Evaluation of (R)-Roscovitine Safety and Effects in Subjects With Cystic Fibrosis, Homozygous for the F508del-CFTR Mutation (ROSCO-CF)
Primary Purpose
Cystic Fibrosis
Status
Terminated
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Roscovitine
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Cystic Fibrosis focused on measuring Cystic Fibrosis, Roscovitine, Seliciclib, CYC202
Eligibility Criteria
Inclusion Criteria:
- Male or female aged over 18 years of age on the date of informed consent;
- Diagnosed CF patients. Confirmed diagnosis of CF (Rosenstein and Cutting, 1998);
- Patients carrying 2 Cystic Fibrosis causing mutations with at least one F508del-CFTR mutation, genotype to be confirmed at screening;
- Forced expiratory volume at 1 second (FEV1) 40%
- Chronic lung Pseudomonas aeruginosa infection according to the definition from the French Consensus Conference;
- Able to understand and comply with all protocol requirements, restrictions and instructions and likely to complete the study as planned (as judged by the investigator);
- Provide written informed consent prior to the performance of any study-related procedure;
Exclusion Criteria:
- Acute upper or lower respiratory infection, pulmonary exacerbation or changes in therapy (including antibiotics) for pulmonary disease within 4 weeks before V2;
Recent patient reported history of:
- non recovered viral upper respiratory tract infection
- solid organ or hematological transplantation
- Burkholderia cepacia complex or Non Tuberculous Mycobacteria (NTM) respiratory tract infection;
- Undergone major surgery within 1 month prior to screening;
- Currently treated allergic broncho-pulmonary aspergillosis (ABPA);
- Diabetic patients whose blood glucose is poorly controlled as evidenced by HbA1C >8%;
- Hemoptysis more than 60 mL at any time within 4 weeks prior to first study drug administration (V2);
- History of any other comorbidity that, in the opinion of the investigator, might confound the results of the study or pose an additional risk in administering study drug to the subject;
- Any other clinically significant conditions (not associated with the study indication) at Screening (V1) which might interfere with the assessment of this study;
Any of the following abnormal laboratory values at screening:
- Hemoglobin <10 g/dL
- Abnormal liver function
- Serum K+ <3,5 mmol/L
- Abnormal renal function
- Any clinically significant laboratory abnormalities;
- Patients who have clinically significant impairment in cardiovascular function;
- Concomitant disease(s) that could prolong the QT interval;
- Patients with a history of alcohol or drug abuse in the past year;
- Patients with a history of noncompliance to medical regimens and patients or caregivers who are considered potentially unreliable;
- Use of one (or several) prohibited medications and/or food;
- Administration of any investigational drug within 30 days prior to Screening (V1) or 5 half-lives, whichever is longer;
- Use of systemic anti-pseudomonal antibiotics within 28 days prior to first study drug administration (V2). However use of inhaled anti-pseudomonal antibiotic treatment is allowed if initiated for more than 28 days;
- Use of loop diuretics within 7 days prior to first study drug administration (V2);
- Pregnant or nursing females.
Sites / Locations
- CHR - Hôpital Calmette
- CH Lyon Sud
- Hôpital Arnaud de Villeneuve
- CHU Nantes
- CHU de Nice - Hôpital Pasteur
- Hôpital Cochin
- CHU de Bordeaux - Hôpital Haut-Lévêque
- Centre de Ressources et de Compétences de la mucoviscidose
- Centre de Perharidy
- Hôpital Larrey
- Centre Hospitalier Bretagne Atlantique
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Group 1
Group 2
Group 3
Arm Description
200 mg roscovitine (8) or placebo (4) once daily for 4 cycles of 7 days (4 days "on" and 3 days "off")
400 mg roscovitine (8) or placebo (4) once daily for 4 cycles of 7 days (4 days "on" and 3 days "off")
400 mg roscovitine (8) or (4) placebo twice daily for cycles of 7 days (4 days "on" and 3 days "off")
Outcomes
Primary Outcome Measures
Safety of increasing doses of Roscovitine
The primary objective of this study is to assess the safety of increasing doses of roscovitine administered orally for 4 cycles of 4 consecutive days (treatment "on") separated by a 3 days treatment free period (treatment "off") in adult CF subjects who carrying 2 Cystic Fibrosis causing mutations with at least F508del mutation
Secondary Outcome Measures
Change in the concentration of Pseudomonas Aeruginosa
Change in the concentration (CFU/mL) of Pseudomonas aeruginosa in the sputum at each visit from V1 (Screening) up to V7 (Completion Visit).
PK parameters
PK parameters: Maximum Concentration (Cmax), Time to reach Cmax (Tmax), Area Under Curve (AUCt and AUCInf), Half-life (t1/2) for roscovitine and its M3 metabolite.
Pro- and anti-inflammatory cytokines
Monitoring the levels of pro- and anti-inflammatory cytokines, in particular: interleukin (IL)-17A, IL-5, IFN-γ, IL-1 receptor antagonist, IL-4, IL-6, IL-10, tumor necrosis factor-alpha, and IL-18 on V2, V3 and V7 (Completion Visit)
C-reactive protein
Change in C-reactive protein (CRP) at each visit from V1 (Screening) up to V7 (Completion)
Cystic Fibrosis Questionnaire-Revised
Change in Cystic Fibrosis Questionnaire-Revised (CFQ-R) at each visit from V1 up to V8 (Safety Follow-up)
Body Mass Index
Change in body mass index (BMI) at each visit from V1 (Screening) up to V7 (Completion Visit)
Forced expiratory volume in 1 second
Change in forced expiratory volume in 1 second (FEV1) at each visit from V1 (Screening) up to V7 (Completion Visit)
Sweat Chloride Concentration
Change in Sweat Chloride Concentration at V2, V3, V5 and V7 (Completion)
Nasal Potential Difference
Change in Nasal Potential Difference (NPD) at V1 (Screening) and V6 (for patients included in Paris Cochin CF Center)
Pain questionnaire
Evaluate of the pain and of the impact of the pain in patients with cystic fibrosis
Full Information
NCT ID
NCT02649751
First Posted
January 6, 2016
Last Updated
December 11, 2018
Sponsor
University Hospital, Brest
Collaborators
ManRos Therapeutics, Cyclacel Pharmaceuticals, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT02649751
Brief Title
Evaluation of (R)-Roscovitine Safety and Effects in Subjects With Cystic Fibrosis, Homozygous for the F508del-CFTR Mutation
Acronym
ROSCO-CF
Official Title
A Phase II, Dose Ranging, Multicenter, Double-blind, Placebo Controlled Study to Evaluate Safety and Effects of (R)-Roscovitine in Adults Subjects With Cystic Fibrosis, Carrying 2 Cystic Fibrosis Causing Mutations With at Least One F508del-CFTR Mutation and Chronically Infected With Pseudomonas Aeruginosa, a Study Involving 36 CF Patients (24 Treated, 12 Controls). ROSCO-CF.
Study Type
Interventional
2. Study Status
Record Verification Date
July 2018
Overall Recruitment Status
Terminated
Why Stopped
The centers have no longer patients. In September 2018, set up of a competitive international study.
Study Start Date
February 22, 2016 (Actual)
Primary Completion Date
July 26, 2018 (Actual)
Study Completion Date
July 26, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Brest
Collaborators
ManRos Therapeutics, Cyclacel Pharmaceuticals, Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a phase II, dose ranging, multicenter, randomized, double-blind, placebo-controlled study.
The aim of this study is to assess the safety of increasing doses of roscovitine administered orally for 4 cycles of 4 consecutive days (treatment "on") separated by a 3 days treatment free period (treatment "off") in adult CF subjects with Cystic Fibrosis carrying 2 Cystic Fibrosis causing mutations with at least one F508del-CFTR mutation and chronically infected with Pseudomonas aeruginosa.
This study involved 36 Cystic Fibrosis patients: 24 treated and 12 controls.
Detailed Description
ROSCO-CF is a phase II, dose ranging, multicenter, double-blind, placebo controlled study to evaluate safety and effects of (R)-roscovitine in subjects with Cystic Fibrosis carrying 2 Cystic Fibrosis causing mutations with at least one F508del-CFTR mutation and chronically infected with Pseudomonas aeruginosa.
The aim of this study is to assess the safety of increasing doses of roscovitine administered orally for 4 cycles of 4 consecutive days (treatment "on") separated by a 3 days treatment free period (treatment "off") in 36 adult cystic fibrosis subjects.
These 36 patients will be allocated to 3 groups of 12 subjects who will be randomized in a 2:1 ratio (active drug to matching placebo). In each group, 8 patients will receive roscovitine (200 mg, 400 mg, 2 X 400 mg in group 1, 2 and 3, respectively) and 4 will receive a matching placebo. Treatment will be provided by oral administration of capsules. Each patient will receive the same treatment throughout the 28 day study.
This phase II trial will give some preliminary information about safety and hints of effects of a new experimental treatment. If the data suggest that a short term treatment with roscovitine provides a safe, effective and convenient approach for CF patients chronically infected with Pseudomonas aeruginosa, patients participating in this proof of concept trial will be offered to participate in further longer term studies.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis
Keywords
Cystic Fibrosis, Roscovitine, Seliciclib, CYC202
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
49 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group 1
Arm Type
Experimental
Arm Description
200 mg roscovitine (8) or placebo (4) once daily for 4 cycles of 7 days (4 days "on" and 3 days "off")
Arm Title
Group 2
Arm Type
Experimental
Arm Description
400 mg roscovitine (8) or placebo (4) once daily for 4 cycles of 7 days (4 days "on" and 3 days "off")
Arm Title
Group 3
Arm Type
Experimental
Arm Description
400 mg roscovitine (8) or (4) placebo twice daily for cycles of 7 days (4 days "on" and 3 days "off")
Intervention Type
Drug
Intervention Name(s)
Roscovitine
Other Intervention Name(s)
Seliciclib, CYC202
Intervention Description
Roscovitine is an experimental drug candidate in the family of pharmacological cyclin-dependent kinase (CDK) inhibitors that preferentially inhibit multiple enzyme targets including CDK2, CDK7 and CDK9. Seliciclib is a 2,6,9-substituted purine analog.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The placebo treatment is lactose capsule.
Primary Outcome Measure Information:
Title
Safety of increasing doses of Roscovitine
Description
The primary objective of this study is to assess the safety of increasing doses of roscovitine administered orally for 4 cycles of 4 consecutive days (treatment "on") separated by a 3 days treatment free period (treatment "off") in adult CF subjects who carrying 2 Cystic Fibrosis causing mutations with at least F508del mutation
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Change in the concentration of Pseudomonas Aeruginosa
Description
Change in the concentration (CFU/mL) of Pseudomonas aeruginosa in the sputum at each visit from V1 (Screening) up to V7 (Completion Visit).
Time Frame
3 months
Title
PK parameters
Description
PK parameters: Maximum Concentration (Cmax), Time to reach Cmax (Tmax), Area Under Curve (AUCt and AUCInf), Half-life (t1/2) for roscovitine and its M3 metabolite.
Time Frame
3 months
Title
Pro- and anti-inflammatory cytokines
Description
Monitoring the levels of pro- and anti-inflammatory cytokines, in particular: interleukin (IL)-17A, IL-5, IFN-γ, IL-1 receptor antagonist, IL-4, IL-6, IL-10, tumor necrosis factor-alpha, and IL-18 on V2, V3 and V7 (Completion Visit)
Time Frame
3 months
Title
C-reactive protein
Description
Change in C-reactive protein (CRP) at each visit from V1 (Screening) up to V7 (Completion)
Time Frame
3 months
Title
Cystic Fibrosis Questionnaire-Revised
Description
Change in Cystic Fibrosis Questionnaire-Revised (CFQ-R) at each visit from V1 up to V8 (Safety Follow-up)
Time Frame
3 months
Title
Body Mass Index
Description
Change in body mass index (BMI) at each visit from V1 (Screening) up to V7 (Completion Visit)
Time Frame
3 months
Title
Forced expiratory volume in 1 second
Description
Change in forced expiratory volume in 1 second (FEV1) at each visit from V1 (Screening) up to V7 (Completion Visit)
Time Frame
3 months
Title
Sweat Chloride Concentration
Description
Change in Sweat Chloride Concentration at V2, V3, V5 and V7 (Completion)
Time Frame
3 months
Title
Nasal Potential Difference
Description
Change in Nasal Potential Difference (NPD) at V1 (Screening) and V6 (for patients included in Paris Cochin CF Center)
Time Frame
3 months
Title
Pain questionnaire
Description
Evaluate of the pain and of the impact of the pain in patients with cystic fibrosis
Time Frame
3 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female aged over 18 years of age on the date of informed consent;
Diagnosed CF patients. Confirmed diagnosis of CF (Rosenstein and Cutting, 1998);
Patients carrying 2 Cystic Fibrosis causing mutations with at least one F508del-CFTR mutation, genotype to be confirmed at screening;
Forced expiratory volume at 1 second (FEV1) 40%
Chronic lung Pseudomonas aeruginosa infection according to the definition from the French Consensus Conference;
Able to understand and comply with all protocol requirements, restrictions and instructions and likely to complete the study as planned (as judged by the investigator);
Provide written informed consent prior to the performance of any study-related procedure;
Exclusion Criteria:
Acute upper or lower respiratory infection, pulmonary exacerbation or changes in therapy (including antibiotics) for pulmonary disease within 4 weeks before V2;
Recent patient reported history of:
non recovered viral upper respiratory tract infection
solid organ or hematological transplantation
Burkholderia cepacia complex or Non Tuberculous Mycobacteria (NTM) respiratory tract infection;
Undergone major surgery within 1 month prior to screening;
Currently treated allergic broncho-pulmonary aspergillosis (ABPA);
Diabetic patients whose blood glucose is poorly controlled as evidenced by HbA1C >8%;
Hemoptysis more than 60 mL at any time within 4 weeks prior to first study drug administration (V2);
History of any other comorbidity that, in the opinion of the investigator, might confound the results of the study or pose an additional risk in administering study drug to the subject;
Any other clinically significant conditions (not associated with the study indication) at Screening (V1) which might interfere with the assessment of this study;
Any of the following abnormal laboratory values at screening:
Hemoglobin <10 g/dL
Abnormal liver function
Serum K+ <3,5 mmol/L
Abnormal renal function
Any clinically significant laboratory abnormalities;
Patients who have clinically significant impairment in cardiovascular function;
Concomitant disease(s) that could prolong the QT interval;
Patients with a history of alcohol or drug abuse in the past year;
Patients with a history of noncompliance to medical regimens and patients or caregivers who are considered potentially unreliable;
Use of one (or several) prohibited medications and/or food;
Administration of any investigational drug within 30 days prior to Screening (V1) or 5 half-lives, whichever is longer;
Use of systemic anti-pseudomonal antibiotics within 28 days prior to first study drug administration (V2). However use of inhaled anti-pseudomonal antibiotic treatment is allowed if initiated for more than 28 days;
Use of loop diuretics within 7 days prior to first study drug administration (V2);
Pregnant or nursing females.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilles RAULT, MD
Organizational Affiliation
Centre de Pérharidy - Roscoff
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHR - Hôpital Calmette
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
CH Lyon Sud
City
Lyon
ZIP/Postal Code
69495
Country
France
Facility Name
Hôpital Arnaud de Villeneuve
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
CHU Nantes
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
CHU de Nice - Hôpital Pasteur
City
Nice
ZIP/Postal Code
06001
Country
France
Facility Name
Hôpital Cochin
City
Paris
ZIP/Postal Code
75014
Country
France
Facility Name
CHU de Bordeaux - Hôpital Haut-Lévêque
City
Pessac
ZIP/Postal Code
33604
Country
France
Facility Name
Centre de Ressources et de Compétences de la mucoviscidose
City
Reims
ZIP/Postal Code
51100
Country
France
Facility Name
Centre de Perharidy
City
Roscoff
ZIP/Postal Code
29684
Country
France
Facility Name
Hôpital Larrey
City
Toulouse
ZIP/Postal Code
30030
Country
France
Facility Name
Centre Hospitalier Bretagne Atlantique
City
Vannes
ZIP/Postal Code
56017
Country
France
12. IPD Sharing Statement
Learn more about this trial
Evaluation of (R)-Roscovitine Safety and Effects in Subjects With Cystic Fibrosis, Homozygous for the F508del-CFTR Mutation
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