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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
Lee's Pharmaceutical Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for High-grade Osteosarcoma

Eligibility Criteria

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

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;

    1. Absolute neutrophil count ≥ 1.5 × 10^9 / L.
    2. Platelet count ≥ 75 × 10^9 /L.
    3. Hemoglobin ≥ 90g/L.
    4. Serum albumin ≥ 28g/L.
    5. Total bilirubin ≤ 1.5 × ULN;ALT, AST ≤ 2.5 × ULN.
    6. Serum creatinine ≤ 1.25 × ULN or endogenous creatinine clearance ≥ 50mL/min (using standard Crockcroft-Gault formula).
    7. 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

    First Posted
    April 21, 2020
    Last Updated
    April 27, 2020
    Sponsor
    Lee's Pharmaceutical Limited
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    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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