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CC-4047 (Pomalidomide) for Graft vs. Host Disease
This study is currently recruiting participants.
Verified by Washington University School of Medicine, November 2008
Sponsored by: Washington University School of Medicine
Information provided by: Washington University School of Medicine
ClinicalTrials.gov Identifier: NCT00770757
  Purpose

This study will test the safety and effectiveness CC-4047 (pomalidomide) in patients with advanced, steroid refractory graft-versus-host disease.


Condition Intervention Phase
Graft vs Host Disease
Drug: CC-4047
Phase II

U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase 2, Open-Label, Single-Arm, PILOT Study of Safety and Efficacy of cc-4047 (Pomalidomide) in Patients With ADVANCED Chronic Graft Versus Host Disease Developing After Allogeneic Hematological Stem Cell Transplantation

Further study details as provided by Washington University School of Medicine:

Primary Outcome Measures:
  • Overall response using NIH consensus criteria measuring therapeutic response in clinical trials for chronic GvHD [ Time Frame: At baseline and after every 12 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Organ specific response [ Time Frame: At baseline and after every 12 weeks ] [ Designated as safety issue: No ]
  • Adverse events by grade and attribution [ Time Frame: Continuous throughout study ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 20
Study Start Date: November 2008
Estimated Study Completion Date: May 2011
Estimated Primary Completion Date: May 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental Drug: CC-4047
CC-4047 3 mg po daily for up to 12 months

Detailed Description:

Chronic Graft vs. Host Disease is a major complication after allogeneic hematopoietic stem cell transplantation developing in 30 - 70% of patients. It is a multisystem alloimmune and autoimmune disorder with a negative impact on quality of life and functional status, increased need for extended immunosuppression and is the leading cause of late transplant related mortality.

CC-4047 is a novel immune modulatory drug that is a thalidomide analog with a 4,000 fold greater inhibition of TNF-α production related to thalidomide. Several features of CC-4047 suggest that this drug may be useful in treating chronic GVHD including in vitro suppression of TNF-α production, increasing Th1 and stimulation of IL-12 and sIL-Rα.

This study is a phase 2, open-label, single-arm, pilot study of efficacy and safety of CC-4047 in patients with advanced chronic GvHD who failed to achieve a response with high-dose corticosteroids or second line systemic immunosuppressive therapy.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Patient must meet all of the following inclusion criteria:

  • Must be greater than or equal to 18 years of age at the time of consent.
  • Must be able to adhere to the study visit schedule and other protocol requirements.
  • Chronic graft versus host disease (GHVD) developing after allogeneic hematological stem cell transplantation diagnosed using NIH criteria for diagnosis and staging of chronic GvHD (including both "classic chronic GvHD" and "overlap syndrome")
  • Must have moderate or severe chronic GvHD according to Global Staging System for Chronic GvHD or mild chronic GvHD with platelet count less than 100 x 109/L
  • Must have failed to achieve response to high dose corticosteroid (in average 0.5 mg/kg/day prednisone or equivalent for greater than or equal to 8 weeks), or have failed second line systemic immunosuppressive therapy.
  • If taking corticosteroids at the time of enrolment, must be on stable or tapering schedule without corticosteroid pulses in the preceding 8 weeks.
  • If taking secondary systemic immunosuppressive therapy at the time of enrolment, must be on stable or tapering schedule in the preceding 4 weeks.
  • Karnofsky performance score (KPS) greater than or equal to 60%.
  • Life expectancy greater than or equal to 3 months.
  • Female of childbearing potential (FCBP) must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse for at least 28 days before starting study drug, while participating in the study, and for at least 28 days after discontinuation from the study. The two methods of reliable contraception must include one highly effective method (i.e. intrauterine device (IUD), hormonal [birth control pills, injections, or implants], tubal ligation, partner's vasectomy) and one additional effective (barrier) method (i.e. latex condom, diaphragm, cervical cap). FCBP must be referred to a qualified provider of contraceptive methods if needed.
  • FCBP must agree to pregnancy testing and contraceptive counseling every 28 days during the study. FCBP must also refrain from donating blood and/or egg while participating in the study and for at least 28 days after discontinuation from this study
  • FCBP must have two negative pregnancy tests (sensitivity of at least 50 mIU/mL) prior to starting study drug. The first pregnancy test must be performed within 10-14 days prior to the start of study drug and the second pregnancy test must be performed within 24 hours prior to the start of study drug.
  • Male Subjects must agree to use a latex condom during sexual contact with females of childbearing potential while participating in the study and for at least 28 days following discontinuation from the study even if he has undergone a successful vasectomy
  • Male subjects will be warned that sharing study drug is prohibited and will be counseled about pregnancy precautions and potential risks of fetal exposure
  • Male Subjects must agree to abstain from donating blood, semen, or sperm during study participation and for at least 28 days after discontinuation from the study.
  • Must agree that if a pregnancy or a positive pregnancy test does occur in a study subject or the partner of a male study subject during study participation, study drug must be immediately discontinued.
  • Patients must agree to not share study drug with anyone during participation in the study.
  • Must understand and voluntarily sign an informed consent form.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality or psychiatric illness that would prevent the patient from giving informed consent.
  • Pregnant or lactating females.
  • New immunosuppressive therapy started within the preceding 4 weeks.
  • Extracorporeal photopheresis within the preceding 3 months.
  • Hypersensitivity to any immune modulator drug (IMiD™).
  • Unable to take prophylactic anticoagulation.
  • Irreversible organ/tissue damage as the only manifestation or major determinant of overall severity of chronic GvHD (e.g., bronchiolitis obliterans).
  • Any condition which places the patient at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Acute, persistent, recurrent or late-onset acute GvHD defined by NIH criteria.
  • Any of the following laboratory values at registration:
  • absolute neutrophil count (ANC) less than 1.0 x 109/L,
  • platelets less than 75 x 109/L, or
  • creatinine clearance less than 50 mL/min (Cockroft-Gault formula).
  • Uncontrolled infection requiring systemic antibiotics.
  • Known human immunodeficiency virus (HIV), hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection.
  • Known uncontrolled arrhythmias or symptomatic heart disease or left ventricular ejection fraction less than 40% (an ECHO should be performed as clinically indicated)
  • Recurrence of cancer for which the transplant was done except for presence of minimal residual disease by PCR.
  • Other cancer less than or equal to 2 years prior study-entry except:
  • Basal cell carcinoma of the skin,
  • Squamous cell carcinoma of the skin,
  • Carcinoma in situ of the cervix,
  • Carcinoma in situ of the breast, or
  • Prostate cancer (Tumor, Node, Metastasis [TNM] stage T1a or T1b)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00770757

Contacts
Contact: John F. DiPersio, M.D., Ph.D. 317-454-8304 jdipersi@dom.wustl.edu

Locations
United States, Missouri
Washington University School of Medicine Recruiting
St. Louis, Missouri, United States, 63122
Contact: John F. DiPersio, M.D., Ph.D.     314-454-8304     jdipersi@dom.wustl.edu    
Sub-Investigator: Iskra Pusic, M.D.            
Sub-Investigator: Edie Romvari, RN, MSN, FNP            
Sub-Investigator: Camille N. Abboud, M.D.            
Sub-Investigator: Amanda Cashen, M.D.            
Sub-Investigator: Michael P. Rettig, Ph.D.            
Sub-Investigator: Keith Stockerl-Goldstein, M.D.            
Sub-Investigator: Geoffrey Uy, M.D.            
Sub-Investigator: Ravi Vij, M.D.            
Sub-Investigator: Peter Westervelt, M.D., Ph.D.            
Sub-Investigator: Stephanie Bauer, RN, MSN, FNP            
Sub-Investigator: George Bryant, ND            
Sub-Investigator: Holly Comer, RN, FNP            
Sub-Investigator: Eric Ruettgers, RN, FNP            
Sub-Investigator: Feng Gao, M.D., Ph.D.            
Sponsors and Collaborators
Washington University School of Medicine
Investigators
Principal Investigator: John F. DiPersio, M.D., Ph.D. Washington Univerisity School of Medicine
  More Information

Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine  This link exits the ClinicalTrials.gov site

Responsible Party: Washington University School of Medicine ( John DiPersio, M.D., Ph.D. )
Study ID Numbers: 08-1093
Study First Received: October 7, 2008
Last Updated: November 19, 2008
ClinicalTrials.gov Identifier: NCT00770757  
Health Authority: United States: Food and Drug Administration

Study placed in the following topic categories:
Graft versus host disease
Graft vs Host Disease
Homologous wasting disease

Additional relevant MeSH terms:
Immune System Diseases

ClinicalTrials.gov processed this record on January 16, 2009