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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
CSPC ZhongQi Pharmaceutical Technology Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neutropenia and Fever

Eligibility Criteria

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

Inclusion Criteria:

  1. Aged 18 ~ 75 years (inclusive), no gender limitation.
  2. 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).
  3. 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.
  4. Female patients must meet one of the following conditions:

    1. Menopausal patients, menopause at least 1 year;
    2. 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.
  5. Male patients and their partners must use effective contraception throughout the study period and up to 4 weeks after leaving the study.
  6. Patients fully understand and voluntarily participate in this study and sign informed consent.

Exclusion Criteria:

  1. History of allergy to liposomes or amphotericin B.
  2. Received systemic treatment of amphotericin B or amphotericin B-containing formulation within 10 days prior to enrollment.
  3. Liposome used within 1 month before the signing informed consent.
  4. Confirmed or clinically diagnosed invasive fungal infection or known uncontrolled bacteremia or sepsis at screening.
  5. Eastern Cooperative Oncology Group (ECOG) performance status ≥3;
  6. 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.
  7. Serum creatinine > 2 × ULN.
  8. 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.
  9. 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.
  10. Cardiac function grade III/IV (NYHA).
  11. Tachyarrhythmia requiring intervention and a history of high-risk coronary heart disease such as unstable angina and acute coronary syndrome.
  12. Human immunodeficiency virus (HIV) antibody or treponema pallidum specific antibody (TPHA) positive; active tuberculosis on CT of chest (to be determined by investigator).
  13. Pregnant or lactating female.
  14. 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.
  15. Plan to use prohibited drugs during the study period.
  16. Enrolled in any other clinical trials of drugs or medical devices within 3 months prior to screening.
  17. Life expectancy < 2 months;
  18. 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

    First Posted
    September 30, 2021
    Last Updated
    November 1, 2021
    Sponsor
    CSPC ZhongQi Pharmaceutical Technology Co., Ltd.
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    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

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