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Thrombosomes® in Bleeding Thrombocytopenic Patients Study

Primary Purpose

Thrombocytopenia, Hematologic Malignancy, Bone Marrow Aplasia

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Thrombosomes
Liquid Stored Platelets (LSP)
Sponsored by
Cellphire Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Thrombocytopenia

Eligibility Criteria

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

Inclusion Criteria:

  1. Adults (≥18 years) with TCP as defined by BOTH (a) and (b):

    1. a platlet count of ≤ 70,000 platelets/μL blood
    2. ANY ONE OR MORE of (1-3):

      1. confirmed diagnosis of hematologic malignancy, myeloproliferative disorder, myelodysplastic syndrome, or aplasia
      2. undergoing chemotherapy, immunotherapy, radiation therapy or hematopoietic stem cell transplantation
      3. refractory to platelet transfusion defined as two 1-hour CCI of <5,000 on consecutive transfusions of LSP or as defined by local site policy (Sacher, 2003)
  2. WHO Bleeding Score of 2 or 3
  3. Able to provide informed consent directly or through legally authorized representative, and comply with treatment and monitoring
  4. Negative pregnancy test for women of childbearing potential

Exclusion Criteria:

  1. Any disorder or condition related to any venous thrombosis, embolism, or ischemia within the past 3 months
  2. Any disorder or condition related to arterial thrombosis including: ischemia, stroke, MI, or stent placement, within past 6 months
  3. Any valve replacement and/or repair of left atrial appendance occlusion device
  4. Sinusoidal obstruction syndrom (veno-occlusive disease) or cytopkine release syndrome associated with CAR-T cell therapy
  5. Refusal to accept blood products
  6. Liver enzyme blood levels greater than 3× the upper limit of normal (ULN)
  7. Blood creatinine level greater than 3× ULN
  8. Received platelet inhibitor drugs, cyclooxygenase-2 (COX-2) inhibitors, or nonsteroidal anti-inflammatory drugs within 5 days prior to infusion
  9. Currently (at the time of randomization) receiving anticoagulant therapy or antiplatelet therapy. Low dose prophylaxis for line clots is not excluded.
  10. Receipt of any pro-coagulant agents (e.g., DDAVP, recombinant Factor VIIa or prothrombin complex concentrates (PCC)) other than Tranexamic Acid (TXA) or Epsilon Aminocaproic Acid (EACA, Amicar), within 48 hours of first infusion, or with known hypercoagulable state
  11. WHO Bleeding Score of 2 solely due to lumbar puncture, retinal bleeding or GI bleeding or WHO Bleeding Score of 3 solely due to lumbar puncture
  12. Receiving L-asparaginase as part of a current cycle of treatment
  13. Known inherited or acquired bleeding disorder including, but not limited to: acquired storage pool deficiency or paraproteinemia with platelet inhibition
  14. Known inherited or acquired prothrombotic disorders, including antiphospholipid syndrome (Those with lupus anticoagulant or positive antiphospholipid serology without thrombosis are NOT excluded.)
  15. Anuria
  16. On dialysis
  17. Receipt of an investigational drug within 1 month before first infusion, other than for treatment of their underlying disease
  18. Females pregnant or nursing or unwilling to use contraception during and for 30 days after taking the study product (females). Evidence of effective birth control may be used, at the discretion of the physician
  19. Acute or chronic medical disorder that, in the opinion of the Investigator, would impair the ability of the patient to receive or respond to study treatment
  20. Prior participation in this study with successful infusion of the investigational or control product
  21. Currently enrolled in other trials not related to their primary disease process or involving platelet transfusions, platelet growth factors, or other pro-coagulant agents

Sites / Locations

  • City of Hope
  • Medstar Georgetown
  • Vanderbilt University Medical Center
  • MD Anderson Cancer Center
  • Rambam Medical Center
  • Helse Bergen Haukeland University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Active Comparator

Arm Label

Thrombosomes Low Dose

Thrombosomes Medium Dose

Thrombosomes High Dose

Liquid Stored Platelets (Control)

Arm Description

Outcomes

Primary Outcome Measures

Primary Efficacy Endpoint
Cessation or decrease in bleeding at primary bleeding site, based upon the most severe bleeding location at Day 1 baseline taken with in 12 hours prior to infusion, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score evaluated at 24 hours post initial infusion.

Secondary Outcome Measures

Secondary Efficacy Endpoint assessed by Number of days alive and without WHO (World Health Organization) Grade 2a or greater bleeding
Number of days alive and without WHO (World Health Organization) Grade 2 or greater bleeding through initial 7 days after first Thrombosomes or LSP Infusion
Secondary Efficacy Endpoint assessed by 30 day mortality
30-day mortality post first infusion of Thrombosomes or post first infusion of LSP as control
Secondary Efficacy Endpoint assessed by cessation or decrease in bleeding, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score
Cessation or decrease in primary bleeding site, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score at 24, 48, 72 hours, Day 4, Day 5, Day 6 and Day 7 after first infusion of Thrombosomes or LSP infusion as control.
Secondary Efficacy Endpoint assessed by cessation or decrease in bleeding, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score
Cessation or decrease in each additional bleeding site (other than primary bleeding site), as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score at 24, 48, 72 hours, Day 4, Day 5, Day 6 and Day 7 after first infusion of Thrombosomes or LSP infusion as control.
Secondary Efficacy Endpoint assessed for Number, timing, type and reason for administration of all blood products
Number, timing, type and reason for administration of all blood products including platelets and Thrombosomes during the initial 7 days after first Thrombosomes or LSP infusion
Secondary Efficacy Endpoint assessed by platelet count
Platelet count measured at 24, 48, 72 hours and Day 7 of first infusion of Thrombosomes or LSP. Also evaluate at Day 4-6 if patient is hospitalized at that time.
Secondary Efficacy Endpoint assessed by measures of hematology
Measures of hematology including: Prothrombin Fragment 1+2; thrombin generation assay (TGA); Thrombopoietin; activated Protein C, tissue plasminogen activator (TPA), and plasminogen activator inhibitor (PAI) per schedule of assessments
Secondary Efficacy Endpoint assessed by measures of coagulation
Measures of coagulation including: prothrombin time (PT); international normalized ratio (INR); fibrinogen; D-dimer; activated partial thromboplastin time (aPTT); and thromboelastography (TEG) or rotational thromboelastometry (ROTEM) per schedule of assessments
Secondary Efficacy Endpoint assessed by changes in markers of endothelial cell injury/repair
Changes in markers of endothelial cell injury/repair from preinfusion baseline through 72 hours after first infusion, including: Syndecan-1, hyaluronan, thrombomodulin, vascular endothelial growth factor (VEGF), interleukin 6, sVE cadherin per schedule of assessments.

Full Information

First Posted
November 5, 2020
Last Updated
May 22, 2023
Sponsor
Cellphire Therapeutics, Inc.
Collaborators
Department of Health and Human Services
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1. Study Identification

Unique Protocol Identification Number
NCT04631211
Brief Title
Thrombosomes® in Bleeding Thrombocytopenic Patients Study
Official Title
A Prospective, Multicenter, Randomized, Open-Label Phase 2, Parallel, Dose Ranging Multidose Study of Thrombosomes® vs Liquid Stored Platelets (LSP) in Bleeding Thrombocytopenic Patients
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Terminated
Why Stopped
This study was terminated due to loss of funding for this indication from the Biomedical Advanced Research and Development Authority (BARDA) in November 2022.
Study Start Date
March 5, 2021 (Actual)
Primary Completion Date
January 7, 2022 (Actual)
Study Completion Date
January 7, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cellphire Therapeutics, Inc.
Collaborators
Department of Health and Human Services

4. Oversight

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

5. Study Description

Brief Summary
This prospective, multicenter, randomized, open-label, Phase 2, parallel, dose ranging, multidose trial will enroll patients into 3 Thrombosomes dose groups and 1 control liquid stored platelets (LSP) group in order to evaluate, in a dose-escalation manner, the safety, and impact on bleeding, and the preliminary effect on coagulation measures of increasing doses of allogeneic Thrombosomes in comparison to standard of care, LSP.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thrombocytopenia, Hematologic Malignancy, Bone Marrow Aplasia, Myeloproliferative Disorders, Myelodysplastic Syndromes, Platelet Refractoriness

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Dose Ranging Multidose
Masking
None (Open Label)
Allocation
Randomized
Enrollment
21 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Thrombosomes Low Dose
Arm Type
Experimental
Arm Title
Thrombosomes Medium Dose
Arm Type
Experimental
Arm Title
Thrombosomes High Dose
Arm Type
Experimental
Arm Title
Liquid Stored Platelets (Control)
Arm Type
Active Comparator
Intervention Type
Biological
Intervention Name(s)
Thrombosomes
Intervention Description
Human platelet derived lyophilized hemostatic
Intervention Type
Biological
Intervention Name(s)
Liquid Stored Platelets (LSP)
Intervention Description
Leukocyte reduced apheresis platelets or whole blood derived pooled platelet concentrate equivalent (4-6 units)
Primary Outcome Measure Information:
Title
Primary Efficacy Endpoint
Description
Cessation or decrease in bleeding at primary bleeding site, based upon the most severe bleeding location at Day 1 baseline taken with in 12 hours prior to infusion, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score evaluated at 24 hours post initial infusion.
Time Frame
Evaluated at 24 hours post initial infusion
Secondary Outcome Measure Information:
Title
Secondary Efficacy Endpoint assessed by Number of days alive and without WHO (World Health Organization) Grade 2a or greater bleeding
Description
Number of days alive and without WHO (World Health Organization) Grade 2 or greater bleeding through initial 7 days after first Thrombosomes or LSP Infusion
Time Frame
7 days after first Thrombosomes or LSP infusion
Title
Secondary Efficacy Endpoint assessed by 30 day mortality
Description
30-day mortality post first infusion of Thrombosomes or post first infusion of LSP as control
Time Frame
30 days post first infusion (+/- 2 days)
Title
Secondary Efficacy Endpoint assessed by cessation or decrease in bleeding, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score
Description
Cessation or decrease in primary bleeding site, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score at 24, 48, 72 hours, Day 4, Day 5, Day 6 and Day 7 after first infusion of Thrombosomes or LSP infusion as control.
Time Frame
24, 48, 72 hours, Day 4, Day 5, Day 6 and Day 7 post first infusion
Title
Secondary Efficacy Endpoint assessed by cessation or decrease in bleeding, as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score
Description
Cessation or decrease in each additional bleeding site (other than primary bleeding site), as evidenced by ordinal change in WHO (World Health Organization) Bleeding Score at 24, 48, 72 hours, Day 4, Day 5, Day 6 and Day 7 after first infusion of Thrombosomes or LSP infusion as control.
Time Frame
24, 48, 72 hours, Day 4, Day 5, Day 6 and Day 7 post first infusion
Title
Secondary Efficacy Endpoint assessed for Number, timing, type and reason for administration of all blood products
Description
Number, timing, type and reason for administration of all blood products including platelets and Thrombosomes during the initial 7 days after first Thrombosomes or LSP infusion
Time Frame
7 days after first Thrombosomes or LSP infusion
Title
Secondary Efficacy Endpoint assessed by platelet count
Description
Platelet count measured at 24, 48, 72 hours and Day 7 of first infusion of Thrombosomes or LSP. Also evaluate at Day 4-6 if patient is hospitalized at that time.
Time Frame
24, 48, 72 hours and Day 7 post first infusion
Title
Secondary Efficacy Endpoint assessed by measures of hematology
Description
Measures of hematology including: Prothrombin Fragment 1+2; thrombin generation assay (TGA); Thrombopoietin; activated Protein C, tissue plasminogen activator (TPA), and plasminogen activator inhibitor (PAI) per schedule of assessments
Time Frame
From baseline through last study visit (up to 30 days (+/- 2 days))
Title
Secondary Efficacy Endpoint assessed by measures of coagulation
Description
Measures of coagulation including: prothrombin time (PT); international normalized ratio (INR); fibrinogen; D-dimer; activated partial thromboplastin time (aPTT); and thromboelastography (TEG) or rotational thromboelastometry (ROTEM) per schedule of assessments
Time Frame
From baseline through last study visit (up to 30 days (+/- 2 days))
Title
Secondary Efficacy Endpoint assessed by changes in markers of endothelial cell injury/repair
Description
Changes in markers of endothelial cell injury/repair from preinfusion baseline through 72 hours after first infusion, including: Syndecan-1, hyaluronan, thrombomodulin, vascular endothelial growth factor (VEGF), interleukin 6, sVE cadherin per schedule of assessments.
Time Frame
From baseline through last study visit (up to 30 days (+/- 2 days))
Other Pre-specified Outcome Measures:
Title
Safety Endpoint
Description
Serious Adverse Events (SAEs)
Time Frame
From baseline through last study visit (up to 30 days (+/- 2 days))
Title
Safety Endpoint
Description
Adverse Events (AEs)
Time Frame
From baseline through last study visit (up to 30 days (+/- 2 days))
Title
Safety Endpoint
Description
Unanticipated problems involving risk to human subjects
Time Frame
From baseline through last study visit (up to 30 days (+/- 2 days))

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adults (≥18 years) with TCP as defined by BOTH (a) and (b): a platlet count of ≤ 70,000 platelets/μL blood ANY ONE OR MORE of (1-3): confirmed diagnosis of hematologic malignancy, myeloproliferative disorder, myelodysplastic syndrome, or aplasia undergoing chemotherapy, immunotherapy, radiation therapy or hematopoietic stem cell transplantation refractory to platelet transfusion defined as two 1-hour CCI of <5,000 on consecutive transfusions of LSP or as defined by local site policy (Sacher, 2003) WHO Bleeding Score of 2 or 3 Able to provide informed consent directly or through legally authorized representative, and comply with treatment and monitoring Negative pregnancy test for women of childbearing potential Exclusion Criteria: Any disorder or condition related to any venous thrombosis, embolism, or ischemia within the past 3 months Any disorder or condition related to arterial thrombosis including: ischemia, stroke, MI, or stent placement, within past 6 months Any valve replacement and/or repair of left atrial appendance occlusion device Sinusoidal obstruction syndrom (veno-occlusive disease) or cytopkine release syndrome associated with CAR-T cell therapy Refusal to accept blood products Liver enzyme blood levels greater than 3× the upper limit of normal (ULN) Blood creatinine level greater than 3× ULN Received platelet inhibitor drugs, cyclooxygenase-2 (COX-2) inhibitors, or nonsteroidal anti-inflammatory drugs within 5 days prior to infusion Currently (at the time of randomization) receiving anticoagulant therapy or antiplatelet therapy. Low dose prophylaxis for line clots is not excluded. Receipt of any pro-coagulant agents (e.g., DDAVP, recombinant Factor VIIa or prothrombin complex concentrates (PCC)) other than Tranexamic Acid (TXA) or Epsilon Aminocaproic Acid (EACA, Amicar), within 48 hours of first infusion, or with known hypercoagulable state WHO Bleeding Score of 2 solely due to lumbar puncture, retinal bleeding or GI bleeding or WHO Bleeding Score of 3 solely due to lumbar puncture Receiving L-asparaginase as part of a current cycle of treatment Known inherited or acquired bleeding disorder including, but not limited to: acquired storage pool deficiency or paraproteinemia with platelet inhibition Known inherited or acquired prothrombotic disorders, including antiphospholipid syndrome (Those with lupus anticoagulant or positive antiphospholipid serology without thrombosis are NOT excluded.) Anuria On dialysis Receipt of an investigational drug within 1 month before first infusion, other than for treatment of their underlying disease Females pregnant or nursing or unwilling to use contraception during and for 30 days after taking the study product (females). Evidence of effective birth control may be used, at the discretion of the physician Acute or chronic medical disorder that, in the opinion of the Investigator, would impair the ability of the patient to receive or respond to study treatment Prior participation in this study with successful infusion of the investigational or control product Currently enrolled in other trials not related to their primary disease process or involving platelet transfusions, platelet growth factors, or other pro-coagulant agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Terry Gernsheimer, MD
Organizational Affiliation
University of Washington
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mike Fitzpatrick, PhD
Organizational Affiliation
Cellphire Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Medstar Georgetown
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Rambam Medical Center
City
Haifa
Country
Israel
Facility Name
Helse Bergen Haukeland University Hospital
City
Bergen
Country
Norway

12. IPD Sharing Statement

Plan to Share IPD
No

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Thrombosomes® in Bleeding Thrombocytopenic Patients Study

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