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ASTRAL- a Clinical Study to Assess the Efficacy and Toxicity of High-dose Chemotherapy

Primary Purpose

Aggressive Non-hodgkin Lymphoma (aNHL), Lymphoma, B-Cell, Lymphoma, T-Cell

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
High dose chemotherapy before allogeneic stem cell transplantation (alloSCT)
Bone marrow histology
clinical and laboratory parameters
PET-CT or CT
Sponsored by
GWT-TUD GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for Aggressive Non-hodgkin Lymphoma (aNHL)

Eligibility Criteria

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

Inclusion Criteria:

Subjects must fulfill all of the following criteria to be included in this trial:

  1. Provision of written informed consent and specifically the consent to the collection and processing of health-related data
  2. Age: 18 years and older
  3. Gender: Male and female patients
  4. Histology
  5. Diagnosis of relapsed or primary progressive aggressive B- or T-cell lymphoma including:

    1. B-Cell non-hodgkin lymphoma (B-NHL) or
    2. T-Cell non-hodgkin lymphoma (T-NHL):
  6. Staging at relapse or progression (data should not be older than 4 weeks):
  7. Staging after 2 or 3 cycles of salvage treatment:
  8. Donor availability:
  9. Females of childbearing potential (FCBP) must:

    • Understand the potential teratogenic risk to the unborn child
    • Understand the need and agree to utilize two reliable forms of contraception
    • Understand and agree to inform the investigator if a change or stop of method of contraception is needed
    • Be capable of complying with effective contraceptive measures
    • Be informed and understand the potential consequences of pregnancy and the need to notify her study doctor immediately if there is a risk of pregnancy
    • Understand the need to commence the study treatment as soon as study drug is dispensed following a negative pregnancy test
    • Understand the need and accept to undergo pregnancy testing based on the frequency outlined in this protocol
    • Agree to abstain from breastfeeding during study participation
  10. Males must:

    • Agree to use a latex condom during any sexual contact with females of childbearing potential
    • Agree to refrain from donating semen or sperm while on the study drugs and should seek for sperm cryopreservation before therapy is started and should not father a child while treated and during one year after end of study treatment
  11. Females of non-childbearing potential:

Exclusion Criteria:

Subjects are to be excluded from the study if they display any of the following criteria:

  1. Pregnant females; lactating women must end breast feeding before start of study treatment
  2. Serious accompanying disorder or impaired organ function
  3. Central nervous system (CNS) involvement of lymphoma - to be examined in case of clinical symptoms
  4. History of severe cardiac diseases, and cardiac function impairment
  5. Severe kidney disease
  6. HIV-positivity
  7. Hepatitis B and C as defined by seropositivity
  8. Patients under legal guardianship regarding medical decisions
  9. Ongoing treatment or study procedures within any other clinical trial with the exception of follow up
  10. Ongoing exclusion periods of other clinical studies after end of treatment
  11. In patients tested: Metabolic Computer tomography (CR) in a positron emission tomography-Computer tomography (PET-CT) scan after the last cycle of therapy prior to planned SCT
  12. Subjects with known hypersensitivity to the study drugs
  13. Criteria which in the opinion of the investigator precluded participation for scientific reasons, for reasons of compliance, or for reasons of the subject's safety
  14. Commitment to an institution by virtue of an order issued either by the judicial or the administrative authorities
  15. Dependency on the sponsor, trial site or investigator
  16. Additional exclusion criteria with respect to summary of product characteristics (SmPC) of the investigational medical product (IMPs) fludarabine, thiotepa, cyclophosphamide:

    1. Known hypersensitivity to fludarabine, thiotepa, cyclophosphamide or one of their metabolites
    2. Renal impairment
    3. Decompensated haemolytic anaemia
    4. Concurrent application of vital vaccines
    5. Cystitis
    6. Renal tract obstruction
    7. Active and uncontrolled infection
    8. Notice: myelosuppression and impaired hematopoietic function is not an exclusion criterion as this usual contraindication to the application to any of the IMPs will be overcome by the stem cell transplantation following conditioning therapy.

      -

Sites / Locations

  • HELIOS Klinik Berlin-Buch, Klinik für Hämatologie und Stammzelltransplantation
  • Klinikum Augsburg, Medizinische Klinik II
  • Medizinisches Universitätsklinikum
  • Klinikum Chemnitz gGmbH
  • Universitätsklinikum Carl Gustav Carus Dresden, Medzinische Klinik I
  • Universitäsklinikum Düsseldorf
  • Universitätsmedizin Göttingen Klinik für Hämatologie/Med. Onkologie
  • Universitätsklinikum Halle
  • Universitätsklinikum Hamburg-Eppendorf, Zentrum für Onkologie, Interdisziplinäre Klinik und Poliklinik für Stammzelltransplantation
  • Universitätsklinikum Heidelberg, Medizinische Klinik, Innere Medizin V
  • Universitätsklinikum Jena, Klinik für Innere Medizin, Abtl. Hämatologie und Innternistische Onkologie
  • Universitätsklinikum Münster, KMT-Zentrum/ Med. Klinik A
  • Klinikum Stuttgart

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

alloSCT

Arm Description

defined high-dose chemotherapy (HDT) followed by allogeneic stem cell transplantation (alloSCT)

Outcomes

Primary Outcome Measures

Measurement of efficacy variables, Rate of Progression free survival (PFS)
To compare a defined high dose therapy (HDT) with study medication followed by alloSCT lead to treatment results in terms of PFS, that are better than results obtained with high-dose therapy and autoSCT in a comparable Patient Population ( historical data).

Secondary Outcome Measures

Measurement of efficacy variables, Rate of complete remissions (CR)
Number of complete remissions divided by the number of patients (CR),
Measurement of efficacy variables, Rate of partial remissions (PR)
Number of partial remissions divided by the number of patients (PR);
Measurement of efficacy variables, Rate of complete and partial remissions (ORR)
Number of complete and partial remissions divided by the number of patients (ORR);
Measurement of efficacy variables, Rate of progressive diseases (PD)
Number of progressive diseases after SCT divided by the number of patients (PD);
Measurement of efficacy variables, Rate of relapse (RR)
safety item
Measurement of efficacy variables, Rate of treatment-related mortality
treatment-related death divided by the number of patients
Rate of event free survival at 1 year (EFS)
safety item
Measurement of efficacy variables, Rate of overall survival at 1 year (OS)
safety item
Measurement of efficacy variables, Rate of non-relapse mortality (NRM)
safety item
Measurement of efficacy variables, Causes of death
safety item
Measurement of efficacy variables, Incidence and severity of acute and chronic graft versus host disease (GvHD);
safety item
Measurement of efficacy variables, Adverse events (AEs) grade 3 and 4
safety item
Measurement of efficacy variables, Serious adverse events (SAEs)
safety item
Measurement of number of blood cells
recovery of White blood cells and platelets
Measurement of efficacy variables, Rate of infections
safety item

Full Information

First Posted
July 31, 2019
Last Updated
May 23, 2023
Sponsor
GWT-TUD GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT04121507
Brief Title
ASTRAL- a Clinical Study to Assess the Efficacy and Toxicity of High-dose Chemotherapy
Official Title
A Prospective Phase II Clinical Study to Assess the Efficacy and Toxicity of High-dose Chemotherapy Followed by Allogeneic Stem Cell Transplantation as Treatment of Primary Progressive and Relapsed Aggressive Non-Hodgkin Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
June 24, 2019 (Actual)
Primary Completion Date
March 30, 2022 (Actual)
Study Completion Date
February 2, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GWT-TUD GmbH

4. Oversight

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

5. Study Description

Brief Summary
A prospective Phase II clinical study to assess the efficacy and toxicity of high dose chemotherapy (HDT) followed by allogeneic stem cell transplantation (allo- or autoSCT) as treatment of primary progressive and relapsed aggressive Non-Hodgkin Lymphoma (NHL) - ASTRAL
Detailed Description
This is a clinical study to assess the treatment (efficacy and toxicity) with a high dosed chemotherapy followed by stem cell transplantation in patients suffering from primary progressive and relapsed aggressive Non-Hodgkin Lymphoma (NHL) After end of the active study phase, patients will receive further standard medical care at the discretion of the treating physician. The clinical consultants will provide advice on further treatment if requested.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aggressive Non-hodgkin Lymphoma (aNHL), Lymphoma, B-Cell, Lymphoma, T-Cell

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
alloSCT
Arm Type
Experimental
Arm Description
defined high-dose chemotherapy (HDT) followed by allogeneic stem cell transplantation (alloSCT)
Intervention Type
Drug
Intervention Name(s)
High dose chemotherapy before allogeneic stem cell transplantation (alloSCT)
Other Intervention Name(s)
fludarabine, thiotepa ,cyclophosphamide (FTC)
Intervention Description
High-dose therapy (HDT) prior to alloSCT will consist of FTC
Intervention Type
Procedure
Intervention Name(s)
Bone marrow histology
Intervention Description
Bone marrow histology at staging and restaging is only mandatory if the bone marrow was initially involved
Intervention Type
Diagnostic Test
Intervention Name(s)
clinical and laboratory parameters
Intervention Description
During staging and restaging examinations, all clinical and laboratory parameters relevant for therapy.
Intervention Type
Diagnostic Test
Intervention Name(s)
PET-CT or CT
Intervention Description
Metabolic CR in a PET-CT scan after the last cycle of therapy prior to planned SCT. Consists preferably of a PET-CT or a CT scan according to local practice and other appropriate diagnostic procedures with respect to the sites of primary involvement.
Primary Outcome Measure Information:
Title
Measurement of efficacy variables, Rate of Progression free survival (PFS)
Description
To compare a defined high dose therapy (HDT) with study medication followed by alloSCT lead to treatment results in terms of PFS, that are better than results obtained with high-dose therapy and autoSCT in a comparable Patient Population ( historical data).
Time Frame
1 year after SCT
Secondary Outcome Measure Information:
Title
Measurement of efficacy variables, Rate of complete remissions (CR)
Description
Number of complete remissions divided by the number of patients (CR),
Time Frame
1 year after stem cell transplantation (SCT)
Title
Measurement of efficacy variables, Rate of partial remissions (PR)
Description
Number of partial remissions divided by the number of patients (PR);
Time Frame
1 year after SCT
Title
Measurement of efficacy variables, Rate of complete and partial remissions (ORR)
Description
Number of complete and partial remissions divided by the number of patients (ORR);
Time Frame
1 year after SCT
Title
Measurement of efficacy variables, Rate of progressive diseases (PD)
Description
Number of progressive diseases after SCT divided by the number of patients (PD);
Time Frame
1 year after SCT
Title
Measurement of efficacy variables, Rate of relapse (RR)
Description
safety item
Time Frame
1 year after SCT
Title
Measurement of efficacy variables, Rate of treatment-related mortality
Description
treatment-related death divided by the number of patients
Time Frame
1 year after SCT
Title
Rate of event free survival at 1 year (EFS)
Description
safety item
Time Frame
1 year after SCT
Title
Measurement of efficacy variables, Rate of overall survival at 1 year (OS)
Description
safety item
Time Frame
1 year after SCT
Title
Measurement of efficacy variables, Rate of non-relapse mortality (NRM)
Description
safety item
Time Frame
1year after SCT
Title
Measurement of efficacy variables, Causes of death
Description
safety item
Time Frame
1year after SCT
Title
Measurement of efficacy variables, Incidence and severity of acute and chronic graft versus host disease (GvHD);
Description
safety item
Time Frame
until the last Follow-Up Visit ( 1-2 Year after SCT)
Title
Measurement of efficacy variables, Adverse events (AEs) grade 3 and 4
Description
safety item
Time Frame
until about day 100 after SCT.
Title
Measurement of efficacy variables, Serious adverse events (SAEs)
Description
safety item
Time Frame
until about day 100 after SCT.
Title
Measurement of number of blood cells
Description
recovery of White blood cells and platelets
Time Frame
1year after SCT
Title
Measurement of efficacy variables, Rate of infections
Description
safety item
Time Frame
1year after SCT

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must fulfill all of the following criteria to be included in this trial: Provision of written informed consent and specifically the consent to the collection and processing of health-related data Age: 18 years and older Gender: Male and female patients Histology Diagnosis of relapsed or primary progressive aggressive B- or T-cell lymphoma including: B-Cell non-hodgkin lymphoma (B-NHL) or T-Cell non-hodgkin lymphoma (T-NHL): Staging at relapse or progression (data should not be older than 4 weeks): Staging after 2 or 3 cycles of salvage treatment: Donor availability: Females of childbearing potential (FCBP) must: Understand the potential teratogenic risk to the unborn child Understand the need and agree to utilize two reliable forms of contraception Understand and agree to inform the investigator if a change or stop of method of contraception is needed Be capable of complying with effective contraceptive measures Be informed and understand the potential consequences of pregnancy and the need to notify her study doctor immediately if there is a risk of pregnancy Understand the need to commence the study treatment as soon as study drug is dispensed following a negative pregnancy test Understand the need and accept to undergo pregnancy testing based on the frequency outlined in this protocol Agree to abstain from breastfeeding during study participation Males must: Agree to use a latex condom during any sexual contact with females of childbearing potential Agree to refrain from donating semen or sperm while on the study drugs and should seek for sperm cryopreservation before therapy is started and should not father a child while treated and during one year after end of study treatment Females of non-childbearing potential: Exclusion Criteria: Subjects are to be excluded from the study if they display any of the following criteria: Pregnant females; lactating women must end breast feeding before start of study treatment Serious accompanying disorder or impaired organ function Central nervous system (CNS) involvement of lymphoma - to be examined in case of clinical symptoms History of severe cardiac diseases, and cardiac function impairment Severe kidney disease HIV-positivity Hepatitis B and C as defined by seropositivity Patients under legal guardianship regarding medical decisions Ongoing treatment or study procedures within any other clinical trial with the exception of follow up Ongoing exclusion periods of other clinical studies after end of treatment In patients tested: Metabolic Computer tomography (CR) in a positron emission tomography-Computer tomography (PET-CT) scan after the last cycle of therapy prior to planned SCT Subjects with known hypersensitivity to the study drugs Criteria which in the opinion of the investigator precluded participation for scientific reasons, for reasons of compliance, or for reasons of the subject's safety Commitment to an institution by virtue of an order issued either by the judicial or the administrative authorities Dependency on the sponsor, trial site or investigator Additional exclusion criteria with respect to summary of product characteristics (SmPC) of the investigational medical product (IMPs) fludarabine, thiotepa, cyclophosphamide: Known hypersensitivity to fludarabine, thiotepa, cyclophosphamide or one of their metabolites Renal impairment Decompensated haemolytic anaemia Concurrent application of vital vaccines Cystitis Renal tract obstruction Active and uncontrolled infection Notice: myelosuppression and impaired hematopoietic function is not an exclusion criterion as this usual contraindication to the application to any of the IMPs will be overcome by the stem cell transplantation following conditioning therapy. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bertram Glass, Prof. Dr.
Organizational Affiliation
Helios Klinikum Berlin-Buch
Official's Role
Principal Investigator
Facility Information:
Facility Name
HELIOS Klinik Berlin-Buch, Klinik für Hämatologie und Stammzelltransplantation
City
Berlin
State/Province
Brandenburg
ZIP/Postal Code
13125
Country
Germany
Facility Name
Klinikum Augsburg, Medizinische Klinik II
City
Augsburg
Country
Germany
Facility Name
Medizinisches Universitätsklinikum
City
Bochum
ZIP/Postal Code
44892
Country
Germany
Facility Name
Klinikum Chemnitz gGmbH
City
Chemnitz
ZIP/Postal Code
09116
Country
Germany
Facility Name
Universitätsklinikum Carl Gustav Carus Dresden, Medzinische Klinik I
City
Dresden
Country
Germany
Facility Name
Universitäsklinikum Düsseldorf
City
Düsseldorf
ZIP/Postal Code
40225
Country
Germany
Facility Name
Universitätsmedizin Göttingen Klinik für Hämatologie/Med. Onkologie
City
Göttingen
ZIP/Postal Code
37075
Country
Germany
Facility Name
Universitätsklinikum Halle
City
Halle
ZIP/Postal Code
06120
Country
Germany
Facility Name
Universitätsklinikum Hamburg-Eppendorf, Zentrum für Onkologie, Interdisziplinäre Klinik und Poliklinik für Stammzelltransplantation
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Universitätsklinikum Heidelberg, Medizinische Klinik, Innere Medizin V
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Universitätsklinikum Jena, Klinik für Innere Medizin, Abtl. Hämatologie und Innternistische Onkologie
City
Jena
ZIP/Postal Code
07747
Country
Germany
Facility Name
Universitätsklinikum Münster, KMT-Zentrum/ Med. Klinik A
City
Münster
ZIP/Postal Code
48149
Country
Germany
Facility Name
Klinikum Stuttgart
City
Stuttgart
ZIP/Postal Code
70174
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

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ASTRAL- a Clinical Study to Assess the Efficacy and Toxicity of High-dose Chemotherapy

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