Intravenous Administration of RGI-2001 in Patient Undergoing Allogenic Hematopoietic Stem Cell Transplantation (AHSCT)

Not Recruiting

Trial ID: NCT01379209

Purpose

The clinical trial is a Phase 1/2a, open-label, multi-center, dose-escalation study to evaluate the safety, tolerability and pharmacokinetic profile of RGI-2001 in patients undergoing AHSCT, with radiation or non-radiation myeloablative preparative treatment. The study will be separated into two parts; a dose escalation phase to assess safety, followed by a large expansion phase to further evaluate the pharmacologic effects of either a Maximum Tolerated Dose, Maximum Feasible Dose or optimal pharmacologically active dose of RGI-2001. The initial dose escalation safety portion of the study (Part 1) will include higher risk patients and limit the unrelated donor transplants. After safety is established in part 1 of the study, the second portion of the study will expand the enrollment criteria and allow transplantation by either related or unrelated donors. This study will endeavor to identify the dose range at which RGI-2001 has an acceptable safety profile, at which biologic activity is observed, and to guide possible dose levels to utilize in later phase studies based on biological activity.

Official Title

A Phase 1/2a, Open-Label, Multicenter, Dose-Escalation Study to Evaluate the Safety and Tolerability of Intravenous Administration of RGI-2001 in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation (AHSCT)

Stanford Investigator(s)

Laura Johnston
Laura Johnston

Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)

Wen-Kai Weng, MD, PhD
Wen-Kai Weng, MD, PhD

Associate Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy) and, by courtesy, of Dermatology

Robert Lowsky
Robert Lowsky

Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)

Robert Negrin
Robert Negrin

Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)

Sally Arai
Sally Arai

Associate Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)

Judith Shizuru
Judith Shizuru

Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)

Eligibility


Inclusion Criteria:

   1. Subject has a hematological malignancy or aplastic anemia (AA) and is undergoing a
   first allogeneic transplant procedure.

   2. Meet one of the following underlying disease criteria:

   a. Acute myelogenous leukemia (AML) i. First or subsequent morphologic remission b.
   Acute lymphoblastic leukemia (ALL) i. First or subsequent morphologic remission c.
   Chronic myelogenous leukemia (CML) i. Chronic phase; or ii. Accelerated phase d.
   Multiple Myeloma (MM) i. Not more than 20% plasma cells in the bone marrow e.
   Myelodysplastic syndrome (MDS), including chronic myelomonocytic leukemia (CMML), who
   have received at least one previous induction regimen and have <10% blasts f.
   Myeloproliferative disorder (MPD), including; i. myeloid metaplasia, and ii.
   myelofibrosis g. Non-Hodgkin's Lymphoma (NHL) i. High-risk NHL in first remission; or
   ii. Relapsed or refractory NHL h. Hodgkin's lymphoma (HL) beyond first remission i.
   Aplastic anemia (AA)

   3. Male or female, age ≥18 years of age

   4. Reasonable expectation of survival for at least 3 months, if the transplant procedure
   is successful

   5. Eastern Cooperative Oncology Group (ECOG) status of 0-2 or Karnofsky Performance
   Status (KPS) of > 60

   6. Transplant Donor

      1. Part 1 (Phase 1: Dose Escalation Phase):

      Unrelated transplant donor with no more than 1 HLA allele or antigen mismatch,
      defined as loci A, B, C and DR (note: DQ is excluded)

      2. Part 2 (Phase 2a: Expansion Phase):Related or unrelated transplant donor, with no
      more than 1 HLA allele or antigen mismatch, defined as loci A, B, C and DR (note:
      DQ is excluded).

   7. Source of the allograft

      1. Part 1 (Phase 1: Dose Escalation Phase):Unmodified (non-manipulated) bone marrow,
      or mobilized peripheral blood stem cell (PBSC) transplant, using G-CSF as the
      mobilizing agent.

      2. Part 2: (Phase 2a: Expansion Phase) Unmodified (non-manipulated) bone marrow, or
      mobilized peripheral blood stem cell (PBSC) transplant, using G-CSF as the
      mobilizing agent.

   8. Anti-graft-versus-host disease (GvHD) prophylaxis:

   A calcineurin inhibitor [either tacrolimus (FK506) or cyclosporin A)], in combination
   with either methotrexate (MTX), mycophenolate mofetil (MMF) or sirolimus (RAPA) all at
   doses as per the institutional protocols

   9. Adequate hepatic function, with bilirubin not exceeding the upper limit of normal
   (except when attributed to Gilbert's Disease), and AST and ALT of less than 1.5 times
   the upper limit of normal

10. No clinically significant cardiac conduction disorder on screening ECG

11. Serum creatinine ≤ 2.0 mg/dL

12. Female patients of childbearing potential must have a negative serum pregnancy test
   prior to enrollment and must agree to use dual method of contraception for 30 days
   after study drug administration. Approved methods of contraception include, an IUD
   with spermicide, a female condom with spermicide, a diaphragm with spermicide, a
   cervical cap with spermicide, use of a condom with spermicide by sexual partner or a
   sterile sexual partner.

13. If male, subjects must be sterile or willing to use an approved method of
   contraception from the time of Informed Consent to 30 days after study drug treatment.
   Males must be willing to refrain from sperm donation within 30 days after study drug
   treatment.

14. No clinically significant acute or chronic medical condition that in the opinion of
   the investigator will interfere with study participation

15. No clinically significant laboratory abnormalities as determined by the Principal
   Investigator, in consultation with the Sponsor's Medical Monitor

16. No active infection

17. Have signed written informed consent before undergoing any study related procedures
   and is willing to comply with all study procedures

Exclusion Criteria:

   1. Female subjects who are pregnant or lactating

   2. Subjects about to undergo a non-ablative or non-myeloablative transplant

   3. AML or ALL patient who are in relapse (>5% blasts) or who are defined as primary
   refractory

   4. Blast crisis CML

   5. Radiation, chemotherapy, immunotherapy in the previous 3 weeks, unrelated to the
   transplant procedure

   6. Subjects who, in the judgment of the Investigator have not recovered from the effects
   of previous therapy

   7. Subject who is about to undergo cord blood transplantation

   8. Procedures that are intended to deplete regulatory T-cells from donor transplant
   materials

   9. Known or suspected HIV infection

10. Active hepatitis A, B, or C infection in recipient or donor

11. Uncontrolled active infection requiring IV antibiotics in recipient or donor

12. Major surgery within 1 month before Day 0

13. Participation in an investigational study within 1 month prior to Day 0

14. Prior treatment with anti-CD3 antibodies

15. Treatment with anti-CD20 antibodies or anti-thymocyte globulin (ATG) within 3 months
   of the AHSCT procedure (i.e. infusion of transplant material and RGI-2001).

16. Vaccination within the preceding 2 weeks prior to the planned dose of RGI-2001

17. Planned vaccination within 2 months after study drug administration

18. Known history of cardiac dysfunction (e.g. <50% ejection fraction), ischemia,
   conduction abnormalities, or myocardial infarction in the previous six months

19. Cardiac pacemaker or automatic implantable cardioverter-defibrillator

20. Marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc
   interval >450 ms

21. Congenital long QT syndrome or family history of long QT syndrome

22. History of additional risk factors for torsades de pointes (TdP) (e.g., heart failure,
   hypokalemia)

23. Bundle branch block

24. Connective tissue/rheumatologic disorders

25. History of autoimmune disease

26. History of solid tumor, excluding non-melanoma skin or cervical carcinoma after
   curative resection, within the preceding 5 years

27. Uncontrolled diabetes

28. Prior allogeneic hematopoietic stem cell transplantation

29. Any other prior organ transplant

30. Psychiatric or addictive disorders that preclude obtaining reliable informed consent

31. Any other condition that, in the opinion of the investigator, renders the subject
   unsuitable for study participation

Intervention(s):

drug: RGI-2001

drug: Calcineurin Inhibitors

procedure: Allogeneic Hematopoietic Stem Cell Transplantation

drug: Conditioning Regimen

procedure: Allogeneic Bone Marrow Transplantation

drug: Methotrexate

drug: Mofetil Mycophenolate

drug: sirolimus

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Physician Referrals
6507230822

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