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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06026371
Other study ID # RG1123691
Secondary ID NCI-2023-05599RG
Status Recruiting
Phase Phase 2
First received
Last updated
Start date December 12, 2023
Est. completion date September 30, 2026

Study information

Verified date March 2024
Source Fred Hutchinson Cancer Center
Contact Armin Rashidi
Phone 206-667-2506
Email arashidi@fredhutch.org
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This randomized placebo-controlled double-blind phase II trial tests whether fecal microorganism (microbiota) transplantation prevents severe acute graft versus host disease in adults undergoing allogeneic hematopoietic cell transplantation (HCT). Fecal microbiota transplantation involves receiving processed fecal material orally after allogeneic HCT in order to establish a healthy gut microbiota. Gut microbiota undergoes major alterations during allogeneic HCT because of antibiotic exposures, nutritional changes, and chemotherapy administration. Establishing a healthy gut microbiota via fecal transplantation may help prevent acute graft versus host disease in patients undergoing allogeneic HCT.


Description:

OUTLINE: The first 12 patients are assigned to group I, remaining patients are randomized to 1 of 2 groups. GROUP I: Patients receive fecal microbiota capsules orally (PO) once daily (QD) for 7 days starting at the time of neutrophil engraftment and discontinuation of anti-bacterial antibiotics. GROUP II: Patients receive placebo PO QD for 7 days starting at the time of neutrophil engraftment and discontinuation of anti-bacterial antibiotics. After completion of study intervention, patients are followed up monthly until 12 months post-allogeneic HCT.


Recruitment information / eligibility

Status Recruiting
Enrollment 138
Est. completion date September 30, 2026
Est. primary completion date September 30, 2026
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age >= 18 - Signed informed consent - Able to take oral medications - Planned T-replete allogeneic hematopoietic cell transplantation for any indication. History of prior transplantation is allowed - Planned GVHD prophylaxis using one of the following regimens: - Calcineurin inhibitor (tacrolimus or cyclosporine) plus methotrexate - Calcineurin inhibitor (tacrolimus or cyclosporine) plus mycophenolate mofetil (MMF) - Sirolimus plus cyclosporine plus MMF - Post-transplant cyclophosphamide plus calcineurin inhibitor (with or without MMF) - One of the following HCT donor types: - Human leukocyte antigen (HLA)-matched sibling donor - 9/10 or 10/10 HLA-matched unrelated donor - HLA- haploidentical donor - Cord blood - Willing to use at least 1 accepted method of contraception until day 180 after transplant and agree to not donate eggs/sperm for 180 days after - Not pregnant or breast feeding - ELIGIBILITY CRITERIA FOR RANDOMIZATION: Absolute neutrophil count (ANC) recovery to > 0.5 x 10^9/L from nadir, without ongoing growth factor support - ELIGIBILITY CRITERIA FOR RANDOMIZATION: Discontinuation of all antibacterial antibiotics (except those used for Pneumocystis jiroveci prophylaxis) for 2 days - ELIGIBILITY CRITERIA FOR RANDOMIZATION: Resolution of all acute toxicities (other than anemia and thrombocytopenia) to Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or lower - ELIGIBILITY CRITERIA FOR RANDOMIZATION: Ability to swallow capsules - ELIGIBILITY CRITERIA FOR RANDOMIZATION: No grade II-IV acute GVHD - ELIGIBILITY CRITERIA FOR RANDOMIZATION: No moderate to severe chronic GVHD - ELIGIBILITY CRITERIA FOR RANDOMIZATION: No concurrent antibiotics to treat infections. Prophylactic antiviral and antifungal antibiotics used to prevent infections are allowed Exclusion Criteria: - Severe food allergy in the form of anaphylaxis or attributable symptoms requiring hospitalization - History of chronic aspiration or conditions predisposing to aspiration (e.g. neuromuscular disorders) - Receiving or planned to receive other experimental agents (including ex vivo T-cell depletion) to prevent GVHD

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Fecal Microbiota Transplantation Capsule
Given PO
Placebo
Given PO

Locations

Country Name City State
United States Fred Hutch/University of Washington Cancer Consortium Seattle Washington

Sponsors (1)

Lead Sponsor Collaborator
Fred Hutchinson Cancer Center

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Grade III-IV acute graft versus host disease (GVHD) Based on IBMTR criteria and measured as a probability Up to 6 months post hematopoietic cell transplantation (HCT)
Secondary Grade II-IV acute GVHD Based on IBMTR criteria and measured as a probability Up to 180 days post HCT
Secondary Non-relapse mortality Death not due to relapse/progression of the underlying hematologic disorder and measured as a probability Up to 180 days post HCT
Secondary Clostridium difficile diarrhea Based on a positive stool assay in the consistent clinical setting (e.g. diarrhea) and measured as a probability Up to 180 days post HCT
Secondary Chronic GVHD Diagnosis based on the NIH Consensus Criteria (PMID: 25529383) At 12 months post-HCT
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