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A Combined Study in Pediatric Cancer Patients for Dose Ranging and Efficacy/Safety of Plerixafor Plus Standard Regimens for Mobilization Versus Standard Regimens Alone

Primary Purpose

Ewing's Sarcoma/Soft Tissue Sarcoma, Neuroblastoma, Brain Tumors

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
plerixafor
plerixafor
plerixafor
Sponsored by
Genzyme, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ewing's Sarcoma/Soft Tissue Sarcoma

Eligibility Criteria

1 Year - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 2 to < 18 years during stage 1 and 1 to < 18 years during stage 2
  • Ewing's sarcoma, soft tissue sarcoma, lymphoma, neuroblastoma, brain tumors or other malignancy (excluding any form of leukemia) requiring treatment with high dose chemotherapy and autologous transplant as rescue therapy
  • Eligible for autologous transplantation
  • Recovered from all acute significant toxic effects of prior chemotherapy
  • Adequate performance status (for patients ≥16 years of age, defined as Karnofsky score >60 and for patients <16 years of age, defined as Lansky score >60)
  • Absolute neutrophil count >0.75 × 10^9/L
  • Platelet count >50 × 10^9/L
  • Calculated creatinine clearance (using the Schwartz method): during study Stage 1, >80 mL/min/1.73m^2 and during study Stage 2, >60 mL/min/1.73m^2
  • Aspartate aminotransferase(AST)/serum glutamic oxaloacetic transaminase(SGOT), alanine aminotransferase(ALT)/serum glutamic pyruvic transaminase (SGPT) and total bilirubin <3 × upper limit of normal
  • The patient and/or their parent/legal guardian is willing and able to provide signed informed consent
  • Patients who are sexually active must be willing to abstain from sexual intercourse or agree to use an approved form of contraception while receiving plerixafor and/or standard mobilization treatment and for at least 3 months following any plerixafor treatment

Exclusion Criteria:

  • Any form of leukemia
  • A co-morbid condition which, in the view of the Investigator, renders the patient at high-risk from treatment complications
  • Previous stem cell transplantation
  • Persistent high percentage marrow involvement prior to mobilization will be prohibited.
  • On-going toxicities (excluding alopecia) Grade ≥2 resulting from prior chemotherapy
  • Acute infection
  • Fever (temperature >38.5°C) - if fever is between 37°C and 38.5°C, infection must be excluded as a cause
  • Known HIV seropositivity, AIDS, hepatitis C or active hepatitis B infections
  • Positive pregnancy test in post pubertal girls
  • History of clinically significant cardiac abnormality or arrhythmia
  • Use of an investigational drug which is not approved in any indication either in adults or pediatrics within 2 weeks prior to the first dose of G-CSF to be administered as part of the patient's planned standard mobilization regimen, and/or during the study up until engraftment of the transplant. If patients are on investigational drugs as part of their anti-cancer regimen, this should be discussed with the Sponsor before screening. Drugs approved for other indications that are being used in a manner considered standard of care for this transplant procedure are allowed
  • The patient (and/or their parent/legal guardian), in the opinion of the Investigator, is unable to adhere to the requirements of the study

Sites / Locations

  • Investigational Site Number 51
  • Investigational Site Number 81
  • Investigational Site Number 82
  • Investigational Site Number 61
  • Investigational Site Number 42
  • Investigational Site Number 43
  • Investigational Site Number 33
  • Investigational Site Number 34
  • Investigational Site Number 35
  • Investigational Site Number 31
  • Investigational Site Number 36
  • Investigational Site Number 83
  • Investigational Site Number 92
  • Investigational Site Number 91
  • Investigational Site Number 21
  • Investigational Site Number 24
  • Investigational Site Number 23
  • Investigational Site Number 22
  • Investigational Site Number 26
  • Investigational Site Number 72
  • Investigational Site Number 71
  • Investigational Site Number 85
  • Investigational Site Number 84
  • Investigational Site Number 94
  • Investigational Site Number 93
  • Investigational Site Number 11
  • Investigational Site Number 13

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Plerixafor 160 μg/kg

Plerixafor 240 μg/kg

Plerixafor 320 μg/kg

Arm Description

Patients will receive subcutaneous (SC) injection of 160 μg/kg plerixafor in addition to their standard mobilization regimen. Each dose of plerixafor will be administered in the evening 9 to 11 hours prior to apheresis (up to a maximum of 5 apheresis sessions).

Patients will receive subcutaneous (SC) injection of 240 μg/kg plerixafor in addition to their standard mobilization regimen. Each dose of plerixafor will be administered in the evening 9 to 11 hours prior to apheresis (up to a maximum of 5 apheresis sessions).

Patients will receive subcutaneous (SC) injection of 320 μg/kg plerixafor in addition to their standard mobilization regimen. Each dose of plerixafor will be administered in the evening 9 to 11 hours prior to apheresis (up to a maximum of 5 apheresis sessions).

Outcomes

Primary Outcome Measures

Proportion of patients achieving at least a doubling of peripheral blood CD34+ count during Stage 2

Secondary Outcome Measures

Number of days of apheresis required to reach ≥2 × 10^6 CD34+ cells/kg
During Stage 1 and Stage 2
Yield of CD34+ cells for each apheresis
During Stage 1 and Stage 2
Total CD34+ cell yield
During Stage 1 and Stage 2
Percentage of patients proceeding to transplant
During Stage 1 and Stage 2
Percentage of patients successfully engrafting
During Stage 1 and Stage 2
Percentage of patients with durable engraftment
During Stage 1 and Stage 2
Summary of adverse events (AEs)
During Stage 1 and Stage 2
Duration of hospitalizations (planned or unplanned)
During Stage 1 and Stage 2
Mobilization of tumor cells into peripheral blood
During Stage 1 and Stage 2
Relapse rates
During Stage 1 and Stage 2
Occurrence of secondary malignancies
During Stage 1 and Stage 2
Incidence of primary and secondary graft failure
During Stage 1 and Stage 2
Time to secondary graft failure
During Stage 1 and Stage 2
Survival rates
During Stage 1 and Stage 2

Full Information

First Posted
January 28, 2011
Last Updated
May 15, 2017
Sponsor
Genzyme, a Sanofi Company
Collaborators
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT01288573
Brief Title
A Combined Study in Pediatric Cancer Patients for Dose Ranging and Efficacy/Safety of Plerixafor Plus Standard Regimens for Mobilization Versus Standard Regimens Alone
Official Title
A Phase 1/2 Combined Dose Ranging and Randomized, Open-label, Comparative Study of the Efficacy and Safety of Plerixafor in Addition to Standard Regimens for Mobilization of Haematopoietic Stem Cells Into Peripheral Blood, and Subsequent Collection by Apheresis, Versus Standard Mobilization Regimens Alone in Pediatric Patients, Aged 1 to <18 Years, With Solid Tumours Eligible for Autologous Transplants.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
March 3, 2014 (undefined)
Primary Completion Date
May 9, 2017 (Actual)
Study Completion Date
May 9, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genzyme, a Sanofi Company
Collaborators
Sanofi

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multi-site study with plerixafor in pediatric cancer patients. The study will be conducted in 2 stages: Stage 1 is a dose-escalation study. Stage 2 is an open-label, randomized, comparative study using the appropriate dosing regimen identified in the Stage 1 dose-escalation study. All participating patients will receive a standard mobilization regimen as per study site practice guidelines (either chemotherapy plus once daily granulocyte-colony stimulating factor (G-CSF) or once daily G-CSF alone). The only change to the standard mobilization regimen is the addition of plerixafor treatment prior to apheresis for all patients in Stage 1 (dose escalation), and for those patients randomized to the plerixafor plus standard mobilization treatment arm in Stage 2 (randomized, comparative). Stage 1 will enroll at least 27 patients. Stage 2 will enroll at least 40 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ewing's Sarcoma/Soft Tissue Sarcoma, Neuroblastoma, Brain Tumors

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Plerixafor 160 μg/kg
Arm Type
Experimental
Arm Description
Patients will receive subcutaneous (SC) injection of 160 μg/kg plerixafor in addition to their standard mobilization regimen. Each dose of plerixafor will be administered in the evening 9 to 11 hours prior to apheresis (up to a maximum of 5 apheresis sessions).
Arm Title
Plerixafor 240 μg/kg
Arm Type
Experimental
Arm Description
Patients will receive subcutaneous (SC) injection of 240 μg/kg plerixafor in addition to their standard mobilization regimen. Each dose of plerixafor will be administered in the evening 9 to 11 hours prior to apheresis (up to a maximum of 5 apheresis sessions).
Arm Title
Plerixafor 320 μg/kg
Arm Type
Experimental
Arm Description
Patients will receive subcutaneous (SC) injection of 320 μg/kg plerixafor in addition to their standard mobilization regimen. Each dose of plerixafor will be administered in the evening 9 to 11 hours prior to apheresis (up to a maximum of 5 apheresis sessions).
Intervention Type
Drug
Intervention Name(s)
plerixafor
Intervention Description
160 μg/kg subcutaneous (SC) injection
Intervention Type
Drug
Intervention Name(s)
plerixafor
Intervention Description
240 μg/kg subcutaneous (SC) injection
Intervention Type
Drug
Intervention Name(s)
plerixafor
Intervention Description
320 μg/kg subcutaneous (SC) injection
Primary Outcome Measure Information:
Title
Proportion of patients achieving at least a doubling of peripheral blood CD34+ count during Stage 2
Time Frame
Up to 5 days
Secondary Outcome Measure Information:
Title
Number of days of apheresis required to reach ≥2 × 10^6 CD34+ cells/kg
Description
During Stage 1 and Stage 2
Time Frame
Up to 5 days
Title
Yield of CD34+ cells for each apheresis
Description
During Stage 1 and Stage 2
Time Frame
Up to 5 days
Title
Total CD34+ cell yield
Description
During Stage 1 and Stage 2
Time Frame
Up to 5 days
Title
Percentage of patients proceeding to transplant
Description
During Stage 1 and Stage 2
Time Frame
Within 6 months of last apheresis
Title
Percentage of patients successfully engrafting
Description
During Stage 1 and Stage 2
Time Frame
3, 6, 12 and 24 months post-transplant
Title
Percentage of patients with durable engraftment
Description
During Stage 1 and Stage 2
Time Frame
3, 6, 12 and 24 months post-transplant
Title
Summary of adverse events (AEs)
Description
During Stage 1 and Stage 2
Time Frame
Up to 24 months after last transplant or 24 months after last dose (for patients that do not transplant within 6 months of last apheresis)
Title
Duration of hospitalizations (planned or unplanned)
Description
During Stage 1 and Stage 2
Time Frame
Throughout the duration of the study
Title
Mobilization of tumor cells into peripheral blood
Description
During Stage 1 and Stage 2
Time Frame
Up to 5 days
Title
Relapse rates
Description
During Stage 1 and Stage 2
Time Frame
3, 6, 12 and 24 months post-transplant
Title
Occurrence of secondary malignancies
Description
During Stage 1 and Stage 2
Time Frame
3, 6, 12 and 24 months post-transplant
Title
Incidence of primary and secondary graft failure
Description
During Stage 1 and Stage 2
Time Frame
3, 6, 12 and 24 months post-transplant
Title
Time to secondary graft failure
Description
During Stage 1 and Stage 2
Time Frame
Up to 24 months post-transplant
Title
Survival rates
Description
During Stage 1 and Stage 2
Time Frame
3, 6, 12 and 24 months post-transplant

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 2 to < 18 years during stage 1 and 1 to < 18 years during stage 2 Ewing's sarcoma, soft tissue sarcoma, lymphoma, neuroblastoma, brain tumors or other malignancy (excluding any form of leukemia) requiring treatment with high dose chemotherapy and autologous transplant as rescue therapy Eligible for autologous transplantation Recovered from all acute significant toxic effects of prior chemotherapy Adequate performance status (for patients ≥16 years of age, defined as Karnofsky score >60 and for patients <16 years of age, defined as Lansky score >60) Absolute neutrophil count >0.75 × 10^9/L Platelet count >50 × 10^9/L Calculated creatinine clearance (using the Schwartz method): during study Stage 1, >80 mL/min/1.73m^2 and during study Stage 2, >60 mL/min/1.73m^2 Aspartate aminotransferase(AST)/serum glutamic oxaloacetic transaminase(SGOT), alanine aminotransferase(ALT)/serum glutamic pyruvic transaminase (SGPT) and total bilirubin <3 × upper limit of normal The patient and/or their parent/legal guardian is willing and able to provide signed informed consent Patients who are sexually active must be willing to abstain from sexual intercourse or agree to use an approved form of contraception while receiving plerixafor and/or standard mobilization treatment and for at least 3 months following any plerixafor treatment Exclusion Criteria: Any form of leukemia A co-morbid condition which, in the view of the Investigator, renders the patient at high-risk from treatment complications Previous stem cell transplantation Persistent high percentage marrow involvement prior to mobilization will be prohibited. On-going toxicities (excluding alopecia) Grade ≥2 resulting from prior chemotherapy Acute infection Fever (temperature >38.5°C) - if fever is between 37°C and 38.5°C, infection must be excluded as a cause Known HIV seropositivity, AIDS, hepatitis C or active hepatitis B infections Positive pregnancy test in post pubertal girls History of clinically significant cardiac abnormality or arrhythmia Use of an investigational drug which is not approved in any indication either in adults or pediatrics within 2 weeks prior to the first dose of G-CSF to be administered as part of the patient's planned standard mobilization regimen, and/or during the study up until engraftment of the transplant. If patients are on investigational drugs as part of their anti-cancer regimen, this should be discussed with the Sponsor before screening. Drugs approved for other indications that are being used in a manner considered standard of care for this transplant procedure are allowed The patient (and/or their parent/legal guardian), in the opinion of the Investigator, is unable to adhere to the requirements of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Sciences & Operations
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site Number 51
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Facility Name
Investigational Site Number 81
City
Brno
ZIP/Postal Code
62500
Country
Czechia
Facility Name
Investigational Site Number 82
City
Praha 5 - Motol
ZIP/Postal Code
15006
Country
Czechia
Facility Name
Investigational Site Number 61
City
København Ø
ZIP/Postal Code
2100
Country
Denmark
Facility Name
Investigational Site Number 42
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
Investigational Site Number 43
City
Paris Cedex 05
ZIP/Postal Code
75248
Country
France
Facility Name
Investigational Site Number 33
City
Frankfurt Am Main
ZIP/Postal Code
60590
Country
Germany
Facility Name
Investigational Site Number 34
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Investigational Site Number 35
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Investigational Site Number 31
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Investigational Site Number 36
City
München
ZIP/Postal Code
80337
Country
Germany
Facility Name
Investigational Site Number 83
City
Budapest
ZIP/Postal Code
1097
Country
Hungary
Facility Name
Investigational Site Number 92
City
Petach Tikva
ZIP/Postal Code
4920235
Country
Israel
Facility Name
Investigational Site Number 91
City
Tel-Aviv
ZIP/Postal Code
64239
Country
Israel
Facility Name
Investigational Site Number 21
City
Genova
ZIP/Postal Code
16100
Country
Italy
Facility Name
Investigational Site Number 24
City
Milano
ZIP/Postal Code
20133
Country
Italy
Facility Name
Investigational Site Number 23
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Investigational Site Number 22
City
Roma
ZIP/Postal Code
00165
Country
Italy
Facility Name
Investigational Site Number 26
City
Torino
ZIP/Postal Code
10126
Country
Italy
Facility Name
Investigational Site Number 72
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands
Facility Name
Investigational Site Number 71
City
Rotterdam
ZIP/Postal Code
3015 GJ
Country
Netherlands
Facility Name
Investigational Site Number 85
City
Krakow
ZIP/Postal Code
30-663
Country
Poland
Facility Name
Investigational Site Number 84
City
Wroclaw
ZIP/Postal Code
50-368
Country
Poland
Facility Name
Investigational Site Number 94
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Investigational Site Number 93
City
Madrid
ZIP/Postal Code
28009
Country
Spain
Facility Name
Investigational Site Number 11
City
Birmingham
ZIP/Postal Code
B4 6NH
Country
United Kingdom
Facility Name
Investigational Site Number 13
City
Glasgow
ZIP/Postal Code
G51 4TF
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
36163427
Citation
Sebastien B, Cheverton P, Magnin C, Aouni J, Castan R. Development and validation of a predictive model to guide the use of plerixafor in pediatric population. Bone Marrow Transplant. 2022 Dec;57(12):1827-1832. doi: 10.1038/s41409-022-01831-2. Epub 2022 Sep 26.
Results Reference
derived
PubMed Identifier
32127657
Citation
Morland B, Kepak T, Dallorso S, Sevilla J, Murphy D, Luksch R, Yaniv I, Bader P, Rossler J, Bisogno G, Maecker-Kolhoff B, Lang P, Zwaan CM, Sumerauer D, Krivan G, Bernard J, Liu Q, Doyle E, Locatelli F. Plerixafor combined with standard regimens for hematopoietic stem cell mobilization in pediatric patients with solid tumors eligible for autologous transplants: two-arm phase I/II study (MOZAIC). Bone Marrow Transplant. 2020 Sep;55(9):1744-1753. doi: 10.1038/s41409-020-0836-2. Epub 2020 Mar 3.
Results Reference
derived

Learn more about this trial

A Combined Study in Pediatric Cancer Patients for Dose Ranging and Efficacy/Safety of Plerixafor Plus Standard Regimens for Mobilization Versus Standard Regimens Alone

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