Biomarkers in Predicting Response in Patients With Graft-Versus-Host Disease Undergoing Extracorporeal Photophoresis

Graft Versus Host Disease (GVHD) Clinical Trial

Official title:

T-regulatory Homing Subsets as a Predictor of Response in GVHD Treated With Extracorporeal Photopheresis

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT01324908
• Other study ID #: VICC CTT 1063
• Secondary ID: NCI-2011-00225
• Status: Terminated
• Phase: N/A
• Start date: July 2011
• Est. completion date: November 16, 2020

Study information

• Verified date: January 2021
• Source: Vanderbilt-Ingram Cancer Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This clinical trial studies biomarkers in predicting response in patients with graft-versus-host disease (GVHD) undergoing extracorporeal photopheresis (ECP). ECP treats the patient's blood with ultraviolet light outside the body and kills the white blood cells before returning blood back into the patient's body. Studying samples of blood from patients with GVHD may help doctors identify and learn more about biomarkers related to GVHD.

Description:

PRIMARY OBJECTIVE:

I. To show that extracorporeal photopheresis (ECP)increases skin and gut homing T regulatory (T-reg) cells in patients with GVHD clinically responding to ECP.

SECONDARY OBJECTIVES:

I. Response rates of GVHD with extracorporeal photopheresis(ECP)as measured by NIH response criteria

II. Incidence of T-reg cell frequency(%)with various NIH subtypes of chronic graft-versus-host disease (GVHD)

III. Incidence of T-reg homing subsets(%)with various NIH subtypes of chronic graft-versus-host disease (GVHD)

OUTLINE:

Patients undergo ECP twice a week for 4 weeks and then twice a week every 2 weeks for 8 weeks.

After completion of study treatment, patients are followed up at 2, 4, and 6 months.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 85
• Est. completion date: November 16, 2020
• Est. primary completion date: July 28, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients with any NIH subtype of chronic GVHD that is being treated with ECP

• Karnofsky Performance Scale (KPS) > 60% at time of study enrollment

• Life expectancy > 3 months

• Steroid dose not greater than 2 mg/kg prednisone equivalent at time of study enrollment

• If patient has steroid refractory GVHD (defined as worsening of GVHD after 3 days of 2 mg/kg prednisone equivalent or no improvement after 7 days of 2 mg/kg prednisone equivalent), time interval from start of steroids to initiation of ECP should not be > 14 days

• No use of an investigational agent within 2 weeks of starting ECP

• No uncontrolled bacterial, fungal or viral disease (therapy for cytomegalovirus [CMV] viremia is permitted)

• No evidence of relapse or progression of underlying disease (molecular evidence of relapse/progression or mixed chimerism is permitted)

• Women of childbearing potential (WOCBP) should be willing to use 2 forms of contraception; male patients should be willing to use contraception

• Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care

Exclusion Criteria:

• Female patients who are breastfeeding or pregnant

• Patients known to be human immunodeficiency virus (HIV) positive

• Bronchiolitis obliterans as the sole indication of ECP

• Serious medical or psychiatric illness likely to interfere with participation in this clinical study

• Mechanical ventilation, renal replacement therapy, admitted in intensive care until at time of enrollment

• Stage 4 gastrointestinal GVHD as per Seattle-Glucksberg criteria

Related Conditions & MeSH terms

• Graft Versus Host Disease (GVHD)
• Graft vs Host Disease

Intervention

Procedure:
• extracorporeal photopheresis
Undergo ECP

Other:
• laboratory biomarker analysis
Correlative studies

Locations

Country	Name	City	State
United States	Emory University	Atlanta	Georgia
United States	Dana Farber Cancer Center	Boston	Massachusetts
United States	Vanderbilt-Ingram Cancer Center	Nashville	Tennessee
United States	Virginia Commonwealth University, Massey Cancer Center	Richmond	Virginia

Sponsors (2)

Lead Sponsor	Collaborator
Vanderbilt-Ingram Cancer Center	National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Association of frequency of skin and gut homing Tregs (%) in patients with chronic GVHD with response to ECP.		6 months after last patient is on study
Secondary	Response rates of GVHD with ECP as measured by NIH response criteria		at 6 months
Secondary	Incidence of T-reg cell frequency (%) with various NIH subtypes of chronic GVHD		at 6 months
Secondary	Incidence of T-reg homing subsets (%) with various NIH subtypes of chronic GVHD		at 6 months

External Links

•   Vanderbilt-Ingram Cancer Center, Find a Clinical Trial