Efficacy and Safety Phase IIa Study of Myelo001 in Chemotherapy-Induced Neutropenia
- Conditions
- Chemotherapy-Induced NeutropeniaMyelosuppressionBreast Cancer
- Interventions
- Drug: Placebo
- Registration Number
- NCT02692742
- Lead Sponsor
- Myelo Therapeutics GmbH
- Brief Summary
Neutropenia is the most serious hematologic toxicity of cancer chemotherapy, often limiting the doses and density of chemotherapy that can be tolerated. The degree and duration of neutropenia determine the risk of infection. Myelo001, a small orally bioavailable molecule, has been shown in chemotherapy- or radiotherapy-induced myelosuppression to stimulate differentiation of peripheral white blood cells (WBC) and bone marrow cells of the leucocytic, lymphocytic, and erythrocytic lineage. The purpose of the MyeloConcept study is to determine the safety and effectiveness of Myelo001 in preventing or reducing chemotherapy-induced neutropenia and myelosuppression in patients receiving chemotherapy due to breast cancer.
- Detailed Description
Phase IIa study, 1:1 randomized, double-blind, placebo-controlled, parallel-design, multi-center study. Each breast cancer patient will be randomly assigned into one of two treatment arms receiving either Myelo001 or placebo as a tablet. Investigational medicinal product is taken as supportive care for 23 consecutive days during chemotherapy treatment. Hematologic and safety parameters as well as actual begin and doses of following chemotherapy cycles will be assessed. A single primary variable will be analyzed with test statistics based on frequent absolute neutrophil measurements. Additionally, in a subgroup of patients biomarkers and pharmacokinetics of Myelo001 will be investigated.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 137
-
Female patient of any racial origin having fulfilled her 18th birthday on Visit 1 (Screening)
-
Histologically confirmed invasive breast cancer scheduled for neoadjuvant or adjuvant chemotherapy (patient with primary wound healing ([R0])
-
Already selected for neoadjuvant or adjuvant standard of care EC regimen (Epirubicin 90 mg/m2 BSA (body surface area) + Cyclophosphamide 600 mg/m2 BSA q21d (every 21 days)) (with or without treatment with taxanes afterwards)
-
Risk of chemotherapy-induced Febrile Neutropenia ≤20% according to ASCO Guidelines (2015)
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More than 5 days remaining before the planned initiation of the 1st chemotherapy cycle
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Performance status Grade 0-1 (ECOG)
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Echocardiography: No contraindication for the scheduled chemotherapy
-
Haematologic, laboratory and chemistry thresholds at baseline:
- Absolute neutrophil count (ANC) ≥2,000 cells/ mm3 (≥2.0 x 10/L)
- Platelet count ≥100,000/mm3 (≥100 x 10exp9/L)
- Haemoglobin ≥10 g/dL
- Total bilirubin <1.5 x, AST, ALT <2.5 x upper limit of normal (ULN)
- Serum creatinine <2.0 mg/dL
-
Able to read, understand and willing to sign the informed consent form
-
Able to undergo the investigations and to follow the Visit schedule
- Suspected allergy to Myelo001 or its excipients
- Prior chemotherapy
- Prior or concomitant treatment with radiotherapy
- Currently on or scheduled for other immunomodulatory or immunosuppressive therapies (e.g. TNF inhibitors) during the first chemotherapy cycle
- Currently on or scheduled for other immunostimulatory or hematopoietic active therapies (e.g.G-CSF, GM-CSF)
- Currently on or scheduled for primary prophylaxis with antibiotics in the first chemotherapy cycle
- History of bone marrow transplantation or stem cell transplant
- Administration of another investigational medicinal product / medical device within 30 days prior to screening. Participation in non-interventional, national or international cancer registries is allowed.
- Already confirmed HIV, hepatitis B or C virus (HBV or HCV) infection
- History of somatic disease/condition that may interfere with the objectives of the study
- Any other medical disease or clinical laboratory parameter outside the normal range and of clinical significance according to the investigator
- Serious uncontrolled comorbidities
- Pregnant or breast-feeding subject
- Woman considered to be of childbearing potential who do not use highly effective birth control methods during the study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Myelo001 Myelo001 Myelo001 100 mg QD Placebo Placebo Matching Placebo QD
- Primary Outcome Measures
Name Time Method Threshold area over the curve (AOC1) of ANC: Area below the threshold line (ANC 2.0x10^9/L classified as grade 1 neutropenia) and above the individual ANC trajectory visit 3 to visit 10 (22 days) Threshold area over the curve (AOC3) of ANC: Area below the threshold line (ANC 1.0x10^9/L classified as grade 3 neutropenia) and above the individual ANC trajectory visit 3 to visit 10 (22 days) Duration of ANC < 1.0x10^9/L classified as grade 3 neutropenia visit 3 to visit 10 (22 days)
- Secondary Outcome Measures
Name Time Method Change of Threshold Area over the Curve of thrombocytes visit 3 to visit 10 (22 days) Proportion of patients with neutropenia grade 1 and higher; 3 and higher, 4, and ANC ≤0.1x 10^9/L visit 3 to visit 10 (22 days) Duration of neutropenia grade 1 and higher; 3 and higher, 4, and ANC ≤0.1x 10^9/L visit 3 to visit 10 (22 days) ANC at nadir visit 3 to visit 10 (22 days) Time to ANC nadir (from start of chemotherapy) visit 3 to visit 10 (22 days) Time to ANC recovery from grade 3 neutropenia, i. e. time from onset to time of reaching neutropenia grade ≤2 (ANC ≥ 1.5x10^9/L) visit 3 to visit 10 (22 days) Time to ANC recovery from grade 4 neutropenia, i. e. time from onset to time of reaching neutropenia grade ≤2 (ANC ≥ 1.5x10^9/L) visit 3 to visit 10 (22 days) Time to ANC recovery from profound neutropenia (ANC ≥ 0.1x10^9/L), i. e. time from onset to time of reaching neutropenia grade ≤2 (ANC ≥1.5x10^9/L) visit 3 to visit 10 (22 days) Proportion of patients with rescue therapy visit 3 to visit 10 (22 days) Proportion of patients developing febrile neutropenia (body temperature ≥38.3°C by single tympanic or oral measurement) and ANC ≤0.5x 10^9/L (Grade 4) visit 3 to visit 10 (22 days) Proportion of patients with CTX dose reduction and/or delay of CTX cycle 2 visit 10 to visit 11 Treatment success rate: a) Neutropenia grade ≤2, b) No need for G-CSF rescue therapy, c) No early withdrawal (drop-out). visit 3 to visit 10 (22 days) Threshold AOC of ANC (AOC4): Area below the threshold line (ANC 0.5x10^9/L classified as grade 4 neutropenia) and above the individual ANC trajectory visit 3 to visit 10 (22 days) Change of Threshold Area over the Curve of lymphocytes visit 3 to visit 10 (22 days) Change of Threshold Area over the Curve of leukocytes visit 3 to visit 10 (22 days)
Trial Locations
- Locations (23)
Site 10
🇩🇪Hannover, Germany
Site 20
🇩🇪Aachen, Germany
Site 21
🇩🇪Dresden, Germany
Site 16
🇩🇪Aurich, Germany
Site 19
🇩🇪Oldenburg, Germany
Site 17
🇩🇪Ravensburg, Germany
Site 12
🇩🇪Westerstede, Germany
Site 05
🇩🇪Erlangen, Germany
Site 26
🇩🇪Dresden, Germany
Site 09
🇩🇪Esslingen, Germany
Site 25
🇩🇪Goslar, Germany
Site 11
🇩🇪Hamburg, Germany
Site 22
🇩🇪Hannover, Germany
Site 07
🇩🇪Konstanz, Germany
Site 23
🇩🇪Mainz, Germany
Site 04
🇩🇪Offenbach, Germany
Site 28
🇩🇪Tübingen, Germany
Site 03
🇩🇪Mainz, Germany
Site 01
🇩🇪Friedrichshafen, Germany
Site 24
🇩🇪Rosenheim, Germany
Site 13
🇩🇪Frankfurt a.M., Germany
Site 29
🇩🇪Lübeck, Germany
Site 02
🇩🇪Frankfurt a.M., Germany