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Safety and Efficacy of POL6326 for Mobilization/Transplant of Sibling Donor in Patients With Hematologic Malignancies

Primary Purpose

Acute Myeloid Leukemia in Remission, Adult Acute Lymphoblastic Leukemia in Remission, Chronic Myelogenous Leukemia (CML)

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
POL6326
Leukapheresis
PBSC Transplant
Sponsored by
Polyphor Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia in Remission

Eligibility Criteria

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

Donor Inclusion Criteria

  • Donor must be 18 to 70 years of age inclusive.
  • Donor must be a 6/6 HLA-matched sibling willing to donate PBSC for transplant.
  • Donor must have adequate cardiac function with no history of congestive heart failure and no history of atrial fibrillation or ventricular tachyarrhythmia.
  • Donor must have adequate renal function as defined by a minimum creatinine clearance (CrCl) value of >30 ml/min.
  • Donor must have adequate hepatic function as defined by a total bilirubin <3x upper limit of normal.
  • Donor must have adequate neurologic function as defined by NO evidence of a severe central or peripheral neurologic abnormality and no history of cerebrovascular accident or seizure disorder requiring anticonvulsant medication.
  • Donor must be HIV-1&2 antibody and HTLV-1&2 antibody sero-negative by FDA licensed test.
  • Donor must have an ECOG performance status of 0 or 1.
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.
  • Donor must demonstrate ability to be compliant with study regimen.
  • Donor must be able to understand and willing to sign an IRB approved written informed consent document.

Recipient Inclusion Criteria

  • Recipient must have available the successful collection of a POL62326 mobilized product.
  • Recipient must be 18 to 75 years of age inclusive.
  • Recipient must have a 6/6 HLA-matched sibling willing to donate PBSC for transplant.
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.
  • Recipient must have one of the following diagnoses:
  • Acute myelogenous leukemia (AML) in 1st or subsequent remission
  • Acute lymphoblastic leukemia (ALL) in 1st or subsequent remission
  • Chronic myelogenous leukemia (CML)
  • Non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) in 2nd or greater complete remission, partial remission
  • Chronic lymphocytic leukemia (CLL)
  • Multiple myeloma (MM)
  • Myelodysplastic syndrome (MDS)
  • Myeloproliferative disorder (MPD)
  • Recipient must have adequate cardiac function with a left ventricular ejection fraction > 40%.
  • Recipient must have adequate pulmonary function defined as NO severe or symptomatic restrictive or obstructive lung disease, and formal pulmonary function testing showing an FEV1 >50% (predicted) and a DLCO >40% (predicted), corrected for hemoglobin.
  • Recipient must have adequate hepatic function as defined by a total bilirubin <3x upper limit of normal or absence of hepatic fibrosis/cirrhosis.
  • Recipient must have adequate neurologic function as defined by NO evidence of a severe central or peripheral neurologic abnormality. Patients with a history of previous CNS tumor involvement are eligible provided they are without symptoms or signs and the CNS is now free of disease on lumbar puncture and CT scan of the brain.
  • Recipient must be HIV-1&2 antibody and HTLV-1&2 antibody sero-negative by FDA licensed test.
  • Recipient must have an ECOG performance status of 0 or 1.
  • Recipient must demonstrate ability to be compliant with medical regimen.
  • Recipient must have life expectancy of greater than 2 months.
  • Recipient must be able to understand and willing to sign an IRB approved written informed consent document.

Donor Exclusion Criteria

  • Donor must not have an active infection at the time of study entry.
  • Donor must not have active alcohol or substance abuse within 6 months of study entry.
  • Donor must not be currently enrolled on another investigational agent study.
  • Donor must not have any medical condition, which, in the opinion of the clinical investigator, would interfere with his/her evaluation.
  • Donor must not have an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • If female and of child-bearing age, donor must not be pregnant or breastfeeding.

Recipient Exclusion Criteria

  • Recipient must not have had (the following therapies within the following timeframe):
  • Investigative drugs within 21 days
  • Recipient must have no evidence of active infection at the time of the transplant preparative regimen or at time of transplantation.
  • Recipient must have no active alcohol or substance abuse within 6 months of study entry.
  • Recipient must not be pregnant and/or breastfeeding.

Sites / Locations

  • University of Kansas Cancer Center
  • Washington University School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Donor (Phase I and Phase II)

Recipient

Arm Description

On Day 1 (and possibly Day 2) POL6326 IV Infusion with increasing dose levels in Phase I or with random dose assignment (from the 2 selected from Phase I) in phase II Leukapheresis collection on Day 1 (and possibly Day 2)

Day 0 - PBSC transplant with stem cells mobilized with IV POL6326

Outcomes

Primary Outcome Measures

Phase I Study - safety and tolerability of POL6326 as a mobilization agent.
Phase II Study - determine the number of allogeneic donors who require a second leukapheresis
Determine the number of allogeneic donors which collect >= 2 mill CD34+ cells with one or two leukapheresis procedures treated with IV POL6326. Comparison with historic group of donors who were mobilized with 240 µg/kg SC plerixafor.

Secondary Outcome Measures

Phase I Study - define maximum tolerated dose of POL6326
Phase II Study - the proportion of HLA-identical sibling donors who experience grade 3-4 infusional toxicity and the proportion who are safely mobilized
To estimate the proportion of HLA-identical sibling donors who experience grade 3-4 infusional toxicity and the proportion from whom > 2 mill CD34+ cells/kg recipient weight are safely mobilized following one or two leukapheresis procedures
Phase II Study - pharmacokinetics and pharmacodynamics of IV POL6326
Stem cell and T-cell phenotyping
Phase II Study - rate of acute GVHD and chronic GVHD in patients who receive IV POL6326 mobilized peripheral blood stem cells.
Acute GVHD - Day 100 (+/- 7 days) Chronic GVHD - Day 365 (+/- 14 days)
Phase II Study - kinetics of neutrophil and platelet engraftment in recipients of POL6326 mobilized peripheral blood stem cells.

Full Information

First Posted
August 5, 2011
Last Updated
February 25, 2016
Sponsor
Polyphor Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01413568
Brief Title
Safety and Efficacy of POL6326 for Mobilization/Transplant of Sibling Donor in Patients With Hematologic Malignancies
Official Title
A Phase I/II Study Evaluating the Safety and Efficacy of Intravenous POL6326 for the Mobilization and Transplantation of HLA-Matched Sibling Donor Hematopoietic Stem Cells in Patients With Advanced Hematological Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
February 2016
Overall Recruitment Status
Completed
Study Start Date
April 2012 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Polyphor Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Determine the safety and tolerability of POL6326 when used as a single mobilization agent.
Detailed Description
Current protocols use G-CSF to mobilize hematopoietic progenitor cells from matched sibling donors. This process requires from four to six days of G-CSF injection and is associated with significant morbidity, most notably bone pain. POL6326 is associated with few side effects and collection of cells occurs on the same day as POL6326 administration. This study will evaluate the safety and efficacy of this novel agent for hematopoietic progenitor cell mobilization and allogeneic transplantation based on the following hypotheses: Donors mobilized with intravenous POL6326 will require fewer collections than have previously been seen for donors mobilized with subcutaneous plerixafor. Healthy HLA-matched donors receiving one or two infusions of POL6326 will mobilize sufficient CD34+ cells (at least 2.0 x 106 CD34+ cells/kg recipient weights) following leukapheresis to support a hematopoietic cell transplant. IV POL6326 will result in more rapid kinetics and a higher maximum (peak) of human CD34+ stem cells mobilized from human normal allogeneic donors compared to previous donors who were mobilized with plerixafor. The hematopoietic cells mobilized by IV POL6326 will be functional and will result in prompt and durable hematopoietic engraftment following transplantation into HLA-identical siblings with advanced hematological malignancies using various non-myeloablative and myeloablative conditioning regimens and regimens for routine GVHD prophylaxis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia in Remission, Adult Acute Lymphoblastic Leukemia in Remission, Chronic Myelogenous Leukemia (CML), Non-Hodgkin's Lymphoma (NHL) or Hodgkin's Disease (HD) in 2nd or Greater Complete Remission, Partial Remission, Chronic Lymphocytic Leukemia (CLL), Multiple Myeloma (MM), Myelodysplastic Syndrome (MDS), Myeloproliferative Disorders

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Donor (Phase I and Phase II)
Arm Type
Experimental
Arm Description
On Day 1 (and possibly Day 2) POL6326 IV Infusion with increasing dose levels in Phase I or with random dose assignment (from the 2 selected from Phase I) in phase II Leukapheresis collection on Day 1 (and possibly Day 2)
Arm Title
Recipient
Arm Type
Experimental
Arm Description
Day 0 - PBSC transplant with stem cells mobilized with IV POL6326
Intervention Type
Drug
Intervention Name(s)
POL6326
Intervention Type
Procedure
Intervention Name(s)
Leukapheresis
Intervention Type
Procedure
Intervention Name(s)
PBSC Transplant
Primary Outcome Measure Information:
Title
Phase I Study - safety and tolerability of POL6326 as a mobilization agent.
Time Frame
30 days
Title
Phase II Study - determine the number of allogeneic donors who require a second leukapheresis
Description
Determine the number of allogeneic donors which collect >= 2 mill CD34+ cells with one or two leukapheresis procedures treated with IV POL6326. Comparison with historic group of donors who were mobilized with 240 µg/kg SC plerixafor.
Time Frame
2 days
Secondary Outcome Measure Information:
Title
Phase I Study - define maximum tolerated dose of POL6326
Time Frame
30 days
Title
Phase II Study - the proportion of HLA-identical sibling donors who experience grade 3-4 infusional toxicity and the proportion who are safely mobilized
Description
To estimate the proportion of HLA-identical sibling donors who experience grade 3-4 infusional toxicity and the proportion from whom > 2 mill CD34+ cells/kg recipient weight are safely mobilized following one or two leukapheresis procedures
Time Frame
30 days
Title
Phase II Study - pharmacokinetics and pharmacodynamics of IV POL6326
Description
Stem cell and T-cell phenotyping
Time Frame
Day 1-3
Title
Phase II Study - rate of acute GVHD and chronic GVHD in patients who receive IV POL6326 mobilized peripheral blood stem cells.
Description
Acute GVHD - Day 100 (+/- 7 days) Chronic GVHD - Day 365 (+/- 14 days)
Time Frame
Day 100 (+/- 7 days) or Day 365 (+/-14 days)
Title
Phase II Study - kinetics of neutrophil and platelet engraftment in recipients of POL6326 mobilized peripheral blood stem cells.
Time Frame
Day 365 (+/- 14 days)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Donor Inclusion Criteria Donor must be 18 to 70 years of age inclusive. Donor must be a 6/6 HLA-matched sibling willing to donate PBSC for transplant. Donor must have adequate cardiac function with no history of congestive heart failure and no history of atrial fibrillation or ventricular tachyarrhythmia. Donor must have adequate renal function as defined by a minimum creatinine clearance (CrCl) value of >30 ml/min. Donor must have adequate hepatic function as defined by a total bilirubin <3x upper limit of normal. Donor must have adequate neurologic function as defined by NO evidence of a severe central or peripheral neurologic abnormality and no history of cerebrovascular accident or seizure disorder requiring anticonvulsant medication. Donor must be HIV-1&2 antibody and HTLV-1&2 antibody sero-negative by FDA licensed test. Donor must have an ECOG performance status of 0 or 1. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately. Donor must demonstrate ability to be compliant with study regimen. Donor must be able to understand and willing to sign an IRB approved written informed consent document. Recipient Inclusion Criteria Recipient must have available the successful collection of a POL62326 mobilized product. Recipient must be 18 to 75 years of age inclusive. Recipient must have a 6/6 HLA-matched sibling willing to donate PBSC for transplant. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately. Recipient must have one of the following diagnoses: Acute myelogenous leukemia (AML) in 1st or subsequent remission Acute lymphoblastic leukemia (ALL) in 1st or subsequent remission Chronic myelogenous leukemia (CML) Non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) in 2nd or greater complete remission, partial remission Chronic lymphocytic leukemia (CLL) Multiple myeloma (MM) Myelodysplastic syndrome (MDS) Myeloproliferative disorder (MPD) Recipient must have adequate cardiac function with a left ventricular ejection fraction > 40%. Recipient must have adequate pulmonary function defined as NO severe or symptomatic restrictive or obstructive lung disease, and formal pulmonary function testing showing an FEV1 >50% (predicted) and a DLCO >40% (predicted), corrected for hemoglobin. Recipient must have adequate hepatic function as defined by a total bilirubin <3x upper limit of normal or absence of hepatic fibrosis/cirrhosis. Recipient must have adequate neurologic function as defined by NO evidence of a severe central or peripheral neurologic abnormality. Patients with a history of previous CNS tumor involvement are eligible provided they are without symptoms or signs and the CNS is now free of disease on lumbar puncture and CT scan of the brain. Recipient must be HIV-1&2 antibody and HTLV-1&2 antibody sero-negative by FDA licensed test. Recipient must have an ECOG performance status of 0 or 1. Recipient must demonstrate ability to be compliant with medical regimen. Recipient must have life expectancy of greater than 2 months. Recipient must be able to understand and willing to sign an IRB approved written informed consent document. Donor Exclusion Criteria Donor must not have an active infection at the time of study entry. Donor must not have active alcohol or substance abuse within 6 months of study entry. Donor must not be currently enrolled on another investigational agent study. Donor must not have any medical condition, which, in the opinion of the clinical investigator, would interfere with his/her evaluation. Donor must not have an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. If female and of child-bearing age, donor must not be pregnant or breastfeeding. Recipient Exclusion Criteria Recipient must not have had (the following therapies within the following timeframe): Investigative drugs within 21 days Recipient must have no evidence of active infection at the time of the transplant preparative regimen or at time of transplantation. Recipient must have no active alcohol or substance abuse within 6 months of study entry. Recipient must not be pregnant and/or breastfeeding.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Couriel, M.D.
Organizational Affiliation
University of Utah
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Kansas Cancer Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66205
Country
United States
Facility Name
Washington University School of Medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Safety and Efficacy of POL6326 for Mobilization/Transplant of Sibling Donor in Patients With Hematologic Malignancies

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