiocytic disease will be considered eligible
Exclusion Criteria:
-
Prior therapy with stipulations as described:
- Myelosuppressive Chemotherapy: Must not have received any cytotoxic chemotherapy which impacts the growth and development of cells in the bone marrow within 14 days of enrollment onto this study (i.e. cytarabine, cladribine, clofarabine, mercaptopurine, methotrexate, vinblastine)
- MEK Inhibitors: Must not have received a MEK inhibitor within 30 days (or 5 half-lives, whichever is longer) of enrollment, NOR have had disease progression on MEK inhibitor
- Steroids: Due to the increased risk of an ocular event, the use of systemic oral, inhaled, or ocular glucocorticoid therapy is prohibited within 14 days prior to first dose of mirdametinib. Throughout the treatment period, short term glucocorticoid treatment (30 days or less) is permitted. Any patients requiring long-term steroid use (more than 30 consecutive days) are not eligible. The exception to this rule is subjects with endocrine deficiencies who require physiologic steroids
- Radiation: Must not have received radiation within 14 days of study enrollment or have received radiation to the orbit at any time
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Risk factors for retinal vein occlusion (RVO) are listed. Exclusion should be considered by clinical discretion if they have any of the following risk factors for RVO at screening:
- Intraocular pressure (IOP) > 21 mmHg; if IOP is unable to be obtained (eg age, cooperation, tolerability), ophthalmologist's exam findings and overall assessment will be utilized. If in the ophthalmologist's assessment there are no signs of raised IOP, the subject will be considered eligible for this parameter
- Glaucoma or any significant abnormality (≥ grade 2) on ophthalmologic exam that is uncontrolled with intervention
- Serum cholesterol > 300 mg/dL
- Serum triglycerides > 300 mg/dL
- Hyperglycemia (either fasting blood glucose > 125 mg/dL OR random blood glucose > 200 mg/dL)
- Uncontrolled hypertension (participants ≤ 12 years of age with a blood pressure ≥ 95th percentile for age + 12 mmHg; participants ≥ 13 years of age with a blood pressure ≥ 140/90 mm Hg) unresolved on repeat measurement
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LVEF < 55% at screening OR history of clinically significant cardiac disease, unless deemed to be the direct result of disease
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Subjects who are pregnant or breastfeeding, or are at risk of pregnancy or fathering a baby and are unable to use acceptable methods of birth control during the length of the study
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Experimental: Mirdametinib
Mirdametinib will be dosed by mouth twice a day at a dose of 2 mg/m2 BID with a max of 4 mg BID (8 mg per day max). |
Mirdametinib is administered by mouth twice daily on a continuous schedule, with each cycle being 4 weeks. Patients are instructed to take consecutive doses separated by a minimum of 6 hours and a maximum of 14 hours. |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Response rate to mirdametinib
Zeitfenster: 1 year (completion of 13 four week cycles)
|
Best overall response rate to mirdametinib after 13 four-week cycles as defined by positron emission tomography (PET) or magnetic resonance imaging (MRI) (for isolated pituitary/central nervous system (CNS) disease) response criteria. |
1 year (completion of 13 four week cycles)
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Duration of response to mirdametinib
Zeitfenster: 2 years (completion of 26 four week cycles)
|
Duration of response to mirdametinib on study as defined by PET or MRI (for isolated pituitary/CNS disease) response criteria. |
2 years (completion of 26 four week cycles)
|
|
Maximum Plasma Concentration (Cmax)
Zeitfenster: Day 1 of the first 5 four week cycles)
|
Blood samples will be drawn for the pharmacokinetic profile before, and during mirdametinib therapy. Maximum plasma concentration will be calculated as data allow. |
Day 1 of the first 5 four week cycles)
|
|
Time to peak drug concentration (Tmax)
Zeitfenster: Day 1 of the first 5 four week cycles)
|
Blood samples will be drawn for the pharmacokinetic profile before, and during mirdametinib therapy. Time to peak drug concentration (Tmax) will be calculated as data allow. |
Day 1 of the first 5 four week cycles)
|
|
Area under the plasma concentration time curve (AUC)
Zeitfenster: Day 1 of the first 5 four week cycles)
|
Blood samples will be drawn for the pharmacokinetic profile before, and during mirdametinib therapy. Area under the plasma concentration time curve (AUC) will be calculated as data allow. |
Day 1 of the first 5 four week cycles)
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Allison Bartlett, MD, Children's Hospital Medical Center, Cincinnati
- Hauptermittler: Ashish Kumar, MD, PhD, Children's Hospital Medical Center, Cincinnati
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen der Atemwege
- Lungenkrankheit
- Hautkrankheiten
- Lymphatische Erkrankungen
- Lungenerkrankungen, Interstitial
- Histiozytose, Nicht-Langerhans-Zelle
- Histiozytose
- Haut- und Bindegewebserkrankungen
- Hämische und lymphatische Krankheiten
- Histiozytose, Langerhans-Cell
- Xanthogranulom, juvenil
- Histiozytose, Sinus
- Mirdametinib
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- 2021-0206
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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