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Administration of GRASPA (Suspension of Erythrocytes Encapsulating L-asparaginase) in Elderly Patients With First Line Acute Lymphoblastic Leukemia

21 settembre 2021 aggiornato da: ERYtech Pharma

An Escalating Dose Phase IIa Study of L-Asparaginase Encapsulated in Erythrocytes (GRASPA®) in Association With Polychemotherapy During Induction Phase for Treatment of Elderly Patients With Acute Lymphoblastic Leukaemia (ALL), Aged 55 Years and Over, With Philadelphia Chromosome-negative (ALL Ph-)

The main purpose of this study is to determine the maximum tolerated and efficient dose of GRASPA® in combination with polychemotherapy treatment of elderly patients with ALL, 55 years and over, Philadelphia chromosome-negative (ALL Ph-).

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

This open label, non randomised, multicentric and national phase IIa study was designed to evaluate the safety and efficacy of GRASPA®, a suspension of red blood cells encapsulating E. Coli L-asparaginase, at different doses and in combination with the polychemotherapy regimen recommended by the European Working Group on Adult ALL (EWALL) for frontline therapy of patients with ALL Ph-, aged 55 years old and over. Patients with a good performance status (WHO score ≤2) and a newly diagnosed ALL Ph- were treated with the backbone polychemotherapy consisting of a first 4-week induction phase comprising dexamethasone, vincristine and idarubicin, a second 4-week induction phase including cyclophosphamide, cytarabine, a 6-month consolidation phase consisting of 6 alternating cycles with methotrexate, asparaginase and folinic acid (cycles 1, 3 and 5) and high-dose cytarabine (cycles 2, 4 and 6) with Granulocyte colony stimulating factor (G-CSF) support followed by a 16-month maintenance period with mercaptopurine, methotrexate and vincristine/dexamethasone pulses. GRASPA® was administered on day 3 of induction 1 and on day 6 of induction 2 of the chemotherapy regimen.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

30

Fase

  • Fase 2

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

55 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Patient aged ≥55 years old
  • With newly diagnosed ALL without prior treatment
  • Capable to receive polychemotherapy (World Health Organization (WHO) performance status ≤2)
  • With or without meningeal disease
  • Having signed an Informed Consent Form
  • Subscribed to social security insurance

Exclusion Criteria:

  • ALL translocation(9;22) and/or BCR-ABL (Breakpoint Cluster Region-Abelson) positive
  • Performance status incompatible with chemotherapy treatment (WHO score >2)
  • Patient presenting with a general or visceral contraindication to intensive treatment including :

    • Cardiac insufficiency defined as Left Ventricular Ejection Fraction <50% of the theoretical value
    • Plasma creatinine concentration 2 times greater than the upper limit of laboratory ranges, except if related to ALL
    • Aspartate aminotransferase (ASAT) or alanine aminotransferase (ALAT) levels 5 times greater than the upper limit of laboratory ranges, except if related to ALL
    • Patient with another evolutive cancer other than ALL
    • Severe evolutive infection, or Human Immunodeficiency Virus (HIV) seropositive or, active hepatitis related to B or C viral infection
  • Prior treatment with L-asparaginase (irrespective of the form)
  • History of grade 3 transfusional incident (life threatening)
  • Patient presenting rare and/or dangerous anti-erythrocyte antibodies thus leading to the unavailability of phenotype compatible Red Blood Cells Concentrate
  • Patient included in another clinical trial during the last 4 weeks

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: GRASPA 50 IU/kg
Each patient will receive GRASPA 50 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase.
Each patient will receive GRASPA at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase
Sperimentale: GRASPA 100 IU/kg
Each patient will receive GRASPA 100 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase
Each patient will receive GRASPA at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase
Sperimentale: GRASPA 150 IU/kg
Each patient will receive GRASPA 150 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase
Each patient will receive GRASPA at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Efficacy Primary Endpoint - Percentage of Patients Responding to Treatment
Lasso di tempo: 7 days after the first administration of GRASPA® during Induction 1
The main evaluation criterion is a composite efficacy/toxicity criterion. Efficacy, assessed during induction 1: percentage of patients responding to treatment, i.e. with plasma Asn concentration ≤2µM (depleted), for a duration of at least 7 days after the administration of GRASPA®
7 days after the first administration of GRASPA® during Induction 1
Safety Endpoint - DLTs Assessed During Induction 1 and Induction 2
Lasso di tempo: Induction 1 and Induction 2
Safety: Toxicity, assessed during Induction 1 and Induction 2: according to NCI-CTCAE v3.0 August 2006, with Dose Limiting Toxicities (DLT) defined as: Grade 2 to 4 pancreatic toxicity, Grade 3 or 4 hepatic toxicity, allergic toxicity or deep cerebral thrombosis, known as potentially related to L-asparaginase; hematological toxicity defined as bone marrow blast free aplasia, 30 days following the last injection of chemotherapy, all other Grade 4 toxicities.
Induction 1 and Induction 2

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Plasma Concentrations of Asparagine
Lasso di tempo: Induction 1 & Induction 2
Mean plasma concentration of asparagine over time. Participants who were Below the Lower Limit of Quantification (BLLQ) were assigned a value of 0.51 μmol/L.
Induction 1 & Induction 2
Plasma Concentrations of Aspartic Acid
Lasso di tempo: Induction 1 and Induction 2
Mean plasma concentration of aspartic acid over time.
Induction 1 and Induction 2
Plasma Concentrations of Glutamine
Lasso di tempo: Induction 1 and Induction 2
Mean glutamine concentration over time.
Induction 1 and Induction 2
Plasma Concentrations of Glutamic Acid.
Lasso di tempo: Induction 1 and Induction 2
Mean glutamic acid concentration over time.
Induction 1 and Induction 2
Cerebral Spinal Fluid Concentrations of Asparagine
Lasso di tempo: Induction 1 and Induction 2
Mean cerebral spinal fluid asparagine concentration over time.
Induction 1 and Induction 2
Cerebral Spinal Fluid Concentrations of Aspartic Acid
Lasso di tempo: Induction 1 and Induction 2
Mean cerebral spinal fluid aspartic acid concentration
Induction 1 and Induction 2
Cerebral Spinal Fluid Concentrations of Glutamine
Lasso di tempo: Induction 1 and Induction 2
Mean cerebral spinal fluid glutamine concentration
Induction 1 and Induction 2
Cerebral Spinal Fluid Concentrations of Glutamic Acid
Lasso di tempo: Induction 1 and Induction 2
Mean cerebral spinal fluid glutamic acid concentration
Induction 1 and Induction 2
Summary of Free Asparaginase Over Time
Lasso di tempo: Induction 1 and Induction 2
Induction 1 and Induction 2
Summary of Encapsulated Asparaginase (U/L) Over Time
Lasso di tempo: Induction 1 and Induction 2
Induction 1 and Induction 2
Number of Patients Positive for Anti-L-asparaginase Antibodies
Lasso di tempo: Induction 1 and Induction 2
Evaluation of the number of patients testing positive for anti-asparaginase antibodies.
Induction 1 and Induction 2
Number of Participants With Complete Remission (CR) Rate Following Induction 1 and Induction 2
Lasso di tempo: 1 and 2 months

CR was defined using:

  • Clinical criteria: disappearance of clinical signs of acute lymphocytic leukemia (ALL)
  • Blood criteria: neutrophils > 1 G/L and platelets >100 G/L
  • Medullary criteria: normally rich bone marrow and percentage of blasts <5%
1 and 2 months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Investigatore principale: Mathilde Hunault-Berger, Professor, University Hospital, Angers

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 aprile 2009

Completamento primario (Effettivo)

1 gennaio 2011

Completamento dello studio (Effettivo)

1 ottobre 2012

Date di iscrizione allo studio

Primo inviato

16 gennaio 2012

Primo inviato che soddisfa i criteri di controllo qualità

30 gennaio 2012

Primo Inserito (Stima)

1 febbraio 2012

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

15 ottobre 2021

Ultimo aggiornamento inviato che soddisfa i criteri QC

21 settembre 2021

Ultimo verificato

1 giugno 2018

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • GRASPALL/GRAALLSA2-2008

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

No

Descrizione del piano IPD

Not applicable for this study

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .