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PRTX-100-202 Open-Label, Dose Escalation Study in Adult Patients With ITP

Primary Purpose

Immune Thrombocytopenia

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
PRTX-100
Sponsored by
Protalex, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Immune Thrombocytopenia focused on measuring ITP, Thrombocytopenia

Eligibility Criteria

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

Inclusion Criteria:

  1. Willing and able to provide written informed consent prior to initiation of any study-related procedures
  2. Male or female ≥ 18 years of age
  3. ITP that has persisted for ≥ 3 months. ITP must be diagnosed in accordance The American Society of Hematology 2011 Evidence-based Practice Guideline for Immune Thrombocytopenia (Neunert et al. 2011) or the International Consensus Report on The Investigation and Management of Primary Immune Thrombocytopenia (Provan et al. 2010), as locally applicable.
  4. Received ≥ 1 typical regime for the treatment of ITP. Splenectomy is considered one standard ITP treatment
  5. A mean platelet count of < 30,000/μL, with no individual platelet count > 35,000/μL; or for those subjects receiving a constant dose of permitted treatments for ITP: a mean platelet count < 50,000/μL, with no count greater than 55,000/μL. (Note: The mean platelet count must be determined based on 2 platelet counts including one obtained within ≤ 7 days of first PRTX-100 dose and the other within ≤ 30 days of the first dose of PRTX-100.)
  6. If on corticosteroids, a dose of < 1 mg/kg prednisone per day or equivalent that has been stable for ≥ 21 days prior to the first dose of PRTX-100. High-dose pulse steroid therapy is NOT allowed within 14 days prior to the first dose of PRTX-100.
  7. If receiving eltrombopag or romiplostim, the dose must have been stable for ≥ 21 days prior to the first dose of PRTX-100
  8. If on steroid-sparing adjunctive immunosuppression with cyclosporine, azathioprine, mycophenolate, or 6-mercaptopurine, the dose must have been stable for ≥ 30 days prior to the first dose of PRTX-100 and must be expected to remain stable through study Day 29, unless dose reduction is required due to toxicities. Treatment with other cytotoxic agents (e.g. cyclophosphamide, vincristine) are not allowed within three months prior to the first dose of PRTX- 100.
  9. Any prior treatment with rituximab or any other anti-CD20 agent must have been > 6 months prior to the first dose of PRTX-100
  10. If female, must not be pregnant (pregnancy testing will be performed locally in all female patients of childbearing potential), must not be nursing and must be one of the following:

    • Surgically sterile (bilateral tubal ligation, hysterectomy)
    • Postmenopausal with last natural menses > 24 months prior
    • Premenopausal and using an acceptable form of birth control. Acceptable forms of birth control include: hormonal contraceptives (implantable, oral, patch) used for ≥ 2 months prior to screening or double barrier methods (any combination of two of the following: intrauterine device [IUD], male or female condom with spermicidal gel, diaphragm, sponge, cervical cap). All premenopausal females must have a negative urine or serum pregnancy test at screening and on Day 1 prior to first PRTX-100 treatment.

Exclusion Criteria:

  1. Splenectomy ≤ 90 days prior to the first dose of PRTX-100
  2. Unstable coronary artery disease or other medical condition (such as type 1 diabetes) that, in the Investigator's opinion, might increase the risk to the patient
  3. Evidence of active infection requiring antibiotic therapy ≤ 14 days prior to the first dose of PRTX- 100
  4. Myelodysplastic syndrome. If clinically significant anemia or pancytopenia exists, documentation of a bone marrow aspirate within 24 months prior to the first dose of PRTX-100 showing no evidence of myelodysplasia is required.
  5. Medical history of vasculitis or lupus erythematosus
  6. Propensity to allergic reactions defined as a history of allergic reaction to more than one medication
  7. History of any treatment for cancer within the past two years other than basal cell or squamous cell carcinoma of the skin that has been treated with curative intent
  8. Seropositive for human immunodeficiency virus (HIV)
  9. History of acute/chronic hepatitis B or C and/or carriers of hepatitis B or C (positive for hepatitis B surface antigen or positive anti-hepatitis C antibody test) and evidence of current or active infection (e.g. HCV RNA test)
  10. History suggestive of substance abuse
  11. History or evidence on physical examination or screening laboratory tests of any systemic disease or any acute or chronic illness that, in the opinion of the investigator, may interfere with the evaluation of the safety or immunogenicity of the study drug
  12. Treatment with IVIG ≤ 14 days prior to the first dose of PRTX-100
  13. Treatment with an anti-Rh D antigen agent (e.g. WinPho) ≤ 14 days prior to the first dose of PRTX-100
  14. Use of any investigational drug, other than eltrombopag or romiplostim, ≤ 30 days or 5 half-lives of the investigational drug (whichever is longer) prior to the first dose of RTX-100
  15. Not willing to stay at the study site for 4 hours after each PRTX-100 infusion

Sites / Locations

  • USC Norris Comprehensive Cancer Center
  • Massachusetts General Hospital
  • Michigan Center of Medical Research
  • Weil-Cornell Medical College
  • Gabrail Cancer Center
  • Cleveland Clinic Foundation
  • Aberdeen Royal Infirmary
  • Leicester Royal Infirmary
  • Queen Elizabeth Hospital
  • Glasgow Royal Infirmary
  • Norfolk and Norwich Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PRTX-100

Arm Description

Patients will be assigned to consecutive PRTX-100 interventions as they are enrolled into the study. Between two and six patients will be enrolled per intervention level. Intervention levels range from one (1) to twenty four (24) micrograms of PRTX-100 per kilogram of patient weight. Patients may receive up to four weekly infusions of PRTX-100 over the study treatment period. PRTX-100 doses ≤ 500 μg will be infused intravenously over 30 minutes. PRTX-100 doses > 500 μg will be infused over 60 minutes. Patients will remain under observation for 4 hours after completion of PRTX-100 dosing for safety management.

Outcomes

Primary Outcome Measures

Platelet Response, Change from Baseline
The primary efficacy endpoint is platelet response defined as a platelet count ≥ 30,000/μL and at least a doubling of baseline platelet count (determined on Day 1 prior to PRTX-100 administration) in patients with a baseline platelet count < 30,000/μL. In patients receiving permitted treatments for ITP with a baseline platelet count ≥ 30,000/μL and < 50,000/μL, an increase in platelet count to ≥ 50,000/μL and at least a doubling of baseline platelet count or an increase to > 100,000/μL be considered a platelet response.

Secondary Outcome Measures

Complete platelet response, Change from Baseline
Defined as a platelet count ≥ 100,000/μL
Time to platelet response defined as the mean number of days from first PRTX-100 dose until platelet response
The mean number of days from first PRTX-100 dose until platelet response
Durability of platelet response
The number of days from first documented platelet response to first platelet count below platelet response criteria
Concomitant ITP medication use (frequency and amount)
ITP medications include eltrombopag, romiplostim, steroid-sparing adjunctive treatment (e.g. cyclosporine, azathioprine, mycophenolate, danazol, dapsone, or 6-mercaptopurine), and any ITP rescue medications (e.g. IVIG) received during the study Screening and Treatment Periods
Adverse Events
Safety will be described by AEs, SAEs, infusion reactions, clinical laboratory tests (hematology, blood chemistry and urinalysis), vital signs, physical findings and ECGs. AE severity will be graded according to Toxicity Grading Criteria derived from published standards

Full Information

First Posted
March 18, 2015
Last Updated
July 2, 2019
Sponsor
Protalex, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02401061
Brief Title
PRTX-100-202 Open-Label, Dose Escalation Study in Adult Patients With ITP
Official Title
A Phase 1/2, Open-Label, Dose Escalation Study of PRTX-100 in Adult Patients With Persistent/Chronic Immune Thrombocytopenia
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Terminated
Why Stopped
Enough data has been collected to allow analysis of safety profile and risk-benefit.
Study Start Date
September 2015 (undefined)
Primary Completion Date
March 2019 (Actual)
Study Completion Date
June 4, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Protalex, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Pre-clinical and clinical evaluations show that PRTX- 100 has biological activity that may lead to improved platelet levels where these are decreased due to immunological pathologies and that PRTX-100 has an acceptable safety profile. In vivo treatment with PRTX-100 has been shown to raise platelet counts in a mouse model of immune thrombocytopenia (ITP). The primary objective of the study is to assess the efficacy of PRTX-100 in terms of platelet response in patients with chronic/persistent ITP. Funding Source - FDA OOPD (1R01FD005750-01A1)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Immune Thrombocytopenia
Keywords
ITP, Thrombocytopenia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PRTX-100
Arm Type
Experimental
Arm Description
Patients will be assigned to consecutive PRTX-100 interventions as they are enrolled into the study. Between two and six patients will be enrolled per intervention level. Intervention levels range from one (1) to twenty four (24) micrograms of PRTX-100 per kilogram of patient weight. Patients may receive up to four weekly infusions of PRTX-100 over the study treatment period. PRTX-100 doses ≤ 500 μg will be infused intravenously over 30 minutes. PRTX-100 doses > 500 μg will be infused over 60 minutes. Patients will remain under observation for 4 hours after completion of PRTX-100 dosing for safety management.
Intervention Type
Drug
Intervention Name(s)
PRTX-100
Other Intervention Name(s)
SpA, Staphylococcal Protein A
Intervention Description
Four weekly infusions of PRTX-100 at a level of 1 (3, 6,12, 18, or 24) microgram of PRTX-100 per kilogram of patient weight, infused over 30 minutes, followed by four hours of observation.
Primary Outcome Measure Information:
Title
Platelet Response, Change from Baseline
Description
The primary efficacy endpoint is platelet response defined as a platelet count ≥ 30,000/μL and at least a doubling of baseline platelet count (determined on Day 1 prior to PRTX-100 administration) in patients with a baseline platelet count < 30,000/μL. In patients receiving permitted treatments for ITP with a baseline platelet count ≥ 30,000/μL and < 50,000/μL, an increase in platelet count to ≥ 50,000/μL and at least a doubling of baseline platelet count or an increase to > 100,000/μL be considered a platelet response.
Time Frame
Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337
Secondary Outcome Measure Information:
Title
Complete platelet response, Change from Baseline
Description
Defined as a platelet count ≥ 100,000/μL
Time Frame
Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337
Title
Time to platelet response defined as the mean number of days from first PRTX-100 dose until platelet response
Description
The mean number of days from first PRTX-100 dose until platelet response
Time Frame
Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337
Title
Durability of platelet response
Description
The number of days from first documented platelet response to first platelet count below platelet response criteria
Time Frame
Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337
Title
Concomitant ITP medication use (frequency and amount)
Description
ITP medications include eltrombopag, romiplostim, steroid-sparing adjunctive treatment (e.g. cyclosporine, azathioprine, mycophenolate, danazol, dapsone, or 6-mercaptopurine), and any ITP rescue medications (e.g. IVIG) received during the study Screening and Treatment Periods
Time Frame
Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337
Title
Adverse Events
Description
Safety will be described by AEs, SAEs, infusion reactions, clinical laboratory tests (hematology, blood chemistry and urinalysis), vital signs, physical findings and ECGs. AE severity will be graded according to Toxicity Grading Criteria derived from published standards
Time Frame
Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to provide written informed consent prior to initiation of any study-related procedures Male or female ≥ 18 years of age ITP that has persisted for ≥ 3 months. ITP must be diagnosed in accordance The American Society of Hematology 2011 Evidence-based Practice Guideline for Immune Thrombocytopenia (Neunert et al. 2011) or the International Consensus Report on The Investigation and Management of Primary Immune Thrombocytopenia (Provan et al. 2010), as locally applicable. Received ≥ 1 typical regime for the treatment of ITP. Splenectomy is considered one standard ITP treatment A mean platelet count of < 30,000/μL, with no individual platelet count > 35,000/μL; or for those subjects receiving a constant dose of permitted treatments for ITP: a mean platelet count < 50,000/μL, with no count greater than 55,000/μL. (Note: The mean platelet count must be determined based on 2 platelet counts including one obtained within ≤ 7 days of first PRTX-100 dose and the other within ≤ 30 days of the first dose of PRTX-100.) If on corticosteroids, a dose of < 1 mg/kg prednisone per day or equivalent that has been stable for ≥ 21 days prior to the first dose of PRTX-100. High-dose pulse steroid therapy is NOT allowed within 14 days prior to the first dose of PRTX-100. If receiving eltrombopag or romiplostim, the dose must have been stable for ≥ 21 days prior to the first dose of PRTX-100 If on steroid-sparing adjunctive immunosuppression with cyclosporine, azathioprine, mycophenolate, or 6-mercaptopurine, the dose must have been stable for ≥ 30 days prior to the first dose of PRTX-100 and must be expected to remain stable through study Day 29, unless dose reduction is required due to toxicities. Treatment with other cytotoxic agents (e.g. cyclophosphamide, vincristine) are not allowed within three months prior to the first dose of PRTX- 100. Any prior treatment with rituximab or any other anti-CD20 agent must have been > 6 months prior to the first dose of PRTX-100 If female, must not be pregnant (pregnancy testing will be performed locally in all female patients of childbearing potential), must not be nursing and must be one of the following: Surgically sterile (bilateral tubal ligation, hysterectomy) Postmenopausal with last natural menses > 24 months prior Premenopausal and using an acceptable form of birth control. Acceptable forms of birth control include: hormonal contraceptives (implantable, oral, patch) used for ≥ 2 months prior to screening or double barrier methods (any combination of two of the following: intrauterine device [IUD], male or female condom with spermicidal gel, diaphragm, sponge, cervical cap). All premenopausal females must have a negative urine or serum pregnancy test at screening and on Day 1 prior to first PRTX-100 treatment. Exclusion Criteria: Splenectomy ≤ 90 days prior to the first dose of PRTX-100 Unstable coronary artery disease or other medical condition (such as type 1 diabetes) that, in the Investigator's opinion, might increase the risk to the patient Evidence of active infection requiring antibiotic therapy ≤ 14 days prior to the first dose of PRTX- 100 Myelodysplastic syndrome. If clinically significant anemia or pancytopenia exists, documentation of a bone marrow aspirate within 24 months prior to the first dose of PRTX-100 showing no evidence of myelodysplasia is required. Medical history of vasculitis or lupus erythematosus Propensity to allergic reactions defined as a history of allergic reaction to more than one medication History of any treatment for cancer within the past two years other than basal cell or squamous cell carcinoma of the skin that has been treated with curative intent Seropositive for human immunodeficiency virus (HIV) History of acute/chronic hepatitis B or C and/or carriers of hepatitis B or C (positive for hepatitis B surface antigen or positive anti-hepatitis C antibody test) and evidence of current or active infection (e.g. HCV RNA test) History suggestive of substance abuse History or evidence on physical examination or screening laboratory tests of any systemic disease or any acute or chronic illness that, in the opinion of the investigator, may interfere with the evaluation of the safety or immunogenicity of the study drug Treatment with IVIG ≤ 14 days prior to the first dose of PRTX-100 Treatment with an anti-Rh D antigen agent (e.g. WinPho) ≤ 14 days prior to the first dose of PRTX-100 Use of any investigational drug, other than eltrombopag or romiplostim, ≤ 30 days or 5 half-lives of the investigational drug (whichever is longer) prior to the first dose of RTX-100 Not willing to stay at the study site for 4 hours after each PRTX-100 infusion
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William E Gannon Jr., MD
Organizational Affiliation
Protalex, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
USC Norris Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Michigan Center of Medical Research
City
Farmington Hills
State/Province
Michigan
ZIP/Postal Code
48334
Country
United States
Facility Name
Weil-Cornell Medical College
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Gabrail Cancer Center
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
Facility Name
Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Aberdeen Royal Infirmary
City
Aberdeen
State/Province
AB
ZIP/Postal Code
AB25 27N
Country
United Kingdom
Facility Name
Leicester Royal Infirmary
City
Leicester
State/Province
Leichester
ZIP/Postal Code
LE1 5WW
Country
United Kingdom
Facility Name
Queen Elizabeth Hospital
City
Birmingham
ZIP/Postal Code
B15 2TH
Country
United Kingdom
Facility Name
Glasgow Royal Infirmary
City
Glasgow
ZIP/Postal Code
G4 0SF
Country
United Kingdom
Facility Name
Norfolk and Norwich Hospital
City
Norwich
ZIP/Postal Code
NR4 7UY
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

PRTX-100-202 Open-Label, Dose Escalation Study in Adult Patients With ITP

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