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Study of CMX001 to Prevent/Control Cytomegalovirus Infection in R+ Hematopoietic Stem Cell Transplant Recipients

28 juni 2021 uppdaterad av: Chimerix

A Multicenter, Randomized, Double-blind, Placebo-controlled, Dose-escalation Study of the Safety, Tolerability and Ability of CMX001 to Prevent or Control CMV Infection in R+ Hematopoietic Stem Cell Transplant Recipients

This was a multicenter, randomized, double-blind, placebo-controlled, dose-escalation study of brincidofovir (BCV) administered orally once or twice weekly for up to 11 weeks. Dosing was initiated immediately following engraftment (between Days 14-30 post-transplant) to prevent/control cytomegalovirus (CMV) infection or prevent disease in R+ hematopoietic stem cell transplant (HCT) recipients.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

This was to be a 2-part study. Part 1 was a randomized, double-blind, placebo-controlled, dose-escalation study of multiple doses of oral brincidofovir (BCV) in R+ hematopoietic stem cell transplant (HCT) recipients. In Part 2, one of the dose levels administered in Part 1 was to be tested against placebo to evaluate the statistical significance of BCV as a therapy for preventing progression of cytomegalovirus (CMV) infection or preventing CMV disease. The first 3 dose-escalating cohorts in Part 1 were to include 32 subjects within each cohort (24 randomized to receive oral BCV and 8 randomized to receive placebo in a 3:1 ratio) for a total of 96 planned subjects. Following completion of the first 3 cohorts and subsequent safety review of the data, up to an additional 3 cohorts of 32 subjects each could have been enrolled. Two additional cohorts (labeled Cohort 4 and Cohort 4A) beyond the initial 3 cohorts were actually enrolled in Part 1 of the study. Following the safety and antiviral activity analyses of the 5 cohorts in Part 1 and the number of subjects enrolled in each of those cohorts, Part 2 of the study was not conducted.

Studietyp

Interventionell

Inskrivning (Faktisk)

239

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Alabama
      • Birmingham, Alabama, Förenta staterna, 35294
        • The University of Alabama at Birmingham
    • California
      • La Jolla, California, Förenta staterna, 92093
        • Moores UCSD Cancer Center
      • Los Angeles, California, Förenta staterna, 90095
        • UCLA Medical Center
    • Colorado
      • Aurora, Colorado, Förenta staterna, 80045
        • University of Colorado Denver
    • Georgia
      • Atlanta, Georgia, Förenta staterna, 30322
        • Winship Cancer Institute at Emory University
    • Illinois
      • Chicago, Illinois, Förenta staterna, 60637
        • University Of Chicago Medical Center
    • Massachusetts
      • Boston, Massachusetts, Förenta staterna, 02115
        • Brigham and Womens Hospital, Division of Infectious Disease
    • Michigan
      • Ann Arbor, Michigan, Förenta staterna, 48109
        • University of Michigan Medical School
      • Detroit, Michigan, Förenta staterna, 48201
        • Harper University Hospital
    • Minnesota
      • Minneapolis, Minnesota, Förenta staterna, 55455
        • University of Minnesota Medical Center
    • Nebraska
      • Omaha, Nebraska, Förenta staterna, 68198-5130
        • Nebraska Medical Center
    • New Jersey
      • Hackensack, New Jersey, Förenta staterna, 07601
        • Hackensack University Medical Center
    • New York
      • Bronx, New York, Förenta staterna, 10467
        • Montefiore Medical Center Oncology
      • New York, New York, Förenta staterna, 10065
        • Memorial Sloan Kettering Cancer Center
      • New York, New York, Förenta staterna, 10029
        • Mt. Sinai School of Medicine
      • Rochester, New York, Förenta staterna, 14642
        • University of Rochester Medical Center
    • North Carolina
      • Chapel Hill, North Carolina, Förenta staterna, 27599
        • UNC Health Care Center
      • Durham, North Carolina, Förenta staterna, 27710
        • Duke University Medical Center
      • Winston-Salem, North Carolina, Förenta staterna, 27517
        • Wake Forest University School of Medicine
    • Ohio
      • Cleveland, Ohio, Förenta staterna, 44195
        • The Cleveland Clinic
    • Oregon
      • Portland, Oregon, Förenta staterna, 97239
        • Oregon Health and Science University
    • Texas
      • Dallas, Texas, Förenta staterna, 75246
        • Baylor University Medical Center
      • Dallas, Texas, Förenta staterna, 75390-8565
        • UT Southwestern Medical Center at Dallas
      • Houston, Texas, Förenta staterna, 77030
        • University of Texas, MD Anderson Cancer Center
    • Utah
      • Salt Lake City, Utah, Förenta staterna, 84088
        • Utah Cancer Specialists - Intermountain Healthcare
    • Washington
      • Seattle, Washington, Förenta staterna, 98109
        • Fred Hutchinson Cancer Research Center

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria

For inclusion into the study, all prospective subjects were required to fulfill all of the following criteria (as applicable):

  1. Were aged ≥18 years. Males must have been able and willing to use adequate contraceptive methods throughout the treatment and follow-up phases of the study.
  2. Were cytomegalovirus (CMV) seropositive before allogeneic hematopoietic stem cell transplantation (HCT) (i.e., R+ subjects).
  3. Were less than 30 days post qualifying transplant.
  4. Had evidence of engraftment before randomization and receiving their first dose of study drug.
  5. Were able to ingest and absorb oral medication (in the judgment of the investigator and based on lack of significant gastrointestinal [GI] events).
  6. Were willing and able to understand and provide written informed consent.
  7. To the best of his or her knowledge, were willing and able to participate in all required study activities for the duration of the study.

Exclusion Criteria

Subjects meeting any of the following exclusion criteria were to be excluded from participation in the study:

  1. Females who were pregnant or currently nursing.
  2. Had a body mass index >35 kg/m2. [Note: This criterion was removed per Protocol Amendment 2 dated 27 August 2010.]
  3. Had hypersensitivity to cidofovir (CDV) or brincidofovir.
  4. Recipients for whom the current, predose clinical course of CMV infection suggested that the investigator would not be able to withhold treatment for CMV for a minimum of 5, but preferably 7 days following the subject's first dose of study drug.

  5. Received any of the following:

    • Ganciclovir, valganciclovir, foscarnet or CDV within 14 days prior to enrollment;
    • Any anti-CMV therapy following transplantation (including Cytogam®1);
    • Any CMV vaccine;
    • Any investigational drug with antiviral activity against double-stranded DNA (dsDNA) viruses within 14 days prior to enrollment. [Note: An investigational drug was defined as a drug that was not approved for any indication by the Food and Drug Administration.]; or
    • Any other investigational drug (i.e., those without any "anti-dsDNA virus" activity; e.g., anti-influenza compounds) within 14 days prior to enrollment without the prior written consent of the medical monitor. The use of investigational drugs in certain circumstances was added per Protocol Amendment 1 dated 15 January 2010.
  6. Received high dose acyclovir (>2000 mg total oral daily dose or >5 mg/kg intravenously 3 times daily) or valacyclovir (Valtrex; >3000 mg total daily dose) at the time of dosing.
  7. Were diagnosed with active CMV disease within 6 months prior to enrollment; patients with CMV DNAemia requiring intervention with antiviral therapy at the time of enrollment.
  8. Were HIV positive; patients with active hepatitis C virus (HCV) or hepatitis B virus (HBV) infection as evidenced by plasma levels of HCV RNA or HBV DNA, respectively.
  9. Received another allogeneic HCT within the past 2 years, other than the qualifying HCT.
  10. Had renal insufficiency as evidenced by glomerular filtration rate (GFR) <30 mL/min.
  11. Had a current diagnosis of hypotony, uveitis, or retinitis or any intraocular pathology that would predispose the subject to any one of these conditions.
  12. Had hepatic dysfunction as evidenced by alanine aminotransferase or aspartate aminotransferase >5 x the upper limit of normal (ULN) or direct bilirubin >2.5 x the ULN.
  13. Had any of the following active autoimmune disorders: myasthenia gravis, Addison's disease, Wegener's granulomatosis, primary biliary cirrhosis, bullous pemphigoid, autoimmune hemolytic anemia, autoimmune hepatitis, multiple sclerosis, Goodpasture's syndrome, idiopathic thrombocytopenic purpura, lupus erythematosus, dermatomyositis, polymyositis, or vasculitis.
  14. Had active solid tumor malignancies with the exception of basal cell carcinoma or the condition under treatment (e.g., lymphomas).
  15. Had 1 or more episode of hyperglycemic coma or diabetic ketoacidosis within the 6 months prior to enrollment.
  16. Had cardiovascular disease which, in the opinion of the investigator, would interfere with the conduct of the study.
  17. Had Grade 3 or 4 graft versus host disease of the GI tract; subjects with any GI disease that would, in the judgment of the investigator, preclude the subject from taking or absorbing oral medication (e.g. clinically active Crohn's disease, ischemic colitis, moderate or severe ulcerative colitis, or any condition expected to require abdominal surgery during the course of study participation).
  18. Any other condition including abnormal laboratory values that would have, in the judgment of the investigator, put the subject at increased risk for participating in the trial, or interferes with the conduct of the trial.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Sekventiell tilldelning
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Placebo-jämförare: Placebo
  • Cohort 1 = 40 mg of matching placebo administered once weekly (QW)
  • Cohort 2 = 100 mg of matching placebo administered QW
  • Cohort 3 = 200 mg of matching placebo administered QW
  • Cohort 4 = 200 mg of matching placebo administered twice weekly (BIW)
  • Cohort 4A = 100 mg of matching placebo administered BIW
Läkemedel: Placebo

Subjects received their first dose of study drug within 30 (+5) days post-transplant and were treated through Week 13 post-transplant.

Matching placebo administered for each cohort.
Experimentell: Brincidofovir
  • Cohort 1 = 40 mg brincidofovir (BCV) administered once weekly (QW)
  • Cohort 2 = 100 mg BCV administered QW
  • Cohort 3 = 200 mg BCV administered QW
  • Cohort 4 = 200 mg BCV administered twice weekly (BIW)
  • Cohort 4A = 100 mg BCV administered BIW
Läkemedel: Brincidofovir
Subjects received their first dose of study drug of brincidofovir (BCV) within 30 (+5) days post-transplant and were treated through Week 13 post-transplant.
Andra namn:
  • BCV
  • CMX001

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of Participants With Clinically Significant CMV Infection
Tidsram: Randomization to Week 8 post-treatment (~19 weeks)
The primary efficacy endpoint was a binomial outcome of failure to prevent cytomegalovirus (CMV) infection defined as CMV DNAemia >200 copies/mL obtained at the time of the last treatment with study drug or diagnosis of CMV disease at some point during the treatment phase.
Randomization to Week 8 post-treatment (~19 weeks)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Chimerix

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Användbara länkar

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 oktober 2009

Primärt slutförande (Faktisk)

1 januari 2012

Avslutad studie (Faktisk)

1 januari 2012

Studieregistreringsdatum

Först inskickad

17 juli 2009

Först inskickad som uppfyllde QC-kriterierna

17 juli 2009

Första postat (Uppskatta)

20 juli 2009

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

16 juli 2021

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

28 juni 2021

Senast verifierad

1 juni 2021

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CMX001-201

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

Nej

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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