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Eltrombopag for Chemotherapy-induced Thrombocytopenia

Primary Purpose

Chemotherapy-induced Thrombocytopenia, Eltrombopag

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Eltrombopag
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chemotherapy-induced Thrombocytopenia

Eligibility Criteria

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

Inclusion Criteria:

  • Aged ≥18 years old, male or female;
  • Conform to the diagnostic criteria of chemotherapy-induced thrombocytopenia (CIT); Ineffective after repeated treatment with rhTPO or IL-11;
  • Stop radiotherapy or chemotherapy for more than 1 month;
  • Platelet counts <30 ×10^9/L, and bleeding tendency;
  • Estimated survival period ≥ 6 months;
  • People who are willing to sign the informed consent voluntarily and follow the research program.
  • Liver and kidney function<1.5×upper limit of normal, qualified for physical examination;
  • Subject is practicing an acceptable method of contraception. Women of childbearing potential must have a negative serum pregnancy test in the whole study;

Exclusion Criteria:

  • Those with uncontrollable primary diseases of important organs, such as extensive metastasis of malignant tumors, liver failure, heart failure, kidney failure and other diseases;
  • Patients with poor compliance;
  • Positive serology for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and/or hepatitis D virus (HDV), Syphilis; Positive for Epstein-Barr Virus DNA, Cytomegalovirus DNA;
  • Accompanied by extensive and severe bleeding, such as hemoptysis, upper gastrointestinal bleeding, intracranial hemorrhage, etc.
  • There is currently a heart disease requiring treatment or a poorly controlled hypertension judged by the investigator;
  • Patients with thrombotic diseases such as pulmonary embolism, thrombosis, and atherosclerosis;
  • Those who have received allogeneic stem cell transplantation or organ transplantation in the past;
  • Patients with mental disorders who cannot normally obtain informed consent and undergo trials and follow-up;
  • Patients whose toxic symptoms caused by treatment before participating in the trial have not disappeared;
  • Other serious diseases that may restrict participants from participating in this trial (such as diabetes; severe heart failure; myocardial obstruction or unstable arrhythmia or unstable angina in the past 6 months; gastric ulcers; mobility Autoimmune diseases, etc.);
  • Patients with sepsis or patients with other irregular bleeding;
  • Patients taking antiplatelet drugs at the same time;
  • Pregnant women, suspected pregnancy (a positive pregnancy test for human chorionic gonadotropin in urine at screening) and breastfeeding patients;
  • Pre-existing cardiac disease, including congestive heart failure of New York Heart Association [NYHA] Grade III/IV, arrhythmia requiring treatment or myocardial infarction within the last 6 months. No arrhythmia known to increase the risk of thrombotic events (e.g. atrial fibrillation), or patients with a QT >450msec or QTc > 480 for patients with a Bundle Branch Block;
  • Researchers believe that patients should not participate in the test of any other condition.

Sites / Locations

  • Chinese Academy of Medical Science and Blood Disease HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

50 subjects with chemotherapy-induced thrombocytopenia

Arm Description

50 enrolled subjects will be picked up to take eltrombopag at the indicated dose.

Outcomes

Primary Outcome Measures

Changes of the platelet counts after the treatment of eltrombopag
The investigator will assess the changes of the platelet counts after the treatment of eltrombopag from week 1 to week 24.
Incidence of adverse events after the treatment of eltrombopag
The investigator will observe incidence of adverse events after the treatment of eltrombopag, including thrombosis, diarrhea, skin rash, abnormal liver function and so on.

Secondary Outcome Measures

Changes of concentration of TPO in peripheral blood
The investigator will observe the concentration of TPO in peripheral blood before and after the treatment of eltrombopag,if necessary
Changes of concentration of TPO antibodies in peripheral blood
The investigator will observe the concentration of antibodies in peripheral blood ,if necessary
Changes of concentration of anti-c-Mpl antibodies in peripheral blood
The investigator will observe the concentration of antibodies in peripheral blood ,if necessary
Changes of concentration of TPO neutralizing antibodies in peripheral blood
The investigator will observe the concentration of antibodies in peripheral blood ,if necessary

Full Information

First Posted
October 19, 2020
Last Updated
January 24, 2023
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
Collaborators
Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Second Hospital, Tianjin Third Central Hospital, Tianjin People's Hospital, Henan Cancer Hospital, The Second Affiliated Hospital of Kunming Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT04600960
Brief Title
Eltrombopag for Chemotherapy-induced Thrombocytopenia
Official Title
Eltrombopag for Chemotherapy-induced Thrombocytopenia: a Prospective Multi-center One-arm Study in Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 31, 2020 (Actual)
Primary Completion Date
March 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Institute of Hematology & Blood Diseases Hospital, China
Collaborators
Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Second Hospital, Tianjin Third Central Hospital, Tianjin People's Hospital, Henan Cancer Hospital, The Second Affiliated Hospital of Kunming Medical University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To evaluate the efficacy and safety of eltrombopag to treat chemotherapy-induced thrombocytopenia in solid tumors
Detailed Description
This is a single-arm study to evaluate the safety and efficacy of eltrombopag to treat chemotherapy-induced thrombocytopenia(CIT). These subjects have been treated with recombinant human thrombopoietin(rhTPO) or interleukin 11(IL-11) before, the platelets can rise to normal or reach the effective standard, but after the re-application, the effective standard is not reached, or the effective standard is still not reached after the rhTPO 300U/kg/d treatment for 14 days. The investigator will assess the changes of the platelet counts after the treatment of eltrombopag from week 1 to week 24, and observe incidence of adverse events during the treatment of eltrombopag.The investigator will complete the 4 weeks safety visits(once a week),if the subjects end or withdraw from the clinical trial. Patients with chemotherapy-induced thrombocytopenia who had the same inclusion and exclusion criteria in the same period or in the past will be compared with the efficacy and safety of supportive treatment in the same period or history, so as to preliminarily explore and evaluate the efficacy and safety of eltrombopag treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chemotherapy-induced Thrombocytopenia, Eltrombopag

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
50 subjects with chemotherapy-induced thrombocytopenia
Arm Type
Experimental
Arm Description
50 enrolled subjects will be picked up to take eltrombopag at the indicated dose.
Intervention Type
Drug
Intervention Name(s)
Eltrombopag
Intervention Description
The subjects will initiate treatment with 75 mg eltrombopag. Platelet counts is obtained weekly and dose adjustment should be done according to platelet counts, and maximum dose should not exceed 75 mg daily. Subjects whose platelet count ≤100×109/L,the eltrombopag dose will maintain. If platelet count >100×109/L for 2 weeks, the subjects need to reduce the dose of eltrombopag to the next lower dose or lower frequency. If subjects whose platelet count exceeds 100×109/L for 4 weeks,already have reduced the dose of eltrombopag to 25mg once every other day during the treatment period, eltrombopag can be stopped for observation, until platelet counts fall below 100×109/L. If the subjects do not need further chemotherapy or radiotherapy, the subjects can taper off eltrombopag if the platelet is greater than 50×109/L.
Primary Outcome Measure Information:
Title
Changes of the platelet counts after the treatment of eltrombopag
Description
The investigator will assess the changes of the platelet counts after the treatment of eltrombopag from week 1 to week 24.
Time Frame
24 weeks
Title
Incidence of adverse events after the treatment of eltrombopag
Description
The investigator will observe incidence of adverse events after the treatment of eltrombopag, including thrombosis, diarrhea, skin rash, abnormal liver function and so on.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Changes of concentration of TPO in peripheral blood
Description
The investigator will observe the concentration of TPO in peripheral blood before and after the treatment of eltrombopag,if necessary
Time Frame
24 weeks
Title
Changes of concentration of TPO antibodies in peripheral blood
Description
The investigator will observe the concentration of antibodies in peripheral blood ,if necessary
Time Frame
24 weeks
Title
Changes of concentration of anti-c-Mpl antibodies in peripheral blood
Description
The investigator will observe the concentration of antibodies in peripheral blood ,if necessary
Time Frame
24 weeks
Title
Changes of concentration of TPO neutralizing antibodies in peripheral blood
Description
The investigator will observe the concentration of antibodies in peripheral blood ,if necessary
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged ≥18 years old, male or female; Conform to the diagnostic criteria of chemotherapy-induced thrombocytopenia (CIT); Ineffective after repeated treatment with rhTPO or IL-11; Stop radiotherapy or chemotherapy for more than 1 month; Platelet counts <30 ×10^9/L, and bleeding tendency; Estimated survival period ≥ 6 months; People who are willing to sign the informed consent voluntarily and follow the research program. Liver and kidney function<1.5×upper limit of normal, qualified for physical examination; Subject is practicing an acceptable method of contraception. Women of childbearing potential must have a negative serum pregnancy test in the whole study; Exclusion Criteria: Those with uncontrollable primary diseases of important organs, such as extensive metastasis of malignant tumors, liver failure, heart failure, kidney failure and other diseases; Patients with poor compliance; Positive serology for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and/or hepatitis D virus (HDV), Syphilis; Positive for Epstein-Barr Virus DNA, Cytomegalovirus DNA; Accompanied by extensive and severe bleeding, such as hemoptysis, upper gastrointestinal bleeding, intracranial hemorrhage, etc. There is currently a heart disease requiring treatment or a poorly controlled hypertension judged by the investigator; Patients with thrombotic diseases such as pulmonary embolism, thrombosis, and atherosclerosis; Those who have received allogeneic stem cell transplantation or organ transplantation in the past; Patients with mental disorders who cannot normally obtain informed consent and undergo trials and follow-up; Patients whose toxic symptoms caused by treatment before participating in the trial have not disappeared; Other serious diseases that may restrict participants from participating in this trial (such as diabetes; severe heart failure; myocardial obstruction or unstable arrhythmia or unstable angina in the past 6 months; gastric ulcers; mobility Autoimmune diseases, etc.); Patients with sepsis or patients with other irregular bleeding; Patients taking antiplatelet drugs at the same time; Pregnant women, suspected pregnancy (a positive pregnancy test for human chorionic gonadotropin in urine at screening) and breastfeeding patients; Pre-existing cardiac disease, including congestive heart failure of New York Heart Association [NYHA] Grade III/IV, arrhythmia requiring treatment or myocardial infarction within the last 6 months. No arrhythmia known to increase the risk of thrombotic events (e.g. atrial fibrillation), or patients with a QT >450msec or QTc > 480 for patients with a Bundle Branch Block; Researchers believe that patients should not participate in the test of any other condition.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yunfei Chen, MD
Phone
+86-22-23909009
Email
chenyunfei@ihcams.ac.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Lei Zhang, MD
Phone
+86-22-23909240
Email
zhanglei1@ihcams.ac.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lei Zhanglei, MD
Organizational Affiliation
Chinese Academy of Medical Science and Blood Disease Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Chinese Academy of Medical Science and Blood Disease Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yunfei Chen, MD
Phone
+86-22-23909009
Email
chenyunfei@ihcams.ac.cn

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Researchers qualified can request the dataset, including de-identified individual subject data. Data may be requested from PI from 12 months 36 months after study completion.
IPD Sharing Time Frame
From 12 months 36 months after study completion.
IPD Sharing Access Criteria
Upon request to PI.
Citations:
PubMed Identifier
25165041
Citation
Winer ES, Safran H, Karaszewska B, Richards DA, Hartner L, Forget F, Ramlau R, Kumar K, Mayer B, Johnson BM, Messam CA, Mostafa Kamel Y. Eltrombopag with gemcitabine-based chemotherapy in patients with advanced solid tumors: a randomized phase I study. Cancer Med. 2015 Jan;4(1):16-26. doi: 10.1002/cam4.326. Epub 2014 Aug 28.
Results Reference
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PubMed Identifier
28864871
Citation
Winer ES, Safran H, Karaszewska B, Bauer S, Khan D, Doerfel S, Burgess P, Kalambakas S, Mostafa Kamel Y, Forget F. Eltrombopag for thrombocytopenia in patients with advanced solid tumors receiving gemcitabine-based chemotherapy: a randomized, placebo-controlled phase 2 study. Int J Hematol. 2017 Dec;106(6):765-776. doi: 10.1007/s12185-017-2319-9. Epub 2017 Sep 1.
Results Reference
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Eltrombopag for Chemotherapy-induced Thrombocytopenia

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