TXA127 in Enhancement of Engraftment in Adult Double Cord Blood Transplantation - Full Text View

Purpose

The purpose of this study is to evaluate the effect of TXA127 on neutrophil and platelet counts in adult patients who have undergone a double cord blood transplant. The study will also evaluate the effect of TXA127 on chemotherapy-induced mucositis, an inflammation of the mucous membranes in the digestive tract (mouth to anus) and immune reconstitution which helps patients fight infections. For patients undergoing CBT, both neutrophil and platelet normalization and immune reconstitution can be delayed. TXA127 has shown to be well tolerated by patients and appears to induce a rapid production of neutrophils and platelets in the bloodstream as well as increase the immune system components. It has also been shown to reduce the severity of chemotherapy-induced mucositis.

Condition	Intervention	Phase
Double Cord Blood Transplant Acute Myelogenous Leukemia Myelodysplastic Syndrome Myelofibrosis Acute Lymphoblastic Leukemia Chronic Myelocytic Leukemia Non Hodgkins Lymphoma Hodgkins Lymphoma Chronic Lymphocytic Leukemia	Drug: TXA127 300 mcg/kg/day Drug: TXA127 1000 mcg/kg/day	Phase 1


Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Supportive Care
Official Title:	Phase I Evaluation of the Safety and Efficacy of TXA127 (Angiotensin 1-7) to Enhance Engraftment in Adults Undergoing Double Cord Blood Transplantation

Resource links provided by NLM:

Genetics Home Reference related topics: core binding factor acute myeloid leukemia cytogenetically normal acute myeloid leukemia familial acute myeloid leukemia with mutated CEBPA primary myelofibrosis

MedlinePlus related topics: Leukemia

Genetic and Rare Diseases Information Center resources: Acute Lymphoblastic Leukemia Acute Monoblastic Leukemia Acute Myeloblastic Leukemia Type 5 Acute Myelocytic Leukemia Acute Myeloid Leukemia, Adult Acute Non Lymphoblastic Leukemia Chronic Lymphocytic Leukemia Chronic Myeloid Leukemia Chronic Myeloproliferative Disorders Hodgkin Lymphoma Leukemia, B-cell, Chronic Leukemia, Myeloid Lymphosarcoma Myelodysplastic Syndromes Myelofibrosis

U.S. FDA Resources

Further study details as provided by US Biotest, Inc.:

Primary Outcome Measures:

Safety of TXA127 (Angiotensin 1-7) in subjects undergoing double cord blood transplantation [ Time Frame: 100 days post-transplantation ] [ Designated as safety issue: Yes ]
The safety and tolerability profile of TXA127 will be provided by descriptively summarizing, at a minimum, the following outcomes: 1) number and proportion of patients with adverse events presented by preferred term, by system organ class (SOC), and by severity grade and relationship to TXA127, as assessed by the Investigator; 2) number and proportion of patients terminating TXA127 due to adverse events related to TXA127; 3) Day 100 treatment-related mortality (TRM) rate; 4) Day 100 mortality rate; 5) number of red blood cell and other blood component transfusions; 6) incidence of infection.

Secondary Outcome Measures:

Platelet transfusion requirements [ Time Frame: 100 days post-transplantation ] [ Designated as safety issue: No ]
Platelet transfusion requirements based on units of platelets transfused and days of platelet transfusions
Immune reconstitution [ Time Frame: 100 days post-transplantation ] [ Designated as safety issue: No ]
Immune reconstitution will be assessed via the measurement of peripheral blood concentrations of CD3+, CD4+, CD8+, CD19+, and CD56+ cells (performed at Study Days 62 and 100).
Incidence, duration, and severity grade of mucositis [ Time Frame: 100 days post-transplantation ] [ Designated as safety issue: No ]
Incidence of mucositis is defined by the occurrence of least one adverse event with MedDRA preferred term that includes "mucositis" or "stomatitis". The severity grade will be determined by NCI-CTCAE.
Incidence, duration, and severity grade of acute graft-vs-host-disease (aGVHD) [ Time Frame: 100 days post-transplantation ] [ Designated as safety issue: No ]
Incidence, severity and duration of aGVHD will be reported as a proportion (with 95% CIs) of subjects with Grade II-IV aGVHD. All incidents of aGVHD will at a minimum be listed, with the severity and time course included.
Time to engraftment/recovery [ Time Frame: 100 days post-transplantation ] [ Designated as safety issue: No ]
Time to neutrophil engraftment and platelet recovery


Estimated Enrollment:	20
Study Start Date:	January 2011
Estimated Study Completion Date:	May 2014
Estimated Primary Completion Date:	February 2014 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: TXA127 300 mcg/kg/day Treatment group 1 (300 mcg/kg/day) of a two-arm, dose-escalation pilot feasibility trial of TXA127 (Angiotensin 1-7) in subjects undergoing double cord blood transplantation for the treatment of a variety of hematologic malignancies for whom there is no available therapy with substantive anti-disease effect.	Drug: TXA127 300 mcg/kg/day Injection, 300 mcg/kg/day for 28 days
Experimental: TXA127 1000 mcg/kg/day Treatment group 2 (1000 mcg/kg/day) of a two-arm, dose-escalation pilot feasibility trial of TXA127 (Angiotensin 1-7) in subjects undergoing double cord blood transplantation for the treatment of a variety of hematologic malignancies for whom there is no available therapy with substantive anti-disease effect.	Drug: TXA127 1000 mcg/kg/day Injection, 1000 mcg/kg/day for 28 days

Detailed Description:

Cord blood as a hematopoietic stem cell source has multiple advantages. Cord blood is normally discarded at birth and can easily be collected and stored. Availability of numerous CB banks has resulted in genetically diverse CB units including those from non-Caucasians. Once a suitable CB unit is located, confirmatory typing can be quickly performed and a donor unit can be shipped to the transplant center. Furthermore, because a CB graft results in a lower incidence of graft-versus-host-disease, one or two antigen-mismatched units are acceptable for transplantation. Despite these advantages, CB has a significant drawback which is that the number of hematopoietic stem cells obtained from a unit of CB is significantly lower than from a bone marrow (BM) harvest or peripheral blood stem cell (PBSC) harvest. Both engraftment and immune reconstitution are delayed in patients undergoing CB transplant. TXA127 is pharmaceutically-formulated angiotensin 1-7, a non-hypertensive derivative of angiotensin II (which contains the 8th amino acid conferring receptor binding to blood pressure receptors). TXA127 has multilineage effects on hematopoietic progenitors in vitro and in vivo. The hematopoietic properties demonstrated in preclinical and clinical studies support the investigation of TXA127 to reduce time to neutrophil and platelet engraftment following transfusion of limited number of CD34+ cells.

Eligibility


Ages Eligible for Study:	18 Years to 60 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Subjects with Acute Myelogenous Leukemia (AML) past first remission, in first or subsequent relapse, induction failure, or in first remission with high-risk for relapse (with high-risk cytogenetics or presence of flt3 mutation or secondary leukemia from prior chemotherapy)
Myelodysplastic Syndrome or Myelofibrosis of intermediate or high-risk
Acute Lymphoblastic Leukemia (ALL): Induction failure, fist complete remission with Philadelphia chromosome or translocation (4:11), hypodiploidy and or evidence of minimal residual disease by flow cytometry, second or third complete remission or second relapse
Chronic Myelocytic leukemia (CML): Second chronic phase or accelerated phase
Non-Hodgkin's Lymphoma (NHL): Induction failures, second or third complete remission or relapse
Hodgkin's Lymphoma (HL): Induction failures, second or third complete remission or relapse
Chronic Lymphocytic leukemia (CLL): Progressive disease following standard therapy
Other hematologic malignancies which meet investigational site standards for cord blood transplant
Subjects must be at least 18 years of age
Subjects must have ECOG status of ≤ 2
Subjects with bone marrow blasts ≤ 10%
Subjects must have adequate major organ function
Male and Female Subjects capable of reproduction must agree to use contraceptive methods during the course of the study and for 2 months following the last administration of study drug
Cord blood requirements: a) Unrelated CB will be used as a source of hematopoietic support if a 7/8 or 8/8 related or 8/8 unrelated bone marrow donor is not available, or if the tempo of the subject's disease dictates it is not in the subject's best interest to wait for an unrelated marrow donor to be procured. b) Subjects must have two CB units available which are matched with the subject at 4/6, 5/6, or 6/6 HLA class I (serological) and II (molecular) antigens. Each unit must contain at least 1 x 10^7 total nucleated cells/kg recipient body weight (pre-thaw).

Exclusion Criteria:

Subjects who received antineoplastic treatment including chemotherapy, immunotherapy and radiation therapy ≤ 2 weeks prior to Screening Period
Subjects who underwent prior total body irradiation
Subjects who received prior allogeneic hematopoietic cell transplants
Subjects seropositive for HIV, Hepatitis B or Hepatitis C
Female subjects who are pregnant or breastfeeding
Subjects who have received an investigational drug within 30 days of projected first administration of study drug (Day 0)
Subjects with current alcohol use, illicit drug use, or any other condition (e.g., psychiatric disorder) that, in the opinion of the Investigator, may interfere with the subject's ability to comply with the study requirements or visit schedule
Subjects with known hypersensitivity to TXA127
Subjects with uncontrolled medical or psychiatric condition which would limit informed consent
Subjects with a willing and appropriate HLA-matched related marrow donor

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: NCT01300611

Locations


United States, Texas
MD Anderson Cancer Center
Houston, Texas, United States, 77030

Sponsors and Collaborators

US Biotest, Inc.

Tarix Pharmaceuticals

Investigators


Principal Investigator:	Uday R Popat, MD	M.D. Anderson Cancer Center

More Information

No publications provided


Responsible Party:	US Biotest, Inc.
ClinicalTrials.gov Identifier:	NCT01300611 History of Changes
Obsolete Identifiers:	NCT01302678
Other Study ID Numbers:	TXA127-2010-001
Study First Received:	February 17, 2011
Last Updated:	December 18, 2013
Health Authority:	United States: Food and Drug Administration

Keywords provided by US Biotest, Inc.:


Double Cord Blood Transplantation Neutrophil Engraftment Platelet Engraftment Immune Reconstitution Mucositis

Additional relevant MeSH terms:


Leukemia Leukemia, Lymphocytic, Chronic, B-Cell Leukemia, Lymphoid Leukemia, Myelogenous, Chronic, BCR-ABL Positive Leukemia, Myeloid Leukemia, Myeloid, Acute Lymphoma Lymphoma, Non-Hodgkin Myelodysplastic Syndromes Precursor Cell Lymphoblastic Leukemia-Lymphoma Preleukemia	Bone Marrow Diseases Hematologic Diseases Immune System Diseases Immunoproliferative Disorders Leukemia, B-Cell Lymphatic Diseases Lymphoproliferative Disorders Myeloproliferative Disorders Neoplasms Neoplasms by Histologic Type Precancerous Conditions

ClinicalTrials.gov processed this record on February 27, 2015

TXA127 in Enhancement of Engraftment in Adult Double Cord Blood Transplantation (USBTXA127CBT)