Testing a Reduced Conditioning Regimen FB2A2 Preceded by a Fractionated Radio-immunotherapy (RIT) With 90Y-Epratuzumab Before Allogeneic Stem Cell Transplantation for Patients With Lymphocyte B CD22 Positive Acute Lymphoblastic Leukemia (EPRALLO)
Primary Purpose
Lymphocyte B CD22 Positive Acute Lymphoblastic Leukemia
Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
90Y-DOTA-Epratuzumab IgG/Epratuzumab IgG
Busulfan
allogeneic stem cell transplantation.
Fludarabine
Thymoglobulines
Sponsored by
About this trial
This is an interventional treatment trial for Lymphocyte B CD22 Positive Acute Lymphoblastic Leukemia focused on measuring CD22 positive- lymphoblastic leukemia-RIT-Yttrium
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18
- Acute lymphoblastic Leukemia (ALL) CD22 + B-type in RC1 with high risk
- B-Cell Acute Lymphoblastic Leukemia (ALL) CD22+ beyond RC1.
- Expression of CD22 ≥ 30% in tumor population evaluated by flow cytometry or immunohistochemistry at diagnosis stage or relapse stage.
- HLA-identical donor intra family or not, without major HLA mismatch (9 / 10th accepted) without contra-indication for stem cell mobilization
- ECOG (Eastern Cooperative Oncology Group) ≤ 2
- Having or not received previously Epratuzumab
- Eligible for an allograft with reduced conditioning regimen
- With a signed informed consent
- Patient in age of children bearing with adequate contraception
- Patient affiliated to or beneficiary of the National Health Service
Exclusion Criteria:
- T-cell ALL
- Known hypersensibility to 90Y-DOTA-hLL2
- Immunization against hLL2 for patients having already received one or several injections of this antibody
- Patient eligible for myeloablative conditioning regimen
- Other prior malignancies must have had at least a 2-year disease-free interval with the exception of successfully treated carcinoma skin cancer or carcinoma in situ of the cervix.
- Patient with progressive psychiatric condition.
- HIV positive, hepatitis B-antigen positive, or hepatitis C positive patients who need a treatment
- Pregnant or breast-feeding women
- Women with childbearing potential without effective contraception
- Serious concomitant and uncontrolled infection
- Usual contraindications in the allogeneic transplant:
- Adult patient protected by the French law
Sites / Locations
Outcomes
Primary Outcome Measures
Determination of the maximum tolerated dose (MTD)
Patient toxicity will be evaluated according to NTCAE V4 criteria.
Secondary Outcome Measures
Overall survival
Disease free survival at one year post-transplant
Incidence of relapse at 1 year post-transplant
Non relapse mortality at day 100 post-transplant
Non relapse mortality at one year post-transplant
Hematologic reconstitutions post-transplant
Biological follow-up
Immune reconstitutions post-transplant
Biological follow-up
Incidence of acute and chronic GVHD
Chimerism post-transplant
Blood sample and/or bone marrow analysis by molecular biology
Residual disease post-transplant
by flow cytometry analysis
Toxicity of RIT
biological follow up and physical examination
Tolerance of RIT
biological follow up and physical examination
Immunization analysis : detection of antibody anti epratuzumab
By ELISA assay
90Y-DOTA-Epratuzumab blood pharmacokinetics
Detection of the radioactivity within the patient's blood samples
Dosage of FLT3-ligand in plasma and correlation with efficacy and toxicity of RIT
by biological assay
Full Information
NCT ID
NCT02577094
First Posted
October 2, 2015
Last Updated
January 17, 2017
Sponsor
Nantes University Hospital
Collaborators
Gilead Sciences, Institut Cancerologie de l'Ouest
1. Study Identification
Unique Protocol Identification Number
NCT02577094
Brief Title
Testing a Reduced Conditioning Regimen FB2A2 Preceded by a Fractionated Radio-immunotherapy (RIT) With 90Y-Epratuzumab Before Allogeneic Stem Cell Transplantation for Patients With Lymphocyte B CD22 Positive Acute Lymphoblastic Leukemia
Acronym
EPRALLO
Study Type
Interventional
2. Study Status
Record Verification Date
January 2017
Overall Recruitment Status
Withdrawn
Study Start Date
undefined (undefined)
Primary Completion Date
January 2017 (Actual)
Study Completion Date
January 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nantes University Hospital
Collaborators
Gilead Sciences, Institut Cancerologie de l'Ouest
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Determination of the maximum tolerated dose (MTD) of fractionated RIT with epratuzumab radiolabeled with yttrium-90 (90Y-epratuzumab) preceding a reduced conditioning regimen FB2A2 before allogeneic stem cell transplantation.
Detailed Description
Physical examination (screening and follow-up)
Complete blood counts (screening and follow-up)
Dosage of FLT3-ligand in plasma (screening and follow-up)
Blood ionogramme, creatinine hepatic work-up (screening and follow-up)
Left ventricular ejection fraction at pre-implant assessment
Immunization test (screening and follow-up)
Bone marrow aspiration or/and blood CD 22 immunophenotype for minimal residual disease evaluation (screening and follow-up)
All exams which were initially abnormal and which are necessary for response evaluation and All exams which are needed in case of relapse suspicion.
Pharmacokinetic of 90Y-hLL2
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphocyte B CD22 Positive Acute Lymphoblastic Leukemia
Keywords
CD22 positive- lymphoblastic leukemia-RIT-Yttrium
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Intervention Type
Drug
Intervention Name(s)
90Y-DOTA-Epratuzumab IgG/Epratuzumab IgG
Other Intervention Name(s)
90Y-DOTA- hLL2 IgG and hLL2 IgG
Intervention Description
2 injections of 90Y-DOTA- hLL2 IgG- hLL2 IgG at day -21 and day -14. (The 2 drugs are mixted in the same infusion)
Intervention Type
Drug
Intervention Name(s)
Busulfan
Intervention Description
Between the last injection of 90Y-DOTA- hLL2 IgG/hLL2 IgG (J-14) and the allogeneic stem cell transplantation
Intervention Type
Biological
Intervention Name(s)
allogeneic stem cell transplantation.
Intervention Description
At Day 0
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Intervention Description
Between the last injection of 90Y-DOTA- hLL2 IgG/hLL2 IgG (J-14) and the allogeneic stem cell transplantation
Intervention Type
Biological
Intervention Name(s)
Thymoglobulines
Intervention Description
Between the last injection of 90Y-DOTA- hLL2 IgG/hLL2 IgG (J-14) and the allogeneic stem cell transplantation
Primary Outcome Measure Information:
Title
Determination of the maximum tolerated dose (MTD)
Description
Patient toxicity will be evaluated according to NTCAE V4 criteria.
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Overall survival
Time Frame
Month 12
Title
Disease free survival at one year post-transplant
Time Frame
Month 12
Title
Incidence of relapse at 1 year post-transplant
Time Frame
Month 12
Title
Non relapse mortality at day 100 post-transplant
Time Frame
Day 100
Title
Non relapse mortality at one year post-transplant
Time Frame
Month 12
Title
Hematologic reconstitutions post-transplant
Description
Biological follow-up
Time Frame
Month 3
Title
Immune reconstitutions post-transplant
Description
Biological follow-up
Time Frame
Month 3
Title
Incidence of acute and chronic GVHD
Time Frame
Month 3 and 12
Title
Chimerism post-transplant
Description
Blood sample and/or bone marrow analysis by molecular biology
Time Frame
Month 3
Title
Residual disease post-transplant
Description
by flow cytometry analysis
Time Frame
Month 3 and Month 12
Title
Toxicity of RIT
Description
biological follow up and physical examination
Time Frame
Week 6 and Month 12
Title
Tolerance of RIT
Description
biological follow up and physical examination
Time Frame
Week 6 and Month 12
Title
Immunization analysis : detection of antibody anti epratuzumab
Description
By ELISA assay
Time Frame
Month 12
Title
90Y-DOTA-Epratuzumab blood pharmacokinetics
Description
Detection of the radioactivity within the patient's blood samples
Time Frame
Month 2
Title
Dosage of FLT3-ligand in plasma and correlation with efficacy and toxicity of RIT
Description
by biological assay
Time Frame
Month 12
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 18
Acute lymphoblastic Leukemia (ALL) CD22 + B-type in RC1 with high risk
B-Cell Acute Lymphoblastic Leukemia (ALL) CD22+ beyond RC1.
Expression of CD22 ≥ 30% in tumor population evaluated by flow cytometry or immunohistochemistry at diagnosis stage or relapse stage.
HLA-identical donor intra family or not, without major HLA mismatch (9 / 10th accepted) without contra-indication for stem cell mobilization
ECOG (Eastern Cooperative Oncology Group) ≤ 2
Having or not received previously Epratuzumab
Eligible for an allograft with reduced conditioning regimen
With a signed informed consent
Patient in age of children bearing with adequate contraception
Patient affiliated to or beneficiary of the National Health Service
Exclusion Criteria:
T-cell ALL
Known hypersensibility to 90Y-DOTA-hLL2
Immunization against hLL2 for patients having already received one or several injections of this antibody
Patient eligible for myeloablative conditioning regimen
Other prior malignancies must have had at least a 2-year disease-free interval with the exception of successfully treated carcinoma skin cancer or carcinoma in situ of the cervix.
Patient with progressive psychiatric condition.
HIV positive, hepatitis B-antigen positive, or hepatitis C positive patients who need a treatment
Pregnant or breast-feeding women
Women with childbearing potential without effective contraception
Serious concomitant and uncontrolled infection
Usual contraindications in the allogeneic transplant:
Adult patient protected by the French law
12. IPD Sharing Statement
Learn more about this trial
Testing a Reduced Conditioning Regimen FB2A2 Preceded by a Fractionated Radio-immunotherapy (RIT) With 90Y-Epratuzumab Before Allogeneic Stem Cell Transplantation for Patients With Lymphocyte B CD22 Positive Acute Lymphoblastic Leukemia
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