search
Back to results

IDH2-Post-Allo-Trial for Patients With IDH2-mut Myeloid Neoplasms After Allo-SCT

Primary Purpose

Leukemia, Myeloid, Acute, Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia

Status
Active
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Enasidenib
Sponsored by
Heinrich-Heine University, Duesseldorf
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Myeloid, Acute focused on measuring IDH2 Gene Mutation, MDS, CMML, AML, allogeneic blood stem cell transplantation, maintenance, consolidation

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with myeloid malignancy (AML, MDS and CMML) and known IDH2 mutation (IDH2 R172 or R140 mutation) at diagnosis prior to first allo-SCT
  • hematological CR after allo-SCT determined during screening period between day +25 and day +35 (the hematological remission will be confirmed locally by cytomorphological/histological evaluation)
  • Hematopoietic recovery after transplantation indicated by an absolute neutrophil count of at least 1.000/µl and platelet count of at least 50.000/µl
  • no previous therapy with Enasidenib or any other IDH2 inhibitor
  • ECOG performance status ≤ 2 at study entry (s. Appendix)
  • no active, steroid refractory GvHD treated with additional systemic immunosuppression within 4 weeks before inclusion
  • no uncontrolled infection at inclusion
  • Understand and voluntarily sign an informed consent form.
  • Age ≥18 years at the time of signing the informed consent form.
  • Able to adhere to the study visit schedule and other protocol requirements.
  • Female of childbearing potential (FCBP) must:

Understand that Enasidenib can cause embryo-fetal harm when administered to a pregnant woman Agree to have a medically supervised pregnancy test within 72 hours prior study start and at day 1 of every treatment cycle Use effective contraception during treatment with Enasidenib and for at least 2 months after the last dose Coadministration of Enasidenib may increase or decrease the concentrations of combined hormonal contraceptives Avoid becoming pregnant while receiving Enasidenib Notify her study doctor immediately if there is a risk of pregnancy Agree to abstain from breastfeeding during study participation and for at least 30 days after study drug discontinuation Understand that Enasidenib may impair fertility in females of reproductive potential and this effect may be not reversible

- Males must: Understand that Enasidenib can cause embryo-fetal harm Use effective contraception during treatment with Enasidenib and for at least 2 months after the last dose of Enasidenib if engaged in sexual activity with a pregnant female or a female with childbearing potential Agree to notify the investigator immediately, if pregnancy or a positive pregnancy test occurs in his partner during study participation Understand that Enasidenib may impair fertility in males of reproductive potential and this effect may be not reversible

Exclusion Criteria:

  • Any evidence of hematological relapse of the underlying IDH2-mutated myeloid malignancy (AML, MDS and CMML) determined during screening period until start of treatment
  • Any previous prophylactic therapy given within the interval between allo-SCT and screening period
  • Patients with myeloid malignancy (AML, MDS and CMML) and known IDH2 mutation (IDH2 R172 or R140 mutation) after second allo-SCT
  • Active, steroid refractory GvHD treated with additional systemic immunosuppression within the last 4 weeks
  • Uncontrolled infection
  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or lactating females
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study
  • Impaired renal function (GFR < 30 ml/min)
  • Impaired hepatic function, as follows:

Aspartate aminotransferase (19) ≥3 x ULN or Alanine aminotransferase (ALT) ≥3 x ULN or Total bilirubin ≥3 x ULN or Alkaline Phosphatase ≥3 x ULN

  • Known hypersensitivity to Enasidenib or any other component of the treatment
  • Prior history of malignancy other than AML, MDS or CMML (except basal and squamous cell carcinoma or carcinoma in situ of the cervix or breast) unless the subject has been free of disease for ≥3 years
  • Concurrent use of other anti-cancer agents or treatments
  • Known positive for HIV or active infectious hepatitis, type A, B or C
  • Participation in another study with ongoing use of unlicensed investigational product from 28 days before study enrollment until the end of the study (in cases where the investigational product has an unusually long half-life (e.g. antibodies), the interval until study enrollment must be at least five times the plasma half-life of the investigational product)

Sites / Locations

  • University Hospital Duesseldorf Dept. of Hematology, Oncology and Clinical Immunology
  • Uniklinik RWTH Aachen Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation (Med. Klinik IV)
  • Universitätsklinikum Carl Gustav Carus Medizinische Klinik und Poliklinik I
  • Universitätsklinikum Essen Klinik für Hämatologie und Stammzelltransplantation
  • Universitätsklinikum Frankfurt Med. Klinik II
  • Universitätsklinikum Hamburg-Eppendorf Interdisziplinäre Klinik für Stammzelltransplantation
  • Universitätsklinikum Heidelberg Innere Medizin V: Hämatologie, Onkologie und Rheumatologie
  • Universitätsklinikum Köln Klinik I für Innere Medizin
  • Universitätsklinikum Leipzig Medizinische Klinik und Poliklinik I, Hämatologie und Zelltherapie
  • Klinikum rechts der Isar der TU München Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie
  • Universitätsklinikum Münster Medizinische Klinik A / KMT Zentrum

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Consolidation Arm

Arm Description

Enasidenib (investigational product) will be started on day 1 for 28 days every 28 days for a maximum of 12 cycles. The starting dose of Enasidenib will be 100 mg once daily in every patient and may be reduced individually according to a dose modification scheme.

Outcomes

Primary Outcome Measures

Type, incidence and severity of adverse events specifying seriousness and expectedness (AE, SAE, SUSAR)
Number of participants with Adverse Events as assessed by CTCAE v5.0

Secondary Outcome Measures

Number of participants who maintain remission (molecular/hematological) after allo-SCT
Number of participants who maintain Remission (molecular/hematological) as a measure of efficacy
Overall Survival
Days from start of Treatment and from date of allo-SCT until death or last follow up as a measure of efficacy
Relapse-free Survival
Days from evaluation of remission at screening and from date of allo-SCT until relapse, death, or last follow up as a measure of efficacy
Non-relapse mortality
Days from evaluation of remission at screening and from date of allo-SCT until death without relapse or last follow up as a measure of efficacy
Relapse incidence
number of participants that relapse during the study as a measure of efficacy
Numbers of Participants Meeting Criteria of Treatment Failure
Number of participants who require any cellular or pharmacological intervention due to pending or frank relapse (defined as treatment-failure) as a measure of efficacy
Correlation of cytogenetics/molecular alterations and relapse-free survival
Comparison of relapse-free survival between different cytogenetics/molecular subtypes as a measure of efficacy using time to event curves and log-rank test
Incidence, course and severity of aGvHD and cGvHD
Incidence, course and severity of aGvHD and cGvHD as a measure of safety
Number of hospitalizations
Number of hospitalizations per participant as a measure of safety
Number of participants who require dose reductions for toxicity reasons
Number of participants who require dose reductions for toxicity reasons as a measure of safety
Number of participants who have to stop consolidation therapy due to toxicity (Consolidation Arm)
Number of participants who have to stop consolidation therapy due to toxicity as a measure of safety (Consolidation Arm)
Number of participants who can receive all 12 cycles of consolidation therapy(Consolidation Arm)
Number of participants who can receive all 12 cycles of consolidation therapy as a measure of Safety (Consolidation Arm)
Number of screened participants that can start consolidation therapy within the envisaged time frame (Consolidation Arm)
Number of screened participants that can start consolidation therapy within the envisaged time Frame as a measure of safety (Consolidation Arm)

Full Information

First Posted
May 29, 2020
Last Updated
July 28, 2022
Sponsor
Heinrich-Heine University, Duesseldorf
Collaborators
Celgene Corporation, Koordinierungszentrum für Klinische Studien Düsseldorf
search

1. Study Identification

Unique Protocol Identification Number
NCT04522895
Brief Title
IDH2-Post-Allo-Trial for Patients With IDH2-mut Myeloid Neoplasms After Allo-SCT
Official Title
IDH2-Post-Allo-Trial: Enasidenib as Consolidation or Salvage Therapy for Patients With IDH2 Mutated AML or MDS Following Allogeneic Blood Stem Cell Transplantation
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 27, 2020 (Actual)
Primary Completion Date
August 30, 2024 (Anticipated)
Study Completion Date
August 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Heinrich-Heine University, Duesseldorf
Collaborators
Celgene Corporation, Koordinierungszentrum für Klinische Studien Düsseldorf

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, open label, single arm, multi-centre phase II trial aiming to evaluate the safety and efficacy of Enasidenib (investigational product) as prophylactic consolidation in patients with IDH2-mutated MDS, CMML and AML in remission after allo-SCT.
Detailed Description
This is a prospective, open label, single arm, multi-centre phase II trial aiming to evaluate the safety and efficacy of Enasidenib (investigational product) as prophylactic consolidation in patients with IDH2-mutated MDS, CMML and AML in remission after allo-SCT. Study Design: interventional prospective, open-label, single arm, multicenter phase-II trial total patients sample size: 50 patients number of trial sites: 11 all located in Germany and members of the EBMT Patients with AML, MDS and CMML, in whom an IDH2 mutation has been detected at diagnosis prior allo-SCT, are eligible for consolidation therapy, if they are in complete hematological remission after first allo-SCT. IDH2 mutation might be absent at this time (CRMRDnegative), or might be detectable at submicroscopical levels (CRMRDpositive) given the high sensitivity of detection methods nowadays available. Remission will be evaluated within a screening period between day +25 and day +35. Evaluation of remission will be performed locally with IDH2 mutation analysis performed at an experienced local laboratory of the respective center. The report about IDH2 mutation testing at diagnosis has to be sent to the principle investigator for review at screening to include the patient; a BM sample will be stored for central retesting, which will be performed in batch during the course of the study. Having a documented hematological CR, patients will enter the treatment phase within 30 days after this BM evaluation (latest time point day +65) and start treatment with Enasidenib. They are envisaged to receive Enasidenib (100 mg per day, day 1-28) for up to 12 cycles (=12 months). Patients will go off protocol prematurely in case of relapse, intolerability of study treatment and in case of withdrawal of consent. In those patients who relapse during study treatment subsequent therapy for relapse will be performed according to the choice of the individual treating physician. Patients who finish study as planned or prematurely will be regularly followed for one year, lost to follow up, death or withdrawal of consent.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Myeloid, Acute, Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia, IDH2 Gene Mutation, IDH2 R172, IDH2 R140
Keywords
IDH2 Gene Mutation, MDS, CMML, AML, allogeneic blood stem cell transplantation, maintenance, consolidation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
single arm
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Consolidation Arm
Arm Type
Experimental
Arm Description
Enasidenib (investigational product) will be started on day 1 for 28 days every 28 days for a maximum of 12 cycles. The starting dose of Enasidenib will be 100 mg once daily in every patient and may be reduced individually according to a dose modification scheme.
Intervention Type
Drug
Intervention Name(s)
Enasidenib
Intervention Description
Participants receive up to 12 cycles of Enasidenib.
Primary Outcome Measure Information:
Title
Type, incidence and severity of adverse events specifying seriousness and expectedness (AE, SAE, SUSAR)
Description
Number of participants with Adverse Events as assessed by CTCAE v5.0
Time Frame
through study completion, an average of 2 years
Secondary Outcome Measure Information:
Title
Number of participants who maintain remission (molecular/hematological) after allo-SCT
Description
Number of participants who maintain Remission (molecular/hematological) as a measure of efficacy
Time Frame
through study completion, an average of 2 years
Title
Overall Survival
Description
Days from start of Treatment and from date of allo-SCT until death or last follow up as a measure of efficacy
Time Frame
through study completion, an average of 2 years
Title
Relapse-free Survival
Description
Days from evaluation of remission at screening and from date of allo-SCT until relapse, death, or last follow up as a measure of efficacy
Time Frame
through study completion, an average of 2 years
Title
Non-relapse mortality
Description
Days from evaluation of remission at screening and from date of allo-SCT until death without relapse or last follow up as a measure of efficacy
Time Frame
through study completion, an average of 2 years
Title
Relapse incidence
Description
number of participants that relapse during the study as a measure of efficacy
Time Frame
through study completion, an average of 2 years
Title
Numbers of Participants Meeting Criteria of Treatment Failure
Description
Number of participants who require any cellular or pharmacological intervention due to pending or frank relapse (defined as treatment-failure) as a measure of efficacy
Time Frame
through study completion, an average of 2 years
Title
Correlation of cytogenetics/molecular alterations and relapse-free survival
Description
Comparison of relapse-free survival between different cytogenetics/molecular subtypes as a measure of efficacy using time to event curves and log-rank test
Time Frame
through study completion, an average of 2 years
Title
Incidence, course and severity of aGvHD and cGvHD
Description
Incidence, course and severity of aGvHD and cGvHD as a measure of safety
Time Frame
through study completion, an average of 2 years
Title
Number of hospitalizations
Description
Number of hospitalizations per participant as a measure of safety
Time Frame
through treatment completion, an average of 1 year
Title
Number of participants who require dose reductions for toxicity reasons
Description
Number of participants who require dose reductions for toxicity reasons as a measure of safety
Time Frame
through treatment completion, an average of 1 year
Title
Number of participants who have to stop consolidation therapy due to toxicity (Consolidation Arm)
Description
Number of participants who have to stop consolidation therapy due to toxicity as a measure of safety (Consolidation Arm)
Time Frame
through treatment completion, an average of 1 year
Title
Number of participants who can receive all 12 cycles of consolidation therapy(Consolidation Arm)
Description
Number of participants who can receive all 12 cycles of consolidation therapy as a measure of Safety (Consolidation Arm)
Time Frame
through treatment completion, an average of 1 year
Title
Number of screened participants that can start consolidation therapy within the envisaged time frame (Consolidation Arm)
Description
Number of screened participants that can start consolidation therapy within the envisaged time Frame as a measure of safety (Consolidation Arm)
Time Frame
up to 65 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with myeloid malignancy (AML, MDS and CMML) and known IDH2 mutation (IDH2 R172 or R140 mutation) at diagnosis prior to first allo-SCT hematological CR after allo-SCT determined during screening period between day +25 and day +35 (the hematological remission will be confirmed locally by cytomorphological/histological evaluation) Hematopoietic recovery after transplantation indicated by an absolute neutrophil count of at least 1.000/µl and platelet count of at least 50.000/µl no previous therapy with Enasidenib or any other IDH2 inhibitor ECOG performance status ≤ 2 at study entry (s. Appendix) no active, steroid refractory GvHD treated with additional systemic immunosuppression within 4 weeks before inclusion no uncontrolled infection at inclusion Understand and voluntarily sign an informed consent form. Age ≥18 years at the time of signing the informed consent form. Able to adhere to the study visit schedule and other protocol requirements. Female of childbearing potential (FCBP) must: Understand that Enasidenib can cause embryo-fetal harm when administered to a pregnant woman Agree to have a medically supervised pregnancy test within 72 hours prior study start and at day 1 of every treatment cycle Use effective contraception during treatment with Enasidenib and for at least 2 months after the last dose Coadministration of Enasidenib may increase or decrease the concentrations of combined hormonal contraceptives Avoid becoming pregnant while receiving Enasidenib Notify her study doctor immediately if there is a risk of pregnancy Agree to abstain from breastfeeding during study participation and for at least 30 days after study drug discontinuation Understand that Enasidenib may impair fertility in females of reproductive potential and this effect may be not reversible - Males must: Understand that Enasidenib can cause embryo-fetal harm Use effective contraception during treatment with Enasidenib and for at least 2 months after the last dose of Enasidenib if engaged in sexual activity with a pregnant female or a female with childbearing potential Agree to notify the investigator immediately, if pregnancy or a positive pregnancy test occurs in his partner during study participation Understand that Enasidenib may impair fertility in males of reproductive potential and this effect may be not reversible Exclusion Criteria: Any evidence of hematological relapse of the underlying IDH2-mutated myeloid malignancy (AML, MDS and CMML) determined during screening period until start of treatment Any previous prophylactic therapy given within the interval between allo-SCT and screening period Patients with myeloid malignancy (AML, MDS and CMML) and known IDH2 mutation (IDH2 R172 or R140 mutation) after second allo-SCT Active, steroid refractory GvHD treated with additional systemic immunosuppression within the last 4 weeks Uncontrolled infection Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form. Pregnant or lactating females Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study Impaired renal function (GFR < 30 ml/min) Impaired hepatic function, as follows: Aspartate aminotransferase (19) ≥3 x ULN or Alanine aminotransferase (ALT) ≥3 x ULN or Total bilirubin ≥3 x ULN or Alkaline Phosphatase ≥3 x ULN Known hypersensitivity to Enasidenib or any other component of the treatment Prior history of malignancy other than AML, MDS or CMML (except basal and squamous cell carcinoma or carcinoma in situ of the cervix or breast) unless the subject has been free of disease for ≥3 years Concurrent use of other anti-cancer agents or treatments Known positive for HIV or active infectious hepatitis, type A, B or C Participation in another study with ongoing use of unlicensed investigational product from 28 days before study enrollment until the end of the study (in cases where the investigational product has an unusually long half-life (e.g. antibodies), the interval until study enrollment must be at least five times the plasma half-life of the investigational product)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas Schroeder, PD Dr.
Organizational Affiliation
University Hospital Duesseldorf Dept. of Hematology, Oncology and Clinical Immunology
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Duesseldorf Dept. of Hematology, Oncology and Clinical Immunology
City
Duesseldorf
State/Province
NRW
ZIP/Postal Code
40225
Country
Germany
Facility Name
Uniklinik RWTH Aachen Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation (Med. Klinik IV)
City
Aachen
ZIP/Postal Code
52074
Country
Germany
Facility Name
Universitätsklinikum Carl Gustav Carus Medizinische Klinik und Poliklinik I
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Universitätsklinikum Essen Klinik für Hämatologie und Stammzelltransplantation
City
Essen
ZIP/Postal Code
45147
Country
Germany
Facility Name
Universitätsklinikum Frankfurt Med. Klinik II
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
Facility Name
Universitätsklinikum Hamburg-Eppendorf Interdisziplinäre Klinik für Stammzelltransplantation
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Universitätsklinikum Heidelberg Innere Medizin V: Hämatologie, Onkologie und Rheumatologie
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Universitätsklinikum Köln Klinik I für Innere Medizin
City
Köln
ZIP/Postal Code
50937
Country
Germany
Facility Name
Universitätsklinikum Leipzig Medizinische Klinik und Poliklinik I, Hämatologie und Zelltherapie
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Klinikum rechts der Isar der TU München Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie
City
München
ZIP/Postal Code
81675
Country
Germany
Facility Name
Universitätsklinikum Münster Medizinische Klinik A / KMT Zentrum
City
Münster
ZIP/Postal Code
48149
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

IDH2-Post-Allo-Trial for Patients With IDH2-mut Myeloid Neoplasms After Allo-SCT

We'll reach out to this number within 24 hrs