Administration of GRASPA (Suspension of Erythrocytes Encapsulating L-asparaginase) in Elderly Patients With First Line Acute Lymphoblastic Leukemia
21 de setembro de 2021 atualizado por: 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-).
Visão geral do estudo
Status
Concluído
Condições
Intervenção / Tratamento
Descrição detalhada
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 de estudo
Intervencional
Inscrição (Real)
30
Estágio
- Fase 2
Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
55 anos e mais velhos (Adulto, Adulto mais velho)
Aceita Voluntários Saudáveis
Não
Gêneros Elegíveis para o Estudo
Tudo
Descrição
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
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Não randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: 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
|
|
Experimental: 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
|
|
Experimental: 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
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Efficacy Primary Endpoint - Percentage of Patients Responding to Treatment
Prazo: 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
Prazo: 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.
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Induction 1 and Induction 2
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Plasma Concentrations of Asparagine
Prazo: 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
Prazo: Induction 1 and Induction 2
|
Mean plasma concentration of aspartic acid over time.
|
Induction 1 and Induction 2
|
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Plasma Concentrations of Glutamine
Prazo: Induction 1 and Induction 2
|
Mean glutamine concentration over time.
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Induction 1 and Induction 2
|
|
Plasma Concentrations of Glutamic Acid.
Prazo: Induction 1 and Induction 2
|
Mean glutamic acid concentration over time.
|
Induction 1 and Induction 2
|
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Cerebral Spinal Fluid Concentrations of Asparagine
Prazo: Induction 1 and Induction 2
|
Mean cerebral spinal fluid asparagine concentration over time.
|
Induction 1 and Induction 2
|
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Cerebral Spinal Fluid Concentrations of Aspartic Acid
Prazo: Induction 1 and Induction 2
|
Mean cerebral spinal fluid aspartic acid concentration
|
Induction 1 and Induction 2
|
|
Cerebral Spinal Fluid Concentrations of Glutamine
Prazo: Induction 1 and Induction 2
|
Mean cerebral spinal fluid glutamine concentration
|
Induction 1 and Induction 2
|
|
Cerebral Spinal Fluid Concentrations of Glutamic Acid
Prazo: Induction 1 and Induction 2
|
Mean cerebral spinal fluid glutamic acid concentration
|
Induction 1 and Induction 2
|
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Summary of Free Asparaginase Over Time
Prazo: Induction 1 and Induction 2
|
Induction 1 and Induction 2
|
|
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Summary of Encapsulated Asparaginase (U/L) Over Time
Prazo: Induction 1 and Induction 2
|
Induction 1 and Induction 2
|
|
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Number of Patients Positive for Anti-L-asparaginase Antibodies
Prazo: Induction 1 and Induction 2
|
Evaluation of the number of patients testing positive for anti-asparaginase antibodies.
|
Induction 1 and Induction 2
|
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Number of Participants With Complete Remission (CR) Rate Following Induction 1 and Induction 2
Prazo: 1 and 2 months
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CR was defined using:
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1 and 2 months
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Investigadores
- Investigador principal: Mathilde Hunault-Berger, Professor, University Hospital, Angers
Publicações e links úteis
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Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo
1 de abril de 2009
Conclusão Primária (Real)
1 de janeiro de 2011
Conclusão do estudo (Real)
1 de outubro de 2012
Datas de inscrição no estudo
Enviado pela primeira vez
16 de janeiro de 2012
Enviado pela primeira vez que atendeu aos critérios de CQ
30 de janeiro de 2012
Primeira postagem (Estimativa)
1 de fevereiro de 2012
Atualizações de registro de estudo
Última Atualização Postada (Real)
15 de outubro de 2021
Última atualização enviada que atendeu aos critérios de controle de qualidade
21 de setembro de 2021
Última verificação
1 de junho de 2018
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- GRASPALL/GRAALLSA2-2008
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Não
Descrição do plano IPD
Not applicable for this study
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