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TXA127 in Enhancement of Engraftment in Adult Double Cord Blood Transplantation (USBTXA127CBT)

2020年12月7日 更新者:Tarix Pharmaceuticals

Phase I Evaluation of the Safety and Efficacy of TXA127 (Angiotensin 1-7) to Enhance Engraftment in Adults Undergoing Double Cord Blood Transplantation

The purpose of this study is to evaluate the effect of TXA127 on neutrophil and platelet counts in adult patients who have undergone a double cord blood transplant. The study will also evaluate the effect of TXA127 on chemotherapy-induced mucositis, an inflammation of the mucous membranes in the digestive tract (mouth to anus) and immune reconstitution which helps patients fight infections. For patients undergoing CBT, both neutrophil and platelet normalization and immune reconstitution can be delayed. TXA127 has shown to be well tolerated by patients and appears to induce a rapid production of neutrophils and platelets in the bloodstream as well as increase the immune system components. It has also been shown to reduce the severity of chemotherapy-induced mucositis.

調査の概要

詳細な説明

Cord blood as a hematopoietic stem cell source has multiple advantages. Cord blood is normally discarded at birth and can easily be collected and stored. Availability of numerous CB banks has resulted in genetically diverse CB units including those from non-Caucasians. Once a suitable CB unit is located, confirmatory typing can be quickly performed and a donor unit can be shipped to the transplant center. Furthermore, because a CB graft results in a lower incidence of graft-versus-host-disease, one or two antigen-mismatched units are acceptable for transplantation. Despite these advantages, CB has a significant drawback which is that the number of hematopoietic stem cells obtained from a unit of CB is significantly lower than from a bone marrow (BM) harvest or peripheral blood stem cell (PBSC) harvest. Both engraftment and immune reconstitution are delayed in patients undergoing CB transplant. TXA127 is pharmaceutically-formulated angiotensin 1-7, a non-hypertensive derivative of angiotensin II (which contains the 8th amino acid conferring receptor binding to blood pressure receptors). TXA127 has multilineage effects on hematopoietic progenitors in vitro and in vivo. The hematopoietic properties demonstrated in preclinical and clinical studies support the investigation of TXA127 to reduce time to neutrophil and platelet engraftment following transfusion of limited number of CD34+ cells.

研究の種類

介入

入学 (予想される)

20

段階

  • フェーズ 1

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Texas
      • Houston、Texas、アメリカ、77030
        • MD Anderson Cancer Center

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~60年 (大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Subjects with Acute Myelogenous Leukemia (AML) past first remission, in first or subsequent relapse, induction failure, or in first remission with high-risk for relapse (with high-risk cytogenetics or presence of flt3 mutation or secondary leukemia from prior chemotherapy)
  • Myelodysplastic Syndrome or Myelofibrosis of intermediate or high-risk
  • Acute Lymphoblastic Leukemia (ALL): Induction failure, fist complete remission with Philadelphia chromosome or translocation (4:11), hypodiploidy and or evidence of minimal residual disease by flow cytometry, second or third complete remission or second relapse
  • Chronic Myelocytic leukemia (CML): Second chronic phase or accelerated phase
  • Non-Hodgkin's Lymphoma (NHL): Induction failures, second or third complete remission or relapse
  • Hodgkin's Lymphoma (HL): Induction failures, second or third complete remission or relapse
  • Chronic Lymphocytic leukemia (CLL): Progressive disease following standard therapy
  • Other hematologic malignancies which meet investigational site standards for cord blood transplant
  • Subjects must be at least 18 years of age
  • Subjects must have ECOG status of ≤ 2
  • Subjects with bone marrow blasts ≤ 10%
  • Subjects must have adequate major organ function
  • Male and Female Subjects capable of reproduction must agree to use contraceptive methods during the course of the study and for 2 months following the last administration of study drug
  • Cord blood requirements: a) Unrelated CB will be used as a source of hematopoietic support if a 7/8 or 8/8 related or 8/8 unrelated bone marrow donor is not available, or if the tempo of the subject's disease dictates it is not in the subject's best interest to wait for an unrelated marrow donor to be procured. b) Subjects must have two CB units available which are matched with the subject at 4/6, 5/6, or 6/6 HLA class I (serological) and II (molecular) antigens. Each unit must contain at least 1 x 10^7 total nucleated cells/kg recipient body weight (pre-thaw).

Exclusion Criteria:

  • Subjects who received antineoplastic treatment including chemotherapy, immunotherapy and radiation therapy ≤ 2 weeks prior to Screening Period
  • Subjects who underwent prior total body irradiation
  • Subjects who received prior allogeneic hematopoietic cell transplants
  • Subjects seropositive for HIV, Hepatitis B or Hepatitis C
  • Female subjects who are pregnant or breastfeeding
  • Subjects who have received an investigational drug within 30 days of projected first administration of study drug (Day 0)
  • Subjects with current alcohol use, illicit drug use, or any other condition (e.g., psychiatric disorder) that, in the opinion of the Investigator, may interfere with the subject's ability to comply with the study requirements or visit schedule
  • Subjects with known hypersensitivity to TXA127
  • Subjects with uncontrolled medical or psychiatric condition which would limit informed consent
  • Subjects with a willing and appropriate HLA-matched related marrow donor

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:支持療法
  • 割り当て:非ランダム化
  • 介入モデル:単一グループの割り当て
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的:TXA127 300 mcg/kg/day
Treatment group 1 (300 mcg/kg/day) of a two-arm, dose-escalation pilot feasibility trial of TXA127 (Angiotensin 1-7) in subjects undergoing double cord blood transplantation for the treatment of a variety of hematologic malignancies for whom there is no available therapy with substantive anti-disease effect.
Injection, 300 mcg/kg/day for 28 days
実験的:TXA127 1000 mcg/kg/day
Treatment group 2 (1000 mcg/kg/day) of a two-arm, dose-escalation pilot feasibility trial of TXA127 (Angiotensin 1-7) in subjects undergoing double cord blood transplantation for the treatment of a variety of hematologic malignancies for whom there is no available therapy with substantive anti-disease effect.
Injection, 1000 mcg/kg/day for 28 days

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Safety of TXA127 (Angiotensin 1-7) in subjects undergoing double cord blood transplantation
時間枠:100 days post-transplantation
The safety and tolerability profile of TXA127 will be provided by descriptively summarizing, at a minimum, the following outcomes: 1) number and proportion of patients with adverse events presented by preferred term, by system organ class (SOC), and by severity grade and relationship to TXA127, as assessed by the Investigator; 2) number and proportion of patients terminating TXA127 due to adverse events related to TXA127; 3) Day 100 treatment-related mortality (TRM) rate; 4) Day 100 mortality rate; 5) number of red blood cell and other blood component transfusions; 6) incidence of infection.
100 days post-transplantation

二次結果の測定

結果測定
メジャーの説明
時間枠
免疫再構築
時間枠:移植後100日
免疫再構成は、CD3+、CD4+、CD8+、CD19+、および CD56+ 細胞の末梢血濃度の測定によって評価されます (研究 62 日目および 100 日目に実施)。
移植後100日
Incidence, duration, and severity grade of mucositis
時間枠:100 days post-transplantation
Incidence of mucositis is defined by the occurrence of least one adverse event with MedDRA preferred term that includes "mucositis" or "stomatitis". The severity grade will be determined by NCI-CTCAE.
100 days post-transplantation
Platelet transfusion requirements
時間枠:100 days post-transplantation
Platelet transfusion requirements based on units of platelets transfused and days of platelet transfusions
100 days post-transplantation
Incidence, duration, and severity grade of acute graft-vs-host-disease (aGVHD)
時間枠:100 days post-transplantation
Incidence, severity and duration of aGVHD will be reported as a proportion (with 95% CIs) of subjects with Grade II-IV aGVHD. All incidents of aGVHD will at a minimum be listed, with the severity and time course included.
100 days post-transplantation
Time to engraftment/recovery
時間枠:100 days post-transplantation
Time to neutrophil engraftment and platelet recovery
100 days post-transplantation

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:Uday R Popat, MD、M.D. Anderson Cancer Center

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2011年1月1日

一次修了 (実際)

2020年12月1日

研究の完了 (実際)

2020年12月1日

試験登録日

最初に提出

2011年2月17日

QC基準を満たした最初の提出物

2011年2月17日

最初の投稿 (見積もり)

2011年2月21日

学習記録の更新

投稿された最後の更新 (実際)

2020年12月8日

QC基準を満たした最後の更新が送信されました

2020年12月7日

最終確認日

2020年12月1日

詳しくは

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