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Phase I Dose Escalation and Pharmacokinetics Clinical Trial of Mitoxantrone Hydrochloride Liposome in Children With Relapsed and Refractory Lymphoma and Solid Tumors

Primary Purpose

Pediatric Solid Tumor

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Mitoxantrone Hydrochloride Liposome
Irinotecan
Vincristine
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pediatric Solid Tumor

Eligibility Criteria

2 Years - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 1. Subjects fully understand and voluntarily participate in this study and sign the informed consent form (ICF); 2. 2-21 years old; 3. Expected survival ≥ 3 months; 4. Subjects with histologically confirmed diagnosis of relapsed and refractory lymphoma and solid tumors, which is one of the following subtypes: Lymphoblastic lymphoma Anaplastic large T cell lymphoma Burkitt's lymphoma Diffuse large B-cell lymphoma Peripheral T, NK/T cell lymphoma Soft tissue sarcoma Neuroblastoma Other subtypes of lymphoma or solid tumors that the investigators believe can be included 5. Relapsed lymphoma is defined as the lymphoma that relapse after obtaining complete response (CR) after initial chemotherapy; Refractory lymphoma subjects meet one of the following conditions: 1) The tumor shrinks <50% or disease progression after 4 cycles of standard chemotherapy,; 2) CR after standard chemotherapy, but relapse within half a year; 3) 2 or more relapses after CR; 4) relapse after hematopoietic stem cell transplantation; 6. Lymphoma subjects must have at least one evaluable or measurable lesion per lugano2014 criteria: for lymph node lesions, the length should be > 1.5cm; For non-lymph node lesions, the length should be > 1.0cm; 7. Solid tumors must have tumor lesions measurable by CT or MRI; 8. ECOG Performance Status: 0-2; 9. Bone marrow function: Absolute neutrophil count ≥1.5×109/L, Platelet count ≥75×109/L, Hemoglobin ≥ 80g/L (Absolute neutrophil can be relaxed to ≥ 1.0×109/L, Platelet count can be relaxed to ≥50×109/L, Hemoglobin can be relaxed to ≥75 g/L in subjects with poor bone-marrow reserve); 10. Liver and kidney function: serum creatinine ≤ 1.5×ULN (upper limit of normal); AST and ALT ≤ 2.5×ULN (≤ 5×ULN for subjects with liver metastases); total bilirubin ≤ 1.5×ULN (≤ 3×ULN for subjects with liver metastases). Exclusion Criteria: 1. The subject had previously received any of the following anti-tumor treatments: Subjects who have been treated with mitoxantrone or mitoxantrone liposomes; Previously received doxorubicin or other anthracycline treatment, and the total cumulative dose of doxorubicin was more than 360 mg/m2 (1 mg doxorubicin equivalent to 2 mg epirubicin); Subjects who received anti-tumor treatment (including chemotherapy, targeted therapy, glucocorticoid, traditional Chinese medicine with anti-tumor activity, etc.) or participated in other clinical trials and received trial drugs; Subjects who received autologous hematopoietic stem cell transplantation within 100 days after the first medication or allogeneic hematopoietic stem cell transplantation. 2. Hypersensitivity to any study drug or its components; 3. Uncontrolled systemic diseases (such as active infection, uncontrolled hypertension, diabetes, etc.); 4. Heart function and disease meet one of the following conditions: Long QTc syndrome or QTc interval > 480 ms; Complete left bundle branch block, grade II or III atrioventricular block; Serious and uncontrolled arrhythmias requiring drug treatment; New York Heart Association grade ≥ III; Cardiac ejection fraction (LVEF)< 50%; A history of myocardial infarction, unstable angina pectoris, severe unstable ventricular arrhythmia or any other arrhythmia requiring treatment, a history of clinically serious pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before recruitment. 5. Hepatitis B and hepatitis C active infection (plus HBV DNA if one positive for hepatitis B surface antigen or core antibody and HBV DNA more than 1×103 copy/mL excluded; plus HCV RNA if hepatitis C antibody positive and HCV RNA more than 1×103 copy/mL exclude); 6. Human immunodeficiency virus (HIV) infection (HIV antibody positive); 7. Subjects with other malignant tumors past or present (except for non-melanoma skin basal cell carcinoma, breast/cervical carcinoma in control, and other malignant tumors that have been effectively controlled without treatment within the past five years); 8. Subjects suffering from primary or secondary central nervous system (CNS) lymphoma or a history of CNS lymphoma at the time of recruitment; 9. Pregnant and lactating women and childbearing age patients unwilling to take contraceptive measures; 10. Unsuitable subjects for this study determined by the investigator.

Sites / Locations

  • Sun Yat-sen University Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

mitoxantrone hydrochloride liposome alone or combined with Irinotecan+Vincristine

Arm Description

In phase Ia, patients with relapsed and refractory lymphoma and solid tumors will receive mitoxantrone hydrochloride liposome alone (at three doses of 16 mg/m2, 20 mg/m2 and 24 mg/m2, ) or combination of Irinotecan 50mg/ m2,d1-5, Vincristine 1.5mg/ m2,d1 for up to 6 cycles (21 days per cycle). In phase Ib, patients will recive mitoxantrone hydrochloride liposome 24 mg/m2, combination of Irinotecan 50mg/ m2,d1-5, Vincristine 1.5mg/ m2

Outcomes

Primary Outcome Measures

Maximum-tolerated dose
To investigate the safety and preliminary antitumor efficacy
peak time (Tmax)
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Maximum Plasma Concentration (Cmax)
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Area under the plasma concentration versus time curve (AUC)
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Elimination half life (t1/2)
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Incidence and severity of hematological adverse events
To evaluate the incidence and severity of hematological adverse events in patients enrolled in phase Ib

Secondary Outcome Measures

Dose limiting toxicities
To investigate the safety
Objective response rate
To investigate the preliminary antitumor efficacy of phase I dose escalation and pharmacokinetics study
Complete response rate
To investigate the preliminary antitumor efficacy of phase I dose escalation and pharmacokinetics study
Progression free survival
To investigate the preliminary antitumor efficacy of phase I dose escalation and pharmacokinetics study
The incidence and severity of AE and SAE
To identify the incidence and severity of AE and SAE (NCI CTCAE v5.0)
Incidence and severity of non-hematological adverse events
The incidence and severity of non-hematological adverse events were evaluated in patients enrolled in Phase Ib

Full Information

First Posted
November 8, 2022
Last Updated
August 16, 2023
Sponsor
Sun Yat-sen University
Collaborators
CSPC Ouyi Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05620862
Brief Title
Phase I Dose Escalation and Pharmacokinetics Clinical Trial of Mitoxantrone Hydrochloride Liposome in Children With Relapsed and Refractory Lymphoma and Solid Tumors
Official Title
Phase I Dose Escalation and Pharmacokinetics Clinical Trial of Mitoxantrone Hydrochloride Liposome in Children With Relapsed and Refractory Lymphoma and Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 25, 2022 (Actual)
Primary Completion Date
June 1, 2024 (Anticipated)
Study Completion Date
June 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University
Collaborators
CSPC Ouyi Pharmaceutical Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Phase I dose escalation clinical trial: to explore the dose limiting toxicity (DLT) of mitoxantrone hydrochloride liposome injection in the treatment of children with relapsed and refractory lymphoma and solid tumors. Pharmacokinetics clinical trial: to observe the pharmacokinetics of mitoxantrone hydrochloride liposomes in children with relapsed and refractory lymphoma and solid tumors. To evaluate the safety and efficacy of mitoxantrone hydrochloride liposomes in children with lymphoma and solid tumors.
Detailed Description
This is a phase I dose escalation and pharmacokinetics clinical trial to evaluate the safety and efficacy of mitoxantrone hydrochloride liposomes in children with lymphoma and solid tumors. In the phase Ia dose escalation study, patients with relapsed and refractory lymphoma and solid tumors will be treated with mitoxantrone hydrochloride liposome alone or combined treatment at the dose of 16 mg/m2, 20 mg/m2 and 24 mg/m2, each cohort wil enroll 9~18 children. Simultaneously 6~15 cases were added for pharmacokinetic study to ensure 8 cases are included in each dose group with the same mitoxantrone hydrochloride liposome dose. In phase Ib, patients received the combination therapy of mitoxantrone hydrochloride liposome at the MTD dose (24mg/m2) .

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pediatric Solid Tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
68 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
mitoxantrone hydrochloride liposome alone or combined with Irinotecan+Vincristine
Arm Type
Experimental
Arm Description
In phase Ia, patients with relapsed and refractory lymphoma and solid tumors will receive mitoxantrone hydrochloride liposome alone (at three doses of 16 mg/m2, 20 mg/m2 and 24 mg/m2, ) or combination of Irinotecan 50mg/ m2,d1-5, Vincristine 1.5mg/ m2,d1 for up to 6 cycles (21 days per cycle). In phase Ib, patients will recive mitoxantrone hydrochloride liposome 24 mg/m2, combination of Irinotecan 50mg/ m2,d1-5, Vincristine 1.5mg/ m2
Intervention Type
Drug
Intervention Name(s)
Mitoxantrone Hydrochloride Liposome
Intervention Description
In phase Ia, mitoxantrone hydrochloride liposome will be administered by an intravenous infusion at three doses of 16 mg/m2, 20 mg/m2 and 24 mg/m2 . In phase Ib, mitoxantrone hydrochloride liposome will be administered by an intravenous infusion of 24mg/m2. Up to 6 cycles (21 days per cycle)
Intervention Type
Drug
Intervention Name(s)
Irinotecan
Intervention Description
50mg/ m2,d1-5, 21 days per cycle
Intervention Type
Drug
Intervention Name(s)
Vincristine
Intervention Description
Vincristine 1.5mg/ m2,d1 , 21 days per cycle
Primary Outcome Measure Information:
Title
Maximum-tolerated dose
Description
To investigate the safety and preliminary antitumor efficacy
Time Frame
Up to 21 days
Title
peak time (Tmax)
Description
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Time Frame
Up to 18 weeks
Title
Maximum Plasma Concentration (Cmax)
Description
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Time Frame
Up to 18 weeks
Title
Area under the plasma concentration versus time curve (AUC)
Description
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Time Frame
Up to 18 weeks
Title
Elimination half life (t1/2)
Description
To evaluate the pharmacokinetics of mitoxantrone hydrochloride liposome at different doses in subjects
Time Frame
Up to 18 weeks
Title
Incidence and severity of hematological adverse events
Description
To evaluate the incidence and severity of hematological adverse events in patients enrolled in phase Ib
Time Frame
From date of randomization until 4 weeks after the last dose
Secondary Outcome Measure Information:
Title
Dose limiting toxicities
Description
To investigate the safety
Time Frame
Up to 21 days
Title
Objective response rate
Description
To investigate the preliminary antitumor efficacy of phase I dose escalation and pharmacokinetics study
Time Frame
Up to 18 weeks
Title
Complete response rate
Description
To investigate the preliminary antitumor efficacy of phase I dose escalation and pharmacokinetics study
Time Frame
Up to 18 weeks
Title
Progression free survival
Description
To investigate the preliminary antitumor efficacy of phase I dose escalation and pharmacokinetics study
Time Frame
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 70 weeks
Title
The incidence and severity of AE and SAE
Description
To identify the incidence and severity of AE and SAE (NCI CTCAE v5.0)
Time Frame
up to 42 weeks unless related serious adverse events need to be recorded indefinitely
Title
Incidence and severity of non-hematological adverse events
Description
The incidence and severity of non-hematological adverse events were evaluated in patients enrolled in Phase Ib
Time Frame
From date of randomization until 4 weeks after the last dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Subjects fully understand and voluntarily participate in this study and sign the informed consent form (ICF); 2. 2-21 years old; 3. Expected survival ≥ 3 months; 4. Subjects with histologically confirmed diagnosis of relapsed and refractory lymphoma and solid tumors, which is one of the following subtypes: Lymphoblastic lymphoma Anaplastic large T cell lymphoma Burkitt's lymphoma Diffuse large B-cell lymphoma Peripheral T, NK/T cell lymphoma Soft tissue sarcoma Neuroblastoma Other subtypes of lymphoma or solid tumors that the investigators believe can be included 5. Relapsed lymphoma is defined as the lymphoma that relapse after obtaining complete response (CR) after initial chemotherapy; Refractory lymphoma subjects meet one of the following conditions: 1) The tumor shrinks <50% or disease progression after 4 cycles of standard chemotherapy,; 2) CR after standard chemotherapy, but relapse within half a year; 3) 2 or more relapses after CR; 4) relapse after hematopoietic stem cell transplantation; 6. Lymphoma subjects must have at least one evaluable or measurable lesion per lugano2014 criteria: for lymph node lesions, the length should be > 1.5cm; For non-lymph node lesions, the length should be > 1.0cm; 7. Solid tumors must have tumor lesions measurable by CT or MRI; 8. ECOG Performance Status: 0-2; 9. Bone marrow function: Absolute neutrophil count ≥1.5×109/L, Platelet count ≥75×109/L, Hemoglobin ≥ 80g/L (Absolute neutrophil can be relaxed to ≥ 1.0×109/L, Platelet count can be relaxed to ≥50×109/L, Hemoglobin can be relaxed to ≥75 g/L in subjects with poor bone-marrow reserve); 10. Liver and kidney function: serum creatinine ≤ 1.5×ULN (upper limit of normal); AST and ALT ≤ 2.5×ULN (≤ 5×ULN for subjects with liver metastases); total bilirubin ≤ 1.5×ULN (≤ 3×ULN for subjects with liver metastases). Exclusion Criteria: 1. The subject had previously received any of the following anti-tumor treatments: Subjects who have been treated with mitoxantrone or mitoxantrone liposomes; Previously received doxorubicin or other anthracycline treatment, and the total cumulative dose of doxorubicin was more than 360 mg/m2 (1 mg doxorubicin equivalent to 2 mg epirubicin); Subjects who received anti-tumor treatment (including chemotherapy, targeted therapy, glucocorticoid, traditional Chinese medicine with anti-tumor activity, etc.) or participated in other clinical trials and received trial drugs; Subjects who received autologous hematopoietic stem cell transplantation within 100 days after the first medication or allogeneic hematopoietic stem cell transplantation. 2. Hypersensitivity to any study drug or its components; 3. Uncontrolled systemic diseases (such as active infection, uncontrolled hypertension, diabetes, etc.); 4. Heart function and disease meet one of the following conditions: Long QTc syndrome or QTc interval > 480 ms; Complete left bundle branch block, grade II or III atrioventricular block; Serious and uncontrolled arrhythmias requiring drug treatment; New York Heart Association grade ≥ III; Cardiac ejection fraction (LVEF)< 50%; A history of myocardial infarction, unstable angina pectoris, severe unstable ventricular arrhythmia or any other arrhythmia requiring treatment, a history of clinically serious pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before recruitment. 5. Hepatitis B and hepatitis C active infection (plus HBV DNA if one positive for hepatitis B surface antigen or core antibody and HBV DNA more than 1×103 copy/mL excluded; plus HCV RNA if hepatitis C antibody positive and HCV RNA more than 1×103 copy/mL exclude); 6. Human immunodeficiency virus (HIV) infection (HIV antibody positive); 7. Subjects with other malignant tumors past or present (except for non-melanoma skin basal cell carcinoma, breast/cervical carcinoma in control, and other malignant tumors that have been effectively controlled without treatment within the past five years); 8. Subjects suffering from primary or secondary central nervous system (CNS) lymphoma or a history of CNS lymphoma at the time of recruitment; 9. Pregnant and lactating women and childbearing age patients unwilling to take contraceptive measures; 10. Unsuitable subjects for this study determined by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yizhuo Zhang, PhD
Phone
020-87342460
Email
zhangyzh@sysucc.org.cn
Facility Information:
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yi-Zhuo Zhang, MD
Phone
18622221239
Email
zhangyzh@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Yi-Zhuo Zhang, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase I Dose Escalation and Pharmacokinetics Clinical Trial of Mitoxantrone Hydrochloride Liposome in Children With Relapsed and Refractory Lymphoma and Solid Tumors

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