Study of ZKAB001 for Maintenance Therapy in Patients With High-grade Osteosarcoma After Adjuvant Chemotherapy
Primary Purpose
High-grade Osteosarcoma
Status
Unknown status
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Recombinant human anti-PD-L1 monoclonal antibody (ZKAB001)
placebo
Sponsored by
About this trial
This is an interventional treatment trial for High-grade Osteosarcoma
Eligibility Criteria
Inclusion Criteria:
- Voluntarily participate in the trial and sign the informed consent form.
- Age ≥ 12 years old, both male and female.
- High-grade osteosarcoma diagnosed by histopathology (Ennecking stage II) ,radical surgery (R0 resection) and the adjuvant chemotherapy was confirmed by investigators. The end of adjuvant chemotherapy was no more than 12 weeks.
- Chemotherapy with more than two drugs must be used; the accumulated dose of doxorubicin should not be less than 300mg/m^2 (including converted dose); the total course of chemotherapy before and after operation should not be less than 12 times, the starting time of postoperative chemotherapy should not exceed 30 days, and the time of postoperative chemotherapy should not exceed 40 weeks.
- The score of the Eastern Cooperative Oncology Group (ECOG) is 0-1.
- The estimated survival time is more than 3 months.
The functions of important organs meet the following requirements;
- Absolute neutrophil count ≥ 1.5 × 10^9 / L.
- Platelet count ≥ 75 × 10^9 /L.
- Hemoglobin ≥ 90g/L.
- Serum albumin ≥ 28g/L.
- Total bilirubin ≤ 1.5 × ULN;ALT, AST ≤ 2.5 × ULN.
- Serum creatinine ≤ 1.25 × ULN or endogenous creatinine clearance ≥ 50mL/min (using standard Crockcroft-Gault formula).
- Thyroid function: thyroid stimulating hormone (TSH) is normal. If TSH is abnormal, free thyroxine( FT3 and FT4 )levels should be examined. Normal FT3 and FT4 levels can be enrolled.
- Female subjects of childbearing age should take effective contraceptive methods during the study period and within 3 months after the end of the study period, and the serum human chorionic gonadotropin pregnancy test (HCG) must be negative within 7 days before enrollment.
Exclusion Criteria:
- Local recurrence or distant metastasis;
- There is active autoimmune disease or history of autoimmune disease (such as, but not limited to, interstitial pneumonia, uveitis, colitis, hepatitis, arthritis, glomerulonephritis, hypophysitis, hyperthyroidism, hypothyroidism, etc.), but does not include autoimmune-mediated hypothyroidism treated with stable doses of thyroid replacement hormones.
- Type I diabetes with stable doses of insulin;
- Vitiligo or cured childhood asthma / allergies in adults without medical intervention.
- The subjects were treated with immunosuppressants, or systemic or absorbable local corticosteroids with the purpose of immunosuppression (prednisone or equivalent for more than 10mg/ days), and continued to use them within 2 weeks before enrollment.
- Have received any form of organ transplantation, including allogeneic stem cell transplantation;
- Previously known to be allergic to macromolecular protein preparations or to any ZKAB001 components;
- Previous or simultaneous suffering from other malignant tumors (except those that have been cured or cancer-free for more than 5 years, such as basal cell carcinoma of the skin, carcinoma in situ of the cervix and papillary carcinoma of the thyroid, etc.);
- Uncontrolled cardiac clinical symptoms or diseases, such as heart failure above New York Heart Association(NYHA) 2, unstable angina pectoris, myocardial infarction within 1 year, clinical supraventricular or ventricular arrhythmias requiring intervention, echocardiography shows that the left ventricular ejection fraction at rest is less than 50%; - The completion of the treatment of radiotherapy, chemotherapy, surgery and/or molecular targeted therapy is less than 3 weeks before the first dose of study drug;
- Active infection (need to be treated with anti-bacterial, viral and/or fungal drugs), or fever of unknown origin occurred during the screening period and occurred within one week before the first dose (judged by the investigators, except the fever caused by tumor).
- Positive for human immunodeficiency virus (HIV); untreated active hepatitis B (hepatitis B surface antigen is positive and peripheral blood HBV-DNA titer ≥ 1000IU/ml or comply with local positive criteria) and/or hepatitis C (hepatitis C antibody is positive and HCV-RNA is higher than the lower limit)
- Patients with active pulmonary tuberculosis infection found by medical history or CT examination, or patients with active pulmonary tuberculosis infection within one year before entering the group, or patients with active pulmonary tuberculosis infection history more than one year ago but without formal treatment;
- Participating in other clinical studies, or less than 4 weeks from the end of the previous clinical study;
- Other systemic anti-tumor therapy may be received during the study period;
- Previously received other PD-1 and / or PD-L1, or CTLA-4 antibody therapy, or other drug therapy for immune receptor modulators;
- The live vaccine was vaccinated within 4 weeks before screening.
- Known history of psychotropic substance abuse, alcohol abuse or drug use;
- Pregnant or lactating women;
- Any mental state that hinders the understanding or provision of informed consent;
- The investigators consider that the patient had other factors that might lead to the termination of the study, such as other serious diseases or serious laboratory abnormalities or accompanied by other factors that would affect the safety of the subjects, or family or social factors that would affect the collection of data and samples.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
treatment group
control group
Arm Description
ZKAB001 injection 10mg/kg once every 3 weeks for 1 cycle (Q3w), up to 16 cycles or 1 year of treatment.
placebo will given in the same way for once every 3 weeks for 1 cycle (Q3w), up to 16 cycles or 1 year of treatment.
Outcomes
Primary Outcome Measures
One-year DFS rate
The percentage of patients with no recurrence or metastasis within one year
Secondary Outcome Measures
Five-years OS rate
Patients who survive within 5 years after the first dose.
adverse events
Incidence and severity of adverse events
Immunogenecity of ZKAB001
To evaluated the number of subjects presenting detectable anti drug antibodies (ADAs).
PD-L1 expression
Correlation between PD-L1 expression level and clinical efficacy
Full Information
NCT ID
NCT04359550
First Posted
April 21, 2020
Last Updated
April 27, 2020
Sponsor
Lee's Pharmaceutical Limited
1. Study Identification
Unique Protocol Identification Number
NCT04359550
Brief Title
Study of ZKAB001 for Maintenance Therapy in Patients With High-grade Osteosarcoma After Adjuvant Chemotherapy
Official Title
A Randomized, Double-blind, Placebo-controlled, Multicenter,Phase III Clinical Study of Recombinant Anti-PD-L1 Monoclonal Antibody (ZKAB001) for Maintenance Therapy in Patients With High-grade Osteosarcoma After Adjuvant Chemotherapy
Study Type
Interventional
2. Study Status
Record Verification Date
April 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 1, 2020 (Anticipated)
Primary Completion Date
June 1, 2022 (Anticipated)
Study Completion Date
June 1, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lee's Pharmaceutical Limited
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
It is a randomized, double-blind, placebo-controlled, multicenter study with the sample size is 362. The patients with high-grade osteosarcoma who had previously received surgery and completed adjuvant chemotherapy will be randomly assigned to ZKAB001 group (trial group) or placebo group (control group) according to 1:1. The purpose is to evaluate the efficacy and safety of ZKAB001 in maintenance therapy after adjuvant chemotherapy in patients with high-grade osteosarcoma.
Detailed Description
The patients will be given ZKAB001 injection in 10mg/kg or placebo once every 3 weeks for a total of 16 cycles or 1 year. The end point is that the patient has been taking the drug for 16 cycles or 1 year, or the patient dies or develops intolerable toxicity or confirmed disease recurrence or distant metastasis or withdrawal of informed consent, whichever comes first.
In this study, after a screening period of no more than 28 days, qualified subjects will be given ZKAB001 or placebo and test visits. Imaging examination will be performed every 12 weeks after the first dose until the local or distant recurrence of the disease, or the initiation of other systematic anti-tumor therapy or death, whichever come first.
The survival follow-up period starts from the last treatment to a maximum of 4 years, or to the death or loss of follow-up or withdrawal of informed consent or the sponsor terminates the study every 3 months.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
High-grade Osteosarcoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
362 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
treatment group
Arm Type
Experimental
Arm Description
ZKAB001 injection 10mg/kg once every 3 weeks for 1 cycle (Q3w), up to 16 cycles or 1 year of treatment.
Arm Title
control group
Arm Type
Placebo Comparator
Arm Description
placebo will given in the same way for once every 3 weeks for 1 cycle (Q3w), up to 16 cycles or 1 year of treatment.
Intervention Type
Biological
Intervention Name(s)
Recombinant human anti-PD-L1 monoclonal antibody (ZKAB001)
Intervention Description
Recombinant human anti-PD-L1 monoclonal antibody (ZKAB001)
Intervention Type
Other
Intervention Name(s)
placebo
Intervention Description
placebo
Primary Outcome Measure Information:
Title
One-year DFS rate
Description
The percentage of patients with no recurrence or metastasis within one year
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Five-years OS rate
Description
Patients who survive within 5 years after the first dose.
Time Frame
5 years
Title
adverse events
Description
Incidence and severity of adverse events
Time Frame
5 years
Title
Immunogenecity of ZKAB001
Description
To evaluated the number of subjects presenting detectable anti drug antibodies (ADAs).
Time Frame
1 year
Title
PD-L1 expression
Description
Correlation between PD-L1 expression level and clinical efficacy
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Voluntarily participate in the trial and sign the informed consent form.
Age ≥ 12 years old, both male and female.
High-grade osteosarcoma diagnosed by histopathology (Ennecking stage II) ,radical surgery (R0 resection) and the adjuvant chemotherapy was confirmed by investigators. The end of adjuvant chemotherapy was no more than 12 weeks.
Chemotherapy with more than two drugs must be used; the accumulated dose of doxorubicin should not be less than 300mg/m^2 (including converted dose); the total course of chemotherapy before and after operation should not be less than 12 times, the starting time of postoperative chemotherapy should not exceed 30 days, and the time of postoperative chemotherapy should not exceed 40 weeks.
The score of the Eastern Cooperative Oncology Group (ECOG) is 0-1.
The estimated survival time is more than 3 months.
The functions of important organs meet the following requirements;
Absolute neutrophil count ≥ 1.5 × 10^9 / L.
Platelet count ≥ 75 × 10^9 /L.
Hemoglobin ≥ 90g/L.
Serum albumin ≥ 28g/L.
Total bilirubin ≤ 1.5 × ULN;ALT, AST ≤ 2.5 × ULN.
Serum creatinine ≤ 1.25 × ULN or endogenous creatinine clearance ≥ 50mL/min (using standard Crockcroft-Gault formula).
Thyroid function: thyroid stimulating hormone (TSH) is normal. If TSH is abnormal, free thyroxine( FT3 and FT4 )levels should be examined. Normal FT3 and FT4 levels can be enrolled.
Female subjects of childbearing age should take effective contraceptive methods during the study period and within 3 months after the end of the study period, and the serum human chorionic gonadotropin pregnancy test (HCG) must be negative within 7 days before enrollment.
Exclusion Criteria:
Local recurrence or distant metastasis;
There is active autoimmune disease or history of autoimmune disease (such as, but not limited to, interstitial pneumonia, uveitis, colitis, hepatitis, arthritis, glomerulonephritis, hypophysitis, hyperthyroidism, hypothyroidism, etc.), but does not include autoimmune-mediated hypothyroidism treated with stable doses of thyroid replacement hormones.
Type I diabetes with stable doses of insulin;
Vitiligo or cured childhood asthma / allergies in adults without medical intervention.
The subjects were treated with immunosuppressants, or systemic or absorbable local corticosteroids with the purpose of immunosuppression (prednisone or equivalent for more than 10mg/ days), and continued to use them within 2 weeks before enrollment.
Have received any form of organ transplantation, including allogeneic stem cell transplantation;
Previously known to be allergic to macromolecular protein preparations or to any ZKAB001 components;
Previous or simultaneous suffering from other malignant tumors (except those that have been cured or cancer-free for more than 5 years, such as basal cell carcinoma of the skin, carcinoma in situ of the cervix and papillary carcinoma of the thyroid, etc.);
Uncontrolled cardiac clinical symptoms or diseases, such as heart failure above New York Heart Association(NYHA) 2, unstable angina pectoris, myocardial infarction within 1 year, clinical supraventricular or ventricular arrhythmias requiring intervention, echocardiography shows that the left ventricular ejection fraction at rest is less than 50%; - The completion of the treatment of radiotherapy, chemotherapy, surgery and/or molecular targeted therapy is less than 3 weeks before the first dose of study drug;
Active infection (need to be treated with anti-bacterial, viral and/or fungal drugs), or fever of unknown origin occurred during the screening period and occurred within one week before the first dose (judged by the investigators, except the fever caused by tumor).
Positive for human immunodeficiency virus (HIV); untreated active hepatitis B (hepatitis B surface antigen is positive and peripheral blood HBV-DNA titer ≥ 1000IU/ml or comply with local positive criteria) and/or hepatitis C (hepatitis C antibody is positive and HCV-RNA is higher than the lower limit)
Patients with active pulmonary tuberculosis infection found by medical history or CT examination, or patients with active pulmonary tuberculosis infection within one year before entering the group, or patients with active pulmonary tuberculosis infection history more than one year ago but without formal treatment;
Participating in other clinical studies, or less than 4 weeks from the end of the previous clinical study;
Other systemic anti-tumor therapy may be received during the study period;
Previously received other PD-1 and / or PD-L1, or CTLA-4 antibody therapy, or other drug therapy for immune receptor modulators;
The live vaccine was vaccinated within 4 weeks before screening.
Known history of psychotropic substance abuse, alcohol abuse or drug use;
Pregnant or lactating women;
Any mental state that hinders the understanding or provision of informed consent;
The investigators consider that the patient had other factors that might lead to the termination of the study, such as other serious diseases or serious laboratory abnormalities or accompanied by other factors that would affect the safety of the subjects, or family or social factors that would affect the collection of data and samples.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yang Yao, Master
Phone
18930177737
Email
yangyao_6@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Haiyan Hu, master
Phone
18930174575
Email
xuri1104@163.com
12. IPD Sharing Statement
Learn more about this trial
Study of ZKAB001 for Maintenance Therapy in Patients With High-grade Osteosarcoma After Adjuvant Chemotherapy
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