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An Open-Label Study of JZP-458 (RC-P) in Patients With Acute Lymphoblastic Leukemia (ALL)/Lymphoblastic Lymphoma (LBL)

Phase 2
Completed
Conditions
Acute Lymphoblastic Leukemia
Lymphoblastic Leukemia
Interventions
Drug: IM JZP-458
Drug: IV JZP-458
Registration Number
NCT04145531
Lead Sponsor
Jazz Pharmaceuticals
Brief Summary

This is an open-label, multicenter, dose confirmation, and PK study of JZP-458 in patients (of any age) with ALL/LBL who are hypersensitive to E. coli-derived asparaginases (allergic reaction or silent inactivation). This study is designed to assess the tolerability and efficacy of JZP-458 (only in patients who develop hypersensitivity to an E. coli-derived asparaginase), as measured by asparaginase activity.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
229
Inclusion Criteria
  1. Pediatric and adult patients with a diagnosis of ALL or LBL.
  2. Have had an allergic reaction to a long-acting E. coli-derived asparaginase OR have silent inactivation.
  3. Have 1 or more courses of E. coli-derived asparaginase remaining in his/her treatment plan.
  4. Patients must have, in the opinion of the Investigator, fully recovered from their prior allergic reaction to E. coli-derived asparaginase.
Exclusion Criteria
  1. Have previously received asparaginase Erwinia chrysanthemi or JZP-458.
  2. Have relapsed ALL or LBL.
  3. Are concurrently receiving another investigational agent and/or treated with an investigational device at the same time as JZP-458 (within 48 hours) during Course 1 of JZP-458.
  4. Have a history of ≥ Grade 3 pancreatitis.
  5. Prior history of asparaginase-associated ≥ Grade 3 hemorrhagic event or asparaginase-associated thrombus requiring anticoagulation therapy, excluding catheter-related thrombotic events.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
JZP-458IM JZP-458Part A (IM JZP-458) of the study will have 2 IM cohorts: * Cohort 1: a JZP-458 repeat dose/confirmatory cohort; a final IM JZP-458 dose level will be selected, and * Cohort 2: an expansion cohort to confirm the efficacy and safety of the final IM JZP-458 dose level and schedule Part B (IV JZP-458 Dose Confirmation) will be conducted to define the optimal dose of the IV administration of JZP-458 for further study in ALL/LBL patients as a repeated dose. Additional courses of JZP-458 (IM or IV depending on patient's allocation at study enrollment) will be administered based on each patient's original treatment plan for as long as the patient derives clinical benefit.
JZP-458IV JZP-458Part A (IM JZP-458) of the study will have 2 IM cohorts: * Cohort 1: a JZP-458 repeat dose/confirmatory cohort; a final IM JZP-458 dose level will be selected, and * Cohort 2: an expansion cohort to confirm the efficacy and safety of the final IM JZP-458 dose level and schedule Part B (IV JZP-458 Dose Confirmation) will be conducted to define the optimal dose of the IV administration of JZP-458 for further study in ALL/LBL patients as a repeated dose. Additional courses of JZP-458 (IM or IV depending on patient's allocation at study enrollment) will be administered based on each patient's original treatment plan for as long as the patient derives clinical benefit.
Primary Outcome Measures
NameTimeMethod
Response Rate During the First Course of JZP-458 AdministrationBaseline up to 2 weeks

The response rate was defined as the number (proportion) of patients with the last 72-hour nadir serum asparaginase activity (NSAA) level ≥ 0.1 IU/mL during the first course of IM JZP-458. Blood samples were collected for serum asparaginase activity level determination.

Number of Participants With Any Treatment-emergent Adverse Events (TEAEs)Date of written informed consent up to 30 days after last dose of last course, up to approximately 2 years 7 months

An adverse event (AE) is any untoward medical occurrence associated with the use of a drug in humans, whether or not considered related to study drug. AEs were classified by the Investigator using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Last 48-hour NSAA Level ≥ 0.1 IU/mL During The First Course (6 Doses) of JZP-458 AdministrationBaseline up to 2 weeks

Blood samples were collected for serum asparaginase activity level determination.

Number of Participants With Last NSAA Levels ≥ 0.4 IU/mL During The First Course (6 Doses) of JZP-458 AdministrationBaseline up to 2 weeks

Blood samples were collected for serum asparaginase activity level determination.

Mean Serum Asparaginase Activity Levels in First Course of JZP-458 AdministrationUp to 2 weeks (6 doses)

Serum asparaginase levels serve as a surrogate marker for asparagine depletion. Mean serum asparaginase activity levels in Course 1 are reported.

Number of Participants Who Are Anti-drug Antibody Positive or Negative Against JZP-458Baseline up to 30 days (ADA- samples) after last dose of last course and up to 6 months (ADA+ samples) after last dose of last course, up to approximately 2 years 7 months

Blood samples were collected for immunogenicity analysis. Anti-drug antibody positive (ADA+) participants were those with a positive result on the first test and also a positive result on the confirmatory test. Anti-drug antibody negative (ADA-) participants had a negative result on the first test.

Trial Locations

Locations (74)

Scottish Rite Hospital

🇺🇸

Atlanta, Georgia, United States

Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Kaiser Permanente - Fontana Medical Center

🇺🇸

Fontana, California, United States

Children's Hospital of Orange County Main Campus - Orange

🇺🇸

Orange, California, United States

Nemours Children's Specialty Care Jacksonville

🇺🇸

Jacksonville, Florida, United States

Kaiser Permanente - Roseville Medical Center

🇺🇸

Roseville, California, United States

University of Texas Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Benioff Children's Hospital Oakland

🇺🇸

Oakland, California, United States

Johns Hopkins All Children's Hospital

🇺🇸

Saint Petersburg, Florida, United States

Medical City Dallas Hospital

🇺🇸

Dallas, Texas, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Kaiser Permanente - Oakland Medical Center

🇺🇸

Oakland, California, United States

Nemours Alfred I. Dupont Hospital for Children

🇺🇸

Wilmington, Delaware, United States

NYU - Stephen D. Hassenfeld Children's Center for Cancer and Blood Disorders

🇺🇸

New York, New York, United States

Herbert Irving Comprehensive Cancer Center

🇺🇸

New York, New York, United States

Memorial Sloan-Kettering Cancer Center - New York

🇺🇸

New York, New York, United States

Washington University School of Medicine in Saint Louis

🇺🇸

Saint Louis, Missouri, United States

Ann and Robert H. Lurie Children's Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

Dana-Farber/Boston Children's Cancer and Blood Disorders Center

🇺🇸

Boston, Massachusetts, United States

Kaiser Permanente - San Diego Medical Center

🇺🇸

San Diego, California, United States

Children's Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Masonic Cancer Center

🇺🇸

Minneapolis, Minnesota, United States

Alliance for Childhood Diseases

🇺🇸

Las Vegas, Nevada, United States

Texas Children's Hospital

🇺🇸

Houston, Texas, United States

Seattle Children's Hospital

🇺🇸

Seattle, Washington, United States

University of Mississippi Medical Center

🇺🇸

Jackson, Mississippi, United States

Arkansas Children's Hospital

🇺🇸

Little Rock, Arkansas, United States

Phoenix Children's Hospital

🇺🇸

Phoenix, Arizona, United States

Children's of Alabama

🇺🇸

Birmingham, Alabama, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

University of California San Francisco Benioff Children's Hospital - Mission Bay

🇺🇸

San Francisco, California, United States

The Children's Hospital at Oklahoma University Medical Center

🇺🇸

Oklahoma City, Oklahoma, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Primary Children's Hospital

🇺🇸

Salt Lake City, Utah, United States

Victoria Hospital & Children's Hospital

🇨🇦

London, Ontario, Canada

Children's Hospital of Eastern Ontario

🇨🇦

Ottawa, Ontario, Canada

SickKids - The Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

Kaiser Permanente - Orange County - Anaheim Medical Center

🇺🇸

Anaheim, California, United States

Loma Linda University Medical Center

🇺🇸

Loma Linda, California, United States

Kaiser Permanente- Los Angeles Medical Center

🇺🇸

Los Angeles, California, United States

MemorialCare Miller Children's and Women's Hospital Long Beach

🇺🇸

Long Beach, California, United States

Connecticut Children's Medical Center

🇺🇸

Hartford, Connecticut, United States

Children's National Health System

🇺🇸

Washington, District of Columbia, United States

Memorial Medical Office Centre

🇺🇸

Hollywood, Florida, United States

Kapi'olani Medical Center for Women and Children

🇺🇸

Honolulu, Hawaii, United States

Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

East Tennessee Children's Hospital

🇺🇸

Knoxville, Tennessee, United States

Methodist Hospital - San Antonio

🇺🇸

San Antonio, Texas, United States

Inova Medical Group - Fairfax Hospital

🇺🇸

Falls Church, Virginia, United States

Children's Hospital of The King's Daughters

🇺🇸

Norfolk, Virginia, United States

Centre Hospitalier Universitaire Sainte-Justine

🇨🇦

Montréal, Quebec, Canada

Kaiser Permanente - Downey Medical Center

🇺🇸

Downey, California, United States

Providence Sacred Heart Medical Center

🇺🇸

Spokane, Washington, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

St. Jude Children's Research Hospital

🇺🇸

Memphis, Tennessee, United States

Kaiser Permanente - Santa Clara Medical Center

🇺🇸

Santa Clara, California, United States

Cohen Children's Medical Center

🇺🇸

New Hyde Park, New York, United States

Golisano Children's Hospital of Southwest Florida

🇺🇸

Fort Myers, Florida, United States

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

McMaster Children's Hospital

🇨🇦

Hamilton, Ontario, Canada

The Montreal Children's Hospital

🇨🇦

Montréal, Quebec, Canada

University of Pittsburgh Medical Center - Children's Hospital of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

Neurology Clinic, P.C

🇺🇸

Cordova, Tennessee, United States

Children's Blood and Cancer Center

🇺🇸

Austin, Texas, United States

CancerCare Manitoba - McDermot and Urgent Care Site

🇨🇦

Winnipeg, Manitoba, Canada

University of California Davis Comprehensive Cancer Center

🇺🇸

Sacramento, California, United States

Smilow Cancer Hospital - New Haven

🇺🇸

New Haven, Connecticut, United States

AdventHealth Orlando

🇺🇸

Orlando, Florida, United States

Norton Children's Hospital

🇺🇸

Louisville, Kentucky, United States

C.S. Mott Children's Hospital

🇺🇸

Ann Arbor, Michigan, United States

Wake Forest Baptist Health

🇺🇸

Winston-Salem, North Carolina, United States

Morristown Medical Center

🇺🇸

Morristown, New Jersey, United States

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