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Plinabulin vs. Pegfilgrastim in Patients With Solid Tumors Receiving Docetaxel Myelosuppressive Chemotherapy Phase 3

Phase 3
Completed
Conditions
Chemotherapy-induced Neutropenia
Registration Number
NCT03102606
Lead Sponsor
BeyondSpring Pharmaceuticals Inc.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
105
Inclusion Criteria

Inclusion Criteria:<br><br> 1. At least = 18 years of age (male or female) at the time of signing the informed<br> consent form.<br><br> 2. ECOG performance status of 0 to 1.<br><br> 3. Patients with:<br><br> Phase 2 only:<br><br> • Advanced or metastatic NSCLC failing platinum-based therapy<br><br> Phase 3 only:<br><br> - Advanced or metastatic breast cancer, who have failed < 5 prior lines of<br> chemotherapy (Note that study treatment may be the first chemotherapy treatment<br> for advanced or metastatic cancer)<br><br> - locally advanced or metastatic NSCLC after platinum therapy failure<br><br> - HRPC (Note that study treatment may be the first chemotherapy treatment)<br><br> 4. Pathology confirmation of cancer is required.<br><br> 5. Patients with = 1 of the following risk factors, at the initiation of docetaxel<br> chemotherapy, that would require neutropenia prophylaxis per National Comprehensive<br> Cancer Network (NCCN) guidelines (version 2, 2016):<br><br> - Prior chemotherapy or radiation treatment<br><br> - Bone marrow involvement by tumor<br><br> - Surgery and/or open wounds within 4 weeks of first administration of study drug<br><br> - Age > 65 years of age and receiving full chemotherapy dose intensity<br><br> 6. Life expectancy of 3 months or more.<br><br> 7. The following laboratory results assessed within 14 days prior to study drug<br> administration:<br><br> - Hemoglobin >/= 9 g/dL independent of transfusion or growth factor support<br><br> - Absolute neutrophil count (ANC) >/= 1.5 x 10**9/L independent of growth factor<br> support<br><br> - Serum total bilirubin </= 1.5 times the upper limit normal (ULN), unless the<br> patient has a diagnosis of Gilbert's disease, in which case direct bilirubin<br> </= 1.5 times ULN of the direct bilirubin.<br><br> - Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) </= 2.5 x<br> ULN (</= 1.5 x ULN if alkaline phosphatase is > 2.5 x ULN)<br><br> - Serum creatinine </= 1.5 x ULN<br><br> Note: Results are from the central laboratory. Local laboratory results may be<br> accepted on a case by case basis after discussion with the Medical Monitor, however<br> in this case central laboratories must also be taken within the screening time<br> window.<br><br> 8. Prothrombin time (PT)/International Normalized Ratio (INR) = 1.5 × upper limit of<br> normal (ULN), activated partial thromboplastin time (PTT) = 1.5 × ULN, based on<br> central laboratory results.<br><br> 9. Female subjects of childbearing potential have a negative pregnancy test at<br> screening. Females of childbearing potential are defined as sexually mature women<br> without prior hysterectomy or who have had any evidence of menses in the past 12<br> months. However, women who have been amenorrhoeic for 12 or more months are still<br> considered to be of childbearing potential if the amenorrhea is possibly due to<br> prior chemotherapy, anti-estrogens, or ovarian suppression.<br><br> - Women of childbearing potential (i.e., menstruating women) must have a negative<br> urine pregnancy test (positive urine tests are to be confirmed by serum test)<br> documented within the 24-hour period prior to the first dose of study drug.<br><br> - Sexually active women of childbearing potential enrolled in the study must<br> agree to use two forms of accepted methods of contraception during the course<br> of the study and for 3 months after their last dose of study drug. Effective<br> birth control includes (a) intrauterine device (IUD) plus one barrier method;<br> (b) on stable doses of hormonal contraception for at least 3 months (e.g.,<br> oral, injectable, implant, transdermal) plus one barrier method; (c) 2 barrier<br> methods. Effective barrier methods are male or female condoms, diaphragms, and<br> spermicides (creams or gels that contain a chemical to kill sperm); or (d) a<br> vasectomized partner.<br><br> - For male patients who are sexually active and who are partners of premenopausal<br> women: agreement to use two forms of contraception during the treatment period<br> and for at least 3 months after the last dose of study drug.<br><br>Exclusion Criteria:<br><br> 1. History of myelogenous leukemia, myelodysplastic syndrome or concomitant sickle cell<br> disease.<br><br> 2. Received chemotherapy within 4 weeks prior to the first dose of study drug.<br><br> 3. Received prior docetaxel treatment, except adjuvant docetaxel given > 1 year prior<br> to first dose of study drug<br><br> 4. Phase 3 only: Received >/= 5 lines of cytotoxic chemotherapy for advanced or<br> metastatic breast cancer (adjuvant chemotherapy will count as one line of<br> chemotherapy, and any hormonal or biological, non conjugate therapy [e.g.,<br> trastuzumab] will not count as a line of therapy).<br><br> 5. Current use of strong cytochrome P450 (CYP) 3A4 inhibitors, within 3 days of the<br> first administration of study drug, and 7 days after treatment with taxanes OR<br> requires use of strong CYP3A4 inhibitors<br><br> 6. Received an investigational agent or tumor vaccine within 2 weeks before the first<br> dose of study drug; patients must have recovered from toxicity of prior treatment<br> and have no > Grade 1 CTCAE (v4.03) treatment emergent AEs.<br><br> 7. Receiving any concurrent anticancer therapies (except continued hormonal treatment).<br><br> 8. Received a prior bone marrow or stem cell transplant.<br><br> 9. Has a co-existing active infection or received systemic anti-infective treatment<br> within 72 hours before the first dose of study drug.<br><br> 10. Prior radiation therapy within the 4 weeks before the first dose of study drug.<br><br> 11. Prior use of pegfilgrastim or filgrastim within 4 weeks before the first dose of<br> study drug.<br><br> 12. Presence of any serious or uncontrolled illness including, but not limited to:<br> uncontrolled diabetes, ongoing or active infection, symptomatic congestive heart<br> failure, unstable angina pectoris, uncontrolled cardiac arrhythmia, uncontrolled<br> arterial thrombosis, symptomatic pulmonary embolism, or psychiatric illness that<br> would limit compliance with study requirements, or any other conditions that would<br> preclude the patient from study treatment as per the discretion of the Investigator.<br><br> 13. Significant cardiovascular history:<br><br> - History of myocardial infarction or ischemic heart disease within 1 year<br> (within a window of up to 18 days less than 1 year) before first study drug<br> administration;<br><br> - Uncontrolled arrhythmia;<br><br> - History of congenital QT prolongation;<br><br> - Electrocardiogram (ECG) findings consistent with active ischemic heart disease;<br><br> - New York Heart Association Class III or IV cardiac disease;<br><br> - Uncontrolled hypertension: blood pressure consistently >150 mm Hg systolic and<br> > 100 mm Hg diastolic in spite of antihypertensive medication.<br><br> 14. History of hemorrhagic diarrhea, inflammatory bowel disease, or active uncontrolled<br> peptic ulcer disease. (Concomitant therapy with ranitidine or its equivalent and/or<br> omeprazole or its equivalent is acceptable). History of ileus or other significant<br> gastrointestinal disorder known to predispose to ileus or chronic bowel<br> hypomotility.<br><br> 15. Any other malignancy requiring active therapy.<br><br>

Exclusion Criteria

Not provided

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Duration of Severe Neutropenia (DSN)
Secondary Outcome Measures
NameTimeMethod
Change in Estimated Mean Bone Pain Score;Change in Patients With at Least 30% Platelet Count From Baseline in Cycle 1;Proportion of Patients With Neutrophil-to-lymphocyte Ratio (NLR) > 5;Proportion of Patients With Thrombocytopenia;Infections;Antibiotic Use;Sepsis
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