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OTI-010 for Graft-Versus-Host Disease Prophylaxis in Treating Patients Who Are Undergoing Donor Peripheral Stem Cell Transplantation for Hematologic Malignancies

Primary Purpose

Graft Versus Host Disease, Leukemia, Myelodysplastic Syndromes

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
autologous expanded mesenchymal stem cells OTI-010
busulfan
cyclophosphamide
cyclosporine
methotrexate
peripheral blood stem cell transplantation
radiation therapy
Sponsored by
Mesoblast International Sàrl
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Graft Versus Host Disease focused on measuring graft versus host disease, adult acute lymphoblastic leukemia in remission, recurrent adult acute lymphoblastic leukemia, adult acute myeloid leukemia in remission, recurrent adult acute myeloid leukemia, accelerated phase chronic myelogenous leukemia, chronic phase chronic myelogenous leukemia, refractory anemia, refractory anemia with excess blasts, refractory anemia with ringed sideroblasts, de novo myelodysplastic syndromes, previously treated myelodysplastic syndromes, secondary myelodysplastic syndromes, adult acute myeloid leukemia with t(8;21)(q22;q22), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with t(15;17)(q22;q12)

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed diagnosis of 1 of the following hematologic malignancies: Acute lymphoblastic leukemia, meeting 1 of the following criteria: In first or second remission In early first or second relapse* Acute myeloid leukemia, meeting 1 of the following criteria: In first or second remission In early first or second relapse* Chronic myelogenous leukemia Chronic or accelerated phase Any of the following myelodysplastic syndromes: Refractory anemia (RA) RA with ringed sideroblasts RA with excess blasts NOTE: *< 24% marrow blasts and < 5% peripheral blood blasts (within 10 days of beginning conditioning regimen) No secondary acute leukemia Prior CNS tumor involvement allowed provided patient is asymptomatic and there is no evidence of CNS disease on lumbar puncture and CT scan of the brain Must have a 6/6 HLA-identical sibling donor available PATIENT CHARACTERISTICS: Age 18 to 55 Performance status Karnofsky 70-100% Life expectancy Not specified Hematopoietic Not specified Hepatic Bilirubin < 2 times upper limit of normal (ULN) SGOT < 10 times ULN Hepatitis B core antigen, surface antigen, and e-antigen negative Hepatitis B DNA negative Hepatitis C RNA negative Renal Creatinine clearance ≥ 60 mL/min Cardiovascular LVEF ≥ 50% by MUGA or echocardiogram No right sided heart failure Pulmonary FEV_1 > 50% of predicted DLCO ≥ 50% of predicted (corrected for anemia) Oxygen saturation ≥ 97% on room air No pulmonary hypertension Immunologic HIV-1 and 2 antibody negative HIV-1 antigen negative HTLV-I and II antibody negative No active infection Other CNS function normal No uncontrolled alcohol or substance abuse within the past 6 months No other concurrent underlying medical condition that would preclude study participation Not pregnant Negative pregnancy test Fertile patients must use 2 effective methods of contraception PRIOR CONCURRENT THERAPY: Biologic therapy No prior allogeneic or autologous hematopoietic stem cell transplantation No concurrent medication to accelerate neutrophil or platelet engraftment except filgrastim (G-CSF) Chemotherapy Not specified Endocrine therapy Not specified Radiotherapy Not specified Surgery No prior solid organ transplantation Other More than 30 days since prior investigational agents or devices No other concurrent investigational agents or devices No concurrent anti-infective therapy except prophylactic therapy No other concurrent conditioning regimen agents No concurrent herbal remedies except multivitamins No other concurrent graft-versus-host disease prophylaxis medications (e.g., ursodeoxycholic acid)

Sites / Locations

  • Jonsson Comprehensive Cancer Center, UCLA

Outcomes

Primary Outcome Measures

Incidence of acute GVHD grade II-IV of skin, liver and gut (stomach to rectum) through Day 84 post-PBSC transplantation

Secondary Outcome Measures

Safety as measured by infusional toxicity, relapse nd survival, formation of potential ectopic tissue foci

Full Information

First Posted
April 7, 2004
Last Updated
December 3, 2014
Sponsor
Mesoblast International Sàrl
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00081055
Brief Title
OTI-010 for Graft-Versus-Host Disease Prophylaxis in Treating Patients Who Are Undergoing Donor Peripheral Stem Cell Transplantation for Hematologic Malignancies
Official Title
A Phase II, Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Safety and Efficacy of OTI-010 in Subjects Who Receive HLA-Identical Sibling Peripheral Blood Stem Cell Transplantation for Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
December 2014
Overall Recruitment Status
Withdrawn
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mesoblast International Sàrl
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: OTI-010 may be effective for graft-versus-host disease prophylaxis (prevention) in patients who are undergoing donor peripheral stem cell transplantation for hematologic malignancies (cancer of the blood or bone marrow). PURPOSE: This randomized phase II trial is studying how well OTI-010 works in preventing graft-versus-host disease in patients who are undergoing donor peripheral stem cell transplantation for hematologic cancer.
Detailed Description
OBJECTIVES: Compare the safety and efficacy of OTI-010 vs placebo as graft-versus-host disease prophylaxis in patients with hematologic malignancies undergoing HLA-identical sibling matched peripheral blood stem cell transplantation. OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to age (18 to 34 vs 35 to 55) and donor/recipient gender (female donor/male recipient vs female donor/female recipient vs male donor/female recipient vs male donor/male recipient). Conditioning regimen: Patients receive cyclophosphamide IV once daily on days -5 and -4 and undergo total body irradiation twice daily on days -3 to -1 OR busulfan IV over 2 hours every 6 hours on days -7 to -4 and cyclophosphamide IV once daily on days -3 and -2. Graft-versus-host disease prophylaxis: Patients receive methotrexate IV on days 1, 3, 6, and 11. Patients also receive cyclosporine orally or IV (over 1-4 hours) twice daily beginning on day -1 and continuing for at least 6 months followed by a taper until 1 year after transplantation. OTI-010 therapy: Patients are randomized to 1 of 3 treatment arms. Arm I: Patients receive placebo IV 4 hours before peripheral blood stem cell transplantation (PBSCT) on day 0. Arm II: Patients receive OTI-010 IV 4 hours before PBSCT on day 0. Arm III: Patients receive a higher dose of OTI-010 IV 4 hours before PBSCT on day 0. Allogeneic stem cell transplantation: Patients undergo allogeneic PBSCT on day 0. Patients are followed at 18 weeks, at 6, 9, and 12 months, every 6 months for 1 year, and then annually for 3 years. PROJECTED ACCRUAL: A total of 99 patients (33 per treatment arm) will be accrued for this study within 5 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Graft Versus Host Disease, Leukemia, Myelodysplastic Syndromes
Keywords
graft versus host disease, adult acute lymphoblastic leukemia in remission, recurrent adult acute lymphoblastic leukemia, adult acute myeloid leukemia in remission, recurrent adult acute myeloid leukemia, accelerated phase chronic myelogenous leukemia, chronic phase chronic myelogenous leukemia, refractory anemia, refractory anemia with excess blasts, refractory anemia with ringed sideroblasts, de novo myelodysplastic syndromes, previously treated myelodysplastic syndromes, secondary myelodysplastic syndromes, adult acute myeloid leukemia with t(8;21)(q22;q22), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with t(15;17)(q22;q12)

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Masking
Double
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
autologous expanded mesenchymal stem cells OTI-010
Intervention Type
Drug
Intervention Name(s)
busulfan
Intervention Type
Drug
Intervention Name(s)
cyclophosphamide
Intervention Type
Drug
Intervention Name(s)
cyclosporine
Intervention Type
Drug
Intervention Name(s)
methotrexate
Intervention Type
Procedure
Intervention Name(s)
peripheral blood stem cell transplantation
Intervention Type
Radiation
Intervention Name(s)
radiation therapy
Primary Outcome Measure Information:
Title
Incidence of acute GVHD grade II-IV of skin, liver and gut (stomach to rectum) through Day 84 post-PBSC transplantation
Time Frame
Day 84
Secondary Outcome Measure Information:
Title
Safety as measured by infusional toxicity, relapse nd survival, formation of potential ectopic tissue foci
Time Frame
84 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed diagnosis of 1 of the following hematologic malignancies: Acute lymphoblastic leukemia, meeting 1 of the following criteria: In first or second remission In early first or second relapse* Acute myeloid leukemia, meeting 1 of the following criteria: In first or second remission In early first or second relapse* Chronic myelogenous leukemia Chronic or accelerated phase Any of the following myelodysplastic syndromes: Refractory anemia (RA) RA with ringed sideroblasts RA with excess blasts NOTE: *< 24% marrow blasts and < 5% peripheral blood blasts (within 10 days of beginning conditioning regimen) No secondary acute leukemia Prior CNS tumor involvement allowed provided patient is asymptomatic and there is no evidence of CNS disease on lumbar puncture and CT scan of the brain Must have a 6/6 HLA-identical sibling donor available PATIENT CHARACTERISTICS: Age 18 to 55 Performance status Karnofsky 70-100% Life expectancy Not specified Hematopoietic Not specified Hepatic Bilirubin < 2 times upper limit of normal (ULN) SGOT < 10 times ULN Hepatitis B core antigen, surface antigen, and e-antigen negative Hepatitis B DNA negative Hepatitis C RNA negative Renal Creatinine clearance ≥ 60 mL/min Cardiovascular LVEF ≥ 50% by MUGA or echocardiogram No right sided heart failure Pulmonary FEV_1 > 50% of predicted DLCO ≥ 50% of predicted (corrected for anemia) Oxygen saturation ≥ 97% on room air No pulmonary hypertension Immunologic HIV-1 and 2 antibody negative HIV-1 antigen negative HTLV-I and II antibody negative No active infection Other CNS function normal No uncontrolled alcohol or substance abuse within the past 6 months No other concurrent underlying medical condition that would preclude study participation Not pregnant Negative pregnancy test Fertile patients must use 2 effective methods of contraception PRIOR CONCURRENT THERAPY: Biologic therapy No prior allogeneic or autologous hematopoietic stem cell transplantation No concurrent medication to accelerate neutrophil or platelet engraftment except filgrastim (G-CSF) Chemotherapy Not specified Endocrine therapy Not specified Radiotherapy Not specified Surgery No prior solid organ transplantation Other More than 30 days since prior investigational agents or devices No other concurrent investigational agents or devices No concurrent anti-infective therapy except prophylactic therapy No other concurrent conditioning regimen agents No concurrent herbal remedies except multivitamins No other concurrent graft-versus-host disease prophylaxis medications (e.g., ursodeoxycholic acid)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mary C. Territo, MD
Organizational Affiliation
Jonsson Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Jonsson Comprehensive Cancer Center, UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-1678
Country
United States

12. IPD Sharing Statement

Learn more about this trial

OTI-010 for Graft-Versus-Host Disease Prophylaxis in Treating Patients Who Are Undergoing Donor Peripheral Stem Cell Transplantation for Hematologic Malignancies

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