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Phase II Study of Folotyn With Leucovorin to Prevent/Reduce Mucositis in Patients With Hematological Malignancies

Primary Purpose

Relapsed Peripheral T-Cell Lymphoma, Refractory Peripheral T-Cell Lymphoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Folotyn and Leucovorin
Folic Acid
Vitamin B12
Sponsored by
Acrotech Biopharma Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Relapsed Peripheral T-Cell Lymphoma focused on measuring Relapsed PTCL, Refractory PTCL

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient is diagnosed with hematological malignancies including PTCL and CTCL and are eligible for treatment with a dose of 30 mg/m^2
  2. Patient is at least 18 years of age
  3. Patient has been informed of the investigational nature of this study and has given written Informed Consent and is able to adhere to dosing and visit schedules and meet all study requirements
  4. Patient has recovered from the toxic effects of prior therapy, and is at least 30 days from the most recent cytotoxic therapy, prior to enrollment
  5. Patient has adequate hematologic, hepatic, and renal function as defined by:

    • ANC ≥1000/µL
    • Platelet count ≥100,000/µL
    • Total bilirubin ≤1.5 mg/dL
    • Aspartate aminotransferase/serum glutamic-oxaloacetic transaminase (AST/SGOT), alanine aminotransferase/serum glutamic-pyruvic transaminase (ALT/SGPT), and gamma-glutamyltransferase (GGT) ≤2.5 xupper limit of normal (ULN) (AST/ALT/GGT ≤5 xULN if documented hepatic involvement with lymphoma)
    • Creatinine ≤2.0 mg/dL or calculated creatinine clearance ≥50 mL/min
  6. Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤2
  7. Females of childbearing potential are to agree to practice a medically acceptable contraceptive regimen (including a barrier method) from study treatment initiation until at least 30 days after the last administration of Folotyn or leucovorin, whichever is last, and are to have a negative urine beta human chorionic gonadotropin (β-HCG) pregnancy test within 14 days prior to the first day of study treatment. Females who are postmenopausal for at least 1 year (defined as >12 months since last menses) or are surgically sterilized do not require this test
  8. Male patients are to agree to use a barrier method of contraception from study treatment initiation until at least 90 days after the last administration of Folotyn

Exclusion Criteria:

  1. Patient has congestive heart failure Class III/IV according to the New York Heart Association (NYHA) Functional Classification
  2. Patient has uncontrolled hypertension
  3. Patient has known, uncontrolled human immunodeficiency virus (HIV)-positive diagnosis
  4. Patient has symptomatic central nervous system (CNS) metastases or lesions for which treatment is required. Patients who received prophylactic CNS treatment are eligible
  5. Patient has an active uncontrolled infection, underlying medical condition, or other serious illness that would impair the ability of the patient to receive protocol treatment
  6. Patient has had major surgery within 14 days prior to enrollment
  7. Patient has used any investigational drugs, biologics, or devices within 14 days prior to study treatment or plans to use any of these during the course of the study
  8. Patient has had previous exposure to Folotyn within 6 months of study enrollment
  9. Patient is pregnant or breast-feeding

Sites / Locations

  • City of Hope
  • Cancer Center of Kansas
  • Seattle Cancer Care Alliance

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Folotyn and Leucovorin

Arm Description

Folotyn will be administered by IV push at a dose of 30 mg/m2 once weekly for 6 weeks in each cycle, followed by 1 week of rest (no treatment). Leucovorin (25 mg tablets) will be taken orally tid for 2 days for a total of six doses (150 mg cumulative weekly dose), beginning 24 hours after each dose of Folotyn is administered. Folic acid and Vitamin B12 is given prior to initiation of Folotyn.

Outcomes

Primary Outcome Measures

Grade 2 Oral Mucositis Prevention
To evaluate the effect of leucovorin in preventing or reducing Folotyn-related Grade 2 or higher oral mucositis.

Secondary Outcome Measures

Grade 3 Oral Mucositis Prevention
To evaluate the effect of leucovorin in preventing or reducing Folotyn-related Grade 3 or higher oral mucositis.
Grade 2 Oral Mucositis Duration of first occurrence
To evaluate the time to first occurrence of Folotyn-related Grade 2 or higher oral mucositis.
Grade 2 Oral Mucositis Duration
To evaluate the duration of Folotyn-related Grade 2 or higher oral mucositis.
Effectiveness of Leucovorin in Folotyn dose modification
To evaluate the effect of leucovorin on the number and proportion of patients whose subsequent dose of Folotyn is omitted, delayed, or reduced due to the onset of oral mucositis.
Objective Response Rate
To evaluate objective response rate (ORR) of Folotyn in patients with relapsed or refractory (R/R) PTCL.

Full Information

First Posted
March 28, 2014
Last Updated
November 18, 2019
Sponsor
Acrotech Biopharma Inc.
Collaborators
Axis Clinicals Limited
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1. Study Identification

Unique Protocol Identification Number
NCT02106650
Brief Title
Phase II Study of Folotyn With Leucovorin to Prevent/Reduce Mucositis in Patients With Hematological Malignancies
Official Title
A Phase 2, Single-Arm, Open-Label, Multicenter, Study of Folotyn® (Pralatrexate Injection) in Combination With Oral Leucovorin to Prevent or Reduce Mucositis in Patients With Hematological Malignancies Including PTCL and CTCL
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
July 2014 (Actual)
Primary Completion Date
October 2018 (Actual)
Study Completion Date
June 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Acrotech Biopharma Inc.
Collaborators
Axis Clinicals Limited

4. Oversight

5. Study Description

Brief Summary
This study is to evaluate the effect of leucovorin in preventing or reducing Folotyn-related Grade 2 or higher oral mucositis.
Detailed Description
This is a Phase 2, single-arm, open-label, multicenter study to determine the effect of leucovorin in preventing or reducing Folotyn-related Grade 2 or higher oral mucositis in patients with hematological malignancies including PTCL and CTCL. Patients with hematological malignancies, including PTCL and CTCL, will be enrolled based on meeting all protocol eligibility criteria. The primary endpoint will be evaluated in the first 7-week treatment cycle. For patients who respond to study treatment, the Investigator can treat patients for a total of 6 cycles. Approximately 37 patients will be enrolled. Safety, as assessed by reported SAEs, will continue to be monitored during the optional treatment period. Efficacy will be followed to the extent that it is evaluated according to the Institution's standard of care. No formal analysis of efficacy will be made.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed Peripheral T-Cell Lymphoma, Refractory Peripheral T-Cell Lymphoma
Keywords
Relapsed PTCL, Refractory PTCL

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Folotyn and Leucovorin
Arm Type
Experimental
Arm Description
Folotyn will be administered by IV push at a dose of 30 mg/m2 once weekly for 6 weeks in each cycle, followed by 1 week of rest (no treatment). Leucovorin (25 mg tablets) will be taken orally tid for 2 days for a total of six doses (150 mg cumulative weekly dose), beginning 24 hours after each dose of Folotyn is administered. Folic acid and Vitamin B12 is given prior to initiation of Folotyn.
Intervention Type
Drug
Intervention Name(s)
Folotyn and Leucovorin
Other Intervention Name(s)
Pralatrexate (Folotyn)
Intervention Type
Drug
Intervention Name(s)
Folic Acid
Intervention Description
Folic acid (1.0 mg PO QD) is to be initiated at least 10 days prior to Folotyn administration, or per the USPI for Folotyn.
Intervention Type
Drug
Intervention Name(s)
Vitamin B12
Intervention Description
Vitamin B12 (1 mg IM) is to be administered within 10 weeks prior to initiation of Folotyn and can be administered during Screening. Subsequent vitamin B12 injections may be given the same day as treatment with Folotyn and patients are to receive vitamin B12 every 8 to 10 weeks while treated with Folotyn.
Primary Outcome Measure Information:
Title
Grade 2 Oral Mucositis Prevention
Description
To evaluate the effect of leucovorin in preventing or reducing Folotyn-related Grade 2 or higher oral mucositis.
Time Frame
15 weeks
Secondary Outcome Measure Information:
Title
Grade 3 Oral Mucositis Prevention
Description
To evaluate the effect of leucovorin in preventing or reducing Folotyn-related Grade 3 or higher oral mucositis.
Time Frame
15 weeks
Title
Grade 2 Oral Mucositis Duration of first occurrence
Description
To evaluate the time to first occurrence of Folotyn-related Grade 2 or higher oral mucositis.
Time Frame
15 weeks
Title
Grade 2 Oral Mucositis Duration
Description
To evaluate the duration of Folotyn-related Grade 2 or higher oral mucositis.
Time Frame
15 weeks
Title
Effectiveness of Leucovorin in Folotyn dose modification
Description
To evaluate the effect of leucovorin on the number and proportion of patients whose subsequent dose of Folotyn is omitted, delayed, or reduced due to the onset of oral mucositis.
Time Frame
15 weeks
Title
Objective Response Rate
Description
To evaluate objective response rate (ORR) of Folotyn in patients with relapsed or refractory (R/R) PTCL.
Time Frame
17 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is diagnosed with hematological malignancies including PTCL and CTCL and are eligible for treatment with a dose of 30 mg/m^2 Patient is at least 18 years of age Patient has been informed of the investigational nature of this study and has given written Informed Consent and is able to adhere to dosing and visit schedules and meet all study requirements Patient has recovered from the toxic effects of prior therapy, and is at least 30 days from the most recent cytotoxic therapy, prior to enrollment Patient has adequate hematologic, hepatic, and renal function as defined by: ANC ≥1000/µL Platelet count ≥100,000/µL Total bilirubin ≤1.5 mg/dL Aspartate aminotransferase/serum glutamic-oxaloacetic transaminase (AST/SGOT), alanine aminotransferase/serum glutamic-pyruvic transaminase (ALT/SGPT), and gamma-glutamyltransferase (GGT) ≤2.5 xupper limit of normal (ULN) (AST/ALT/GGT ≤5 xULN if documented hepatic involvement with lymphoma) Creatinine ≤2.0 mg/dL or calculated creatinine clearance ≥50 mL/min Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤2 Females of childbearing potential are to agree to practice a medically acceptable contraceptive regimen (including a barrier method) from study treatment initiation until at least 30 days after the last administration of Folotyn or leucovorin, whichever is last, and are to have a negative urine beta human chorionic gonadotropin (β-HCG) pregnancy test within 14 days prior to the first day of study treatment. Females who are postmenopausal for at least 1 year (defined as >12 months since last menses) or are surgically sterilized do not require this test Male patients are to agree to use a barrier method of contraception from study treatment initiation until at least 90 days after the last administration of Folotyn Exclusion Criteria: Patient has congestive heart failure Class III/IV according to the New York Heart Association (NYHA) Functional Classification Patient has uncontrolled hypertension Patient has known, uncontrolled human immunodeficiency virus (HIV)-positive diagnosis Patient has symptomatic central nervous system (CNS) metastases or lesions for which treatment is required. Patients who received prophylactic CNS treatment are eligible Patient has an active uncontrolled infection, underlying medical condition, or other serious illness that would impair the ability of the patient to receive protocol treatment Patient has had major surgery within 14 days prior to enrollment Patient has used any investigational drugs, biologics, or devices within 14 days prior to study treatment or plans to use any of these during the course of the study Patient has had previous exposure to Folotyn within 6 months of study enrollment Patient is pregnant or breast-feeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wasim Khan, MD
Organizational Affiliation
Acrotech Biopharma Inc.
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Cancer Center of Kansas
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214
Country
United States
Facility Name
Seattle Cancer Care Alliance
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Phase II Study of Folotyn With Leucovorin to Prevent/Reduce Mucositis in Patients With Hematological Malignancies

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