A Study of Belimumab in Treating Symptomatic Waldenstroms Macroglobulinaemia
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Purpose
Hypothesis; That inhibition of plasma Blys by the monoclonal antibody Belimumab will reduce both the survival of the lymphoplasmacytoid cells of Waldenstrom Macroglobulinaemia (WM), and their production of monoclonal IgM, resulting in a reduction of IgM paraprotein.
| Condition | Intervention | Phase |
|---|---|---|
|
Symptomatic Waldenstroms Macroglobulinaemia |
Drug: Belimumab |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Single Arm, Phase II Study of the Anti-Blys Monoclonal Antibody, Belimumab in Symptomatic Waldenstroms Macroglobulinaemia |
- Safety of Belimumab infusions in symptomatic WM [ Time Frame: Patients are assessed every 28 days while on treatment ] [ Designated as safety issue: Yes ]
- Reduction of IgM paraprotein [ Time Frame: Serum Immunoglobulins will be tested every 28 days ] [ Designated as safety issue: No ]
- Reduction of splenomegaly and/or lymphadenopathy [ Time Frame: This will be tested every 28 days ] [ Designated as safety issue: No ]
- Improvement in anaemia [ Time Frame: Patients will be assessed every 28 days while on treatment ] [ Designated as safety issue: No ]
- Correlate the degree of response with Belimumab levels [ Time Frame: Pharmacokinetics will be performed on days 1, 15, 56, 168, 364 ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 15 |
| Study Start Date: | November 2009 |
| Estimated Study Completion Date: | January 2013 |
| Estimated Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Belimumab
The first cycle of Belimumab is a loading cycle of 3 doses over 28 days (days 1, 15, 29). After the first cycle, additional cycles of belimumab will be administered every 28 ± 1 days (cycle 2 and all subsequent cycles). |
Drug: Belimumab
The first cycle of Belimumab (10mg/kg by intravenous (IV) infusion) is a loading cycle of 3 doses over 28 days (days 1, 15, 29). After the first cycle, additional cycles of belimumab (10mg/kg by intravenous (IV) infusion) will be administered every 28 ± 1 days (cycle 2 and all subsequent cycles). The infusion will be administered over a minimum period of 1 hour. |
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- At least 18 years of age.
- Diagnosis of WM histologically confirmed on bone marrow biopsy.
- Detectable IgM paraprotein >5 g/L
- Less than 3 lines of prior therapy for WM
- Full blood count within 4 weeks prior to screening shows ANC >1.0 x109/l AND platelet count >50 x109/l
Therapy indicated due to development of one or more of the following:
- symptomatic anaemia
- hyperviscosity symptoms
- rapidly rising paraprotein of >25% or >5g/l over 3 months
- splenomegaly
- bulky lymphadenopathy
- B symptoms or paraneoplastic phenomena, which, in the opinion of the investigator are the result of progressive WM.
- Life expectancy >12 months
- ECOG < 3
- Able to provide informed consent
- Ability to understand the requirements of the study, provide written informed consent, including consent for the use and disclosure of research-related health information, and comply with the protocol procedures, including required study visits.
- Subjects of child bearing potential must agree to use effective contraception throughout the study and for 3 months after the last dose of belimumab
Exclusion Criteria:
- Prior therapy with belimumab.
- Pregnant or breast feeding
- Chemotherapy, immunotherapy or biological therapy within 4 weeks of enrolment. Therapeutic plasma exchange can continue- see section 3.1.4.
- Creatinine clearance (calculated by Cockcroft-Gault) < 60ml/min
- Bilirubin >2x ULN, ALT >2x ULN.
- History of an allergic or anaphylactic reaction to parenteral administration of contrast agents, human or murine proteins or monoclonal antibodies, a history of severe allergic reaction to drugs, food, or insects requiring medical intervention, or a history of hypersensitive triad (having all 3 features of allergic rhinitis with nasal polyps, asthma, and aspirin sensitivity).
- Prior opportunistic infection including tuberculosis or atypical mycobacterial infection, multi-dermatome Herpes Zoster or Pneumocystis pneumonia or invasive fungal infection (not including oral or vaginal candidiasis or superficial dermatophytes) .
- Active infection with hepatitis B, hepatitis C or HIV or historically positive test or test positive at screening for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody.
- History of organ transplant (eg, heart, lung, kidney, liver) or hematopoietic stem cell/marrow transplant.
- Planned surgical procedure during the treatment period of this study or a history of any other medical disease (eg, cardiopulmonary), laboratory abnormality, or condition that, in the opinion of the principal investigator, makes the subject unsuitable for the study.
- Hospitalization for treatment of infection within 60 days of Day 1.
- Use of parenteral (IV or IM) antibiotics (antibacterials, antivirals, anti-fungals, or anti parasitic agents) within 60 days of Day 1.
- Current drug or alcohol abuse or dependence, or a history of drug or alcohol abuse or dependence within 364 days prior to Day 1.
Contacts and Locations| Contact: David Ritchie Ritchie | +61396561111 | david.ritchie@petermac.org |
| Australia, Victoria | |
| The Peter MacCallum Cancer Centre | Recruiting |
| Melbourne, Victoria, Australia, 3002 | |
| Principal Investigator: David Ritchie | |
| Alfred Health | Recruiting |
| Melbourne, Victoria, Australia, 3181 | |
| Contact: Andrew Spencer +61390762000 aspencer@netspace.net.au | |
| Principal Investigator: Andrew Spencer | |
| Principal Investigator: | David Ritchie | The Peter MacCallum Cancer Centre |
| Principal Investigator: | Andrew Spencer | The Alfred |
More Information
Publications:
| Responsible Party: | Cancer Trials Australia |
| ClinicalTrials.gov Identifier: | NCT01142011 History of Changes |
| Other Study ID Numbers: | HGSI Belimumab in WM |
| Study First Received: | June 10, 2010 |
| Last Updated: | February 8, 2012 |
| Health Authority: | United States: Food and Drug Administration Australia: Therapeutic Goods Administration |
Keywords provided by Cancer Trials Australia:
|
Waldenstroms Belimumab anti Blys monoclonal antibody |
Additional relevant MeSH terms:
|
Waldenstrom Macroglobulinemia Neoplasms, Plasma Cell Neoplasms by Histologic Type Neoplasms Hemostatic Disorders Vascular Diseases Cardiovascular Diseases Paraproteinemias Blood Protein Disorders Hematologic Diseases |
Hemorrhagic Disorders Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Antibodies, Monoclonal Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 17, 2013