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Amphotericin B for Breakthrough Fungal Infections After Triazole Prophylaxis in Hematological Patients
A Multicenter, Prospective, Observational Study to Evaluate the Efficacy and Safety of Amphotericin B in the Treatment of Breakthrough Invasive Fungal Disease in Hematological Patients Receiving Triazole Prophylaxis
The goal of this clinical trial is to learn if amphotericin B works to treat breakthrough invasive fungal disease (IFD) in patients with hematological diseases who have received azole-based prophylaxis. It will also learn about the safety of amphotericin B in this population.
The main questions it aims to answer are:
- What is the overall response rate (complete remission + partial remission) of amphotericin B in treating breakthrough IFD after azole prophylaxis?
- What medical problems do participants have when taking amphotericin B?
- What is the 6-week (42-day) overall survival rate after starting treatment?
This is a single-arm, prospective study. Participants will:
- Receive intravenous liposomal amphotericin B (3-5 mg/kg daily) for 4-6 weeks.
- Undergo weekly clinical and laboratory assessments, including serum G/GM tests, microbiology tests, and imaging (CT) at 2, 4, and 6 weeks.
- Have safety monitoring including liver and kidney function, electrolytes, and ECG.
- Be followed for treatment response and survival.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Rui Ma
- Telefoonnummer: +86 18834948122
- E-mail: marui_pku_ed@163.com
Studie Locaties
-
-
Beijing Municipality
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Beijing, Beijing Municipality, China
- Peking University People's Hospital
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Contact:
- Rui Ma
- Telefoonnummer: +86 18834948122
- E-mail: marui_pku_ed@163.com
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Age ≥ 18 years old.
- Diagnosed with hematological diseases and receiving triazole prophylaxis.
- Confirmed or suspected breakthrough invasive fungal disease (IFD) according to EORTC/MSG 2020 criteria.
- Able to understand and sign the informed consent form voluntarily.
Exclusion Criteria:
- Severe liver or renal dysfunction (ALT/AST > 3×ULN, Cr > 2×ULN).
- Known allergy to amphotericin B or any component of the study drug.
- Pregnant or lactating women.
- Severe underlying diseases with expected survival < 3 months.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Amphotericin B Treatment
|
Amphotericin B is a polyene antifungal drug used to treat breakthrough fungal infections.
The dosage and duration will be determined based on pathogen results and clinical guidelines.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Overall Response Rate of Antifungal Therapy at 6 Weeks (42 Days)
Tijdsspanne: 6 weeks (42 days) after treatment initiation
|
The overall response rate will be assessed at 6 weeks (42 days) after the initiation of amphotericin B treatment, evaluated according to the EORTC/MSG 2020 criteria for invasive fungal disease, including complete response, partial response, stable disease, and progressive disease.
|
6 weeks (42 days) after treatment initiation
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Overall Survival Rate at 6 Weeks
Tijdsspanne: 6 weeks (42 days) after treatment initiation
|
Proportion of participants alive at 6 weeks (42 days) after initiation of amphotericin B therapy.
|
6 weeks (42 days) after treatment initiation
|
|
Change in serum G test level
Tijdsspanne: From enrollment to the end of 6-week treatment
|
Change from baseline in serum (1,3)-β-D-glucan level.
Unit of measure: pg/mL.
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From enrollment to the end of 6-week treatment
|
|
Change in serum GM test level
Tijdsspanne: From enrollment to the end of 6-week treatment
|
Change from baseline in serum galactomannan test value.
Unit of measure: ug/L.
|
From enrollment to the end of 6-week treatment
|
|
Microbiological clearance
Tijdsspanne: From enrollment to the end of 6-week treatment
|
Proportion of participants with negative conversion of baseline positive microbiological evidence (e.g., blood culture, sputum culture, mNGS, or site smear/culture).
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From enrollment to the end of 6-week treatment
|
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Change in chest CT findings
Tijdsspanne: Baseline to 6 weeks after treatment initiation
|
Change from baseline in chest CT lesion characteristics (e.g., reduction in size, new lesions, complete resolution).
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Baseline to 6 weeks after treatment initiation
|
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Proportion of participants with treatment-emergent adverse events (AEs)
Tijdsspanne: From first dose to 30 days after last dose.
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Proportion of participants experiencing any AE, graded according to WHO toxicity criteria (grade 3 or higher AEs leading to drug discontinuation).
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From first dose to 30 days after last dose.
|
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Proportion of participants discontinuing amphotericin B due to adverse events
Tijdsspanne: During treatment period (up to 6 weeks).
|
Proportion of participants who permanently stop amphotericin B because of any AE.
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During treatment period (up to 6 weeks).
|
|
Change in serum alanine aminotransferase (ALT)
Tijdsspanne: Baseline to end of treatment up to 6 weeks (twice weekly).
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Change from baseline in ALT level.
Unit of measure: U/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in serum aspartate aminotransferase (AST)
Tijdsspanne: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Change from baseline in AST level.
Unit of measure: U/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in serum total bilirubin
Tijdsspanne: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Change from baseline in total bilirubin level.
Unit of measure: μmol/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
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Change in serum creatinine
Tijdsspanne: Baseline to end of treatment up to 6 weeks (twice weekly).
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Description: Change from baseline in serum creatinine level.
Unit of measure: μmol/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in serum electrolyte levels (potassium, sodium, calcium, magnesium)
Tijdsspanne: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Change from baseline in serum levels of potassium, sodium, calcium, and magnesium.
Each electrolyte will be reported separately as absolute change (mmol/L) from baseline.
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Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in electrocardiogram (ECG) findings
Tijdsspanne: Baseline to end of treatment up to 6 weeks (weekly).
|
Change from baseline in ECG parameters (e.g., QTc interval).
|
Baseline to end of treatment up to 6 weeks (weekly).
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Medewerkers en onderzoekers
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- PKUPH20260411
Plan Individuele Deelnemersgegevens (IPD)
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