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Phase I Study of KW-0761 in Relapsed Patients With CCR4-Positive ATL and PTCL

Primary Purpose

Adult T-Cell Leukemia and Lymphoma (ATL), Adult Peripheral T-Cell Lymphoma (PTCL)

Status
Completed
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
KW-0761
Sponsored by
Kyowa Kirin Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adult T-Cell Leukemia and Lymphoma (ATL) focused on measuring Adult T-Cell Leukemia, ATL, Adult Peripheral T-Cell Lymphoma, PTCL

Eligibility Criteria

20 Years - 69 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 1. Histologically confirmed diagnosis of a CCR4-positive ATL and PTCL that is any of the following: A. ATL (Adult T-Cell Leukemia-Lymphoma) Seropositive for anti-Human T-lymphotrophic Virus type-I (HTLV-I) antibody; Acute, Lymphoma, or Chronic phase with high-risk factors (within 14 days before the study entry); B. PTCL (Peripheral T-Cell Lymphoma) Includes Mycosis Fungoides and Sezary Syndrome; 2: Relapsed to the latest standard chemotherapy; 3: Received at least one prior chemotherapy; 4: After 4 weeks from a prior therapy; 5: Have measurable disease; 6:Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1; 7: Male or female, at least 20 years and not older than 70 years of age; 8: Signed written informed consent; 9: Stay in hospital for 4 weeks; 10: HBs antigen: negative, HBV-DNA: below the limit of quantification (within 14 days before the study entry); 11: Adequate bone marrow, hepatic and cardiac function including the followings: Neutrophil count ≥ 1,500 /mm3, Platelets ≥ 75,000 /mm3, Hemoglobin ≥ 8.0 g/dL Serum creatinine ≤ 1.5 x ULN; Serum SGOT (AST) and SGPT (ALT) ≤ 2.5 x ULN (≤ 5.0 x ULN if considered due to disease involvement in liver); Serum bilirubin ≤ 1.5 x ULN (≤ 3.0 x ULN if considered due to disease involvement in liver) Serum calcium ≤ 11.0 mg/dL PaO2 ≥ 65 mmHg or SaO2 ≥ 90% No clinically significant Electrocardiogram abnormality Left Ventricular Ejection Fraction ≥ 50% [by ECHO or MUGA] Exclusion Criteria: Co-existing active infection or any co-existing medical condition that may compromise the safety of patients during the study, affect the patient's ability to complete the study, or interfere with interpretation of study results; Active tuberculosis; Prior stem cell transplantation; Myocardial infarction (within 12 months prior to the study entry); Concurrent acute or chronic hepatitis, or cirrhosis; Anti-HCV: positive, Anti-HIV: positive Concurrent active malignant disease; Known allergic reaction to antibody therapy; Concomitant treatment with systemic steroids; Prior and Concurrent psychiatric disorder including dementia, epilepsy or any other CNS diseases; Evidence of CNS metastasis at baseline; Prior and Concurrent spinal cord disease; Radiation therapy for bulky mass disease at the time of study entry or considered to require radiation therapy during the study; Female patients who are pregnant or breast feeding; Female patients of childbearing potential, unwilling to use an approved, effective means of contraception in accordance with the institution's standards; Treatment with any other investigational agent within the 4 months prior to study entry; For any reason is judged by the Investigator to be inappropriate for study participation, including an inability to communicate or cooperate with the Investigator.

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1

Arm Description

KW-0761

Outcomes

Primary Outcome Measures

Incidence of Dose-Limiting Toxicities (DLTs)
Subjects who were properly monitored for DLTs were to be analyzed to determine the number of subjects with a DLT by dose level.
Maximum Tolerated Dose (MTD)
The dose level at which Dose-Limiting Toxicity (DLT) was recognized was to be regarded as Maximum Tolerated Dose (MTD), and the dose level below MTD by one level was to be regarded as the recommended dose level (when MTD was not reached, 1.0 mg/kg was to be regarded as the recommended dose level) and 3 more subjects were to be newly added to the recommended dose level.
Pharmacokinetics-Plasma KW-0761 Concentrations
Plasma KW-0761 concentrations were to be summarized in tabular form with the descriptive statistics on a dose-by-dose basis. Individual and mean (+ standard deviation) plasma KW-0761 concentrations on an actual or logarithmic scale were to be plotted against the time of blood sampling.
Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (AUC0-7 Days)
The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis.
Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (t1/2)
The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis.

Secondary Outcome Measures

Antitumor Effect
The antitumor response criteria (Complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD)) were created based on the criteria for non-Hodgkin's lymphoma and chronic lymphocytic leukemia provided in the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology as well as the criteria for non-Hodgkin's lymphoma by the Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG).
Time to Progression (TTP)
TTP was defined as the period from the day starting the first KW-0761 dosing to the day of PD identification (or the day of death if the subject died before PD was documented). Subjects were to be censored at the time of starting post-treatment, if it was started before PD identification.

Full Information

First Posted
July 20, 2006
Last Updated
October 17, 2012
Sponsor
Kyowa Kirin Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT00355472
Brief Title
Phase I Study of KW-0761 in Relapsed Patients With CCR4-Positive ATL and PTCL
Official Title
Phase I Dose Escalation Study of KW-0761 in Patients With Relapsed Adult T-Cell Lymphoma (ATL) and Peripheral T-Cell Lymphoma (PTCL)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2012
Overall Recruitment Status
Completed
Study Start Date
February 2007 (undefined)
Primary Completion Date
October 2008 (Actual)
Study Completion Date
October 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kyowa Kirin Co., Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase I label dose escalation study of KW-0761 in relapsed patients with CCR4 positive Adult T-Cell Leukemia-Lymphoma (ATL) and Peripheral T-Cell lymphoma (PTCL).
Detailed Description
This is a Phase I open-label dose escalation study of KW-0761 in relapsed patients with CCR4 positive Adult T-Cell Leukemia-Lymphoma (ATL) and Peripheral T-Cell Lymphoma (PTCL). This study is designed to evaluate safety, pharmacokinetics, immunogenicity and preliminary efficacy. Enrollment will proceed until a maximum tolerated dose (MTD) and a recommended Phase II dose (RPIID) have been established.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adult T-Cell Leukemia and Lymphoma (ATL), Adult Peripheral T-Cell Lymphoma (PTCL)
Keywords
Adult T-Cell Leukemia, ATL, Adult Peripheral T-Cell Lymphoma, PTCL

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
KW-0761
Intervention Type
Drug
Intervention Name(s)
KW-0761
Intervention Description
IV administration at 4 escalating dose levels.
Primary Outcome Measure Information:
Title
Incidence of Dose-Limiting Toxicities (DLTs)
Description
Subjects who were properly monitored for DLTs were to be analyzed to determine the number of subjects with a DLT by dose level.
Time Frame
28 days
Title
Maximum Tolerated Dose (MTD)
Description
The dose level at which Dose-Limiting Toxicity (DLT) was recognized was to be regarded as Maximum Tolerated Dose (MTD), and the dose level below MTD by one level was to be regarded as the recommended dose level (when MTD was not reached, 1.0 mg/kg was to be regarded as the recommended dose level) and 3 more subjects were to be newly added to the recommended dose level.
Time Frame
28 days
Title
Pharmacokinetics-Plasma KW-0761 Concentrations
Description
Plasma KW-0761 concentrations were to be summarized in tabular form with the descriptive statistics on a dose-by-dose basis. Individual and mean (+ standard deviation) plasma KW-0761 concentrations on an actual or logarithmic scale were to be plotted against the time of blood sampling.
Time Frame
0-7 days post final dose
Title
Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (AUC0-7 Days)
Description
The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis.
Time Frame
0-7 days post final dose
Title
Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (t1/2)
Description
The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis.
Time Frame
0 to 28 days post final dose and follow-up examinations (1 month and 2 months after the end of the post-dosing observation period).
Secondary Outcome Measure Information:
Title
Antitumor Effect
Description
The antitumor response criteria (Complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD)) were created based on the criteria for non-Hodgkin's lymphoma and chronic lymphocytic leukemia provided in the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology as well as the criteria for non-Hodgkin's lymphoma by the Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG).
Time Frame
50 days
Title
Time to Progression (TTP)
Description
TTP was defined as the period from the day starting the first KW-0761 dosing to the day of PD identification (or the day of death if the subject died before PD was documented). Subjects were to be censored at the time of starting post-treatment, if it was started before PD identification.
Time Frame
Baseline to response

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
69 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Histologically confirmed diagnosis of a CCR4-positive ATL and PTCL that is any of the following: A. ATL (Adult T-Cell Leukemia-Lymphoma) Seropositive for anti-Human T-lymphotrophic Virus type-I (HTLV-I) antibody; Acute, Lymphoma, or Chronic phase with high-risk factors (within 14 days before the study entry); B. PTCL (Peripheral T-Cell Lymphoma) Includes Mycosis Fungoides and Sezary Syndrome; 2: Relapsed to the latest standard chemotherapy; 3: Received at least one prior chemotherapy; 4: After 4 weeks from a prior therapy; 5: Have measurable disease; 6:Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1; 7: Male or female, at least 20 years and not older than 70 years of age; 8: Signed written informed consent; 9: Stay in hospital for 4 weeks; 10: HBs antigen: negative, HBV-DNA: below the limit of quantification (within 14 days before the study entry); 11: Adequate bone marrow, hepatic and cardiac function including the followings: Neutrophil count ≥ 1,500 /mm3, Platelets ≥ 75,000 /mm3, Hemoglobin ≥ 8.0 g/dL Serum creatinine ≤ 1.5 x ULN; Serum SGOT (AST) and SGPT (ALT) ≤ 2.5 x ULN (≤ 5.0 x ULN if considered due to disease involvement in liver); Serum bilirubin ≤ 1.5 x ULN (≤ 3.0 x ULN if considered due to disease involvement in liver) Serum calcium ≤ 11.0 mg/dL PaO2 ≥ 65 mmHg or SaO2 ≥ 90% No clinically significant Electrocardiogram abnormality Left Ventricular Ejection Fraction ≥ 50% [by ECHO or MUGA] Exclusion Criteria: Co-existing active infection or any co-existing medical condition that may compromise the safety of patients during the study, affect the patient's ability to complete the study, or interfere with interpretation of study results; Active tuberculosis; Prior stem cell transplantation; Myocardial infarction (within 12 months prior to the study entry); Concurrent acute or chronic hepatitis, or cirrhosis; Anti-HCV: positive, Anti-HIV: positive Concurrent active malignant disease; Known allergic reaction to antibody therapy; Concomitant treatment with systemic steroids; Prior and Concurrent psychiatric disorder including dementia, epilepsy or any other CNS diseases; Evidence of CNS metastasis at baseline; Prior and Concurrent spinal cord disease; Radiation therapy for bulky mass disease at the time of study entry or considered to require radiation therapy during the study; Female patients who are pregnant or breast feeding; Female patients of childbearing potential, unwilling to use an approved, effective means of contraception in accordance with the institution's standards; Treatment with any other investigational agent within the 4 months prior to study entry; For any reason is judged by the Investigator to be inappropriate for study participation, including an inability to communicate or cooperate with the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Kyowa Kirin Co., Ltd.
Official's Role
Study Director
Facility Information:
City
Tokyo
Country
Japan

12. IPD Sharing Statement

Citations:
PubMed Identifier
16952304
Citation
Ishida T, Ueda R. CCR4 as a novel molecular target for immunotherapy of cancer. Cancer Sci. 2006 Nov;97(11):1139-46. doi: 10.1111/j.1349-7006.2006.00307.x. Epub 2006 Sep 5. Erratum In: Cancer Sci. 2007 Jul;98(7):1137.
Results Reference
background
PubMed Identifier
17975162
Citation
Yano H, Ishida T, Inagaki A, Ishii T, Ding J, Kusumoto S, Komatsu H, Iida S, Inagaki H, Ueda R. Defucosylated anti CC chemokine receptor 4 monoclonal antibody combined with immunomodulatory cytokines: a novel immunotherapy for aggressive/refractory Mycosis fungoides and Sezary syndrome. Clin Cancer Res. 2007 Nov 1;13(21):6494-500. doi: 10.1158/1078-0432.CCR-07-1324.
Results Reference
background
PubMed Identifier
17278106
Citation
Yano H, Ishida T, Inagaki A, Ishii T, Kusumoto S, Komatsu H, Iida S, Utsunomiya A, Ueda R. Regulatory T-cell function of adult T-cell leukemia/lymphoma cells. Int J Cancer. 2007 May 1;120(9):2052-7. doi: 10.1002/ijc.22536.
Results Reference
background

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Phase I Study of KW-0761 in Relapsed Patients With CCR4-Positive ATL and PTCL

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