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Brentuximab Vedotin Prevention of (GVHD) After Unrelated Allogeneic Stem Cell Transplantation

12. april 2019 oppdatert av: Washington University School of Medicine

A Pilot Study of Brentuximab Vedotin in the Prevention of Graft-Versus-Host Disease (GVHD) After Unrelated Allogeneic Stem Cell Transplantation

This pilot clinical trial studies the safety and maximum tolerated dose of brentuximab vedotin when given with tacrolimus and methotrexate after unrelated allogeneic donor stem cell transplant in patients with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndromes. The addition of brentuximab vedotin to tacrolimus and methotrexate may result in a significant reduction of graft versus host disease in these patients.

Studieoversikt

Studietype

Intervensjonell

Registrering (Faktiske)

17

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Missouri
      • Saint Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 70 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Patient must be scheduled to undergo stem cell transplantation for one of the following diagnoses:

    • acute myeloid leukemia (AML) in CR1 (first complete remission, CR or CRi) or CR2 (second complete remission, CR or CRi),
    • acute lymphoblastic leukemia (ALL) in CR1 or CR2 (CR or CRi)
    • myelodysplastic syndrome (MDS) without progression to AML.
    • Chronic myelogenous leukemia (CML)
    • Non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD)
    • Chronic lymphocytic leukemia (CLL)
    • Multiple myeloma (MM)
  • Patients must be the recipient of unrelated donor peripheral blood stem cell products. Mismatches at both antigen and allele level will be eligible. Match must be 6 or 7 out of 8 loci (HLA A, B, C, and DRB1).
  • Patient must receive any one of the following conditioning regimens: total body radiation (single or fractionated dose)/cyclophosphamide, busulfan/ cyclophosphamide, or fludarabine/busulfan/lymphocyte immune globulin (ATGAM/thymo).
  • Patient must be ≥ 18 years and ≤ 70 years of age.
  • Patient must have an ECOG performance status ≤ 2 or Karnofsky performance scale ≥ 60%
  • Patient must have CD34+ stem cells ≥ 2x106/kg (actual body weight of the recipient) available for transplantation.
  • Patient must have appropriate organ function as defined below (this criterion should be met on screening and on the day of the first dose of brentuximab vedotin (as assessed prior to dosing)):

    • Total bilirubin ≤ 2.0 x IULN
    • AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN
    • Serum creatinine ≤ 2.0 x IULN
    • Estimated Creatinine Clearance > 30 ml/min
    • Cardiac ejection fraction > 40%
    • DLCO/VA > 40%
  • Women of childbearing potential 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. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.
  • Patient must be able to understand and willing to sign an IRB approved written informed consent document.

Exclusion Criteria:

  • Patient must not have had prior exposure to brentuximab vedotin.
  • Patient must not have a history of other malignancy that has not been in remission for at least 3 years, with the exception of basal non-melanoma skin cancer which were treated with local resection only or intraepithelial lesions or carcinoma in situ of the cervix or prostate that has been curatively treated.
  • Patient must not be receiving any other investigational agents.
  • Patient must not have active CNS involvement.
  • Patient must not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to brentuximab vedotin or other agents used in the study.
  • Patients must not have had previous radiation therapy to the mediastinum or lungs.
  • Patient must not have an uncontrolled inter-current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active pulmonary diseases, or psychiatric illness/social situations that would limit compliance with study requirements (this criterion should be met on screening and on the day of but prior to first dose of brentuximab vedotin).
  • Patient must not be pregnant and/or breastfeeding.
  • Patient must not be known to be HIV-positive on combination antiretroviral therapies.
  • Patient must not have had a previous allogeneic or syngeneic transplant. Prior autologous transplant is allowed.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Dose Level 0 (starting dose)
brentuximab vedotin 0.3mg/kg, given IV on Days 7, 28, 49 & 70
Andre navn:
  • Adcetris
Eksperimentell: Dose Level 1
brentuximab vedotin 0.6mg/kg, given IV on Days 7, 28, 49 & 70
Andre navn:
  • Adcetris
Eksperimentell: Dose Level 2
brentuximab vedotin 1.2mg/kg, given IV on Days 7, 28, 49 & 70
Andre navn:
  • Adcetris
Eksperimentell: Dose Level 3
brentuximab vedotin 1.8mg/kg, given IV on Days 7, 28, 49 & 70
Andre navn:
  • Adcetris
Ingen inngripen: Control Dose Level
The first 3 patients will not receive brentuximab vedotin.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
MTD of brentuximab vedotin when administered with a GVHD prophylaxis regimen
Tidsramme: 37 days

Defined as the dose level immediately below the dose level at which 2 patients of a cohort (of 2 to 6 patients) experience dose-limiting toxicity; Hematologic DLT is defined as ANC < 500/mm3 for three consecutive days beyond Day +21 that was determined by the investigator to be likely related to brentuximab vedotin.

Non-hematologic DLT is defined as any grade 3 or higher non-hematologic toxicity that was determined by the investigator to be possibly, probably, or definitely related to brentuximab vedotin, with the following specific exceptions:

  • Grade 3 or 4 nausea, vomiting, diarrhea, mucositis, or fatigue thought to be associated with conditioning regimens
  • Grade 3 rash will only be considered a DLT for patients who have received two weeks of supportive care treatment with no improvement.
37 days

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Safety and tolerability of brentuximab vedotin when administered with a GVHD prophylaxis regimen
Tidsramme: 100 days
Toxicities described and graded using CTCAE version 4.0; described by patient, type, and grade for each dose level; summarized by counts and percentage of patients in the corresponding categories
100 days
Rate of acute GVHD
Tidsramme: 100 days
Proportion of all subjects who experience symptoms consistent with grade 2-4 acute GVHD; using the standard grading system adapted from the Glucksberg clinical stage and grade of acute GVHD
100 days
Rate of chronic GVHD
Tidsramme: 2 years
Proportion of all subjects who experience symptoms consistent with chronic GVHD; assessment will begin after Day 100 using the NIH consensus criteria for diagnosis and staging of chronic GVHD
2 years
Progression-free survival
Tidsramme: 2 years
Duration from the time of transplant to time of first progression, death, relapse after complete response, or the date the patient was last known to be in remission; estimated with Kaplan-Meier methods.
2 years
Overall survival.
Tidsramme: 2 years
Duration from the time of transplant to death or last follow-up; estimated with Kaplan-Meier methods.
2 years
1-year non-relapse mortality rate
Tidsramme: 1 year
Defined as the percentage of patients dying from etiologies other than disease relapse; estimated with Kaplan-Meier methods.
1 year
2-year non-relapse mortality rate
Tidsramme: 2 years
Defined as the percentage of patients dying from etiologies other than disease relapse; estimated with Kaplan-Meier methods.
2 years
1-year disease relapse rate
Tidsramme: 1 year
Defined as the percentage of patients who have disease relapse; estimated with Kaplan-Meier methods.
1 year
2-year disease relapse rate
Tidsramme: 2 years
Defined as the percentage of patients who have disease relapse; estimated with Kaplan-Meier methods.
2 years

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

25. februar 2013

Primær fullføring (Faktiske)

11. november 2015

Studiet fullført (Faktiske)

21. november 2016

Datoer for studieregistrering

Først innsendt

18. september 2012

Først innsendt som oppfylte QC-kriteriene

1. oktober 2012

Først lagt ut (Anslag)

4. oktober 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

16. april 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

12. april 2019

Sist bekreftet

1. april 2019

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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3
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