Description:
Primary Objective:
To evaluate the anti-leukemic activity of isatuximab in combination with standard
chemotherapies in pediatric participants of ages 28 days to less than 18 years with
Relapsed/Refractory Acute Lymphoblastic Leukemia (ALL) or Acute Myeloid Leukemia (AML)
Secondary Objectives:
- Safety and tolerability assessments
- Assessment of infusion reactions (IRs)
- Pharmacokinetics (PK) of isatuximab
- Minimal residual disease
- Overall response rate
- Overall survival
- Event free survival
- Duration of response
- Relationship between clinical effects and CD38 receptor density and occupancy
Title
- Brief Title: Isatuximab in Combination With Chemotherapy in Pediatric Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia or Acute Myeloid Leukemia
- Official Title: Open-label, Single-arm Trial to Evaluate Antitumor Activity, Safety, and Pharmacokinetics of Isatuximab Used in Combination With Chemotherapy in Pediatric Patients From 28 Days to Less Than 18 Years of Age With Relapsed/Refractory B or T Acute Lymphoblastic Leukemia or Acute Myeloid Leukemia in First or Second Relapse
Clinical Trial IDs
- ORG STUDY ID:
ACT15378
- SECONDARY ID:
PIP - 2018-002697-45
- SECONDARY ID:
U1111-1202-1096
- NCT ID:
NCT03860844
Conditions
- Acute Lymphoblastic Leukemia
- Acute Myeloid Leukemia
Interventions
Drug | Synonyms | Arms |
---|
Montelukast | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Isatuximab | SAR650984, Sarclisa | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Dexamethasone | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Fludarabine | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Cytarabine | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Liposomal daunorubicin | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Daunorubicin | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Idarubicin | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Filgrastim | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Mitoxantrone | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Doxorubicin | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Vincristine | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
PEG Asparaginase | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Cyclophosphamide | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Etoposide | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Methotrexate | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
L - Asparginase | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Hydroxyurea | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
L - Asparaginase (Erwinase) | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Tocilizumab | | Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia |
Purpose
Primary Objective:
To evaluate the anti-leukemic activity of isatuximab in combination with standard
chemotherapies in pediatric participants of ages 28 days to less than 18 years with
Relapsed/Refractory Acute Lymphoblastic Leukemia (ALL) or Acute Myeloid Leukemia (AML)
Secondary Objectives:
- Safety and tolerability assessments
- Assessment of infusion reactions (IRs)
- Pharmacokinetics (PK) of isatuximab
- Minimal residual disease
- Overall response rate
- Overall survival
- Event free survival
- Duration of response
- Relationship between clinical effects and CD38 receptor density and occupancy
Detailed Description
The study will include a screening period of up to 21 days (Day -21 to -1), a study treatment
period [Day 1 to Day 57 for Acute Lymphoblastic Leukemia (ALL); Day 1 to Day 22 for Acute
Myeloid Leukemia (AML)], a recovery period (until an end of treatment visit [within 30 days
after hematological recovery]) and a follow-up period (until final analysis cut off date).
Trial Arms
Name | Type | Description | Interventions |
---|
Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia | Experimental | This arm includes participants from 3 cohorts: AML, T-ALL and B-ALL.; AML: Weekly dosing of isatuximab with induction chemotherapy. The therapy may be repeated one more cycle; ALL: (Includes T-ALL and B-ALL) Weekly dosing of isatuximab with induction chemotherapy, then biweekly dosing of isatuximab with consolidation chemotherapy. | - Montelukast
- Isatuximab
- Dexamethasone
- Fludarabine
- Cytarabine
- Liposomal daunorubicin
- Daunorubicin
- Idarubicin
- Filgrastim
- Mitoxantrone
- Doxorubicin
- Vincristine
- PEG Asparaginase
- Cyclophosphamide
- Etoposide
- Methotrexate
- L - Asparginase
- Hydroxyurea
- L - Asparaginase (Erwinase)
- Tocilizumab
|
Eligibility Criteria
Inclusion criteria:
- Participant must be 28 days to less than 18 years of age, at the time of signing the
informed consent.
- Participants must have a confirmed diagnosis of relapsed Acute Lymphoblastic Leukemia
(ALL) of T- or B-cell origin including T-lymphoblastic lymphoma (LBL), or relapsed
Acute Myeloblastic Leukemia (AML) including participants with history of
myelodysplasia.
- Participants must be previously treated for their disease and have relapsed or are
refractory to most recent treatment. Participants in first or second relapse will be
eligible regardless of the remission duration.
- Participants with no more than 1 prior salvage therapy.
- WBC counts below 20 x109/L on Day 1 before isatuximab administration
Exclusion criteria:
- Any serious active disease or co-morbid condition which, in the opinion of the
Investigator, may interfere with the safety of the study treatment or the compliance
with the study protocol.
- Participants must have been off prior treatment with immunotherapy/investigational
agents and chemotherapy for >2 weeks and must have recovered from acute toxicity
before the first study treatment administration. Exceptions are participants who need
to receive cytoreductive chemotherapy in order to decrease tumor burden (the study
treatment may start earlier if necessitated by the patient's medical condition (eg,
rapidly progressive disease) following discussion with the Sponsor).
- Prior stem cell transplant within 3 months and/or evidence of active systemic Graft
versus Host Disease (GVHD) and/or immunosuppressive therapy for GVHD within 1 week
before the first study treatment administration.
- Participants with LBL with bone marrow blasts <5%.
- Participants with Burkitt-type ALL.
- Acute leukemia with testicular or central nerve system involvement alone.
- Participants who have developed therapy related acute leukemia.
- Live vaccine(s) within 30 days prior to the first IMP administration or plans to
receive such vaccines during the study until 90 days after the last IMP
administration.
- Participants with white blood cell count > 50 x109/L at the time of screening visit.
- Participants who have been exposed to anti-CD38 therapies within 6 months prior to
Day-1.
The above information is not intended to contain all considerations relevant to a patient's
potential participation in a clinical trial.
Maximum Eligible Age: | 17 Years |
Minimum Eligible Age: | N/A |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Complete Response (CR) rate in acute myeloid leukemia (AML) cohort |
Time Frame: | Baseline to Day 22 |
Safety Issue: | |
Description: | CR rate is defined as the proportion of participants with CR or CRi, in AML |
Secondary Outcome Measures
Measure: | Safety and tolerability assessments |
Time Frame: | Baseline to approximately 3 months |
Safety Issue: | |
Description: | Number of adverse events and serious adverse events |
Measure: | Assessment of infusion reactions |
Time Frame: | Time from isatuximab infusion to resolution (approximately 2 days) |
Safety Issue: | |
Description: | Incidence and severity of infusion reactions |
Measure: | Pharmacokinetics of isatuximab: Cmax |
Time Frame: | Day 1 to 30 days after hematological recovery |
Safety Issue: | |
Description: | Maximum observed concentration (Cmax) |
Measure: | Pharmacokinetics of isatuximab: Ctrough |
Time Frame: | Day 1 to 30 days after hematological recovery |
Safety Issue: | |
Description: | Concentration observed just before treatment administration during repeated dosing (Ctrough) |
Measure: | Pharmacokinetics of isatuximab: AUC |
Time Frame: | Day 1 to 30 days after hematological recovery |
Safety Issue: | |
Description: | Partial area under the serum concentration time curve: AUC |
Measure: | Minimal residual disease |
Time Frame: | On day 43 |
Safety Issue: | |
Description: | Estimation of minimal residual disease in participants achieving CR or CRi |
Measure: | Overall response rate |
Time Frame: | On day 43 |
Safety Issue: | |
Description: | The overall response rate is defined as the proportion of participants with CR or CRi for blood and bone marrow disease; Partial response (PR) based on the National Comprehensive Cancer Network (NCCN) guideline will be considered |
Measure: | Overall survival |
Time Frame: | Baseline to approximately 3 months |
Safety Issue: | |
Description: | Overall survival is defined as the time interval from the date of first study treatment administration to death from any cause |
Measure: | Event free survival |
Time Frame: | Baseline to approximately 3 months |
Safety Issue: | |
Description: | Event free survival is defined as the time interval from the date of first study treatment administration to the date of the first of: completion or going off protocol induction/consolidation therapy without CR, relapse from CR, or death due to any cause |
Measure: | Duration of response |
Time Frame: | Time from the first response to the first disease progression or death |
Safety Issue: | |
Description: | Duration of response is defined as the time from the date of the first response to the date of first disease progression or death from any cause, whichever happens first |
Measure: | Change in CD38 receptor density and occupancy |
Time Frame: | Baseline to Day 15 |
Safety Issue: | |
Description: | CD38 receptor density will be assessed at baseline and CD38 receptor occupancy at Day 15 and correlated with clinical endpoints. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Sanofi |
Trial Keywords
- Anti-CD38 monoclonal antibody
Last Updated
June 8, 2021