Programmed Cell Death Protein-1 (PD-1) Monoclonal Antibody for EBV-HLH and CAEBV as First-line Therapy

Phase 4

• Conditions: EBV Infection
• Interventions: Drug: PD-1 monoclonal antibody

• Registration Number: NCT05039580
• Lead Sponsor: The First Affiliated Hospital of Soochow University

Brief Summary

EBV-HLH and CAEBV are both caused by EBV infection, part of them can rapidly lead to a syndrome of severe, life-threatening hyper-inflammation, with poor prognosis. Currently, the most effective treatment remains unknown. This study is trying to evaluate the efficacy and safety of PD-1 monoclonal antibody as a first-line therapy for EBV-HLH and CAEBV.

Detailed Description

Eligible patients who were diagnosed with EBV-HLH or CAEBV, age between 12 and 70 years, were enrolled in this study. All of them need to sign the informed consent first.

PD-1 monoclonal antibody 200mg is infused intravenously once for patients whose age \>=18 years, or age \<18 years but weight \>=40kg. While for patients age \<18 years, the dose of PD-1 monoclonal antibody is 3mg/kg. Besides, optimal supportive care is necessary.

Ruxolitinib and/or low-dose glucocorticoid can be used to reduce inflammation.

Cerebrospinal fluid parameters are examined, and methotrexate 15mg combined with dexamethasone will be intrathecal injected without contraindications.

Clinical and laboratory indicators are investigated weekly to evaluate the efficacy and toxicity.

If patients achieve partial response/complete response within 14 days after PD-1 monoclonal antibody, the clinical observations are stopped. If not, the observation period is prolonged to 21 days.

If disease progress at day 21, this study is terminated, and the patient should be transfer to other treatments as soon as quickly.

Study Timeline

• Study Start: 2021-05-15
• Status Verified: 2021-07
• Study First Submitted: 2021-09-01
• Study First Submitted QC: 2021-09-01
• Last Update Submitted: 2021-09-01
• Study First Posted: 2021-09-09
• Last Update Posted: 2021-09-09
• Primary Completion: 2023-04-30
• Study Completion: 2023-04-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 36

Inclusion Criteria

1. Meet the diagnostic criteria of EBV-HLH or CAEBV.
2. Newly diagnosed patients.
3. Eastern Cooperative Oncology Group score 0-3.
4. Total bilirubin <= 10 times of upper limit of normal (except for those caused by EBV-HLH or CAEBV), and serum creatinine <= 1.5 times of upper limit of normal.
5. Serum HIV antigen or antibody is negative.
6. Hepatitis C virus (HCV) antibody is negative, or HCV antibody is positive, but HCV-RNA is negative.
7. Both HbsAg and HbcAb for Hepatitis B virus (HBV) are negative. If not, the quantification of HBV-DNA needs to be <1*10e3 IU/ml.
8. The patient or his/her guardian must be able to understand and be willing to participate in this study, and sign the informed consent.

Exclusion Criteria

1. Non EBV-HLH or CAEBV patients.
2. Refractory or relapsed EBV-HLH or CAEBV.
3. Heart function above grade II (NYHA).
4. Patients suffered from other uncontrollable active infections.
5. Pregnant or lactating women.
6. Patients with mental disorders and cannot cooperate with the requirements of research, treatment and monitoring.
7. Active visceral bleeding.
8. Allergic to PD-1 monoclonal antibody.
9. Patients with known autoimmune diseases.
10. Participate in other clinical research at the same time.
11. The investigator judges that the patient has other reasons not suitable for this study, or participating in the study will bring great risks to the patient.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
PD-1 monoclonal antibody group	PD-1 monoclonal antibody	PD-1 monoclonal antibody 200mg is infused intravenously once for patients whose age \>=18 years, or age \<18 years but weight \>=40kg. While for patients age \<18 years, the dose of PD-1 monoclonal antibody is 3mg/kg.

Primary Outcome Measures

Name	Time	Method
EBV-DNA viral load	3 weeks	EBV-DNA copy by polymerase chain reaction
Response rate	3 weeks	complete response and/or partial response rate

Secondary Outcome Measures

Name	Time	Method
Toxicity of PD-1 monoclonal antibody	3 weeks	Side effects related to immunotherapy
Time for treatment works	3 weeks	Time to achieve partial response or complete response

Trial Locations

Locations (1)

The First Affiliated Hospital of Soochow University; 🇨🇳 Suzhou, Jiangsu, China