PROPHESSOR: AmBisome in Antifungal Primary Prophylaxis Treatment of High Risk Patients Undergoing Allogeneic Stem Cell Transplantation

This study has been completed.
Sponsor:
Information provided by:
Gilead Sciences
ClinicalTrials.gov Identifier:
NCT00326157
First received: May 10, 2006
Last updated: February 11, 2010
Last verified: February 2010
  Purpose

This pilot study was designed in order to evaluate the safety and efficacy of an AmBisome® loading dose regimen, in a weekly administration schedule during the initial phase of allogeneic stem-cell transplant and in case of occurrence of graft versus host disease (GvHD), which are both high risk periods as far as severe fungal infection development is concerned.


Condition Intervention Phase
Fungus Diseases
Drug: AmBisome
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Phase II Pilot Study on Safety of Administration of 3mg/kg/Day Three Times a Week Until Day 22 (21 Days After Transplantation Day) and 7 mg/kg Weekly From Day 29 to the End of Treatment (Day 50-8th Week) of AmBisome® in Antifungal Primary Prophylaxis Treatment of High Risk Patients Undergoing Allogeneic Stem-cell Transplantation

Resource links provided by NLM:


Further study details as provided by Gilead Sciences:

Primary Outcome Measures:
  • Safety and tolerability profile will be obtained by considering: Number (%) of patients with adverse events (AEs) [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Number (%) of patients with infusion related AE [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Laboratory parameters (in particular renal toxicity, hepatotoxicity, hypokalaemia, hypomagnesaemia) [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Overall adverse events [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Number (%) of patients with probable or proven invasive fungal infection according to EORTC-MSG criteria within the 6 months following the initiation of prophylaxis treatment [ Time Frame: Within previous 6 months ] [ Designated as safety issue: No ]
  • Number (%) of patients with fever of unknown origin requiring empirical antifungal treatment within the 6 months following the initiation of prophylaxis treatment [ Time Frame: Within previous 6 months ] [ Designated as safety issue: No ]
  • Number (%) of patients with superficial fungal infections within the 6 months following the initiation of prophylaxis treatment [ Time Frame: Within previous 6 months ] [ Designated as safety issue: No ]
  • Number (%) of patients with evidence of colonization by fungal organisms observed within the 6 months following the initiation of prophylaxis treatment [ Time Frame: Within previous 6 months ] [ Designated as safety issue: No ]
  • Reasons for early study discontinuation [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Survival rate and incidence of mortality related to fungal infection at the end of treatment and within 3, 6, and 12 months after the initiation of prophylaxis treatment [ Time Frame: Within 12 months ] [ Designated as safety issue: No ]
  • Time to probable or proven invasive fungal infection; fever of unknown origin requiring empirical antifungal treatment [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Time to superficial fungal infections [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Time to initiation of empirical antifungal treatment [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Time to study discontinuation [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Number of patients enrolled [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Number of patients completing the study [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Number of patients with early discontinuation [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]
  • Number of patients classified by reason for discontinuing study drug (including the study completion) [ Time Frame: Through 16 weeks ] [ Designated as safety issue: No ]

Enrollment: 34
Study Start Date: June 2006
Study Completion Date: November 2009
Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
AmBisome® will be administered for a duration of 8 weeks
Drug: AmBisome
3mg/kg/day three times a week until day 22 (21 days after transplantation day) and 7 mg/kg weekly from day 29 to the end of treatment (day 50-8th Week) of AmBisome®, IV administration

Detailed Description:

This pilot study was designed in order to evaluate the safety and efficacy of an AmBisome® loading dose regimen, in a weekly administration schedule during the initial phase of allogeneic stem-cell transplant and in case of occurrence of GvHD, which are both high risk periods as far as severe fungal infection development is concerned.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female patients aged more than 18 years
  • Patients with hematological malignancies undergoing allogeneic stem cell transplantation from donors other than human leukocyte antigen (HLA) identical sibling; source of stem cell includes either peripheral blood or bone marrow
  • No evidence of fungal infection at chest computed tomography (CT) scan and at sinus X-ray at baseline
  • Patients with no sign or symptoms of fungal infection and no previous proven or probable invasive fungal infection (IFI)
  • Females of childbearing potential must be surgically incapable of pregnancy, or practising a method of birth control, or agree to abstain from heterosexual intercourse while participating in the study, and with a negative pregnancy test (blood or urine) at baseline
  • An understanding of the study and agreement of the patient to give written informed consent
  • Ability and agreement to comply with all study requirements
  • Patient willing to attend hospital appointments for each injection (infusions will be performed in the hospital, under strict medical supervision). All patients will be hospitalised prior to, and remain in the hospital for at least one day, after the first infusion.

Exclusion Criteria:

  • Known hypersensitivity to amphotericin B, in particular known history of anaphylactic reaction to amphotericin B
  • Patients undergoing cord transplantation
  • Creatinine > 2.0 mg/dL
  • Patient with moderate or severe liver disease as defined by AST or ALT > 5 times the upper limit of normal (ULN)
  • Patients who are unlikely to survive more than 1 month
  • Patients who have received systemic antifungal therapy within 15 days prior to the inclusion
  • Any severe cardiovascular disease (such as arrhythmias, in particular) which may constitute a contra-indication to AmBisome® administration
  • Any severe disease other than the hematological diseases described at the second point of inclusion criteria, which in the investigator's judgement may interfere with study evaluations or affect the patient's safety
  • Pregnant or nursing females
  • Patients previously included in this study
  • Patients who have taken any investigational drug in the last 30 days prior to the inclusion.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00326157

Locations
Italy
Gilead Sciences
Milan, Italy, 20146
Sponsors and Collaborators
Gilead Sciences
Investigators
Study Director: Luigi Picaro, MD Gilead Sciences
  More Information

No publications provided

Responsible Party: Luigi Antonio Picaro, Gilead Sciences
ClinicalTrials.gov Identifier: NCT00326157     History of Changes
Other Study ID Numbers: GS-IT-131-0151
Study First Received: May 10, 2006
Last Updated: February 11, 2010
Health Authority: Italy: The Italian Medicines Agency

Keywords provided by Gilead Sciences:
antifungal primary prophylaxis treatment
allogeneic stem-cell transplantation
antifungal primary prophylaxis treatment of high risk patients undergoing allogeneic stem-cell transplantation

Additional relevant MeSH terms:
Mycoses
Amphotericin B
Liposomal amphotericin B
Antifungal Agents
Clotrimazole
Miconazole
Amebicides
Antiprotozoal Agents
Antiparasitic Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions
Anti-Bacterial Agents
Anti-Infective Agents, Local
14-alpha Demethylase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on July 10, 2014