Safety and Efficacy of Human Myeloid Progenitor Cells (CLT-008) During Chemotherapy for Acute Myeloid Leukemia
Primary Purpose
Acute Myeloid Leukemia, Neutropenia, Infection
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CLT-008
G-CSF
Sponsored by
About this trial
This is an interventional supportive care trial for Acute Myeloid Leukemia focused on measuring Fever, Induction chemotherapy, Infection, Leukemia, Myeloid progenitor cells, Neutropenia
Eligibility Criteria
Inclusion Criteria:
- Acute myeloid leukemia arising de novo (per European LeukemiaNet)
Treated with any established chemotherapy regimen based on either:
- 7+3: Standard-dose cytarabine 100-200 mg per meter squared continuous infusion for 7 days with idarubicin 12 mg per meter squared or daunorubicin 45-90 mg per meter squared for 3 days
- High-dose cytarabine-based (HIDAC) chemotherapy administering a total cytarabine dose of ≥ 4 g per meter squared alone or in combination with other anti-leukemic agents (for example, anthracyclines, purine nucleoside inhibitors, etoposide, etc.)
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 at Screening or by the day chemotherapy is initiated
- Adequate respiratory function with a room air oxygen saturation of at least 92%
- Adequate cardiac function defined as an ejection fraction of at least 45%
- Serum bilirubin ≤ 1.5 times the upper limits of normal. Subjects with a history of Gilbert's syndrome may be enrolled if the total bilirubin is < 3 mg/dL with an indirect bilirubin of > 1.5 mg/dL
- Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times upper limits of normal prior to chemotherapy
- Serum creatinine ≤ 2 times upper limits of normal or estimated glomerular filtration rate ≥ 60 mL/min/1.73 meter squared per Modification of Diet in Renal Disease equation (MDRD)
- All subjects, except post-menopausal women, must be willing to utilize a highly effective method of contraception throughout the study
- Adequately informed of the nature and risks of the study with written informed consent
Exclusion Criteria:
- Pregnant or breast feeding
- Overt central nervous system manifestations of leukemia at diagnosis
- Specifically diagnosed and uncontrolled fungal, bacterial, viral, or other infection (e.g. confirmed sepsis, pneumonia, abscess, cellulitis, etc.) at the day chemotherapy is initiated. "Uncontrolled" is defined as exhibiting ongoing signs and symptoms of infection without improvement despite antimicrobial or other treatment.
- AML subtype M3 (promyelocytic leukemia)
- Previous chemotherapy for AML
- History of or current human immunodeficiency virus (HIV) or hepatitis C virus infection
- History of or current clinically significant immunodeficiency
- Known contraindication to receiving G-CSF
- History of or current clinically significant alloimmunization to leukocyte antigens
- Participation in another clinical study within 28 days of the day chemotherapy is initiated, in which the study drug or device may influence hematopoiesis. Co-enrollment in another study is allowed in cases where the investigational therapy under study is a version of an acceptable chemotherapy regimen for this study per the inclusion criteria.
- Receiving any agent concurrently with CLT-008 infusion which inhibits cell division (e.g., methotrexate or hydroxyurea)
- Acute or chronic medical disorder that, in the opinion of the investigator or medical monitor, may prevent the subject from completing participation in the study
Sites / Locations
- University of California San Diego Moores Cancer Center
- Ronald Reagan UCLA Medical Center
- University of California, San Francisco Medical Center
- UF Health Shands Cancer Hospital
- Mayo Clinic Florida
- Northside Hospital
- Northwestern Medical Faculty Foundation
- University of Illinois Cancer Center
- The University of Chicago
- Loyola University Medical Center
- Indiana Blood and Marrow Transplantation Clinic
- University of Massachusetts Worcester
- University of Minnesota Physicians BMT Clinic
- Kansas City Veterans Affairs Medical Center
- Washington University School of Medicine
- Weill Cornell Medical College - New York Presbyterian Hospital
- Memorial Sloan Kettering Cancer Center
- Westchester Medical Center
- Hospital of the University of Pennsylvania
- West Penn Hospital
- The University of Texas MD Anderson Cancer Center
- Swedish Cancer Institute
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Active Comparator
Arm Label
CLT-008 low dose with G-CSF
CLT-008 high dose with G-CSF
CLT-008 with G-CSF
G-CSF
Arm Description
Dose escalation
Dose escalation
Randomized
Randomized
Outcomes
Primary Outcome Measures
Duration of febrile episodes (fever)
Secondary Outcome Measures
Time to absolute neutrophil count (ANC) recovery
Incidence and duration of febrile neutropenia
Incidence and duration of infection
Incidence and severity of mucositis
Incidence of infusion reactions
Incidence of Graft-versus-Host Disease (GVHD)
Incidence of Adverse Events (AE)
Incidence of Serious Adverse Events (SAE)
Full Information
NCT ID
NCT02282215
First Posted
October 31, 2014
Last Updated
September 25, 2018
Sponsor
Cellerant Therapeutics
Collaborators
Department of Health and Human Services
1. Study Identification
Unique Protocol Identification Number
NCT02282215
Brief Title
Safety and Efficacy of Human Myeloid Progenitor Cells (CLT-008) During Chemotherapy for Acute Myeloid Leukemia
Official Title
An Open-Label Phase 2 Prospective, Randomized, Controlled Study of CLT-008 Myeloid Progenitor Cells as a Supportive Care Measure During Induction Chemotherapy for Acute Myeloid Leukemia
Study Type
Interventional
2. Study Status
Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
December 2014 (Actual)
Primary Completion Date
September 22, 2017 (Actual)
Study Completion Date
September 22, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cellerant Therapeutics
Collaborators
Department of Health and Human Services
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of the study is to explore the safety and efficacy of CLT-008 as an extra supportive care measure after induction chemotherapy for patients with acute myeloid leukemia (AML).
Detailed Description
The prolonged period of severe neutropenia caused by induction chemotherapy for the treatment of AML is associated with a nearly universal risk of febrile neutropenia. Standard supportive care strategies include administration of prophylactic anti-bacterial and anti-fungal agents, but serious breakthrough bacterial and fungal infections still occur. Granulocyte colony-stimulating factor (G-CSF; filgrastim, Neupogen®) has been shown to shorten the duration of severe neutropenia, fever, antibiotic use and hospitalization following induction chemotherapy for AML. CLT-008, a human allogeneic myeloid progenitor cell product, is intended to provide the cellular target for G-CSF to produce neutrophils during the period of chemotherapy-induced bone marrow suppression when the patient's own progenitor cells may be limited in responding to G-CSF. It is hypothesized that the production of allogeneic neutrophils from CLT-008 will be sufficient to mitigate the infection-related consequences of induction chemotherapy for AML.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia, Neutropenia, Infection
Keywords
Fever, Induction chemotherapy, Infection, Leukemia, Myeloid progenitor cells, Neutropenia
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
163 (Actual)
8. Arms, Groups, and Interventions
Arm Title
CLT-008 low dose with G-CSF
Arm Type
Experimental
Arm Description
Dose escalation
Arm Title
CLT-008 high dose with G-CSF
Arm Type
Experimental
Arm Description
Dose escalation
Arm Title
CLT-008 with G-CSF
Arm Type
Experimental
Arm Description
Randomized
Arm Title
G-CSF
Arm Type
Active Comparator
Arm Description
Randomized
Intervention Type
Biological
Intervention Name(s)
CLT-008
Other Intervention Name(s)
human allogeneic myeloid progenitor cells (hMPC), romyelocel-L
Intervention Description
Single intravenous infusion
Intervention Type
Biological
Intervention Name(s)
G-CSF
Other Intervention Name(s)
Neupogen (filgrastim), granulocyte colony-stimulating factor, Zarxio, Granix (tbo-filgrastim)
Intervention Description
Daily subcutaneous injections
Primary Outcome Measure Information:
Title
Duration of febrile episodes (fever)
Time Frame
42 days
Secondary Outcome Measure Information:
Title
Time to absolute neutrophil count (ANC) recovery
Time Frame
42 days
Title
Incidence and duration of febrile neutropenia
Time Frame
42 days
Title
Incidence and duration of infection
Time Frame
42 days
Title
Incidence and severity of mucositis
Time Frame
42 days
Title
Incidence of infusion reactions
Time Frame
42 days
Title
Incidence of Graft-versus-Host Disease (GVHD)
Time Frame
42 days
Title
Incidence of Adverse Events (AE)
Time Frame
42 days
Title
Incidence of Serious Adverse Events (SAE)
Time Frame
42 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Acute myeloid leukemia arising de novo (per European LeukemiaNet)
Treated with any established chemotherapy regimen based on either:
7+3: Standard-dose cytarabine 100-200 mg per meter squared continuous infusion for 7 days with idarubicin 12 mg per meter squared or daunorubicin 45-90 mg per meter squared for 3 days
High-dose cytarabine-based (HIDAC) chemotherapy administering a total cytarabine dose of ≥ 4 g per meter squared alone or in combination with other anti-leukemic agents (for example, anthracyclines, purine nucleoside inhibitors, etoposide, etc.)
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 at Screening or by the day chemotherapy is initiated
Adequate respiratory function with a room air oxygen saturation of at least 92%
Adequate cardiac function defined as an ejection fraction of at least 45%
Serum bilirubin ≤ 1.5 times the upper limits of normal. Subjects with a history of Gilbert's syndrome may be enrolled if the total bilirubin is < 3 mg/dL with an indirect bilirubin of > 1.5 mg/dL
Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times upper limits of normal prior to chemotherapy
Serum creatinine ≤ 2 times upper limits of normal or estimated glomerular filtration rate ≥ 60 mL/min/1.73 meter squared per Modification of Diet in Renal Disease equation (MDRD)
All subjects, except post-menopausal women, must be willing to utilize a highly effective method of contraception throughout the study
Adequately informed of the nature and risks of the study with written informed consent
Exclusion Criteria:
Pregnant or breast feeding
Overt central nervous system manifestations of leukemia at diagnosis
Specifically diagnosed and uncontrolled fungal, bacterial, viral, or other infection (e.g. confirmed sepsis, pneumonia, abscess, cellulitis, etc.) at the day chemotherapy is initiated. "Uncontrolled" is defined as exhibiting ongoing signs and symptoms of infection without improvement despite antimicrobial or other treatment.
AML subtype M3 (promyelocytic leukemia)
Previous chemotherapy for AML
History of or current human immunodeficiency virus (HIV) or hepatitis C virus infection
History of or current clinically significant immunodeficiency
Known contraindication to receiving G-CSF
History of or current clinically significant alloimmunization to leukocyte antigens
Participation in another clinical study within 28 days of the day chemotherapy is initiated, in which the study drug or device may influence hematopoiesis. Co-enrollment in another study is allowed in cases where the investigational therapy under study is a version of an acceptable chemotherapy regimen for this study per the inclusion criteria.
Receiving any agent concurrently with CLT-008 infusion which inhibits cell division (e.g., methotrexate or hydroxyurea)
Acute or chronic medical disorder that, in the opinion of the investigator or medical monitor, may prevent the subject from completing participation in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William Reed, MD
Organizational Affiliation
Cellerant Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
University of California San Diego Moores Cancer Center
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Ronald Reagan UCLA Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
University of California, San Francisco Medical Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
UF Health Shands Cancer Hospital
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Facility Name
Mayo Clinic Florida
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
Northside Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Northwestern Medical Faculty Foundation
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Illinois Cancer Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
The University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Loyola University Medical Center
City
Maywood
State/Province
Illinois
ZIP/Postal Code
60153
Country
United States
Facility Name
Indiana Blood and Marrow Transplantation Clinic
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46237
Country
United States
Facility Name
University of Massachusetts Worcester
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Facility Name
University of Minnesota Physicians BMT Clinic
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Kansas City Veterans Affairs Medical Center
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64128
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Weill Cornell Medical College - New York Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
66215
Country
United States
Facility Name
Westchester Medical Center
City
Valhalla
State/Province
New York
ZIP/Postal Code
10595
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
West Penn Hospital
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Swedish Cancer Institute
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34156898
Citation
Desai PM, Brown J, Gill S, Solh MM, Akard LP, Hsu JW, Ustun C, Andreadis C, Frankfurt O, Foran JM, Lister J, Schiller GJ, Wieduwilt MJ, Pagel JM, Stiff PJ, Liu D, Khan I, Stock W, Kambhampati S, Tallman MS, Morris L, Edwards J, Pusic I, Kantarjian HM, Mamelok R, Wong A, Van Syoc R, Kellerman L, Panuganti S, Mandalam R, Abboud CN, Ravandi F. Open-Label Phase II Prospective, Randomized, Controlled Study of Romyelocel-L Myeloid Progenitor Cells to Reduce Infection During Induction Chemotherapy for Acute Myeloid Leukemia. J Clin Oncol. 2021 Oct 10;39(29):3261-3272. doi: 10.1200/JCO.20.01739. Epub 2021 Jun 22.
Results Reference
derived
Links:
URL
http://www.cellerant.com/pipeline/clt-008-myeloid-progenitor-cells.html
Description
Cellerant Therapeutics CLT-008: Myeloid Progenitor Cells
Learn more about this trial
Safety and Efficacy of Human Myeloid Progenitor Cells (CLT-008) During Chemotherapy for Acute Myeloid Leukemia
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