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Evaluation of Approved Weight-Based Dose Compared to Fixed Dose of Plerixafor in Patients With Non-Hodgkin's Lymphoma (NHL) Weighing Less Than 70 Kilograms

Primary Purpose

Non-Hodgkin's Lymphoma

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Granulocyte-colony stimulating factor (G-CSF)
Fixed Dose Plerixafor
Weight-Based Plerixafor
Sponsored by
Genzyme, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Hodgkin's Lymphoma

Eligibility Criteria

18 Years - 78 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 18 to 78 years (inclusive)
  • Patients diagnosed with NHL who were to receive treatment with an autologous peripheral stem cell transplant for the first time
  • Biopsy-confirmed diagnosis of NHL (chronic lymphocytic leukemia and all variants were excluded)
  • Weight less than or equal to 70 kg
  • In first or second complete remission or partial remission, defined for the purpose of this study as complete or partial response following first or second-line therapy only
  • At least 4 weeks since last cycle of chemotherapy and/or other cancer therapy including rituximab
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Recovered from all acute toxic effects of prior chemotherapy
  • Negative for human immunodeficiency virus (HIV), active hepatitis B, and active hepatitis C from assessments performed within 3 months before signing informed consent
  • Signed informed consent form (ICF)
  • White blood cell count (WBC) greater than (>) 2.5*10^9 per liter (L)
  • Absolute neutrophil count (ANC) >1.5*10^9/L
  • Platelet (PLT) count >100*10^9/L
  • Creatinine clearance >=80 milliliter per minute (mL/min) (estimated by Cockcroft-Gault formula or 24 hour urine collection)
  • Serum glutamic oxaloacetic transaminase (SGOT)/aspartate aminotransferase (AST), serum glutamic pyruvic transaminase (SGPT)/alanine aminotransferase (ALT), and total bilirubin less than 2.5*upper limit of normal
  • Cardiac and pulmonary status sufficient to undergo apheresis and transplantation
  • All patients agreed to an effective method of contraception while on study treatment and for at least 3 months following plerixafor treatment (including both female patients of child-bearing potential and male patients with partners of child-bearing potential)

Exclusion Criteria:

  • A co-morbid condition which, in the view of the Investigator(s), rendered the patient at high risk from treatment complications
  • Failed previous hematopoietic stem cell (HSC) collections or collection attempts
  • Prior autologous or allogeneic transplant
  • Less than 6 weeks off 1,3-bis (2-chloroethyl)-1-nitroso-urea (BCNU) prior to first dose of G-CSF
  • Active central nervous system involvement, active brain metastases, or any history of carcinomatous meningitis (active or inactive)
  • Bone marrow involvement >20 percent (%), as assessed by bone marrow biopsy within 4 months of the first screening assessment, unless a bone marrow biopsy was performed immediately prior to the last chemotherapy and was negative and the patient responded to last chemotherapy achieving a complete or partial remission
  • Received radiation therapy to the pelvis
  • Received granulocyte/macrophage-colony stimulating factor (GM-CSF) or pegfilgrastim within 3 weeks prior to the first dose of granulocyte colony stimulating factor (G-CSF) for mobilization
  • Received G-CSF within 14 days prior to the first dose of G-CSF for mobilization
  • Received prior radio-immunotherapy with ibritumomab tiuxetan or tositumomab iodine
  • Active infection, including unexplained fever (>38.1 degree Celsius / 100.4 Fahrenheit), or antibiotic, antiviral, or antifungal therapy within 7 days prior to the first dose of G-CSF
  • Positive pregnancy test (female patients)
  • Lactating (female patients)
  • Abnormal electrocardiogram (ECG) with clinically significant rhythm disturbance (ventricular arrhythmias) or other conduction abnormality in the last year that, in the opinion of the Investigator(s), warranted exclusion of the patient from the trial
  • Previously received experimental therapy within 4 weeks of enrolling or who were currently enrolled in another experimental protocol during the G CSF and plerixafor treatment period

Sites / Locations

  • City of Hope National Medical Center
  • University of Colorado Cancer Center
  • Princess Margaret Hospital
  • Samsung Medical Center
  • St. Mary's Hospital
  • National Taiwan University Hospital
  • Taipei Veterans General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Fixed Dose Plerixafor

Weight-Based Plerixafor

Arm Description

10 microgram per kilogram (mcg/kg) granulocyte-colony stimulating factor (G-CSF) subcutaneous (SC) injection once daily in morning from Day 1 through Day 4 (G-CSF mobilization period), followed by 20 milligram (mg) plerixafor SC injection (fixed dose) in evening of Day 4 (10 to 11 hours prior to first apheresis), and then 10 mcg/kg G-CSF SC injection in morning of Day 5 (1 hour prior to first apheresis). Apheresis process and treatment with plerixafor (10 to 11 hours prior to apheresis) and G-CSF (1 hour prior to apheresis) was continued until the target number of cluster of differentiation 34 (CD34+) stem cells (greater than or equal to [>=] 5*10^6 cells/kg) was collected or until a maximum 4 apheresis sessions occurred.

G-CSF 10 mcg/kg SC injection once daily in morning from Day 1 through Day 4 (G-CSF mobilization period), followed by plerixafor 0.24 milligram per kilogram (mg/kg) SC injection (weight-based dose) in evening of Day 4 (10 to 11 hours before first apheresis), and then G-CSF 10 mcg/kg SC injection in morning of Day 5 (1 hour prior to first apheresis). Apheresis process and treatment with plerixafor (10 to 11 hours prior to apheresis) and G-CSF (1 hour prior to apheresis) was continued until the target number of CD34+ stem cells (>=5*10^6 cells/kg) was collected or until a maximum 4 apheresis sessions occurred.

Outcomes

Primary Outcome Measures

Proportion of Patients Who Achieved at Least 5*10^6 Cluster of Differentiation 34+ (CD34+) Cells Per Kilogram (Cells/kg)
The cumulative number of CD34+ cells/kg (body weight) collected over all apheresis sessions (up to a maximum of 4 sessions) was used to determine if a patient has achieved the target of >=5*10^6 CD34+ cells/kg (optimum number of CD34+ cells required for transplantation) within 4 days of apheresis. The proportion of patients who achieved the target was reported as percentages for each treatment arm.
Area Under the Concentration-time Curve From Time 0 to 10 Hours (AUC [0-10])

Secondary Outcome Measures

Proportion of Patients Who Achieved at Least 2*10^6 CD34+ Cells/kg in Less Than or Equal to 4 Days of Apheresis
The cumulative number of CD34+ cells/kg (body weight) collected over all apheresis sessions (up to a maximum of 4 sessions) was used to determine if a patient has achieved the target of >= 2*10^6 CD34+ cells/kg (minimum number of CD34+ cells required for transplantation) within 4 days of apheresis. The proportion of patients who achieved the target was reported as percentages for each treatment arm.
Median Number of Days of Apheresis to Collect at Least 2*10^6 CD34+ Cells/kg
Median Number of Days of Apheresis to Collect at Least 5*10^6 CD34+ Cells/kg
Total Number of CD34+ Cells/kg Collected Over up to 4 Aphereses
The cumulative number of CD34+ cells/kg (body weight) collected over all apheresis sessions (up to a maximum of 4 sessions) was reported.
Mean Fold Increase in Peripheral Blood CD34+ Cell Count Following Plerixafor
Fold increase was calculated as CD34+ cell count on Day 5 divided by CD34+ cell count on Day 4.
Maximum Observed Plasma Concentration (Cmax)
Time to Reach Maximum Plasma Concentration (Tmax)
Terminal Elimination Half-life (T1/2)
T1/2 is the time required for the plasma concentration to decrease to one half.

Full Information

First Posted
July 9, 2010
Last Updated
February 7, 2014
Sponsor
Genzyme, a Sanofi Company
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1. Study Identification

Unique Protocol Identification Number
NCT01164475
Brief Title
Evaluation of Approved Weight-Based Dose Compared to Fixed Dose of Plerixafor in Patients With Non-Hodgkin's Lymphoma (NHL) Weighing Less Than 70 Kilograms
Official Title
A Phase 4, Multicenter, Randomized, Comparator Trial Evaluating the Standard Weight-Based Dose (0.24 mg/kg) Compared to a Fixed Dose (20 mg) of Plerixafor Injection in Combination With G-CSF to Mobilize and Collect ≥5 x 10^6 CD34+ Cells/kg in ≤4 Days and to Evaluate the Difference in Total Systemic Exposure in Patients With Non-Hodgkin's Lymphoma Weighing ≤70 kg
Study Type
Interventional

2. Study Status

Record Verification Date
February 2014
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
February 2013 (Actual)
Study Completion Date
February 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genzyme, a Sanofi Company

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study was to compare the responses of 2 different doses of plerixafor in patients with Non-Hodgkin's Lymphoma (NHL) who received an autologous stem cell transplant.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Hodgkin's Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
61 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fixed Dose Plerixafor
Arm Type
Experimental
Arm Description
10 microgram per kilogram (mcg/kg) granulocyte-colony stimulating factor (G-CSF) subcutaneous (SC) injection once daily in morning from Day 1 through Day 4 (G-CSF mobilization period), followed by 20 milligram (mg) plerixafor SC injection (fixed dose) in evening of Day 4 (10 to 11 hours prior to first apheresis), and then 10 mcg/kg G-CSF SC injection in morning of Day 5 (1 hour prior to first apheresis). Apheresis process and treatment with plerixafor (10 to 11 hours prior to apheresis) and G-CSF (1 hour prior to apheresis) was continued until the target number of cluster of differentiation 34 (CD34+) stem cells (greater than or equal to [>=] 5*10^6 cells/kg) was collected or until a maximum 4 apheresis sessions occurred.
Arm Title
Weight-Based Plerixafor
Arm Type
Active Comparator
Arm Description
G-CSF 10 mcg/kg SC injection once daily in morning from Day 1 through Day 4 (G-CSF mobilization period), followed by plerixafor 0.24 milligram per kilogram (mg/kg) SC injection (weight-based dose) in evening of Day 4 (10 to 11 hours before first apheresis), and then G-CSF 10 mcg/kg SC injection in morning of Day 5 (1 hour prior to first apheresis). Apheresis process and treatment with plerixafor (10 to 11 hours prior to apheresis) and G-CSF (1 hour prior to apheresis) was continued until the target number of CD34+ stem cells (>=5*10^6 cells/kg) was collected or until a maximum 4 apheresis sessions occurred.
Intervention Type
Drug
Intervention Name(s)
Granulocyte-colony stimulating factor (G-CSF)
Other Intervention Name(s)
Filgrastim
Intervention Type
Drug
Intervention Name(s)
Fixed Dose Plerixafor
Other Intervention Name(s)
Mozobil, AMD3100
Intervention Type
Drug
Intervention Name(s)
Weight-Based Plerixafor
Other Intervention Name(s)
Mozobil, AMD3100
Primary Outcome Measure Information:
Title
Proportion of Patients Who Achieved at Least 5*10^6 Cluster of Differentiation 34+ (CD34+) Cells Per Kilogram (Cells/kg)
Description
The cumulative number of CD34+ cells/kg (body weight) collected over all apheresis sessions (up to a maximum of 4 sessions) was used to determine if a patient has achieved the target of >=5*10^6 CD34+ cells/kg (optimum number of CD34+ cells required for transplantation) within 4 days of apheresis. The proportion of patients who achieved the target was reported as percentages for each treatment arm.
Time Frame
Day 5 up to Day 8
Title
Area Under the Concentration-time Curve From Time 0 to 10 Hours (AUC [0-10])
Time Frame
0 (pre-plerixafor dose), 0.5, 1, 4 hours post-plerixafor dose on Day 4; 9-10 hours post-plerixafor dose (pre G-CSF dose) on Day 5, 10-11 hours post-plerixafor dose (prior to first apheresis) on Day 5
Secondary Outcome Measure Information:
Title
Proportion of Patients Who Achieved at Least 2*10^6 CD34+ Cells/kg in Less Than or Equal to 4 Days of Apheresis
Description
The cumulative number of CD34+ cells/kg (body weight) collected over all apheresis sessions (up to a maximum of 4 sessions) was used to determine if a patient has achieved the target of >= 2*10^6 CD34+ cells/kg (minimum number of CD34+ cells required for transplantation) within 4 days of apheresis. The proportion of patients who achieved the target was reported as percentages for each treatment arm.
Time Frame
Day 5 up to Day 8
Title
Median Number of Days of Apheresis to Collect at Least 2*10^6 CD34+ Cells/kg
Time Frame
Day 5 up to Day 8
Title
Median Number of Days of Apheresis to Collect at Least 5*10^6 CD34+ Cells/kg
Time Frame
Day 5 up to Day 8
Title
Total Number of CD34+ Cells/kg Collected Over up to 4 Aphereses
Description
The cumulative number of CD34+ cells/kg (body weight) collected over all apheresis sessions (up to a maximum of 4 sessions) was reported.
Time Frame
Day 5 up to Day 8
Title
Mean Fold Increase in Peripheral Blood CD34+ Cell Count Following Plerixafor
Description
Fold increase was calculated as CD34+ cell count on Day 5 divided by CD34+ cell count on Day 4.
Time Frame
Baseline (pre G-CSF dose on Day 4) to Day 5 (prior to first apheresis)
Title
Maximum Observed Plasma Concentration (Cmax)
Time Frame
0 (pre-plerixafor dose), 0.5, 1, 4 hours post-plerixafor dose on Day 4; 9-10 hours post-plerixafor dose (pre G-CSF dose) on Day 5, 10-11 hours post-plerixafor dose (prior to first apheresis) on Day 5
Title
Time to Reach Maximum Plasma Concentration (Tmax)
Time Frame
0 (pre-plerixafor dose), 0.5, 1, 4 hours post-plerixafor dose on Day 4; 9-10 hours post-plerixafor dose (pre G-CSF dose) on Day 5, 10-11 hours post-plerixafor dose (prior to first apheresis) on Day 5
Title
Terminal Elimination Half-life (T1/2)
Description
T1/2 is the time required for the plasma concentration to decrease to one half.
Time Frame
0 (pre-plerixafor dose), 0.5, 1, 4 hours post-plerixafor dose on Day 4; 9-10 hours post-plerixafor dose (pre G-CSF dose) on Day 5, 10-11 hours post-plerixafor dose (prior to first apheresis) on Day 5

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
78 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18 to 78 years (inclusive) Patients diagnosed with NHL who were to receive treatment with an autologous peripheral stem cell transplant for the first time Biopsy-confirmed diagnosis of NHL (chronic lymphocytic leukemia and all variants were excluded) Weight less than or equal to 70 kg In first or second complete remission or partial remission, defined for the purpose of this study as complete or partial response following first or second-line therapy only At least 4 weeks since last cycle of chemotherapy and/or other cancer therapy including rituximab Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Recovered from all acute toxic effects of prior chemotherapy Negative for human immunodeficiency virus (HIV), active hepatitis B, and active hepatitis C from assessments performed within 3 months before signing informed consent Signed informed consent form (ICF) White blood cell count (WBC) greater than (>) 2.5*10^9 per liter (L) Absolute neutrophil count (ANC) >1.5*10^9/L Platelet (PLT) count >100*10^9/L Creatinine clearance >=80 milliliter per minute (mL/min) (estimated by Cockcroft-Gault formula or 24 hour urine collection) Serum glutamic oxaloacetic transaminase (SGOT)/aspartate aminotransferase (AST), serum glutamic pyruvic transaminase (SGPT)/alanine aminotransferase (ALT), and total bilirubin less than 2.5*upper limit of normal Cardiac and pulmonary status sufficient to undergo apheresis and transplantation All patients agreed to an effective method of contraception while on study treatment and for at least 3 months following plerixafor treatment (including both female patients of child-bearing potential and male patients with partners of child-bearing potential) Exclusion Criteria: A co-morbid condition which, in the view of the Investigator(s), rendered the patient at high risk from treatment complications Failed previous hematopoietic stem cell (HSC) collections or collection attempts Prior autologous or allogeneic transplant Less than 6 weeks off 1,3-bis (2-chloroethyl)-1-nitroso-urea (BCNU) prior to first dose of G-CSF Active central nervous system involvement, active brain metastases, or any history of carcinomatous meningitis (active or inactive) Bone marrow involvement >20 percent (%), as assessed by bone marrow biopsy within 4 months of the first screening assessment, unless a bone marrow biopsy was performed immediately prior to the last chemotherapy and was negative and the patient responded to last chemotherapy achieving a complete or partial remission Received radiation therapy to the pelvis Received granulocyte/macrophage-colony stimulating factor (GM-CSF) or pegfilgrastim within 3 weeks prior to the first dose of granulocyte colony stimulating factor (G-CSF) for mobilization Received G-CSF within 14 days prior to the first dose of G-CSF for mobilization Received prior radio-immunotherapy with ibritumomab tiuxetan or tositumomab iodine Active infection, including unexplained fever (>38.1 degree Celsius / 100.4 Fahrenheit), or antibiotic, antiviral, or antifungal therapy within 7 days prior to the first dose of G-CSF Positive pregnancy test (female patients) Lactating (female patients) Abnormal electrocardiogram (ECG) with clinically significant rhythm disturbance (ventricular arrhythmias) or other conduction abnormality in the last year that, in the opinion of the Investigator(s), warranted exclusion of the patient from the trial Previously received experimental therapy within 4 weeks of enrolling or who were currently enrolled in another experimental protocol during the G CSF and plerixafor treatment period
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Monitor
Organizational Affiliation
Genzyme, a Sanofi Company
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope National Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
University of Colorado Cancer Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Facility Name
Samsung Medical Center
City
Seoul
ZIP/Postal Code
135-710
Country
Korea, Republic of
Facility Name
St. Mary's Hospital
City
Seoul
ZIP/Postal Code
137-701
Country
Korea, Republic of
Facility Name
National Taiwan University Hospital
City
Taipei
ZIP/Postal Code
10002
Country
Taiwan
Facility Name
Taipei Veterans General Hospital
City
Taipei
ZIP/Postal Code
10002
Country
Taiwan

12. IPD Sharing Statement

Learn more about this trial

Evaluation of Approved Weight-Based Dose Compared to Fixed Dose of Plerixafor in Patients With Non-Hodgkin's Lymphoma (NHL) Weighing Less Than 70 Kilograms

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