A Study to Evaluate the Safety and Pharmacokinetics of Eflapegrastim in Pediatric Participants With Solid Tumors or Lymphomas and Treated With Myelosuppressive Chemotherapy

Lymphoma Clinical Trial

Official title:

A Multicenter, Open-Label, Phase 2 Study to Evaluate the Safety and Pharmacokinetics of Eflapegrastim in Pediatric Patients With Solid Tumors or Lymphomas and Treated With Myelosuppressive Chemotherapy

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04570423
• Other study ID #: SPI-GCF-202
• Status: Recruiting
• Phase: Phase 2
• Start date: May 20, 2021
• Est. completion date: October 2027

Study information

• Verified date: January 2024
• Source: Spectrum Pharmaceuticals, Inc
• Contact: Howard Franklin, MD
• Phone: 224.419.7106
• Email: Hfranklin[@]assertiotx.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the safety and pharmacokinetics of eflapegrastim in pediatric participants with solid tumors or lymphoma and treated with myelosuppressive chemotherapy.

Description:

This is a Phase 2, open label, multicenter study of eflapegrastim in pediatric participants (≥1 month to <17 years) with solid tumors or lymphoma. Approximately 40 participants will be enrolled and assigned to one of 4 age-based cohorts. Participants enrolled in Cohort 1 will be followed for dose-limiting toxicities (DLTs) prior to initiating parallel enrollment into Cohorts 2 through 4. All participants will receive chemotherapy as Standard of Care after which a subcutaneous (SC) dose of eflapegrastim will be administered up to 4 treatment cycles.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 40
• Est. completion date: October 2027
• Est. primary completion date: October 2027
• Accepts healthy volunteers: No
• Gender: All
• Age group: 1 Month to 17 Years

Eligibility

Inclusion Criteria:

1. Participant must have a pathologic/histologic confirmed newly diagnosed/relapsed/recurrent solid tumor or lymphoma without bone marrow involvement.

2. Participant must be a candidate to receive myelosuppressive chemotherapy, with a febrile neutropenia rate of at least 20% as outlined in the National Comprehensive Cancer Network (NCCN) guidelines.

3. Participant has adequate hematological, renal, and hepatic function.

4. Participant must have an echocardiogram (ECHO) or multigated acquisition (MUGA) within 14 days of Screening if receiving a cardiotoxic therapy and have a cardiac ejection fraction of >50%.

5. Participant must have a lumbar puncture, if clinically indicated, to rule out central nervous system (CNS) involvement within 14 days of study entry.

6. Participant has a Karnofsky performance level =50% for patients =16 years of age or a Lansky performance level =50 for children <16 years of age.

Exclusion Criteria:

1. Participant has an uncontrollable infection, has an underlying medical condition, and/or another serious illness that would impair the ability of the participant to receive protocol-specified treatment.

2. Participant has had previous exposure to filgrastim (within 7 days), pegfilgrastim (within 14 days), or other granulocyte colony stimulating factor (G-CSF) products in clinical development within 2 weeks prior to the administration of study drug (eflapegrastim)

3. Participant requires concurrent radiation therapy specifically in Cycle 1.

4. Participant has had prior bone marrow or hematopoietic stem cell transplant and/or has concurrent bone marrow involvement in their malignancy, including leukemia.

5. Participant has had spinal radiation therapy within 30 days prior to study enrollment.

6. Participant has used any investigational drugs, biologics or devices within 30 days prior to study treatment or plans to use any of these during the study.

7. Participant has a known sensitivity or previous reactions to any of the G-CSF products.

8. Participant with active CNS disease.

9. Participant has not recovered from previous treatment adverse events to =Grade 1.

Related Conditions & MeSH terms

• Lymphoma
• Solid Tumors

Intervention

Drug:
• Eflapegrastim
Eflapegrastim supplied in prefilled, single-use syringes for SC injection.
• Chemotherapy
Chemotherapy agents may include doxorubicin, ifosfamide, docetaxel, CHOP regimen, etoposide, cyclophosphamide and vincristine which will be administered as per standard of care per the Primary Care physician's treatment plan.

Locations

Country	Name	City	State
United States	Carolinas Medical Center/ Levine Children's Hospital	Charlotte	North Carolina
United States	Levine Children's Health	Charlotte	North Carolina
United States	UT MD Anderson Cancer Center	Houston	Texas
United States	New York Medical College	Valhalla	New York

Sponsors (1)

Lead Sponsor	Collaborator
Spectrum Pharmaceuticals, Inc

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of Participants With Treatment Emergent Adverse Events (TEAEs)	An AE is defined as any untoward medical occurrence in a participant or clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A TEAE is any AE that occurs from the first dose of the study drug until 35 days after the last dose of study drug, or on the day a new/additional chemotherapy regimen, or on the day another granulocyte-colony stimulating factor (G-CSF) is administered.	From first dose of study drug to 35 days after the last dose of the study drug (Up to approximately 16 months)
Secondary	Percentage of Participants With Severe Neutropenia in Cycle 1	Severe neutropenia is defined as absolute neutrophil count (ANC) less than 0.5*10^9/liter (L).	Cycle 1 (cycle length may vary and can be up to 28 days or more based on the type of chemotherapy selected)
Secondary	Time to Absolute Neutrophil Count (ANC) Recovery of Severe Neutropenia in Cycle 1	Time to ANC recovery of severe neutropenia is defined as the time from chemotherapy administration until the participants ANC increases to =1.0*10^9/L after the expected nadir.	Cycle 1 (cycle length may vary and can be up to 28 days or more based on the type of chemotherapy selected)
Secondary	Number of Participants With Febrile Neutropenia in Cycle 1	Febrile neutropenia is defined as ANC less than 0.5*10^9/L with a single temperature of >38.3 degree Celsius (°C) or a sustained temperature of =38°C for more than 1 hour.	Cycle 1 (cycle length may vary and can be up to 28 days or more based on the type of chemotherapy selected)
Secondary	Peak Concentration (Cmax) of Eflapegrastim in Cycle 1		Pre-dose and at multiple time points (up to Day 9 [Cohorts 1-3] and Day 6 [Cohort 4]) post-dose in Cycle 1 (cycle length may vary and can be up to 28 days or more based on the type of chemotherapy selected)
Secondary	Time to Reach Peak Concentration (Tmax) of Eflapegrastim in Cycle 1		Pre-dose and at multiple time points (up to Day 9 [Cohorts 1-3] and Day 6 [Cohort 4]) post-dose in Cycle 1 (cycle length may vary and can be up to 28 days or more based on the type of chemotherapy selected)
Secondary	Elimination Half-life (t½) of Eflapegrastim in Cycle 1		Pre-dose and at multiple time points (up to Day 9 [Cohorts 1-3] and Day 6 [Cohort 4]) post-dose in Cycle 1 (cycle length may vary and can be up to 28 days or more based on the type of chemotherapy selected)