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Avatrombopag on the Treatment of Thrombocytopenia Induced by Chemotherapy of Malignant Tumors

Primary Purpose

Thrombocytopenia

Status
Completed
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Avatrombopag
Sponsored by
Anhui Provincial Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Thrombocytopenia focused on measuring chemotherapy, rh-TPO, avatrombopag

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female, aged 18~75 years.
  2. Diagnosed with malignant tumors (gynecological tumors, gastrointestinal tumors, lung cancer, gastric cancer and head and neck tumors) by pathology or cytology and need chemotherapy.
  3. The subject had developed at least grade II thrombocytopenia after the last chemotherapy cycle (10×109/L<PLT count<75×109/L).
  4. Subjects' Eastern Cooperative Oncology Group (ECOG) performance status score ≤ 2.
  5. The subjects' life expectancy at the time of screening is ≥12 weeks, and must continue to receive at least 2 cycles of the same chemotherapy regimen at the time of screening.
  6. Women of childbearing age must have taken reliable contraceptive measures, or have a pregnancy test (serum or urine) within 7 days before enrollment, and the result is negative, and are willing to use appropriate methods of contraception during the trial.
  7. The subjects voluntarily and strictly abide by the requirements of the research protocol and sign a written informed consent.

Exclusion Criteria:

  1. Subjects suffer from severe cardiovascular disease: myocardial ischemia or myocardial infarction above grade II, poorly controlled arrhythmia; according to NYHA standards, grade III to IV cardiac insufficiency, or cardiac color Doppler ultrasound examination suggests left ventricular ejection fraction ( LVEF) <50%.
  2. Subjects have clinically significant acute or active bleeding (such as gastrointestinal or central nervous system) within 7 days before screening.
  3. Subjects received major surgery or minor surgery within 4 weeks of enrollment ≤ 3 days.
  4. Subjects had a history of arterial or venous thrombosis (such as myocardial ischemia, transient ischemic attack, or stroke) within 6 months before screening.
  5. Subjects had active infection or acute infection occurred within 2 weeks before the first administration of the study.
  6. Long-term bed rest, subjects with severe vascular disease.
  7. Subjects had a history of chronic thrombocytopenia or bleeding disorders, or a history of thrombocytopenia (such as chronic liver disease or immune thrombocytopenic purpura) caused by causes other than thrombocytopenia caused by chemotherapy.
  8. Subjects had a history of other malignant tumors, such as acute lymphoblastic leukemia, acute myeloid leukemia, any myeloid malignant tumor, myelodysplastic syndrome, myeloproliferative disease, and multiple myeloma.
  9. There are factors that significantly affect the absorption of oral drugs, such as inability to swallow, chronic diarrhea, and intestinal obstruction.
  10. Subjects had an allergic reaction to avatrombopag or any of its excipients.
  11. Subjects participated in clinical studies of other study drugs or devices within 30 days before screening.
  12. The investigator assessed that the subjects had any accompanying medical history that could impair the subject's safety in completing the study, such as renal failure due to hemodialysis or active infection requiring intravenous antibiotics.
  13. Subjects had a history of psychotropic drug abuse and unable to quit or have mental disorders.
  14. Pregnant or breastfeeding women, and fertile patients who are unwilling or unable to take effective contraceptive measures.
  15. The investigator judges other conditions that may affect the conduct of clinical research and the determination of research results.

Sites / Locations

  • Anhui Provincial Cancer Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Avatrombopag Tablets Oral

Arm Description

When patient is diagnosed with thrombocytopenia induced by chemotherapy of malignant tumor, avatrombopag will be given to patients as a therapeutic plan.

Outcomes

Primary Outcome Measures

Proportion of responders
Proportion of patients with platelet count ≥100×10^9/L or increase of platelet count ≥50×10^9/L or ≥100% from baseline within cycle X after initiation of avatrombopag treatment.Due to chemotherapy induced thrombocytopenia in the X+1 cycle, the dose reduction in chemotherapy of X+2 cycle by ≥15% or chemotherapy delay by ≥4 days.

Secondary Outcome Measures

Duration of grade Ⅲ and Ⅳ thrombocytopenia after initiation of avatrombopag treatment
Time for PLT to recover to ≥75×10^9/L and ≥100×10^9/L after initiation of avatrombopag treatment
minimal platelet count
Proportion of patients without platelet transfusion
Proportion of patients without bleeding

Full Information

First Posted
October 4, 2020
Last Updated
April 24, 2022
Sponsor
Anhui Provincial Cancer Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04609891
Brief Title
Avatrombopag on the Treatment of Thrombocytopenia Induced by Chemotherapy of Malignant Tumors
Official Title
A Single-arm, Multi-center, Open Clinical Study of Avatrombopag on the Treatment of Thrombocytopenia Induced by Chemotherapy of Malignant Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
May 26, 2020 (Actual)
Primary Completion Date
May 16, 2021 (Actual)
Study Completion Date
May 16, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Anhui Provincial Cancer Hospital

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
To observe the clinical efficacy and safety of avatrombopag for chemotherapy-induced thrombocytopenia in patients with malignant tumors.
Detailed Description
Tumor is one of the malignant diseases that people face. In 2015, the incidence of malignant tumors was about 3.929 million, and the annual growth rate is about 3.9%. Chemotherapy is currently the most commonly used treatment for patients with tumor, but chemotherapy also brings many other problems, such as thrombocytopenia which can leads to increased medical costs, chemotherapy cycles delayed, and chemotherapy doses reduced. Studies have found that the reduction of the chemotherapy dose and the delay of the chemotherapy cycle will affect the survival rate of patients. So it is an important to solve the problem of chemotherapy-induced thrombocytopenia. Currently, there are some methods to treat thrombocytopenia such as platelet transfusion, rhTPO, rhIL-11 and other methods. However, these methods have some defects, platelets are at risk of ineffective transfusion, rhTPO may produce neutralizing antibodies and rhIL-11 has serious side effects. Therefore, there is an urgent need for safer and faster methods to treat chemotherapy-induced thrombocytopenia. As a new generation of TPO receptor agonist, avatrombopag has the advantages of being taken with food, no hepatotoxicity, good safety, and rapidly increase platelet count. Therefore, avatrombopag has great research value in the treatment of chemotherapy-induced thrombocytopenia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thrombocytopenia
Keywords
chemotherapy, rh-TPO, avatrombopag

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
74 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Avatrombopag Tablets Oral
Arm Type
Experimental
Arm Description
When patient is diagnosed with thrombocytopenia induced by chemotherapy of malignant tumor, avatrombopag will be given to patients as a therapeutic plan.
Intervention Type
Drug
Intervention Name(s)
Avatrombopag
Intervention Description
10×109/L<PLT<75×109/L, avatrombopag tablet 60 mg once a day for 5-10 days.
Primary Outcome Measure Information:
Title
Proportion of responders
Description
Proportion of patients with platelet count ≥100×10^9/L or increase of platelet count ≥50×10^9/L or ≥100% from baseline within cycle X after initiation of avatrombopag treatment.Due to chemotherapy induced thrombocytopenia in the X+1 cycle, the dose reduction in chemotherapy of X+2 cycle by ≥15% or chemotherapy delay by ≥4 days.
Time Frame
up to 2 months
Secondary Outcome Measure Information:
Title
Duration of grade Ⅲ and Ⅳ thrombocytopenia after initiation of avatrombopag treatment
Time Frame
up to 2 months
Title
Time for PLT to recover to ≥75×10^9/L and ≥100×10^9/L after initiation of avatrombopag treatment
Time Frame
up to 2 months
Title
minimal platelet count
Time Frame
up to 2 months
Title
Proportion of patients without platelet transfusion
Time Frame
up to 2 months
Title
Proportion of patients without bleeding
Time Frame
up to 2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, aged 18~75 years. Diagnosed with malignant tumors (gynecological tumors, gastrointestinal tumors, lung cancer, gastric cancer and head and neck tumors) by pathology or cytology and need chemotherapy. The subject had developed at least grade II thrombocytopenia after the last chemotherapy cycle (10×109/L<PLT count<75×109/L). Subjects' Eastern Cooperative Oncology Group (ECOG) performance status score ≤ 2. The subjects' life expectancy at the time of screening is ≥12 weeks, and must continue to receive at least 2 cycles of the same chemotherapy regimen at the time of screening. Women of childbearing age must have taken reliable contraceptive measures, or have a pregnancy test (serum or urine) within 7 days before enrollment, and the result is negative, and are willing to use appropriate methods of contraception during the trial. The subjects voluntarily and strictly abide by the requirements of the research protocol and sign a written informed consent. Exclusion Criteria: Subjects suffer from severe cardiovascular disease: myocardial ischemia or myocardial infarction above grade II, poorly controlled arrhythmia; according to NYHA standards, grade III to IV cardiac insufficiency, or cardiac color Doppler ultrasound examination suggests left ventricular ejection fraction ( LVEF) <50%. Subjects have clinically significant acute or active bleeding (such as gastrointestinal or central nervous system) within 7 days before screening. Subjects received major surgery or minor surgery within 4 weeks of enrollment ≤ 3 days. Subjects had a history of arterial or venous thrombosis (such as myocardial ischemia, transient ischemic attack, or stroke) within 6 months before screening. Subjects had active infection or acute infection occurred within 2 weeks before the first administration of the study. Long-term bed rest, subjects with severe vascular disease. Subjects had a history of chronic thrombocytopenia or bleeding disorders, or a history of thrombocytopenia (such as chronic liver disease or immune thrombocytopenic purpura) caused by causes other than thrombocytopenia caused by chemotherapy. Subjects had a history of other malignant tumors, such as acute lymphoblastic leukemia, acute myeloid leukemia, any myeloid malignant tumor, myelodysplastic syndrome, myeloproliferative disease, and multiple myeloma. There are factors that significantly affect the absorption of oral drugs, such as inability to swallow, chronic diarrhea, and intestinal obstruction. Subjects had an allergic reaction to avatrombopag or any of its excipients. Subjects participated in clinical studies of other study drugs or devices within 30 days before screening. The investigator assessed that the subjects had any accompanying medical history that could impair the subject's safety in completing the study, such as renal failure due to hemodialysis or active infection requiring intravenous antibiotics. Subjects had a history of psychotropic drug abuse and unable to quit or have mental disorders. Pregnant or breastfeeding women, and fertile patients who are unwilling or unable to take effective contraceptive measures. The investigator judges other conditions that may affect the conduct of clinical research and the determination of research results.
Facility Information:
Facility Name
Anhui Provincial Cancer Hospital
City
Hefei
State/Province
Anhui
ZIP/Postal Code
230000
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
36238568
Citation
Cui Y, He Y, Hu C, Tu C, Huang J, Zhu X, Zang C, Ding K, Zhan B, Zhao Y, Qian L. Avatrombopag for the treatment of thrombocytopenia induced by chemotherapy in patients with solid tumors: A multicenter, open-label, single-arm trial. Front Pharmacol. 2022 Sep 27;13:970978. doi: 10.3389/fphar.2022.970978. eCollection 2022.
Results Reference
derived
PubMed Identifier
36191597
Citation
Zhao H, Ren R, Bao S, Qian W, Ma X, Wang R, Li X, Fang R, Sun Q, Tian Y, Zhu C, Shi J. Efficacy and Safety of Polycaprolactone in Treating Nasolabial Folds: A Prospective, Multicenter, and Randomized Controlled Trial. Facial Plast Surg. 2023 Jun;39(3):300-306. doi: 10.1055/a-1954-3986. Epub 2022 Oct 3.
Results Reference
derived

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Avatrombopag on the Treatment of Thrombocytopenia Induced by Chemotherapy of Malignant Tumors

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