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A Study to Evaluate a Therapeutic Vaccine, ASP0113, in Cytomegalovirus (CMV)-Seropositive Recipients Undergoing Allogeneic, Hematopoietic Cell Transplant (HCT)

Phase 3
Completed
Conditions
Cytomegalovirus (CMV)-Positive Recipients
Allogeneic, Hematopoietic Cell Transplant (HCT)
Interventions
Drug: Placebo
Registration Number
NCT01877655
Lead Sponsor
Astellas Pharma Global Development, Inc.
Brief Summary

The purpose of the study was to evaluate the efficacy of ASP0113 compared with placebo as measured by a primary composite endpoint of overall mortality and CMV end organ disease (EOD) through 1 year post-transplant. Safety of ASP0113 in participants undergoing allogeneic HCT will also be evaluated.

Detailed Description

Participants will be followed for 5.5 years post-transplant for long-term safety via an annual telephone contact.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
514
Inclusion Criteria
  • Participant is a CMV-seropositive HCT recipient

  • Participant is planned to undergo either of the following:

    • Sibling Donor Transplant
    • Unrelated Donor Transplant
  • Participant has one of the following underlying diseases:

    • Acute myeloid leukemia (AML)
    • Acute lymphoblastic leukemia (ALL)
    • Acute undifferentiated leukemia (AUL)
    • Acute biphenotypic leukemia
    • Chronic myelogenous leukemia (CML)
    • Chronic lymphocytic leukemia (CLL).
    • A defined myelodysplastic syndrome(s) (MDS)
    • Primary or secondary myelofibrosis
    • Lymphoma (including Hodgkin's)
Exclusion Criteria
  • Participant has active CMV disease or infection or has received treatment for active CMV disease or infection within 3 months (90 days) prior to transplant
  • Participant has a modified hematopoietic cell transplant comorbidity index (HCT-CI) score ≥ 4
  • Participant has received a prior HCT and has residual Chronic Graft-versus-host Disease (cGVHD)
  • Participant who is scheduled to have a cord blood transplant or a haploidentical transplant
  • Participant has a platelet count of less than 50,000 mm3 within 3 days prior to randomization (platelet transfusions are allowed)
  • Participant has aplastic anemia or multiple myeloma

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ASP0113ASP0113Participants received 1 mL of 5 mg/mL of ASP0113 via intramuscular injection in the deltoid muscle alternating sides with each dose on days -14 to -3 pretransplant, 14 to 40, 60, 90 and 180 in relation to the day of transplant (Day 0).
PlaceboPlaceboParticipants received 1 mL of 5 mg/mL of matching placebo via intramuscular injection in the deltoid muscle alternating sides with each dose on days -14 to -3 pretransplant, 14 to 40, 60, 90 and 180 in relation to the day of transplant (Day 0).
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Composite of All-Cause Mortality and Adjudicated Cytomegalovirus End Organ Disease (CMV EOD) Through 1 Year Post TransplantFrom first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)

This was the composite of all-cause mortality and adjudicated CMV EOD through 1 year posttransplant, The CMV EOD was assessed by the independent and blinded adjudication committee, which counted events that were observed up to day 380 from transplantation. Deaths that occurred up to day 365 from transplant were also counted.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Protocol-Defined CMV Viremia Through 1 Year PosttransplantFrom first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)

Protocol-defined CMV viremia was defined as a CMV plasma viral load ≥1000 IU/mL as assessed by the central laboratory. Rate was based on cumulative incidence function estimated at 1 year. The central laboratory had the lower limit of quantification \[LLOQ\] for CMV viral load assessment, so when the viral load was below the LLOQ the actual viral load reading was not possible and was denoted as ≤LLOQ. If participant had any CMV viral load assessments greater than the LLOQ it was classified as viremic.

Percentage of Participants With Adjudicated CMV-Specific Antiviral Therapy (AVT) Through 1 Year PosttransplantFrom first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)

The CMV-specific AVT use was adjudicated by the independent and blinded committee. When the CMV-specific AVT was initiated, a central CMV viral load was obtained weekly until it was discontinued. Participants without any CMV-specific AVT events were censored on the last study evaluation.

Percentage of Participants With a Composite Endpoint of Protocol-defined CMV Viremia and Adjudicated CMV-Specific AVT UseFrom first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)

Protocol-defined CMV viremia was as CMV plasma viral load ≥ 1000 IU/mL as assessed by the central laboratory. The CMV-specific AVT was determined by the adjudication committee. Participants with no posttransplant viral load data were excluded from the analysis.

Percentage of Participants With First Occurrence of Adjudicated CMV-specific AVT or Adjudicated Diagnosis of CMV EOD After Study Drug First Injection Through 1 Year PosttransplantFrom first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)

Rate was based on cumulative incidence function estimate at 1 year. Time to first CMV-specific AVT was defined as time to the start of AVT for CMV viremia or CMV EOD. CMV-specific AVT and EOD were determined by the adjudication committee. This endpoint was a composite endpoint based on the independent adjudication committee assessments of CMV-specific AVT and CMV EOD.

All-Cause Mortality at 1 Year PosttransplantFrom first study dose injection (Day -14 to -3 prior to transplant) up to one year post study drug injection (Day 365)

All-cause mortality through 1-year post-transplantation summary included all deaths and unknown survival status. For the known deaths, the adjudication committee assessed results and summarized them according to the following category: Mortality due to the participant's primary disease, and mortality due to causes unrelated to the participant's primary disease. Participants with unknown survival status at 1 year were considered dead for this analysis.

Trial Locations

Locations (83)

Site US10045

🇺🇸

Houston, Texas, United States

Site US10039

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Seattle, Washington, United States

Site JP81010

🇯🇵

Bunkyo-ku, Tokyo, Japan

Site JP81008

🇯🇵

Chuo-ku, Tokyo, Japan

Site TW88602

🇨🇳

Taipei City, Taiwan

Site CA15001

🇨🇦

Vancouver, British Columbia, Canada

Site US10012

🇺🇸

Atlanta, Georgia, United States

Site US10035

🇺🇸

San Francisco, California, United States

Site US10016

🇺🇸

Nashville, Tennessee, United States

Site US10007

🇺🇸

Indianapolis, Indiana, United States

Site CA15004

🇨🇦

Montreal, Quebec, Canada

Site CA15003

🇨🇦

Quebec, Canada

Site US10028

🇺🇸

Birmingham, Alabama, United States

Site US10044

🇺🇸

Tucson, Arizona, United States

Site US10026

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Stanford, California, United States

Site US10020

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Westwood, Kansas, United States

Site US10013

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Chicago, Illinois, United States

Site US10030

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Tampa, Florida, United States

Site US10011

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Baltimore, Maryland, United States

Site US10021

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Boston, Massachusetts, United States

Site US10043

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Baltimore, Maryland, United States

Site US10010

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Louisville, Kentucky, United States

Site US10036

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Rochester, Minnesota, United States

Site US10023

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Hackensack, New Jersey, United States

Site US10027

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Rochester, New York, United States

Site US10042

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Saint Louis, Missouri, United States

Site US10047

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New York, New York, United States

Site US10024

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Seattle, Washington, United States

Site US10031

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Richmond, Virginia, United States

Site US10002

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Dallas, Texas, United States

Site US10046

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Salt Lake City, Utah, United States

Site US10025

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Chapel Hill, North Carolina, United States

Site AU43004

🇦🇺

Adelaide, South Australia, Australia

Site BE32001

🇧🇪

Brugge, Belgium

Site AU43001

🇦🇺

Herston, Queensland, Australia

Site US10019

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Milwaukee, Wisconsin, United States

Site BE32007

🇧🇪

Roeselare, Belgium

Site BE32005

🇧🇪

Leuven, Belgium

Site CA15002

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Toronto, Ontario, Canada

Site FR33005

🇫🇷

Creteil, France

Site FR33011

🇫🇷

Besancon, France

Site FR33009

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Nantes, France

Site FR33010

🇫🇷

Nice, France

Site DE49010

🇩🇪

Bonn, Germany

Site DE49014

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Koln, Germany

Site DE49013

🇩🇪

Gottingen, Germany

Site DE49012

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Dusseldorf, Germany

Site DE49002

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Leipzig, Germany

Site DE49015

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Mainz, Germany

Site DE49007

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Muenster, Germany

Site JP81003

🇯🇵

Nagoya, Aichi, Japan

Site DE49006

🇩🇪

Ulm, Germany

Site DE49008

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Tuebingen, Germany

Site DE49005

🇩🇪

Stuttgart, Germany

Site DE49001

🇩🇪

Wurzburg, Germany

Site JP81007

🇯🇵

Sapporo, Hokkaido, Japan

Site JP81011

🇯🇵

Maebashi, Gunma, Japan

Site JP81004

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Shinjuku-ku, Tokyo, Japan

Site JP81009

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Minato-ku, Tokyo, Japan

Site JP81001

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Fukuoka, Japan

Site KR82002

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Seoul, Korea, Republic of

Site KR82004

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Seoul, Seoul Teugbyeolsi, Korea, Republic of

Site JP81005

🇯🇵

Fukuoka, Japan

Site KR82003

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Seoul, Korea, Republic of

Site JP81006

🇯🇵

Osaka, Japan

Site KR82001

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Seoul, Korea, Republic of

Site ES34006

🇪🇸

Barcelona, Spain

Site ES34001

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Badalona, Spain

Site ES34004

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Barcelona, Spain

Site ES34005

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Cordoba, Spain

Site ES34003

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Granada, Spain

Site ES34007

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Murcia, Spain

Site ES34011

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Madrid, Spain

Site ES34002

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Santander, Spain

Site ES34010

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Salamanca, Spain

Site SE46001

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Gothenburg, Sweden

Site SE46006

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Linkoping, Sweden

Site ES34009

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Valencia, Spain

Site SE46003

🇸🇪

Stockholm, Sweden

Site SE46005

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Umea, Sweden

Site SE46004

🇸🇪

Lund, Sweden

Site TW88601

🇨🇳

Taipei City, Taiwan

Site TW88603

🇨🇳

Taoyuan County, Taiwan

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