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Neihulizumab (ALTB-168) in Patients With Steroid-refractory Acute Graft-versus-host Disease or Treatment-refractory Acute Graft-versus-host Disease

Phase 1
Completed
Conditions
Treatment-refractory Acute Graft-versus-Host Disease
Steroid-refractory Acute Graft-versus-Host Disease
Interventions
Biological: Neihulizumab (ALTB-168)
Registration Number
NCT03327857
Lead Sponsor
AltruBio Inc.
Brief Summary

A Phase I study to establish the pharmacokinetics, pharmacodynamics, safety and efficacy profiles of Neihulizumab in patients with steroid-refractory or treatment refractory acute graft-versus-host disease (SR/TR-aGVHD)

Detailed Description

Neihulizumab (ALTB-168) is an immune checkpoint agonist antibody that regulates T cell homeostasis. The unique mechanism of action provides a natural regulation of T cell homeostasis that induces cell death preferentially in late-stage activated T cells without affecting resting T cells and early-activated T cells. Because pathogenic T cells underlying the inflammatory conditions are usually in late-stage activated state, eliminating this population of cells can potentially result in controlling autoimmune inflammation of T cell associated diseases, such as GvHD.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
37
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Neihulizumab (ALTB-168)Neihulizumab (ALTB-168)Intravenous doses of Neihulizumab (ALTB-168)
Primary Outcome Measures
NameTimeMethod
Pharmacokinetics of Neihulizumab - t1/2Up to Day 56

Half life

Pharmacokinetics of Neihulizumab - tmaxUp to Day 56

Time to reach Cmax

Pharmacokinetics of Neihulizumab - Lambda-zUp to Day 56

Terminal phase elimination rate constant

Pharmacokinetics of Neihulizumab - AUCUp to Day 56

Including AUC0-t, AUC0-tz, AUC 0-inf

Pharmacokinetics of Neihulizumab - CmaxUp to Day 56

Maximum plasma concentration

Pharmacokinetics of Neihulizumab - MRTUp to Day 56

Mean Residence Time

Pharmacokinetics of Neihulizumab - Vz and VssUp to Day 56

Volume of distribution and volume of distribution at steady state

Secondary Outcome Measures
NameTimeMethod
To measure the Receptor Occupancy (RO)Up to Day 56

Receptor occupancy will be monitored using a flow cytometry based method

Overall Response Rate (ORR)Day 28

To assess the Overall Response Rate (ORR) at Day 28: CR+PR

ImmunogenicityUp to Day 56

Immunogenicity will be monitored by anti-drug antibody (ADA) ELISA

Adverse Events (AEs)Up to Day 180

AEs graded according to CTCAE v4.03

To measure regenerating islet-derived 3-alpha (REG3α) and suppression of tumorigenicity 2 (ST2) as Pharmacodynamics (PD) biomarkers.Up to Day 56

Receptor occupancy will be monitored using a flow cytometry based method

Complete Response (CR)Day 28

To assess the rate of complete response (CR) at Day 28 in patients treated with Neihulizumab

Duration of ResponseUp to Day 180

For subjects with CR at Day 28, duration of response will be assessed according to the time interval from Day 28 to the first occurrence of (1) resumption of Neihulizumab administration or initiation of new systemic treatment for aGvHD or (for patients who have tapered steroids) an increase in corticosteroids to methylprednisolone 2 mg/kg (+/-10%) equivalent or more, or (2) death.

Non Relapse Mortality (NRM)Day 180

Patients will be followed-up for survival for 6 months after the first Neihulizumab treatment

Trial Locations

Locations (13)

David Geffen School of Medicine at UCLA

🇺🇸

Los Angeles, California, United States

Baylor College of Medicine-Houston Methodist & Texas Children's Hospital

🇺🇸

Houston, Texas, United States

University of Miami - Sylvester Comprehensive Cancer Center

🇺🇸

Miami, Florida, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

The University of Kansas Cancer Center

🇺🇸

Westwood, Kansas, United States

University Hospitals Seidman Cancer Center

🇺🇸

Cleveland, Ohio, United States

Fred Hutchinson Cancer Research Center

🇺🇸

Seattle, Washington, United States

University of Chicago

🇺🇸

Chicago, Illinois, United States

Dana Farber Cancer Center

🇺🇸

Boston, Massachusetts, United States

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

City of Hope

🇺🇸

Duarte, California, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

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