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A Pralatrexate Study in Asian Patients With Peripheral T-cell Lymphoma After Prior Therapy

Primary Purpose

Peripheral T Cell Lymphoma, Progression, Disease

Status
Unknown status
Phase
Phase 4
Locations
Taiwan
Study Type
Interventional
Intervention
Pralatrexate
Sponsored by
Taiwan Mundipharma Pharmaceuticals Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral T Cell Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  1. At least 20 years of age, inclusive
  2. Patients with histologically/cytologically confirmed PTCL using either: NCCN diagnosis criteria, the Revised European American Lymphoma (REAL), and World Health Organization (WHO) disease classification (PTCL histology/cytology subtypes diagnosed by site investigators, PTCL histology/cytology subtypes rechecked by study central pathology lab):

    1. At least 5 patients with Peripheral T-cell lymphoma, NOS
    2. At least 5 patients with Angioimmunoblastic T-cell lymphoma
    3. At least 5 patients with Extranodal NK/T-cell lymphoma, nasal type
    4. Enteropathy-type T-cell lymphoma
    5. Hepatosplenic T-cell lymphoma
    6. Subcutaneous panniculitis-like T-cell lymphoma
    7. Adult T-cell lymphoma/leukemia (human T-cell leukemia virus [HTLV] 1+)
  3. Patients with documented progressive disease (PD) failed after prior treatment

    1. Patients may not have received an experimental drug as their only prior therapy
    2. Patient has had at least 1 biopsy from initial diagnosis of PTCL or in the relapsed setting to confirm PTCL subtypes
    3. Patient has recovered from the toxic effects of prior therapy
  4. Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2.
  5. Adequate hematological, hepatic, and renal function as defined by: absolute neutrophil count (ANC) ≥ 1000/µL, platelet count ≥ 100,000/µL (and ≥ 50,000/µL for any following dose), total bilirubin ≤ 1.5 mg/dL, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 X upper limit of normal (ULN) (AST/ALT < 5 X ULN if documented hepatic involvement with lymphoma), creatinine ≤ 1.5 mg/dL or a calculated creatinine clearance ≥ 50 mL/min.
  6. Women of childbearing potential must agree to practice medically acceptable contraceptive regimen from 30 days prior to study treatment initiation until at least 30 days after the last administration of pralatrexate and must have had a negative serum pregnancy test within 14 days prior to the first day of study treatment. Patients who are postmenopausal for at least 1 year (> 12 months since last menses) or were surgically sterilized do not require this test.
  7. Men who are not surgically sterile must agree to practice a medically acceptable contraceptive regimen from study treatment initiation until at least 90 days after the last administration of pralatrexate.
  8. Patient has provided written informed consent (IC)

Exclusion Criteria:

  1. Patient has following subtypes (histologically/cytologically confirmed) of PTCL

    1. Anaplastic large cell lymphoma, ALK +/-
    2. Patient has: Precursor T/NK neoplasms, with the exception of blastic NK lymphoma
    3. T-cell prolymphocytic leukemia (T-PLL)
    4. T-cell large granular lymphocytic leukemia
    5. Mycosis fungoides and transformed mycosis fungoides
    6. Sézary syndrome
    7. Primary cutaneous CD30+ disorders: Anaplastic large cell lymphoma and lymphomatoid papulosis
    8. Patient has: Extranodal NK/T-cell lymphoma, nasal type with local recurrence
  2. Active concurrent malignancy (except for non-melanoma skin cancer or carcinoma in situ of the cervix). If there is a history of prior malignancy, the patient must be disease-free for ≥ 5 years.
  3. Congestive heart failure Class III/IV according to the New York Heart Association's Heart Failure guidelines.
  4. Patients with human immunodeficiency virus (HIV)-positive diagnosis and are receiving combination anti-retroviral therapy.
  5. Current or the history of brain metastases or central nervous system (CNS) diseases
  6. Have undergone allogeneic stem cell transplant
  7. Relapsed less than 75 days from time of autologous stem cell transplant
  8. Patients with uncontrolled hypertension, active uncontrolled infection, underlying medical condition including unstable cardiac disease, or other serious illness that would impair the ability of the patient to receive protocol treatment
  9. Had major surgery within 2 weeks of study entry
  10. Receipt of any conventional chemotherapy or radiation therapy (RT) within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to study treatment or planned use during the course of the study
  11. Receipt of corticosteroids within 7 days of study treatment, unless patient has been taking a stable dose of no more than 10 mg/day of prednisone for at least 1 month
  12. Use of any investigational drug, biologic modifier, or device within 4 weeks prior to study treatment or planned use during the course of the study
  13. Previous exposure to pralatrexate
  14. Other conditions that investigators consider not suitable for study enrollment

Sites / Locations

  • Ntional Taiwan University HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pralatrexate treatment

Arm Description

Pralatrexate will initially be administered at a dose of 30 mg/m2/week on days 1, 8, 15, 22, 29 and 36 for 6 weeks in a 7-week cycle (cycle: 6 weeks + 1 week rest). The scheduled date can be done within a window time of plus or minus 1 day

Outcomes

Primary Outcome Measures

Objective Response Rate
Objective response rate (ORR) to pralatrexate treatment in Asian PTCL patients after prior treatment failure, as determined by independent imaging reviewer(s) using international workshop lymphoma response criteria (IWC)

Secondary Outcome Measures

Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Incidence of adverse events (AE) and serious adverse events (SAE) emergent from the treatment
Overall survival
Duration of overall survival (months)
Progression-free survival
Duration of PFS (months)
Completion response rate
The percentage of CR
Partial response rate
The percentage of PR
Duration of CR and PR
Duration of completion response and partial response (days)
Treatment duration
Treatment duration with pralatrexate in the patients without HSCT who achieve CR or PR
Hematopoietic stem cell transplant (HSCT)
Percentage of patients who undergo HSCT
1-year OS rate after HSCT
1-year overall survival rate after conducting HSCT
1-year PFS rate after HSCT
1-year progression-free survival rate after conducting HSCT
1-year relapse rate after HSCT
1-year relapse rate after conducting HSCT
2-year OS rate after HSCT
2-year overall survival rate after conducting HSCT
2-year PFS rate after HSCT
2-year progression-free survival rate after conducting HSCT
2-year relapse rate after HSCT
2-year relapse rate after conducting HSCT

Full Information

First Posted
May 5, 2017
Last Updated
May 10, 2017
Sponsor
Taiwan Mundipharma Pharmaceuticals Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03150602
Brief Title
A Pralatrexate Study in Asian Patients With Peripheral T-cell Lymphoma After Prior Therapy
Official Title
A Multi-Center, Open-Labelled, Pralatrexate Study in Asian Patients With Peripheral T-cell Lymphoma After Prior Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Unknown status
Study Start Date
August 30, 2016 (Actual)
Primary Completion Date
December 31, 2020 (Anticipated)
Study Completion Date
December 31, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Taiwan Mundipharma Pharmaceuticals 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 study is to evaluate the objective response rate to pralatrexate in Asian PTCL patients after prior treatment failure, as determined by independent imaging reviewer(s) using international workshop lymphoma response criteria (IWC)
Detailed Description
Peripheral T-cell lymphomas (PTCL) are a group of aggressive and diverse lymphoproliferative disorders. It is characterized by the presence of malignant mature T-cells or NK cells. There is as yet no consensus regarding standard frontline or relapsed/refractory therapy for PTCL. A previous phase II study conducted in US showed durable responses of pralatrexate treatment in relapsed or refractory PTCL, irrespective of age, histological subtypes, amount of prior therapy, prior methotrexate, and prior autologous stem-cell transplant. This single-arm, multi-center study aims to evaluate the efficacy and safety of pralatrexate monotherapy in prior treatment failure PTCL patients who may undergo HSCT in case of CR or PR, or continue pralatrexate in case of CR, PR or SD. Primary objective: To evaluate the objective response rate to pralatrexate in Asian PTCL patients after prior treatment failure, as determined by independent imaging reviewer(s) using international workshop lymphoma response criteria (IWC) Secondary objectives: To determine the safety of pralatrexate in Asian PTCL patients by, Incidence of adverse events (AEs) and serious adverse events (SAEs) emergent from the treatment To evaluate the efficacy of pralatrexate in Asian PTCL patients after prior treatment failure by, Overall survival (OS), progression-free-survival (PFS), complete response (CR) and partial response (PR) rate, and duration of CR and PR Treatment duration with pralatrexate in the patients without hematopoietic stem cell transplant (HSCT) who achieve CR or PR Percentage of patients who undergo HSCT 1-year OS, 1-year PFS, and 1-year relapse rate after HSCT 2-year OS, 2-year PFS, and 2-year relapse rate after HSCT

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral T Cell Lymphoma, Progression, Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pralatrexate treatment
Arm Type
Experimental
Arm Description
Pralatrexate will initially be administered at a dose of 30 mg/m2/week on days 1, 8, 15, 22, 29 and 36 for 6 weeks in a 7-week cycle (cycle: 6 weeks + 1 week rest). The scheduled date can be done within a window time of plus or minus 1 day
Intervention Type
Drug
Intervention Name(s)
Pralatrexate
Other Intervention Name(s)
Folotyn
Intervention Description
This is a single arm study. Pralatrexate will be administered via IV over 3-5 minutes into a IV line containing normal saline (0.9% sodium chloride, NaCl) with the initial dose of 30 mg/m2/week on days 1, 8, 15, 22, 29, and 36 for 6 weeks in a 7-week cycle. The scheduled date can be done within a window time of plus or minus 1 day. The pralatrexate dose may be reduced to 20 mg/m2/week or omit if a patient experiences adverse events. Pralatrexate administration can be up to 5 cycles or until subject meets withdrawal criteria.
Primary Outcome Measure Information:
Title
Objective Response Rate
Description
Objective response rate (ORR) to pralatrexate treatment in Asian PTCL patients after prior treatment failure, as determined by independent imaging reviewer(s) using international workshop lymphoma response criteria (IWC)
Time Frame
Up to 35 weeks
Secondary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Description
Incidence of adverse events (AE) and serious adverse events (SAE) emergent from the treatment
Time Frame
Up to 40 weeks
Title
Overall survival
Description
Duration of overall survival (months)
Time Frame
Up to 5 years
Title
Progression-free survival
Description
Duration of PFS (months)
Time Frame
Up to 5 years
Title
Completion response rate
Description
The percentage of CR
Time Frame
Up to 5 years
Title
Partial response rate
Description
The percentage of PR
Time Frame
Up to 5 years
Title
Duration of CR and PR
Description
Duration of completion response and partial response (days)
Time Frame
Up to 5 years
Title
Treatment duration
Description
Treatment duration with pralatrexate in the patients without HSCT who achieve CR or PR
Time Frame
Up to 35 weeks
Title
Hematopoietic stem cell transplant (HSCT)
Description
Percentage of patients who undergo HSCT
Time Frame
Up to 5 years
Title
1-year OS rate after HSCT
Description
1-year overall survival rate after conducting HSCT
Time Frame
Up to 1 year
Title
1-year PFS rate after HSCT
Description
1-year progression-free survival rate after conducting HSCT
Time Frame
Up to 1 year
Title
1-year relapse rate after HSCT
Description
1-year relapse rate after conducting HSCT
Time Frame
Up to 1 year
Title
2-year OS rate after HSCT
Description
2-year overall survival rate after conducting HSCT
Time Frame
Up to 2 years
Title
2-year PFS rate after HSCT
Description
2-year progression-free survival rate after conducting HSCT
Time Frame
Up to 2 years
Title
2-year relapse rate after HSCT
Description
2-year relapse rate after conducting HSCT
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At least 20 years of age, inclusive Patients with histologically/cytologically confirmed PTCL using either: NCCN diagnosis criteria, the Revised European American Lymphoma (REAL), and World Health Organization (WHO) disease classification (PTCL histology/cytology subtypes diagnosed by site investigators, PTCL histology/cytology subtypes rechecked by study central pathology lab): At least 5 patients with Peripheral T-cell lymphoma, NOS At least 5 patients with Angioimmunoblastic T-cell lymphoma At least 5 patients with Extranodal NK/T-cell lymphoma, nasal type Enteropathy-type T-cell lymphoma Hepatosplenic T-cell lymphoma Subcutaneous panniculitis-like T-cell lymphoma Adult T-cell lymphoma/leukemia (human T-cell leukemia virus [HTLV] 1+) Patients with documented progressive disease (PD) failed after prior treatment Patients may not have received an experimental drug as their only prior therapy Patient has had at least 1 biopsy from initial diagnosis of PTCL or in the relapsed setting to confirm PTCL subtypes Patient has recovered from the toxic effects of prior therapy Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2. Adequate hematological, hepatic, and renal function as defined by: absolute neutrophil count (ANC) ≥ 1000/µL, platelet count ≥ 100,000/µL (and ≥ 50,000/µL for any following dose), total bilirubin ≤ 1.5 mg/dL, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 X upper limit of normal (ULN) (AST/ALT < 5 X ULN if documented hepatic involvement with lymphoma), creatinine ≤ 1.5 mg/dL or a calculated creatinine clearance ≥ 50 mL/min. Women of childbearing potential must agree to practice medically acceptable contraceptive regimen from 30 days prior to study treatment initiation until at least 30 days after the last administration of pralatrexate and must have had a negative serum pregnancy test within 14 days prior to the first day of study treatment. Patients who are postmenopausal for at least 1 year (> 12 months since last menses) or were surgically sterilized do not require this test. Men who are not surgically sterile must agree to practice a medically acceptable contraceptive regimen from study treatment initiation until at least 90 days after the last administration of pralatrexate. Patient has provided written informed consent (IC) Exclusion Criteria: Patient has following subtypes (histologically/cytologically confirmed) of PTCL Anaplastic large cell lymphoma, ALK +/- Patient has: Precursor T/NK neoplasms, with the exception of blastic NK lymphoma T-cell prolymphocytic leukemia (T-PLL) T-cell large granular lymphocytic leukemia Mycosis fungoides and transformed mycosis fungoides Sézary syndrome Primary cutaneous CD30+ disorders: Anaplastic large cell lymphoma and lymphomatoid papulosis Patient has: Extranodal NK/T-cell lymphoma, nasal type with local recurrence Active concurrent malignancy (except for non-melanoma skin cancer or carcinoma in situ of the cervix). If there is a history of prior malignancy, the patient must be disease-free for ≥ 5 years. Congestive heart failure Class III/IV according to the New York Heart Association's Heart Failure guidelines. Patients with human immunodeficiency virus (HIV)-positive diagnosis and are receiving combination anti-retroviral therapy. Current or the history of brain metastases or central nervous system (CNS) diseases Have undergone allogeneic stem cell transplant Relapsed less than 75 days from time of autologous stem cell transplant Patients with uncontrolled hypertension, active uncontrolled infection, underlying medical condition including unstable cardiac disease, or other serious illness that would impair the ability of the patient to receive protocol treatment Had major surgery within 2 weeks of study entry Receipt of any conventional chemotherapy or radiation therapy (RT) within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to study treatment or planned use during the course of the study Receipt of corticosteroids within 7 days of study treatment, unless patient has been taking a stable dose of no more than 10 mg/day of prednisone for at least 1 month Use of any investigational drug, biologic modifier, or device within 4 weeks prior to study treatment or planned use during the course of the study Previous exposure to pralatrexate Other conditions that investigators consider not suitable for study enrollment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Bor-Sheng Ko, PhD
Phone
886-23123456
Ext
63576
Email
kevinkomd@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Brook Chung, MSc
Phone
886-87297521
Email
brook.chung@mundipharma.com.tw
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bor-Sheng Ko, PhD
Organizational Affiliation
National Taiwan University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ntional Taiwan University Hospital
City
Taipei
ZIP/Postal Code
100
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bor-Sheng Ko, PhD
Phone
886-23123456
Ext
63576
Email
kevinkomd@gmail.com
First Name & Middle Initial & Last Name & Degree
Brook Chung, MSc
Phone
886-87297521
Email
brook.chung@mundipharma.com.tw
First Name & Middle Initial & Last Name & Degree
Bor-Sheng Ko, PhD

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
17512649
Citation
Savage KJ. Peripheral T-cell lymphomas. Blood Rev. 2007 Jul;21(4):201-16. doi: 10.1016/j.blre.2007.03.001. Epub 2007 May 18.
Results Reference
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PubMed Identifier
23730495
Citation
Shustov A. Novel therapies for peripheral T-cell lymphomas. Ther Adv Hematol. 2013 Jun;4(3):173-87. doi: 10.1177/2040620713481980.
Results Reference
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PubMed Identifier
18385450
Citation
Savage KJ, Harris NL, Vose JM, Ullrich F, Jaffe ES, Connors JM, Rimsza L, Pileri SA, Chhanabhai M, Gascoyne RD, Armitage JO, Weisenburger DD; International Peripheral T-Cell Lymphoma Project. ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project. Blood. 2008 Jun 15;111(12):5496-504. doi: 10.1182/blood-2008-01-134270. Epub 2008 Apr 2.
Results Reference
background
Citation
Society TLL, Peripheral T-Cell Lymphoma Facts, 2014.
Results Reference
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PubMed Identifier
12854905
Citation
Wang ES, O'Connor O, She Y, Zelenetz AD, Sirotnak FM, Moore MA. Activity of a novel anti-folate (PDX, 10-propargyl 10-deazaaminopterin) against human lymphoma is superior to methotrexate and correlates with tumor RFC-1 gene expression. Leuk Lymphoma. 2003 Jun;44(6):1027-35. doi: 10.1080/1042819031000077124.
Results Reference
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PubMed Identifier
10999734
Citation
Krug LM, Ng KK, Kris MG, Miller VA, Tong W, Heelan RT, Leon L, Leung D, Kelly J, Grant SC, Sirotnak FM. Phase I and pharmacokinetic study of 10-propargyl-10-deazaaminopterin, a new antifolate. Clin Cancer Res. 2000 Sep;6(9):3493-8. Erratum In: Clin Cancer Res 2001 Apr;7(4):1102.
Results Reference
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PubMed Identifier
21245435
Citation
O'Connor OA, Pro B, Pinter-Brown L, Bartlett N, Popplewell L, Coiffier B, Lechowicz MJ, Savage KJ, Shustov AR, Gisselbrecht C, Jacobsen E, Zinzani PL, Furman R, Goy A, Haioun C, Crump M, Zain JM, Hsi E, Boyd A, Horwitz S. Pralatrexate in patients with relapsed or refractory peripheral T-cell lymphoma: results from the pivotal PROPEL study. J Clin Oncol. 2011 Mar 20;29(9):1182-9. doi: 10.1200/JCO.2010.29.9024. Epub 2011 Jan 18.
Results Reference
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A Pralatrexate Study in Asian Patients With Peripheral T-cell Lymphoma After Prior Therapy

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