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

2019年4月12日 更新者: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.

研究概览

研究类型

介入性

注册 (实际的)

17

阶段

  • 阶段1

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Missouri
      • Saint Louis、Missouri、美国、63110
        • Washington University School of Medicine

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 至 70年 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

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.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:非随机化
  • 介入模型:单组作业
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:Dose Level 0 (starting dose)
brentuximab vedotin 0.3mg/kg, given IV on Days 7, 28, 49 & 70
其他名称:
  • Adcetris
实验性的:Dose Level 1
brentuximab vedotin 0.6mg/kg, given IV on Days 7, 28, 49 & 70
其他名称:
  • Adcetris
实验性的:Dose Level 2
brentuximab vedotin 1.2mg/kg, given IV on Days 7, 28, 49 & 70
其他名称:
  • Adcetris
实验性的:Dose Level 3
brentuximab vedotin 1.8mg/kg, given IV on Days 7, 28, 49 & 70
其他名称:
  • Adcetris
无干预:Control Dose Level
The first 3 patients will not receive brentuximab vedotin.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
MTD of brentuximab vedotin when administered with a GVHD prophylaxis regimen
大体时间: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

次要结果测量

结果测量
措施说明
大体时间
Safety and tolerability of brentuximab vedotin when administered with a GVHD prophylaxis regimen
大体时间: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
大体时间: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
大体时间: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
大体时间: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.
大体时间: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
大体时间: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
大体时间: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
大体时间:1 year
Defined as the percentage of patients who have disease relapse; estimated with Kaplan-Meier methods.
1 year
2-year disease relapse rate
大体时间:2 years
Defined as the percentage of patients who have disease relapse; estimated with Kaplan-Meier methods.
2 years

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2013年2月25日

初级完成 (实际的)

2015年11月11日

研究完成 (实际的)

2016年11月21日

研究注册日期

首次提交

2012年9月18日

首先提交符合 QC 标准的

2012年10月1日

首次发布 (估计)

2012年10月4日

研究记录更新

最后更新发布 (实际的)

2019年4月16日

上次提交的符合 QC 标准的更新

2019年4月12日

最后验证

2019年4月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

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brentuximab vedotin的临床试验

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