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Maraviroc-Based GVHD Prophylaxis in HLA-Unrelated and HLA-Mismatched Related Transplantation

9. juni 2016 oppdatert av: Affiliated Hospital to Academy of Military Medical Sciences

Safety and Efficacy of Maraviroc-Based Graft-Versus-Host-Disease Prophylaxis in HLA-Unrelated and HLA-Mismatched Related Donor Transplantation

HLA-mismatched unrelated donor (MMUD) and HLA-haploidentical donor (Haplo Donor) hematopoietic stem cell transplantation (HSCT) is associated with increased graft-versus-host-disease (GVHD) and impaired survival. The chemokine receptor 5 (CCR5) antagonist maraviroc has immunomodulatory properties potentially beneficial for GVHD control as it can blockade lymphocyte chemotaxis without impairing T-cell function. The aim of this study is to evaluate the safety and efficacy of maraviroc combined with standard graft-versus-host-disease prophylaxis in patients with hematologic malignancies after allogeneic stem cell transplantation from HLA-Unrelated or HLA-Mismatched Related donors. Based on the results of our previously small sample study with maraviroc combined with cyclosporine/tacrolimus and methotrexate for prophylaxis of GVHD, the investigators plan to perform the clinical trail.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Forventet)

40

Fase

  • Fase 2

Kontakter og plasseringer

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

Studiesteder

  • Kina
    • Beijing
      • Beijing, Beijing, Kina, 100071
        • Rekruttering
        • Department of Hematopoietic Stem Cell Transplantation

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

12 år til 65 år (Barn, Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  1. Age 12-65 years (patient is older than 12.0 and less than 66.0 years old)
  2. Patients with acute leukemia, myelodysplastic syndrome or lymphoma who scheduled to undergo allogeneic stem-cell transplantation from HLA-Unrelated or HLA-Mismatched Related donors
  3. Renal function: estimated creatinine clearance greater than 40 mL/minute (using the Cockcroft-Gault formula and actual body weight)
  4. Hepatic function: Baseline direct bilirubin, alanine aminotransferase (ALT) lower than three times the upper limit of normal
  5. Pulmonary disease: forced vital capacity (FVC) or forced expiratory volume at one second (FEV1) > 40% predicted
  6. Cardiac ejection fraction > 40%
  7. Signed informed consent

Exclusion Criteria:

  1. Patients not expected to be available for follow-up in our institution for at least 100 days after the transplant
  2. Prior allogeneic transplant
  3. Karnofsky Performance Score < 70%
  4. Patients who are not undergoing standard GVHD prophylaxis with cyclosporine/tacrolimus and methotrexate
  5. Patients with uncontrolled bacterial, viral or fungal infections
  6. Patients receiving other investigational drugs for GVHD

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Maraviroc + standard GVHD prophylaxis
Maraviroc administration (in addition to the standard prophylaxis therapy of cyclosporine/tacrolimus and methotrexate) will start on day -2 and will end on day +30 after stem cell transplant, making the total number of days of drug administration 33 days. Maraviroc will be administered 300mg twice daily orally.
Legemiddel: Maraviroc
Maraviroc will be administered 300mg twice daily and start on day -2 end on day +30 after stem cell transplant for 33 days.
Andre navn:
  • Selzentry
Legemiddel: Cyclosporine (in HLA-Unrelated Donor Transplantation)
Cyclosporine will be given intravenously at a dose of 2-3 mg/kg starting Day -1. Subsequent dosing will be based on blood levels. Patients were advanced to oral cyclosporine once they could tolerate. The dose should be adjusted accordingly to maintain a suggested target serum level of 150-250 ng/mL. In the absence of aGVHD, the oral cyclosporine dose was reduced by approximately 5% weekly, beginning on or near day 100, and therapy was usually discontinued by Day 180 after transplantation or relapse.
Andre navn:
  • Sandimmun
  • Neoral
  • Gengraf
Legemiddel: Tacrolimus (in HLA-Mismatched Related Donor Transplantation)
Tacrolimus will be given orally at a dose of 0.05 mg/kg twince a day or intravenously at a dose of 0.03 mg/kg starting Day -3. Subsequent dosing should be adjusted accordingly to maintain a suggested target serum level of 5-10 ng/mL. Tacrolimus taper can be initiated at a minimum of 100 days post HSCT if there is no evidence of active GVHD. The rate of tapering will be done according institutional practices but patients should be off tacrolimus by Day 180 post HSCT if there is no evidence of active GVHD.
Andre navn:
  • FK506
  • Prograf®
Legemiddel: Methotrexate
Methotrexate will be administered intravenously at a dose of 15 mg/m^2 on day +1, and 10 mg/m^2 on day +3, +6 and +11 after HSC transplantation.at the doses of 15 mg/m^2 IV bolus on Day +1, and 10 mg/m^2 IV bolus on Days +3, +6 and +11 after hematopoietic stem cell infusion. The Day +11 dose of methotrexate will be not given to those patients who fail to reach white blood cell count (WBC) of more than 1.0×10^9/L.
Andre navn:
  • MTX

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Incidence of Acute GVHD Grades II-IV
Tidsramme: 1 Year
1 Year

Sekundære resultatmål

Resultatmål
Tidsramme
Samlet overlevelse
Tidsramme: 1 år
1 år
Incidence of Acute GVHD Grades III-IV
Tidsramme: By day +100 post-HSCT
By day +100 post-HSCT
Incidence of Chronic GVHD
Tidsramme: 1 Year
1 Year
Hematologic Recovery (Neutrophils and Platelets)
Tidsramme: Up to day +100 post-HSCT
Up to day +100 post-HSCT
Disease Relapse or Progression
Tidsramme: 1 Year
1 Year
Incidence of Transplant-Related Mortality
Tidsramme: By day +100 post-HSCT
By day +100 post-HSCT
Frequency of Grade 3 or Greater Toxicities
Tidsramme: Up to day +100 post-HSCT
Up to day +100 post-HSCT
Incidence of Grade 2 and 3 Infections
Tidsramme: 1 Year
1 Year

Samarbeidspartnere og etterforskere

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

Sponsor

Affiliated Hospital to Academy of Military Medical Sciences

Etterforskere

  • Hovedetterforsker: Hu Chen, M.D., Ph.D., Affiliated Hospital to Academy of Military Medical Sciences

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

1. april 2014

Primær fullføring (Forventet)

1. desember 2016

Studiet fullført (Forventet)

1. april 2017

Datoer for studieregistrering

Først innsendt

3. juni 2016

Først innsendt som oppfylte QC-kriteriene

9. juni 2016

Først lagt ut (Anslag)

15. juni 2016

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

15. juni 2016

Siste oppdatering sendt inn som oppfylte QC-kriteriene

9. juni 2016

Sist bekreftet

1. juni 2016

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 307-maraviroc-001

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