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Study in Subjects With Light Chain (AL) Amyloidosis

Primary Purpose

AL Amyloidosis

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
NEOD001
Sponsored by
Prothena Biosciences Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for AL Amyloidosis

Eligibility Criteria

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

Inclusion Criteria:

  1. Completed the End of Study Visit in Study NEOD001-201
  2. Adequate bone marrow reserve, hepatic and renal function, as demonstrated by:

    • Absolute neutrophil count (ANC) ≥1.0 × 109/L
    • Platelet count ≥75 × 109/L
    • Hemoglobin ≥9 g/dL
    • Total bilirubin ≤2 × upper limit of normal (ULN)
    • Aspartate aminotransferase (AST) ≤3 × ULN
    • Alanine aminotransferase (ALT) ≤3 × ULN
    • Alkaline phosphatase (ALP) ≤5 × ULN (except for subjects with hepatomegaly and isozymes specific to liver, rather than bone)
    • Estimated glomerular filtration rate (eGFR) ≥25 mL/min/1.73 m2 as estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, or measured GFR ≥25 mL/min/1.73 m2
  3. Systolic blood pressure 80-180 mmHg
  4. Women of childbearing potential must have a negative pregnancy test during Screening and must agree to use highly effective physician-approved contraception from Screening to 90 days following the last study drug administration
  5. Male subjects must be surgically sterile or must agree to use highly effective physician-approved contraception from Screening to 90 days following the last study drug administration
  6. Ability to understand and willingness to sign an informed consent form prior to initiation of any study procedures

Exclusion Criteria:

  1. Any new medical contraindication or clinically significant abnormality on physical, neurological, laboratory, vital signs, or electrocardiographic (ECG) examination (e.g., atrial fibrillation; with the exception of subjects for whom the ventricular rate is controlled) that precludes continuation or initiation of treatment with NEOD001 or participation in the study
  2. Symptomatic orthostatic hypotension that in the medical judgment of the Investigator would interfere with subject's ability to safely receive treatment or complete study assessments
  3. Myocardial infarction, uncontrolled angina, uncontrolled ventricular arrhythmias, or ECG evidence of acute ischemia, within 6 months prior to the Month 1-Day 1 Visit
  4. Severe valvular stenosis (e.g., aortic or mitral stenosis with a valve area <1.0 cm2) or severe congenital heart disease
  5. ECG evidence of acute ischemia or active conduction system abnormalities with the exception of any of the following:

    • First degree atrioventricular (AV) block
    • Second degree AV block Type 1 (Mobitz Type 1/ Wenckebach type)
    • Right or left bundle branch block
    • Atrial fibrillation with a controlled ventricular rate (uncontrolled [i.e., >110 bpm] ventricular rate is not allowed [determined by an average of three beats in Lead II or 3 representative beats if Lead II is not representative of the overall ECG])
  6. Has not recovered (i.e., equivalent to a Common Terminology Criteria for Adverse Events [CTCAE] ≥Grade 2) from the clinically significant toxic effects of prior anticancer therapy. Exception: subjects who have received treatment with a proteasome inhibitor such as bortezomib may have CTCAE Grade 2 neuropathy.
  7. Received any of the following within the specified time frame prior to the Month 1-Day 1 Visit:

    • Oral or IV antibiotics, antifungals, or antivirals within 1 week, with the exception of prophylactic oral agents. Note: In the event that a subject requires the chronic use of antivirals, Medical Monitor permission is required for entry into the study.
    • Hematopoietic growth factors, transfusions of blood or blood products within 1 week
    • Chemotherapy, radiotherapy, HDAC inhibitors, or other plasma cell directed therapy within 2 weeks
    • ASCT within 4 weeks (i.e., ASCT is allowed if it occurred before enrollment in Study NEOD001-201 or after completion of Study NEOD001-201 if it was at least 4 weeks before Month 1-Day 1 of this study)
    • Major surgery within 4 weeks (or within 2 weeks following consultation with and approval of Medical Monitor)
    • Planned organ transplant during the study
    • Any investigational agent, other than NEOD001, within 4 weeks
    • Any experimental imaging agent directed at amyloid within 2 weeks
  8. Active malignancy with the exception of any of the following:

    • Adequately treated basal cell carcinoma, squamous cell carcinoma, or in situ cervical cancer
    • Adequately treated Stage I cancer from which the subject is currently in remission and has been in remission for ≥2 years
    • Low-risk prostate cancer with Gleason score <7 and prostate-specific antigen <10 mg/mL
    • Any other cancer from which the subject has been disease-free for ≥2 years
  9. History of Grade ≥3 infusion-related adverse events (AEs) or hypersensitivity to NEOD001
  10. History of severe allergy to any of the components of NEOD001 such as histidine/L-Histidine, Trehalose, or Polysorbate 20
  11. Currently known uncontrolled bacterial, viral, fungal, HIV, hepatitis B, or hepatitis C infection
  12. Women who are breastfeeding
  13. Any condition which could interfere with, or the treatment for which might interfere with, the conduct of the study or which would, in the opinion of the Investigator, unacceptably increase the subject's risk by participating in the study
  14. Unable or unwilling to adhere to the study-specified procedures and restrictions
  15. Subject is under legal custodianship

Sites / Locations

  • City of Hope
  • Colorado Blood Cancer Institute
  • Mayo Clinic Hospital - Florida
  • University of Chicago Medicine
  • Indiana University Simon Cancer Center
  • Tufts Medical Center
  • Karmanos Cancer Institute
  • Mayo Clinic - Minnesota
  • Memorial Sloan-Kettering Cancer Center
  • Duke University Medical Center
  • Cleveland Clinic
  • Oregon Health & Science University
  • Hospital of the University of Pennsylvania
  • Vanderbilt University Medical Center
  • The University of Texas MD Anderson Cancer Center
  • Medical College of Wisconsin
  • Westmead Hospital
  • Princess Alexandra Hospital
  • Eastern Health (Box Hill Hospital)
  • Medizinische Universität Wien
  • Hôpital Dupuytren - CHU Limoges
  • Hôpital Pitié-Salpêtrière
  • Charité - Universitätsmedizin Berlin
  • University of Duisburg-Essen
  • Universitätsklinikum Hamburg-Eppendorf (UKE)
  • Universitätsklinikum Heidelberg
  • Alexandra General Hospital of Athens
  • University Hospital of Patras
  • Hadassah Medical Center (HMC)
  • Fondazione IRCCS Policlinico San Matteo
  • Hospital Clínic de Barcelona
  • Hospital Universitario Puerta de Hierro - Majadahonda
  • Queen Elizabeth Hospital
  • The Royal Free Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Open label

Arm Description

Open Label Study Drug NEOD001

Outcomes

Primary Outcome Measures

Number of Participants With Adverse Events
AEs are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome, or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards.

Secondary Outcome Measures

Full Information

First Posted
April 28, 2017
Last Updated
March 12, 2019
Sponsor
Prothena Biosciences Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03154047
Brief Title
Study in Subjects With Light Chain (AL) Amyloidosis
Official Title
A Phase 2b Open-label Extension Study to Evaluate the Long-term Safety and Efficacy of NEOD001 in Subjects With Light Chain (AL) Amyloidosis Who Were Previously Enrolled in Study NEOD001-201 (PRONTO)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Terminated
Why Stopped
NEOD001 program terminated due to lack of clinical benefit
Study Start Date
June 14, 2017 (Actual)
Primary Completion Date
May 30, 2018 (Actual)
Study Completion Date
May 30, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Prothena Biosciences Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to evaluate the long-term safety and efficacy of NEOD001 in subjects with AL amyloidosis who have completed Study NEOD001-201.
Detailed Description
Global, multicenter, Phase 2b, open-label extension study of subjects with AL amyloidosis who had a hematologic response to first-line treatment for their amyloidosis (e.g., chemotherapy, autologous stem cell transplant [ASCT]) and completed Study NEOD001-201. Subjects in this study may receive concomitant chemotherapy. Subject screening will occur during the 28 days prior to the first administration of study drug, which may overlap with the last visit in Study NEOD001-201. If all eligibility requirements are met, the subject will be enrolled and Screening assessments will be completed. Study visits will occur every 28 days based on scheduling from Month 1 Day 1. A ±5-day window is allowed for visits starting after Month 1. Subjects who discontinue study drug before the End of Study Visit (EOS) should have an Early Treatment Discontinuation Visit 30 (±5) days after their final administration of study drug. Each subject's study participation may be up to 38 months or until the study is terminated, whichever occurs first. The study consists of a Screening Phase (1 month), Treatment Phase (36 months), and EOS Visit (30 [±5] days after the last dose).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
AL Amyloidosis

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Open label
Arm Type
Experimental
Arm Description
Open Label Study Drug NEOD001
Intervention Type
Drug
Intervention Name(s)
NEOD001
Intervention Description
humanized monoclonal antibody
Primary Outcome Measure Information:
Title
Number of Participants With Adverse Events
Description
AEs are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome, or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards.
Time Frame
Each subject's study participation may have been up to 36 months or until the study was terminated

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Completed the End of Study Visit in Study NEOD001-201 Adequate bone marrow reserve, hepatic and renal function, as demonstrated by: Absolute neutrophil count (ANC) ≥1.0 × 109/L Platelet count ≥75 × 109/L Hemoglobin ≥9 g/dL Total bilirubin ≤2 × upper limit of normal (ULN) Aspartate aminotransferase (AST) ≤3 × ULN Alanine aminotransferase (ALT) ≤3 × ULN Alkaline phosphatase (ALP) ≤5 × ULN (except for subjects with hepatomegaly and isozymes specific to liver, rather than bone) Estimated glomerular filtration rate (eGFR) ≥25 mL/min/1.73 m2 as estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, or measured GFR ≥25 mL/min/1.73 m2 Systolic blood pressure 80-180 mmHg Women of childbearing potential must have a negative pregnancy test during Screening and must agree to use highly effective physician-approved contraception from Screening to 90 days following the last study drug administration Male subjects must be surgically sterile or must agree to use highly effective physician-approved contraception from Screening to 90 days following the last study drug administration Ability to understand and willingness to sign an informed consent form prior to initiation of any study procedures Exclusion Criteria: Any new medical contraindication or clinically significant abnormality on physical, neurological, laboratory, vital signs, or electrocardiographic (ECG) examination (e.g., atrial fibrillation; with the exception of subjects for whom the ventricular rate is controlled) that precludes continuation or initiation of treatment with NEOD001 or participation in the study Symptomatic orthostatic hypotension that in the medical judgment of the Investigator would interfere with subject's ability to safely receive treatment or complete study assessments Myocardial infarction, uncontrolled angina, uncontrolled ventricular arrhythmias, or ECG evidence of acute ischemia, within 6 months prior to the Month 1-Day 1 Visit Severe valvular stenosis (e.g., aortic or mitral stenosis with a valve area <1.0 cm2) or severe congenital heart disease ECG evidence of acute ischemia or active conduction system abnormalities with the exception of any of the following: First degree atrioventricular (AV) block Second degree AV block Type 1 (Mobitz Type 1/ Wenckebach type) Right or left bundle branch block Atrial fibrillation with a controlled ventricular rate (uncontrolled [i.e., >110 bpm] ventricular rate is not allowed [determined by an average of three beats in Lead II or 3 representative beats if Lead II is not representative of the overall ECG]) Has not recovered (i.e., equivalent to a Common Terminology Criteria for Adverse Events [CTCAE] ≥Grade 2) from the clinically significant toxic effects of prior anticancer therapy. Exception: subjects who have received treatment with a proteasome inhibitor such as bortezomib may have CTCAE Grade 2 neuropathy. Received any of the following within the specified time frame prior to the Month 1-Day 1 Visit: Oral or IV antibiotics, antifungals, or antivirals within 1 week, with the exception of prophylactic oral agents. Note: In the event that a subject requires the chronic use of antivirals, Medical Monitor permission is required for entry into the study. Hematopoietic growth factors, transfusions of blood or blood products within 1 week Chemotherapy, radiotherapy, HDAC inhibitors, or other plasma cell directed therapy within 2 weeks ASCT within 4 weeks (i.e., ASCT is allowed if it occurred before enrollment in Study NEOD001-201 or after completion of Study NEOD001-201 if it was at least 4 weeks before Month 1-Day 1 of this study) Major surgery within 4 weeks (or within 2 weeks following consultation with and approval of Medical Monitor) Planned organ transplant during the study Any investigational agent, other than NEOD001, within 4 weeks Any experimental imaging agent directed at amyloid within 2 weeks Active malignancy with the exception of any of the following: Adequately treated basal cell carcinoma, squamous cell carcinoma, or in situ cervical cancer Adequately treated Stage I cancer from which the subject is currently in remission and has been in remission for ≥2 years Low-risk prostate cancer with Gleason score <7 and prostate-specific antigen <10 mg/mL Any other cancer from which the subject has been disease-free for ≥2 years History of Grade ≥3 infusion-related adverse events (AEs) or hypersensitivity to NEOD001 History of severe allergy to any of the components of NEOD001 such as histidine/L-Histidine, Trehalose, or Polysorbate 20 Currently known uncontrolled bacterial, viral, fungal, HIV, hepatitis B, or hepatitis C infection Women who are breastfeeding Any condition which could interfere with, or the treatment for which might interfere with, the conduct of the study or which would, in the opinion of the Investigator, unacceptably increase the subject's risk by participating in the study Unable or unwilling to adhere to the study-specified procedures and restrictions Subject is under legal custodianship
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Colorado Blood Cancer Institute
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Facility Name
Mayo Clinic Hospital - Florida
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
University of Chicago Medicine
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Indiana University Simon Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Mayo Clinic - Minnesota
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
48201
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
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
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
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
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
Westmead Hospital
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Princess Alexandra Hospital
City
Woolloongabba
State/Province
Queensland
ZIP/Postal Code
4102
Country
Australia
Facility Name
Eastern Health (Box Hill Hospital)
City
Box Hill
State/Province
Victoria
ZIP/Postal Code
3128
Country
Australia
Facility Name
Medizinische Universität Wien
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Facility Name
Hôpital Dupuytren - CHU Limoges
City
Limoges
ZIP/Postal Code
87042
Country
France
Facility Name
Hôpital Pitié-Salpêtrière
City
Paris
ZIP/Postal Code
75651
Country
France
Facility Name
Charité - Universitätsmedizin Berlin
City
Berlin
ZIP/Postal Code
12200
Country
Germany
Facility Name
University of Duisburg-Essen
City
Essen
ZIP/Postal Code
45122
Country
Germany
Facility Name
Universitätsklinikum Hamburg-Eppendorf (UKE)
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Universitätsklinikum Heidelberg
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Alexandra General Hospital of Athens
City
Athens
ZIP/Postal Code
11528
Country
Greece
Facility Name
University Hospital of Patras
City
Patras
Country
Greece
Facility Name
Hadassah Medical Center (HMC)
City
Jerusalem
ZIP/Postal Code
91120
Country
Israel
Facility Name
Fondazione IRCCS Policlinico San Matteo
City
Pavia
ZIP/Postal Code
27100
Country
Italy
Facility Name
Hospital Clínic de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hospital Universitario Puerta de Hierro - Majadahonda
City
Majadahonda
ZIP/Postal Code
28222
Country
Spain
Facility Name
Queen Elizabeth Hospital
City
Birmingham
State/Province
England
ZIP/Postal Code
B15 2GW
Country
United Kingdom
Facility Name
The Royal Free Hospital
City
London
State/Province
England
ZIP/Postal Code
NW3 2QG
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Study in Subjects With Light Chain (AL) Amyloidosis

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