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Pilot Trial of Eltrombopag in Patients Undergoing Chemotherapy for Malignant Solid Tumors (CCPO011)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04485416
Recruitment Status : Recruiting
First Posted : July 24, 2020
Last Update Posted : May 23, 2023
Sponsor:
Information provided by (Responsible Party):
Anjali Pawar, University of California, Davis

Study Description
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Brief Summary:

Primary Objective: To assess safety of eltrombopag in pediatric patients undergoing intensive chemotherapy for malignant solid tumors.

Secondary Objectives: To assess the efficacy of eltrombopag in increasing platelet count up to 2 weeks after completion of chemotherapy in pediatric patients undergoing intensive chemotherapy for malignant solid tumors.

Hypothesis: The hypothesis is that eltrombopag an oral thrombopoietin receptor agonist will increase the platelet count safely and efficaciously in children having chemotherapy induced thrombocytopenia while on therapy for solid tumors.


Condition or disease Intervention/treatment Phase
Solid Tumor, Childhood Solid Tumor Drug: Eltrombopag Phase 1

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Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 10 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Open Label Single Arm Prospective Pilot Trial of Eltrombopag in Patients 1 Year to 18 Years of Age Undergoing Intensive Chemotherapy for Malignant Solid Tumors (CCPO011)
Actual Study Start Date : July 16, 2021
Estimated Primary Completion Date : December 2024
Estimated Study Completion Date : December 2024

Resource links provided by the National Library of Medicine

Drug Information available for: Eltrombopag

Arms and Interventions
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Arm Intervention/treatment
Experimental: Treatment group
Subjects will receive eltrombopag
 Drug: Eltrombopag
Eltrombopag is an orally administered small-molecule nonpeptide TPO-R agonist.
Other Name: Promacta


Outcome Measures
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Primary Outcome Measures :
  1. Safety objectives [ Time Frame: Through follow up after end of treatment ]
    For safety our end point is liver enzymes ALT, AST up to 5 x upper limit of normal (ULN) in <80% of patients.


Secondary Outcome Measures :
  1. Efficacy objectives [ Time Frame: 2 weeks after completion of chemotherapy ]
    For efficacy the end point is 6 of 10 patients respond to the study treatment by an increase in platelet counts by 20,000/μL and are able to proceed with their next cycle of chemotherapy.


Eligibility Criteria
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Ages Eligible for Study:   1 Year to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Patients must meet all of the following criteria to be eligible for study entry.

  1. Persons aged ≥ 1 to ≤18 years of age.
  2. Histologically confirmed solid tumors (including rhabdomyosarcoma, Ewings sarcoma, osteosarcoma, non- rhabdomyosarcoma soft tissue sarcoma, peripheral nerve sheath tumor, desmoplastic small round cell tumor, hepatoblastoma, hepatocellular carcinoma, renal cell carcinoma, higher grade neuroblastoma, brain tumors (e.g. medulloblastoma), and other rare solid tumors.
  3. Currently receiving cancer directed therapy for solid tumor or scheduled to start receiving cancer directed therapy for solid tumor within 60 days.
  4. Karnofsky Performance Status (KPS) performance status of 80% or greater.
  5. Life expectancy ≥ 6 months.
  6. Ability to swallow liquid solution/suspensions or tablets/capsules
  7. Platelet count < 150,000µL

  8. Blood chemistry levels defined by:

    • Serum creatinine less than or equal to 2.5 × the upper limit of normal (ULN) range
    • Total bilirubin level less than or equal to 1.5 × the upper limit of normal (ULN) range
    • AST and ALT < 3 x upper limit of normal (ULN)
  9. INR and aPTT less than or equal to 1.5 × ULN (for patients on anticoagulation they must be receiving a stable dose for at least 1 week prior to first treatment)
  10. Ability to understand and willingness to sign an informed consent form; or Parent/Guardian with ability to understand and willingness to sign an informed consent form.
  11. Ability to adhere to the study visit schedule and other protocol requirements.

Exclusion Criteria:

Patients who meet any of the following criteria will be excluded from study entry.

  1. Patients with known with hematologic malignancy diagnosis.
  2. Contraindications to receiving chemotherapy.
  3. Patients with history of thromboembolic disease or history of thrombophilic risk factors.

  4. History or current diagnosis of cardiac disease indicating significant risk of safety for patients participating in the study such as uncontrolled or significant cardiac disease, including any of the following:

    • Recent myocardial infarction (within last 6 months),
    • Uncontrolled congestive heart failure,
    • Unstable angina (within last 6 months),
    • Clinically significant (symptomatic) cardiac arrhythmias (e.g., sustained ventricular tachycardia, and clinically significant second or third degree AV block without a pacemaker.)
    • Long QT syndrome, family history of idiopathic sudden death, congenital long QT syndrome or additional risk factors for cardiac repolarization abnormality, as determined by the investigator.

  5. Impaired cardiac function, defined as:

    • Corrected QTc >450 msec using Fridericia correction (QTcF) on the screening ECG (using triplicate ECGs),
    • Other clinically significant cardio-vascular disease (e.g., uncontrolled hypertension, history of labile hypertension),
    • History of known structural abnormalities (e.g. cardiomyopathy).
  6. Pregnant or lactating women.
  7. Subjects with liver enzymes 5x upper limit of normal or liver cirrhosis (as determined by the investigator).
  8. Patients with known history of HIV positivity.
  9. Patient with known active or uncontrolled infections not responding to appropriate therapy.
  10. History of alcohol/drug abuse.
  11. Concurrent participation in an investigational study within 30 days prior to enrollment or within 8 days (> than 5-half-lives)of the investigational product, whichever is longer. Note: parallel enrollment in a disease registry is permitted.
  12. Known thrombophilic risk factors or history of thromboembolic disease. Exception: Subjects for whom the potential benefits of participating in the study outweigh the potential risks of thromboembolic events, as determined by the investigator.
  13. Known immediate or delayed hypersensitivity reaction to eltrombopag or its excipient.

  14. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using basic methods of contraception during dosing of study treatment. Basic contraception methods include:

    • Total abstinence (when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception
    • Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy), total hysterectomy, or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment
    • Male sterilization (at least 6 months prior to screening). The vasectomized male partner should be the sole partner for that subject.
    • Barrier methods of contraception: Condom or Occlusive cap.
    • Use of oral, injected or implanted hormonal methods of contraception or placement of an intrauterine device (IUD) or intrauterine system (IUS), or other forms of hormonal contraception that have comparable efficacy (failure rate <1%), for example hormone vaginal ring or transdermal hormone contraception. In case of use of oral contraception women should have been stable on the same pill for a minimum of 3 months before taking study treatment.
  15. Female subjects who are nursing or pregnant (positive serum or urine B-human chorionic gonadotrophin (B-hCG) pregnancy test) at screening or pre-dose on Day 1.
  16. Sexually active males unless they use a condom during intercourse while taking the drug during treatment, and for 8 days (> 5 half-lives ) after stopping eltrombopag and for 5 half-lives after the last dose of chemotherapy treatment and should not father a child in this period. A condom is required to be used also by vasectomized men as well as during intercourse with a male partner in order to prevent delivery of the drug via semen.
  17. Any condition that would prohibit the understanding or rendering of informed consent.
  18. Any condition that in the opinion of the investigator would interfere with the patient's safety or compliance on trial.
  19. Severe infection within 4 weeks prior to enrollment that in the opinion of the investigator would interfere with patient safety or compliance on trial.
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04485416


Contacts
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Contact: Alfredo Lopez Aguirre, BS 9167346606 alalopez@ucdavis.edu
Contact: Annika Bryant, BA 9167343213 abryant@ucdavis.edu

Locations
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United States, California
University of California Davis Health System, Comprehensive Cancer Center Recruiting
Sacramento, California, United States, 95817
Contact: Anjali Pawar, MD    916-734-2781    apawar@ucdavis.edu   
Principal Investigator: Anjali Pawar, MD         
Sub-Investigator: Marcio Malogolowkin, MD         
Sponsors and Collaborators
Anjali Pawar
Investigators
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Principal Investigator: Anjali Pawar, MD University of California, Davis
More Information
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Publications:

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Responsible Party: Anjali Pawar, Professor, Medical Director of the Pediatric Infusion Center, University of California, Davis
ClinicalTrials.gov Identifier: NCT04485416    
Other Study ID Numbers: 1602666
150124 ( Other Identifier: FDA (IND) )
CCPO011 ( Other Identifier: UC Davis Comprehensive Cancer Center )
First Posted: July 24, 2020    Key Record Dates
Last Update Posted: May 23, 2023
Last Verified: May 2023

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Anjali Pawar, University of California, Davis:
chemotherapy
pediatric
Additional relevant MeSH terms:
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Neoplasms