Acute B-Cell Lymphoblastic Leukaemia Clinical Trial
Official title:
A Clinical Phase II Trial to Describe Pharmacokinetics, Pharmacodynamics, Safety and Immunogenicity of Spectrila® With the Pharmaceutical Active Ingredient Recombinant L-Asparaginase in Adult Subjects With Newly Diagnosed Acute B-Cell Lymphoblastic Leukaemia
This is a non-controlled, single-arm, open-label clinical trial to describe the PK, PD, immunogenicity and safety of ASNase. All subjects enrolled will receive the IP recombinant ASNase (Spectrila®). Since Spectrila is already approved in the European Economic Area for first-line treatment of ALL patients of all age groups and showed similar efficacy and safety in comparison to Asparaginase medac no blinding or control groups are necessary. As underlying treatment protocol the BRALL 2014 treatment protocol will be used.
The BRALL (Brazilian Acute Lymphocytic Leukaemia) treatment protocol was developed to standardise adult ALL treatment in Brazil since previously each centre used a different protocol. As in other treatment regimens of study groups, ASNase is an important component of ALL therapy. The rationale of the BRALL protocol was to use less myelotoxic drugs as daunorubicin, etoposide and cyclophosphamide and focus on more specific ALL directed therapies as asparaginase and methotrexate. The higher asparaginase dose regimen was chosen in BRALL 2014 to strengthen ASNase as major component of the treatment protocol while etoposide administration is reduced. Native ASNase is widely used and the data investigating non-inferiority, safety and tolerability of Asparaginase medac vs. Spectrila received a positive opinion from the European Medicines Agency (EMA). Nevertheless, data on efficacy and safety of Spectrila in adults are limited. Therefore, robust data on PK, pharmacodynamics (PD), safety and immunogenicity of Spectrila will be investigated in this trial in subjects with de novo ALL. The measurement of ASNase activity is considered to correlate with clinical effectiveness and therefore chosen as primary objective. Subjects eligible for participation in this clinical trial will be treated with 3 intravenous doses of Spectrila of 10 000 U/m² BSA each during induction phase I of the underlying BRALL 2014 treatment protocol. Spectrila will be administered on Days 21, 23 and 25. Additionally, the subjects (standard risk subjects only) will receive doses of 10 000 U/m² BSA Spectrila each on Days 2, 4, 6, 9, 11 and 13 of the consolidation phase II, III and VI of BRALL 2014 treatment protocol. One final Analysis is planned. ;