免费获得国外相关药品,最快 1 个工作日回馈药物信息

出境医 / 临床实验 / High-Dose Post-Transplant Cyclophosphamide and Bortezomib (CyBor) for the Prevention of Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)

High-Dose Post-Transplant Cyclophosphamide and Bortezomib (CyBor) for the Prevention of Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)

Study Description
Brief Summary:
This is a single arm open label phase II clinical trial. Adult patients with hematological malignancies undergoing allogeneic HSCT from matched-related or unrelated donor are eligible for the study if they meet the standard criteria defined in the investigator's institutional standard operation procedures (SOPs), meet all inclusion criteria, and do not satisfy any exclusion criteria. Patients will receive reduced-intensity or myeloablative conditioning regimen of fludarabine, busulfan, and rabbit anti-thymocyte globulin (rATG). Patients will receive PTCyBor as GvHD prophylaxis.

Condition or disease Intervention/treatment Phase
GVHD Drug: Bortezomib Drug: Cyclophosphamide Phase 2

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 47 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of High-Dose Post-Transplant Cyclophosphamide and Bortezomib (CyBor) for the Prevention of Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)
Actual Study Start Date : June 20, 2019
Estimated Primary Completion Date : November 2022
Estimated Study Completion Date : November 2022
Arms and Interventions
Arm Intervention/treatment
Experimental: Cyclophosphamide and Bortezomib Drug: Bortezomib
1.3 mg/m2 IV 6 hours after graft infusion and 72 hours thereafter.

Drug: Cyclophosphamide
50 mg/kg IV over 2 hours on Day +3 and +4

Outcome Measures
Primary Outcome Measures :
  1. Incidence of Acute GvHD [ Time Frame: Day +45 ]
    The first day of acute GvHD of any grade will be recorded for that grade. This end point will be evaluated through day +120 post-transplant. The diagnosis of acute GvHD is based on clinical and pathological evaluation by the principal investigator in collaboration with the treating physician. Cumulative incidence curves will be provided along with 95% confidence intervals for the 120 day cumulative incidence.

  2. Incidence of Chronic GvHD [ Time Frame: Day +45 ]
    The first day of chronic GvHD will be recorded. The diagnosis of chronic GvHD is based on clinical and pathological evaluation by the principal investigator in collaboration with the treating physician. All participants that completed transplant and any prophylactic treatment will be included in the analysis.


Secondary Outcome Measures :
  1. Primary graft failure [ Time Frame: Day +45 ]
    evaluated to day +45 and incidence of graft failure will be calculated from date of transplant to failure for all patients who receive a transplant and any prophylactic treatment and from date of completion of prophylactic treatment for all participants that completed treatment.

  2. Poor graft function [ Time Frame: Day +30 ]
    evaluated to day +30 incidence of poor graft function will be calculated, from date of transplant to failure for all patients who receive a transplant and any prophylactic treatment and from date of completion of prophylactic treatment for all participants that completed treatment.

  3. Secondary graft failure [ Time Frame: day +730 ]
    evaluated after engraftment is achieved will be calculated from date of engraftment for all patients with engraftment.

  4. Treatment Related Mortality (TRM) [ Time Frame: day +730 ]
    analyzed based on participants that who received a transplant with any prophylactic treatment and for all patients who received a transplant and completed prophylactic treatment.

  5. Relapse Rate (RR) [ Time Frame: day +730 ]
    analyzed for all patients who received a transplant and for all transplanted patients that completed treatment.

  6. Graft versus Host Disease Relapse Free Survival (GRFS) [ Time Frame: day +730 ]
    participants that are without reported GvHD III-IV acute GvHD, chronic GvHD requiring systemic therapy and have not experienced relapse or death after transplant.

  7. Overall Survival (OS) [ Time Frame: day +730 ]
    considers all participants who received a transplant and for all transplanted patients who completed prophylactic treatment as described above. .


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Karnofsky score ≥ 70%
  • No evidence of progressive bacterial, viral, or fungal infection
  • Creatinine clearance > 50 mL/min/1.72m2
  • Total bilirubin, ALT and AST < 2 x the upper limit of normal (except for Gilbert's syndrome)
  • Alkaline phosphatase ≤ 250 IU/L
  • Left Ventricular Ejection Fraction (LVEF) > 45%
  • Adjusted Carbon Monoxide Diffusing Capacity (DLCO) > 60%
  • Negative HIV serology
  • Negative pregnancy test: confirmation per negative serum β-human chorionic gonadotropin (β-hCG)

Exclusion Criteria:

  • Pregnant or nursing females or women of reproductive capability who are unwilling to completely abstain from heterosexual sex or practice 2 effective methods of contraception from the first dose of bortezomib through 90 days after the last dose. A woman of reproductive capability is one who has not undergone a hysterectomy (removal of the womb), has not had both ovaries removed, or has not been post-menopausal (stopped menstrual periods) for more than 24 months in a row.
  • Male subjects who refuse to practice effective barrier contraception during the entire study treatment period and through a minimum of 90 days after the last dose of study drug, or completely abstain from heterosexual intercourse. This must be done even if they are surgically sterilized (i.e., post-vasectomy).
  • Inability to provide informed consent.
  • Patient had myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure (see Appendix E), uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening must be documented by the investigator as not medically relevant.
  • Known allergies to any of the components of the investigational treatment regimen.
  • Serious medical or psychiatric illness likely to interfere with participation in this clinical study.
  • Diagnosed or treated for another malignancy within 3 years of enrollment, with the exception of complete resection of basal cell carcinoma or squamous cell carcinoma, an in-situ malignancy, or low-risk prostate cancer after curative therapy.
  • Participation in clinical trials with other investigational agents not included in this trial, within 14 days of the start of this trial and throughout the duration of this trial.
  • Prisoners
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Ankeeta Joshi 2122634431 Ankeeta.Joshi@nyulangone.org

Locations
Layout table for location information
United States, New York
New York University School of Medicine Recruiting
New York, New York, United States, 10016
Contact: Ankeeta Joshi    212-263-4431    Ankeeta.Joshi@nyulangone.org   
Principal Investigator: Ahmad Al-Homsi, MD         
Sponsors and Collaborators
NYU Langone Health
Investigators
Layout table for investigator information
Principal Investigator: Ahmad Al-Homsi, MD New York Langone Medical Center
Tracking Information
First Submitted Date  ICMJE May 8, 2019
First Posted Date  ICMJE May 10, 2019
Last Update Posted Date April 22, 2021
Actual Study Start Date  ICMJE June 20, 2019
Estimated Primary Completion Date November 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 9, 2019)
  • Incidence of Acute GvHD [ Time Frame: Day +45 ]
    The first day of acute GvHD of any grade will be recorded for that grade. This end point will be evaluated through day +120 post-transplant. The diagnosis of acute GvHD is based on clinical and pathological evaluation by the principal investigator in collaboration with the treating physician. Cumulative incidence curves will be provided along with 95% confidence intervals for the 120 day cumulative incidence.
  • Incidence of Chronic GvHD [ Time Frame: Day +45 ]
    The first day of chronic GvHD will be recorded. The diagnosis of chronic GvHD is based on clinical and pathological evaluation by the principal investigator in collaboration with the treating physician. All participants that completed transplant and any prophylactic treatment will be included in the analysis.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: May 9, 2019)
  • Primary graft failure [ Time Frame: Day +45 ]
    evaluated to day +45 and incidence of graft failure will be calculated from date of transplant to failure for all patients who receive a transplant and any prophylactic treatment and from date of completion of prophylactic treatment for all participants that completed treatment.
  • Poor graft function [ Time Frame: Day +30 ]
    evaluated to day +30 incidence of poor graft function will be calculated, from date of transplant to failure for all patients who receive a transplant and any prophylactic treatment and from date of completion of prophylactic treatment for all participants that completed treatment.
  • Secondary graft failure [ Time Frame: day +730 ]
    evaluated after engraftment is achieved will be calculated from date of engraftment for all patients with engraftment.
  • Treatment Related Mortality (TRM) [ Time Frame: day +730 ]
    analyzed based on participants that who received a transplant with any prophylactic treatment and for all patients who received a transplant and completed prophylactic treatment.
  • Relapse Rate (RR) [ Time Frame: day +730 ]
    analyzed for all patients who received a transplant and for all transplanted patients that completed treatment.
  • Graft versus Host Disease Relapse Free Survival (GRFS) [ Time Frame: day +730 ]
    participants that are without reported GvHD III-IV acute GvHD, chronic GvHD requiring systemic therapy and have not experienced relapse or death after transplant.
  • Overall Survival (OS) [ Time Frame: day +730 ]
    considers all participants who received a transplant and for all transplanted patients who completed prophylactic treatment as described above. .
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE High-Dose Post-Transplant Cyclophosphamide and Bortezomib (CyBor) for the Prevention of Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)
Official Title  ICMJE A Phase II Study of High-Dose Post-Transplant Cyclophosphamide and Bortezomib (CyBor) for the Prevention of Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)
Brief Summary This is a single arm open label phase II clinical trial. Adult patients with hematological malignancies undergoing allogeneic HSCT from matched-related or unrelated donor are eligible for the study if they meet the standard criteria defined in the investigator's institutional standard operation procedures (SOPs), meet all inclusion criteria, and do not satisfy any exclusion criteria. Patients will receive reduced-intensity or myeloablative conditioning regimen of fludarabine, busulfan, and rabbit anti-thymocyte globulin (rATG). Patients will receive PTCyBor as GvHD prophylaxis.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE GVHD
Intervention  ICMJE
  • Drug: Bortezomib
    1.3 mg/m2 IV 6 hours after graft infusion and 72 hours thereafter.
  • Drug: Cyclophosphamide
    50 mg/kg IV over 2 hours on Day +3 and +4
Study Arms  ICMJE Experimental: Cyclophosphamide and Bortezomib
Interventions:
  • Drug: Bortezomib
  • Drug: Cyclophosphamide
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: May 9, 2019)
47
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE November 2022
Estimated Primary Completion Date November 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Karnofsky score ≥ 70%
  • No evidence of progressive bacterial, viral, or fungal infection
  • Creatinine clearance > 50 mL/min/1.72m2
  • Total bilirubin, ALT and AST < 2 x the upper limit of normal (except for Gilbert's syndrome)
  • Alkaline phosphatase ≤ 250 IU/L
  • Left Ventricular Ejection Fraction (LVEF) > 45%
  • Adjusted Carbon Monoxide Diffusing Capacity (DLCO) > 60%
  • Negative HIV serology
  • Negative pregnancy test: confirmation per negative serum β-human chorionic gonadotropin (β-hCG)

Exclusion Criteria:

  • Pregnant or nursing females or women of reproductive capability who are unwilling to completely abstain from heterosexual sex or practice 2 effective methods of contraception from the first dose of bortezomib through 90 days after the last dose. A woman of reproductive capability is one who has not undergone a hysterectomy (removal of the womb), has not had both ovaries removed, or has not been post-menopausal (stopped menstrual periods) for more than 24 months in a row.
  • Male subjects who refuse to practice effective barrier contraception during the entire study treatment period and through a minimum of 90 days after the last dose of study drug, or completely abstain from heterosexual intercourse. This must be done even if they are surgically sterilized (i.e., post-vasectomy).
  • Inability to provide informed consent.
  • Patient had myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure (see Appendix E), uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening must be documented by the investigator as not medically relevant.
  • Known allergies to any of the components of the investigational treatment regimen.
  • Serious medical or psychiatric illness likely to interfere with participation in this clinical study.
  • Diagnosed or treated for another malignancy within 3 years of enrollment, with the exception of complete resection of basal cell carcinoma or squamous cell carcinoma, an in-situ malignancy, or low-risk prostate cancer after curative therapy.
  • Participation in clinical trials with other investigational agents not included in this trial, within 14 days of the start of this trial and throughout the duration of this trial.
  • Prisoners
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Ankeeta Joshi 2122634431 Ankeeta.Joshi@nyulangone.org
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03945591
Other Study ID Numbers  ICMJE 18-01185
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: Yes
Plan Description: Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices).Upon reasonable request is likely the most appropriate as well will report on incidental findings (i.e. infections) that may impact transplant.
Supporting Materials: Statistical Analysis Plan (SAP)
Time Frame: Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.
Access Criteria: Requests should be directed to Ankeeta.Joshi@nyulangone.org To gain access, data requestors will need to sign a data access agreement.
Responsible Party NYU Langone Health
Study Sponsor  ICMJE NYU Langone Health
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Ahmad Al-Homsi, MD New York Langone Medical Center
PRS Account NYU Langone Health
Verification Date April 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

治疗医院