Graft vs Host Disease Clinical Trial
Official title:
A Pilot Study of Imatinib Mesylate in Steroid Refractory Chronic Graft Versus Host Disease
Verified date | April 2020 |
Source | Stanford University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
To determine if subjects with steroid refractory cGVHD can tolerate imatinib mesylate and whether their cGVHD responds to imatinib mesylate.
Status | Completed |
Enrollment | 15 |
Est. completion date | April 2012 |
Est. primary completion date | April 2012 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
INCLUSION CRITERIA - Chronic graft-vs-host disease (cGVHD) requiring systemic therapy occurring > 100 days after hematopoietic cell transplant with either: 1. Persistent steroid dependence defined as the inability to taper steroid treatment to less than 0.25 mg/kg/d prednisone or its equivalent for at least 3 months. 2. Progression of cGVHD signs and symptoms on steroid therapy equivalent to prednisone 0.5 mg/kg/d for at least 1 month. - At least one of the following manifestations: 1. Skin changes (rash, sclerosis, fasciitis, or ulceration). 2. Abnormal eye wetness = 5 mm as measured by Schirmer's test. 3. Oral mucosal changes (erythema, lichenoid changes, ulcers, or mucoceles). 4. Thrombocytopenia (platelets < 50,000/uL). 5. Abnormal liver function testing defined as alkaline phosphatase, AST, ALT, or total bilirubin > upper limit of normal (ULN). 6. Bronchiolitis obliterans (diagnosed by a > 5% annual decline in FEV1 with the lowest post-transplant FEV1/FVC < 0.8 and an appropriate CT scan or lung biopsy). - Has been on a fixed dose of steroids or a fixed dose of steroids and one other immunosuppressant (cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil, or extracorporeal photopheresis) for = 30 days before starting imatinib. - Life expectancy = 6 months. - Ability to understand and willingness to sign a written informed consent document. - Karnofsky performance status = 3 50% (Appendix B). - At least 18 years of age. - If a female of reproductive potential (defined as having at least 1 menstrual period in the past 12 months), must have a negative pregnancy test performed = 7 days before starting study drug. - If a female of reproductive potential, agrees to use contraception for the duration of the trial. - Total bilirubin < 1.5X ULN. - Aspartate transaminase (AST) < 2.5 x ULN. - Alanine aminotransferase (ALT) < 2.5 x ULN. - Alkaline phosphatase < 2.5 x ULN. - Absolute neutrophil count (ANC) > 500/uL (growth factor supplementation is allowed). - Hematocrit > 26% (transfusion support is allowed). - Platelet count > 20,000/uL. EXCLUSION CRITERIA - Received another investigational agent = 30 days before starting the study drug. - Ongoing intercurrent illness such as an infection not responsive to antibiotics, antiviral medicines, or antifungal medicines. - Progressive malignant disease. - Secondary malignancy that has not been effectively treated within the past 5 years (except localized basal cell or squamous cell carcinoma). - Imatinib intolerance or allergy. - Participant is breast-feeding. - Not willing to comply with treatment or response evaluation. - Received an allogeneic cell product [including donor lymphocyte infusion (DLI) or hematopoietic cell boost] = 100 days before starting study drug. - Steroid and/or immunosuppressant dose has changed = 30 days before starting study drug. |
Country | Name | City | State |
---|---|---|---|
United States | Fred Hutchinson Cancer Research Center (FHCRC) | Seattle | Washington |
United States | Stanford University School of Medicine | Stanford | California |
Lead Sponsor | Collaborator |
---|---|
David Miklos | Novartis |
United States,
Chen GL, Arai S, Flowers ME, Otani JM, Qiu J, Cheng EC, McMillan A, Johnston LJ, Shizuru JA, Miklos DB. A phase 1 study of imatinib for corticosteroid-dependent/refractory chronic graft-versus-host disease: response does not correlate with anti-PDGFRA ant — View Citation
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