A Study of Amphotericin B Liposome for Injection in Patients With Persistent Neutropenia and Fever
Primary Purpose
Neutropenia and Fever
Status
Unknown status
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Amphotericin B liposomes
Sponsored by
About this trial
This is an interventional treatment trial for Neutropenia and Fever
Eligibility Criteria
Inclusion Criteria:
- Aged 18 ~ 75 years (inclusive), no gender limitation.
- Patients with neutrophilic deficiency after solid tumor chemotherapy, hematological tumor chemotherapy, hematopoietic stem cell transplantation, etc. (absolute neutrophil count (ANC) in peripheral blood <500 /mm^3 (0.5×10^9 /L) for at least 72 hours at screening).
- Persistent or recurrent fever (oral temperature ≥38℃ or axillary temperature ≥37.7℃ within 24 hours prior to randomization) after at least 72 hours on broad-spectrum antibiotics, and considering fever to be associated with suspected fungal infection.
Female patients must meet one of the following conditions:
- Menopausal patients, menopause at least 1 year;
- Patients of childbearing age: Negative for blood/urine pregnancy test before enrollment; agree to take a guaranteed, effective contraception during the study and within 4 weeks after the study.
- Male patients and their partners must use effective contraception throughout the study period and up to 4 weeks after leaving the study.
- Patients fully understand and voluntarily participate in this study and sign informed consent.
Exclusion Criteria:
- History of allergy to liposomes or amphotericin B.
- Received systemic treatment of amphotericin B or amphotericin B-containing formulation within 10 days prior to enrollment.
- Liposome used within 1 month before the signing informed consent.
- Confirmed or clinically diagnosed invasive fungal infection or known uncontrolled bacteremia or sepsis at screening.
- Eastern Cooperative Oncology Group (ECOG) performance status ≥3;
- Abnormal liver function, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≥5 × the upper limit of normal (ULN), or ALT/AST ≥3 × ULN with total bilirubin ≥1.5 × ULN, or total bilirubin ≥3 × ULN.
- Serum creatinine > 2 × ULN.
- Serum potassium concentration ≤3.0 mmol/L prior to the first administration, or serum potassium concentration ≤the lower limit of normal value (LLN) in patients undergoing digitalization.
- 12-lead ECG presenting II or III degree atrioventricular block, long QT syndrome or corrected QT interval>480 ms in the absence of a pacemaker.
- Cardiac function grade III/IV (NYHA).
- Tachyarrhythmia requiring intervention and a history of high-risk coronary heart disease such as unstable angina and acute coronary syndrome.
- Human immunodeficiency virus (HIV) antibody or treponema pallidum specific antibody (TPHA) positive; active tuberculosis on CT of chest (to be determined by investigator).
- Pregnant or lactating female.
- A history of drug abuse (non-medical use of narcotic drugs or psychotropic substances) or drug dependence (narcotics, stimulants and psychotropic substances, etc.) within 2 years.
- Plan to use prohibited drugs during the study period.
- Enrolled in any other clinical trials of drugs or medical devices within 3 months prior to screening.
- Life expectancy < 2 months;
- Not suitable for this study as decided by the investigator due to other reasons
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Amphotericin B liposomes
Arm Description
Patients with suspected fungal neutropenia and fever will receive amphotericin B liposome 3 mg/kg intravenously. Treatment will be continued until the ANC≥500 /mm^3 (0.5×10^9 /L) for more than 72 hrs in terms of patients without evidence of baseline fungal infection and breakthrough fungal infection; or treatment will be continued according to investigator's judgement with a duration ranging from 14 days to 12 weeks in terms of patients with evidence of baseline fungal infection and breakthrough fungal infection.
Outcomes
Primary Outcome Measures
Overall success rate
A successful outcome is defined as fulfilling all components of a prespecified 5-part composite endpoint.
Secondary Outcome Measures
Percentage of patients without new fungal infections from the initiation of the first dose to 7 days after the last dose
Percentage of patients without new fungal infections
Percentage of patients survived from the initiation of the first dose to 7 days after the last dose
Percentage of patients survived
Percentage of patients without discontinuation of study drug due to side effects or lack of efficacy during the treatment period
Percentage of patients without discontinuation of study drug due to side effects or lack of efficacy
Percentage of patients experienced fever reduction during neutropenia after initiation of treatment
Percentage of patients experienced fever reduction during neutropenia
Percentage of patients with complete or partial remission of confirmed or clinically diagnosed IFD (baseline fungal infection) at the end of treatment
Percentage of patients with complete or partial remission of confirmed or clinically diagnosed Invasive fungal disease (baseline fungal infection)
Adverse events
Adverse events
Pharmacokinetic profile of amphotericin B
Pharmacokinetic profile of amphotericin B, Such as "Peak Plasma Concentration (Cmax)"
Pharmacokinetic profile of amphotericin B
Full Information
NCT ID
NCT05108545
First Posted
September 30, 2021
Last Updated
November 1, 2021
Sponsor
CSPC ZhongQi Pharmaceutical Technology Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT05108545
Brief Title
A Study of Amphotericin B Liposome for Injection in Patients With Persistent Neutropenia and Fever
Official Title
A Multicenter, Open-label, Phase Ⅲ Study to Evaluate the Efficacy and Safety of Amphotericin B Liposome for Injection in Patients With Persistent Febrile Neutropenia
Study Type
Interventional
2. Study Status
Record Verification Date
September 2021
Overall Recruitment Status
Unknown status
Study Start Date
December 15, 2021 (Anticipated)
Primary Completion Date
July 31, 2022 (Anticipated)
Study Completion Date
January 15, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CSPC ZhongQi Pharmaceutical Technology Co., Ltd.
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
This is a multicenter, open-label, single-arm, phase III study to evaluate the safety and efficacy of Amphotericin B liposomes in patients with persistent neutropenia and fever.
Detailed Description
This is a multicenter, open-label, single-arm, phase III study to evaluate the safety and efficacy of Amphotericin B liposomes in patients with persistent neutropenia and fever. About 93 patients will be recruited in this study. The patients will receive Amphotericin B liposomes intravenous infusion at a dose of 3 mg/kg over 2 hours once daily (qd) for a maximum of 12 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neutropenia and Fever
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
93 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Amphotericin B liposomes
Arm Type
Experimental
Arm Description
Patients with suspected fungal neutropenia and fever will receive amphotericin B liposome 3 mg/kg intravenously. Treatment will be continued until the ANC≥500 /mm^3 (0.5×10^9 /L) for more than 72 hrs in terms of patients without evidence of baseline fungal infection and breakthrough fungal infection; or treatment will be continued according to investigator's judgement with a duration ranging from 14 days to 12 weeks in terms of patients with evidence of baseline fungal infection and breakthrough fungal infection.
Intervention Type
Drug
Intervention Name(s)
Amphotericin B liposomes
Intervention Description
Amphotericin B liposomes for injection, 3 mg/kg, qd, IV
Primary Outcome Measure Information:
Title
Overall success rate
Description
A successful outcome is defined as fulfilling all components of a prespecified 5-part composite endpoint.
Time Frame
From the initiation of the third dose to 7 days after the last dose
Secondary Outcome Measure Information:
Title
Percentage of patients without new fungal infections from the initiation of the first dose to 7 days after the last dose
Description
Percentage of patients without new fungal infections
Time Frame
From the initiation of the third dose to 7 days after the last dose
Title
Percentage of patients survived from the initiation of the first dose to 7 days after the last dose
Description
Percentage of patients survived
Time Frame
From the initiation of the third dose to 7 days after the last dose
Title
Percentage of patients without discontinuation of study drug due to side effects or lack of efficacy during the treatment period
Description
Percentage of patients without discontinuation of study drug due to side effects or lack of efficacy
Time Frame
From the initiation of the third dose to 7 days after the last dose
Title
Percentage of patients experienced fever reduction during neutropenia after initiation of treatment
Description
Percentage of patients experienced fever reduction during neutropenia
Time Frame
From the initiation of the third dose to 7 days after the last dose
Title
Percentage of patients with complete or partial remission of confirmed or clinically diagnosed IFD (baseline fungal infection) at the end of treatment
Description
Percentage of patients with complete or partial remission of confirmed or clinically diagnosed Invasive fungal disease (baseline fungal infection)
Time Frame
From the initiation of the third dose to 7 days after the last dose
Title
Adverse events
Description
Adverse events
Time Frame
From the screening period to 14 days after the last dose
Title
Pharmacokinetic profile of amphotericin B
Description
Pharmacokinetic profile of amphotericin B, Such as "Peak Plasma Concentration (Cmax)"
Time Frame
Pre-dose and multiple timepoints up to 4 hours of the last dose
Title
Pharmacokinetic profile of amphotericin B
Time Frame
Pre-dose and multiple timepoints up to 4 hours of the last dosePharmacokinetic profile of amphotericin B, Such as "Area under the plasma concentration versus time curve (AUC)"
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:
Aged 18 ~ 75 years (inclusive), no gender limitation.
Patients with neutrophilic deficiency after solid tumor chemotherapy, hematological tumor chemotherapy, hematopoietic stem cell transplantation, etc. (absolute neutrophil count (ANC) in peripheral blood <500 /mm^3 (0.5×10^9 /L) for at least 72 hours at screening).
Persistent or recurrent fever (oral temperature ≥38℃ or axillary temperature ≥37.7℃ within 24 hours prior to randomization) after at least 72 hours on broad-spectrum antibiotics, and considering fever to be associated with suspected fungal infection.
Female patients must meet one of the following conditions:
Menopausal patients, menopause at least 1 year;
Patients of childbearing age: Negative for blood/urine pregnancy test before enrollment; agree to take a guaranteed, effective contraception during the study and within 4 weeks after the study.
Male patients and their partners must use effective contraception throughout the study period and up to 4 weeks after leaving the study.
Patients fully understand and voluntarily participate in this study and sign informed consent.
Exclusion Criteria:
History of allergy to liposomes or amphotericin B.
Received systemic treatment of amphotericin B or amphotericin B-containing formulation within 10 days prior to enrollment.
Liposome used within 1 month before the signing informed consent.
Confirmed or clinically diagnosed invasive fungal infection or known uncontrolled bacteremia or sepsis at screening.
Eastern Cooperative Oncology Group (ECOG) performance status ≥3;
Abnormal liver function, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≥5 × the upper limit of normal (ULN), or ALT/AST ≥3 × ULN with total bilirubin ≥1.5 × ULN, or total bilirubin ≥3 × ULN.
Serum creatinine > 2 × ULN.
Serum potassium concentration ≤3.0 mmol/L prior to the first administration, or serum potassium concentration ≤the lower limit of normal value (LLN) in patients undergoing digitalization.
12-lead ECG presenting II or III degree atrioventricular block, long QT syndrome or corrected QT interval>480 ms in the absence of a pacemaker.
Cardiac function grade III/IV (NYHA).
Tachyarrhythmia requiring intervention and a history of high-risk coronary heart disease such as unstable angina and acute coronary syndrome.
Human immunodeficiency virus (HIV) antibody or treponema pallidum specific antibody (TPHA) positive; active tuberculosis on CT of chest (to be determined by investigator).
Pregnant or lactating female.
A history of drug abuse (non-medical use of narcotic drugs or psychotropic substances) or drug dependence (narcotics, stimulants and psychotropic substances, etc.) within 2 years.
Plan to use prohibited drugs during the study period.
Enrolled in any other clinical trials of drugs or medical devices within 3 months prior to screening.
Life expectancy < 2 months;
Not suitable for this study as decided by the investigator due to other reasons
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xuefang Xia
Phone
+86-010-63932012
Email
xiaxuefang@mail.ecspc.com
12. IPD Sharing Statement
Learn more about this trial
A Study of Amphotericin B Liposome for Injection in Patients With Persistent Neutropenia and Fever
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