MedPath

Vedolizumab in the Prophylaxis of Intestinal Acute Graft Versus Host Disease (aGVHD) in Participants Undergoing Allogeneic Hematopoietic Stem Cell (Allo-HSCT) Transplantation

Phase 3
Completed
Conditions
Hematopoietic Stem Cells
Interventions
Registration Number
NCT03657160
Lead Sponsor
Millennium Pharmaceuticals, Inc.
Brief Summary

The purpose of this study is to evaluate the efficacy of vedolizumab when added to background aGvHD prophylaxis regimen compared to placebo and background aGvHD prophylaxis regimen on intestinal aGvHD-free survival by Day +180 in participants who receive allo-HSCT as treatment for a hematologic malignancy or myeloproliferative disorder.

Detailed Description

The drug being tested in this study is called vedolizumab. Vedolizumab is being tested to treat people who are undergoing allo-HSCT transplantation. This study will look at the efficacy and safety of vedolizumab in the prophylaxis of intestinal aGvHD in participants undergoing allo-HSCT transplantation.

The study will enroll approximately 558 participants. Participants will be randomly assigned (by chance, like flipping a coin) in 1:1 ratio to one of the two treatment groups-which will remain undisclosed to the participant and study doctor during the study (unless there is an urgent medical need) along with background GvHD prophylaxis regimen:

* Vedolizumab 300 mg

* Placebo (dummy inactive intravenous infusion)

This multi-center trial will be conducted Worldwide. The overall time to participate in this study is 12 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
343
Inclusion Criteria
  1. Must be >= 18 years of age and, in selected countries, adolescents aged 12 years and greater and weighing >=30 kilogram (kg) at time of randomization.
  2. Must undergo deoxyribose nucleic acid (DNA)-based human leukocyte antigen (HLA) matching and be 8 of 8 or 7 of 8 HLA-matched (singe allele or antigen mismatch at HLA-A, -B, and -C, and HLA-DRB1 is allowable) unrelated hematopoietic stem cell transplantation (HSCT) from either peripheral blood or bone marrow stem cells for a hematologic malignancy or myeloproliferative disorder.
  3. For whom a myeloablative conditioning or reduced intensity conditioning (RIC) is planned.
  4. Allo-HSCT eligible (meeting institutional criteria)-participants planned medical care should include aGvHD prophylaxis with a combination of calcineurin inhibitor (CNI) (cyclosporine [CYS] or tacrolimus [TAC]) and methotrexate (MTX) or CNI and mycophenolate mofetil (MMF). With the exception of antithymocyte globulin (ATG) (antithymocyte globulin-Fresenius [ATG-F] or thymoglobulin), all other therapies, approved or investigational, for GvHD prophylaxis are excluded.
  5. Eastern Cooperative Oncology Group (ECOG) performance status of <= 2 for participants aged >=18 years at randomization or >=60 % using the Karnofsky performance status for adolescent participants aged >=16 years at randomization or the Lansky performance status for adolescent participants aged 12 to < 16 years at randomization.
Exclusion Criteria
  1. Had prior allo- HSCT.
  2. Planned umbilical cord blood transplant or planned to receive posttransplant cyclophosphamide, in vivo or ex vivo T cell-depleted hematopoietic stem cells (HSCs) with the exception of ATG (ATG-F or thymoglobulin).
  3. Planned allo-HSCT for nonmalignant hematological disorders (example, aplastic anemia, sickle cell anemia, thalassemias, Fanconi anemia or immunodeficiency).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboVedolizumab PlaceboVedolizumab placebo-matching, intravenous (IV) infusion, once on Day -1 along with background graft-versus-host disease (GvHD) prophylaxis regimen prior to Allo-HSCT and once on Days +13, +41, +69, +97, +125, and +153 post Allo-HSCT up to the end of study treatment (up to 182 days).
Vedolizumab 300 mgVedolizumabVedolizumab 300 mg, IV infusion, once on Day -1 along with background GvHD prophylaxis regimen prior to Allo-HSCT and once on Days +13, +41, +69, +97, +125, and +153 post Allo-HSCT up to the end of study treatment (up to 182 days).
Primary Outcome Measures
NameTimeMethod
Intestinal aGvHD-Free Survival After Allo-HSCT by +180 DaysFrom the date of first dose of study drug to first documented intestinal aGvHD or death, whichever occurs first up to +180 days

Intestinal aGvHD Free Survival is the time from the date of first study drug administration (Day-1) to intestinal aGvHD event/death, where an event is defined as death due to any cause or Stage 1-4 intestinal involvement per Acute Graft versus-Host Disease Clinical Stage criteria. Data was censored for participants who have not had the intestinal aGvHD event or died or have had the event after pre-specified timing, e.g., last contact or Day +180 after allo HSCT whichever occurs first.

Secondary Outcome Measures
NameTimeMethod
Grade B-D aGvHD-Free SurvivalFrom the date of first dose of study drug to first documented grade B-D aGvHD or death, whichever occurs first up to Day +180

Grade B-D aGvHD Free Survival is the time from the date of first study drug administration (Day-1) to aGvHD event or death, where an event is defined as death or grade B-D any organ involvement per IBMTR Severity Index for aGvHD.

Intestinal aGvHD-Free and Relapse-Free SurvivalFrom the date of first dose of study drug to first documented intestinal aGvHD, death or relapse, whichever occurs first up to Day +180

Intestinal aGvHD and Relapse Free Survival is the time from the date of first study drug administration (Day-1) to intestinal aGvHD event/death/relapse, where an event is defined as death or Stage 1-4 intestinal involvement per Acute Graft versus-Host Disease Clinical Stage criteria, or relapse. It will be censored for participants who have not had the event or have had the event after pre-specified timing, e.g., last contact or Day +180 after allo-HSCT whichever occurs first.

Grade C-D aGvHD-Free SurvivalFrom the date of first dose of study drug to first documented Grade C-D aGvHD or death, whichever occurs first up to Day +180

Grade C-D aGvHD Free Survival is the time from the date of first study drug administration (Day-1) to GvHD event/death, where an event is defined as Grade C-D aGvHD any organ involvement per International Bone Marrow Transplant Registry Database (IBMTR) Severity Index for aGvHD or death. It will be censored for participants who have not had the event or have had the event after pre-specified timing, eg, last contact or Day +180 after allo-HSCT whichever occurs first.

Nonrelapse Mortality (NRM)From the date of first dose of study drug to first documented death without relapse, up to Day +180

Non-relapse mortality is the time from the date of first study drug administration (Day-1) to death without occurrence of a relapse. Data was censored for participants who have not had the event or have had the event after pre-specified timing, e.g., last contact or Day +180 after allo HSCT whichever occurs first.

Overall Survival (OS)From the date of first dose of study drug to first documented death up to Day +180

Overall Survival by Days +180 is the time from the date of first study drug administration (Day-1) to death from any cause.

Trial Locations

Locations (139)

Children's Healthcare of Atlanta

🇺🇸

Atlanta, Georgia, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

National Research Center for Hematology

🇷🇺

Moscow, Russian Federation

Fundacion Favaloro Hospital Universitario

🇦🇷

Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina

Universitatsspital Zurich

🇨🇭

Zurich, Switzerland

University of North Carolina Hospitals

🇺🇸

Chapel Hill, North Carolina, United States

Oslo University Hospital - Rikshospitalet

🇳🇴

Oslo, Norway

Cardiff and Vale University Health Board

🇬🇧

Cardiff, Wales, United Kingdom

Sheffield Teaching Hospitals NHS Foundation Trust

🇬🇧

Sheffield, England, United Kingdom

Hospital Universitario de Gran Canaria Doctor Negrin

🇪🇸

Las Palmas De Gran Canaria, LAS Palmas, Spain

Buddhist Tzu Chi General Hospital

🇨🇳

Hualien City, Hualien, Taiwan

Uniwersyteckie Centrum Kliniczne

🇵🇱

Gdansk, Pomorskie, Poland

Spitalul Clinic Judetean de Urgenta Targu Mure

🇷🇴

Târgu-Mureş, Mures, Romania

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

Austin Health

🇦🇺

Heidelberg, Victoria, Australia

Hospital Universitario Walter Cantidio - Universidade Federal do Ceara

🇧🇷

Fortaleza, Ceara, Brazil

Hospital de Cancer de Barretos

🇧🇷

Barretos, SAO Paulo, Brazil

The Royal Melbourne Hospital

🇦🇺

Parkville, Victoria, Australia

Centre Hospitalier Universitaire Nantes - Hotel Dieu

🇫🇷

Nantes Cedex 1, PAYS DE LA Loire, France

Universitatsklinikum Carl Gustav Carus Dresden

🇩🇪

Dresden, Sachsen, Germany

Diakonie-Klinikum Stuttgart

🇩🇪

Stuttgart, Baden-wuerttemberg, Germany

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

The Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Universitair Ziekenhuis Leuven

🇧🇪

Leuven, Flemish Brabant, Belgium

Skanes Universitetssjukhus i Lund

🇸🇪

Lund, Skane, Sweden

Saskatchewan Cancer Agency

🇨🇦

Saskatoon, Saskatchewan, Canada

Hopital Necker-Enfants Malades

🇫🇷

Paris, Ile-de-france, France

Centre Hospitalier Universitaire Amiens-Picardie

🇫🇷

Amiens, Picardie, France

Instituto Brasileiro de Controle do Cancer - Sao Camilo Oncolgia

🇧🇷

Sao Paulo, Brazil

Universitatsmedizin Mannheim

🇩🇪

Mannheim, Baden-wuerttemberg, Germany

Hospital General Universitario Morales Meseguer

🇪🇸

Murcia, Spain

Istituto Clinico Humanitas Humanitas Cancer Center

🇮🇹

Milano, Italy

Karolinska Universitetssjukhuset

🇸🇪

Stockholm, Sweden

Hopital Saint Louis

🇫🇷

Paris Cedex 10, Ile-de-france, France

Hospital Santa Marcelina

🇧🇷

Sao Paulo, Brazil

Universitatsklinikum Frankfurt

🇩🇪

Frankfurt am Main, Hessen, Germany

Hokkaido University Hospital

🇯🇵

Sapporo-shi, Hokkaido, Japan

Azienda Ospedaliera Cardinale G. Panico

🇮🇹

Tricase, Lecce, Italy

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda

🇮🇹

Milano, Italy

Hopital Saint-Antoine

🇫🇷

Paris, Ile-de-france, France

Groupe Hospitalier Pitie-Salpetriere

🇫🇷

Paris, Ile-de-france, France

Rambam Health Care Campus - Rambam Medical Center

🇮🇱

Haifa, Israel

Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital

🇯🇵

Nagoya, Aichi, Japan

Ospedale Mazzoni

🇮🇹

Ascoli Piceno, Marche, Italy

Policlinico Universitario di Catania

🇮🇹

Catania, Italy

Hadassah Medical Center

🇮🇱

Jerusalem, Israel

Soroka University Medical Center

🇮🇱

Beer Sheva, Beersheba, Israel

Azienda Grande Ospedale Metropolitano Bianchi Melacrino Morelli

🇮🇹

Reggio Calabria, Calabria, Italy

Instituto Portugues de Oncologia de Lisboa Francisco Gentil

🇵🇹

Lisboa, Portugal

Centro Hospitalar de Lisboa Norte EPE- Hospital Santa Maria

🇵🇹

Lisboa, Portugal

National University Hospital

🇸🇬

Singapore, Singapore

Kaohsiung Medical University Hospital

🇨🇳

Kaohsiung, Taiwan

Kyushu University Hospital

🇯🇵

Fukuoka-shi, Fukuoka, Japan

The Catholic University of Korea - Seoul St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Universitaetsklinikum Schleswig-Holstein - Campus Kiel

🇩🇪

Kiel, Schleswig-holstein, Germany

Fiona Stanley Hospital

🇦🇺

Murdoch, Western Australia, Australia

Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital

🇯🇵

Hiroshima-shi, Hiroshima, Japan

Osaka City University Hospital

🇯🇵

Osaka, Japan

Severance Hospital

🇰🇷

Seoul, Korea, Republic of

David Geffen School of Medicine at University of California Los Angeles

🇺🇸

Los Angeles, California, United States

Robert H. Lurie Comprehensive Cancer Center of Northwestern University

🇺🇸

Chicago, Illinois, United States

Augusta University Georgia Cancer Center

🇺🇸

Augusta, Georgia, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

University of Kentucky Chandler Medical Center

🇺🇸

Lexington, Kentucky, United States

Marlene and Stewart Greenebaum Cancer Center

🇺🇸

Baltimore, Maryland, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Barbara Ann Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Roswell Park Comprehensive Cancer Center

🇺🇸

Buffalo, New York, United States

Weill Cornell Medical College

🇺🇸

New York, New York, United States

Columbia University Medical Center - The Columbia Center for Translational Immunology

🇺🇸

New York, New York, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Texas Oncology - Baylor Charles A. Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

Hospital Privado Centro Medico de Cordoba

🇦🇷

Cordoba, Argentina

Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

Hospital Italiano de Buenos Aires

🇦🇷

Ciudad Autonoma de Buenos Aires, Argentina

Royal Brisbane and Women's Hospital

🇦🇺

Herston, Queensland, Australia

Saint Vincent's Hospital Sydney

🇦🇺

Darlinghurst, New South Wales, Australia

Ziekenhuisnetwerk Stuivenberg

🇧🇪

Antwerpen, Belgium

Fundacao Antonio Prudente - A.C.Camargo Cancer Center

🇧🇷

Sao Paulo, Brazil

Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo

🇧🇷

Sao Paulo, Brazil

Instituto do Cancer e Transplante de Curitiba

🇧🇷

Curitiba, Parana, Brazil

Centre Hospitalier Universitaire de Limoges

🇫🇷

Limoges Cedex, Limousin, Lorraine, France

Universitatsmedizin der Johannes Gutenberg Universitat Mainz

🇩🇪

Mainz, Rheinland-pfalz, Germany

Universitatsklinikum Halle

🇩🇪

Halle, Sachsen-anhalt, Germany

University Regional General Hospital of Patras

🇬🇷

Patras, Peloponnese, Greece

Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona

🇮🇹

Ancona, Italy

Ospedale dell'Angelo

🇮🇹

Mestre, Venezia, Italy

Azienda Ospedaliera Policlinico di Bari

🇮🇹

Bari, Italy

Presidio Ospedaliero di Pescara

🇮🇹

Pescara, Italy

Okayama University Hospital

🇯🇵

Okayama-city, Okayama, Japan

Shizuoka Cancer Center

🇯🇵

Nagaizumi, Shizuoka, Japan

Jichi Medical University Hospital

🇯🇵

Shimotsuke-city, Tochigi, Japan

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Gyeonggi-do, Korea, Republic of

Kyungpook National University Hospital

🇰🇷

Daegu, Gyeongsangbuk-do, Korea, Republic of

Keimyung University Dongsan Hospital

🇰🇷

Daegu, Gyeongsangbuk-do, Korea, Republic of

Pusan National University Hospital

🇰🇷

Busan, Gyeongsangnam-do, Korea, Republic of

Daegu Catholic University Medical Center

🇰🇷

Daegu, Korea, Republic of

Korea University Anam Hospital

🇰🇷

Seoul, Korea, Republic of

Instituto Portugues de Oncologia do Porto Francisco Gentil

🇵🇹

Porto, Portugal

Sverdlovsk Regional Clinical Hospital #1

🇷🇺

Ekaterinburg, Sverdlovsk, Russian Federation

Institutul Clinic Fundeni

🇷🇴

Bucuresti, Romania

Hospital Universitari Germans Trias i Pujol

🇪🇸

Badalona, Barcelona, Spain

Hospital Universitario Ramon Y Cajal

🇪🇸

Madrid, Spain

Hospital Universitario Fundacion Jimenez Diaz

🇪🇸

Madrid, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Hospital Universitario Virgen de la Arrixaca

🇪🇸

Murcia, Spain

Hospital Universitario de Salamanca

🇪🇸

Salamanca, Spain

Hospital Clinico Universitario de Valencia

🇪🇸

Valencia, Spain

Universitatsspital Basel

🇨🇭

Basel, Switzerland

China Medical University Hospital

🇨🇳

Taichung, Taiwan

Koo Foundation Sun Yat-Sen Cancer Center

🇨🇳

Taipei, Taiwan

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Chang Gung Memorial Hospital

🇨🇳

Taoyuan, Taiwan

Imperial College Healthcare NHS Trust

🇬🇧

London, England, United Kingdom

Barts Health NHS Trust

🇬🇧

London, England, United Kingdom

Emory University - Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

Cohen Children's Medical Center

🇺🇸

New Hyde Park, New York, United States

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Indiana University Melvin and Bren Simon Cancer Center

🇺🇸

Indianapolis, Indiana, United States

University of Virginia Health System

🇺🇸

Charlottesville, Virginia, United States

CancerCare Manitoba

🇨🇦

Winnipeg, Manitoba, Canada

Chungnam National University Hospital

🇰🇷

Daejeon, Korea, Republic of

Ordensklinikum Linz Elisabethinen

🇦🇹

Linz, Upper Austria, Austria

University of Alabama at Birmingham Comprehensive Cancer Center

🇺🇸

Birmingham, Alabama, United States

Mayo Clinic - Rochester

🇺🇸

Rochester, Minnesota, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital

🇯🇵

Bunkyo-Ku, Tokyo, Japan

Hopital Pontchaillou

🇫🇷

Rennes Cedex 9, Bretagne, France

University General Hospital of Athens Attikon

🇬🇷

Athens, Attica, Greece

Debreceni Egyetem Klinikai Kozpont

🇭🇺

Debrecen, Hajdu-bihar, Hungary

Hospital Universitario "Dr. Jose Eleuterio Gonzalez"

🇲🇽

Monterrey, Nuevo LEON, Mexico

Singapore General Hospital

🇸🇬

Singapore, Singapore

Raffles Hospital

🇸🇬

Singapore, Singapore

Clinica Universidad de Navarra

🇪🇸

Pamplona, Navarra, Spain

The Clatterbridge Cancer Centre NHS Foundation Trust

🇬🇧

Liverpool, England, United Kingdom

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