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This is a Phase I label dose escalation study of KW-0761 in relapsed patients with CCR4 positive Adult T-Cell Leukemia-Lymphoma (ATL) and Peripheral T-Cell lymphoma (PTCL).
This is a Phase I open-label dose escalation study of KW-0761 in relapsed patients with CCR4 positive Adult T-Cell Leukemia-Lymphoma (ATL) and Peripheral T-Cell Lymphoma (PTCL). This study is designed to evaluate safety, pharmacokinetics, immunogenicity and preliminary efficacy. Enrollment will proceed until a maximum tolerated dose (MTD) and a recommended Phase II dose (RPIID) have been established.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Experimental | KW-0761 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| KW-0761 | Drug | IV administration at 4 escalating dose levels. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Dose-Limiting Toxicities (DLTs) | Subjects who were properly monitored for DLTs were to be analyzed to determine the number of subjects with a DLT by dose level. | 28 days |
| Maximum Tolerated Dose (MTD) | The dose level at which Dose-Limiting Toxicity (DLT) was recognized was to be regarded as Maximum Tolerated Dose (MTD), and the dose level below MTD by one level was to be regarded as the recommended dose level (when MTD was not reached, 1.0 mg/kg was to be regarded as the recommended dose level) and 3 more subjects were to be newly added to the recommended dose level. | 28 days |
| Pharmacokinetics-Plasma KW-0761 Concentrations | Plasma KW-0761 concentrations were to be summarized in tabular form with the descriptive statistics on a dose-by-dose basis. Individual and mean (+ standard deviation) plasma KW-0761 concentrations on an actual or logarithmic scale were to be plotted against the time of blood sampling. | 0-7 days post final dose |
| Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (AUC0-7 Days) | The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis. | 0-7 days post final dose |
| Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (t1/2) | The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis. | 0 to 28 days post final dose and follow-up examinations (1 month and 2 months after the end of the post-dosing observation period). |
| Measure | Description | Time Frame |
|---|---|---|
| Antitumor Effect | The antitumor response criteria (Complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD)) were created based on the criteria for non-Hodgkin's lymphoma and chronic lymphocytic leukemia provided in the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology as well as the criteria for non-Hodgkin's lymphoma by the Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG). |
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Inclusion Criteria:
1. Histologically confirmed diagnosis of a CCR4-positive ATL and PTCL that is any of the following:
A. ATL (Adult T-Cell Leukemia-Lymphoma)
B. PTCL (Peripheral T-Cell Lymphoma)
Includes Mycosis Fungoides and Sezary Syndrome;
2: Relapsed to the latest standard chemotherapy;
3: Received at least one prior chemotherapy;
4: After 4 weeks from a prior therapy;
5: Have measurable disease;
6:Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1;
7: Male or female, at least 20 years and not older than 70 years of age;
8: Signed written informed consent;
9: Stay in hospital for 4 weeks;
10: HBs antigen: negative, HBV-DNA: below the limit of quantification (within 14 days before the study entry);
11: Adequate bone marrow, hepatic and cardiac function including the followings:
Neutrophil count ≥ 1,500 /mm3,
Platelets ≥ 75,000 /mm3,
Hemoglobin ≥ 8.0 g/dL
Serum creatinine ≤ 1.5 x ULN;
Serum SGOT (AST) and SGPT (ALT) ≤ 2.5 x ULN (≤ 5.0 x ULN if considered due to disease involvement in liver);
Serum bilirubin ≤ 1.5 x ULN (≤ 3.0 x ULN if considered due to disease involvement in liver)
Serum calcium ≤ 11.0 mg/dL
PaO2 ≥ 65 mmHg or SaO2 ≥ 90%
No clinically significant Electrocardiogram abnormality
Left Ventricular Ejection Fraction ≥ 50% [by ECHO or MUGA]
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Study Director | Kyowa Kirin Co., Ltd. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tokyo | Japan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16952304 | Background | Ishida T, Ueda R. CCR4 as a novel molecular target for immunotherapy of cancer. Cancer Sci. 2006 Nov;97(11):1139-46. doi: 10.1111/j.1349-7006.2006.00307.x. Epub 2006 Sep 5. | |
| 17975162 | Background | Yano H, Ishida T, Inagaki A, Ishii T, Ding J, Kusumoto S, Komatsu H, Iida S, Inagaki H, Ueda R. Defucosylated anti CC chemokine receptor 4 monoclonal antibody combined with immunomodulatory cytokines: a novel immunotherapy for aggressive/refractory Mycosis fungoides and Sezary syndrome. Clin Cancer Res. 2007 Nov 1;13(21):6494-500. doi: 10.1158/1078-0432.CCR-07-1324. |
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Participants were enrolled from 6 February 2007 through 22 October 2008
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| ID | Title | Description |
|---|---|---|
| FG000 | KW-0761 | KW-0761 was administered 4 times at one-week intervals at a dose of 0.01, 0.1, 0.5 or 1.0 mg/kg in patients with CC chemokine 4 receptor (CCR4) positive Adult T-Cell Leukemia-Lymphoma (ATL) or CCR4 positive Peripheral T-Cell Lymphoma (PTCL) |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | KW-0761 | KW-0761 was administered 4 times at one-week intervals at a dose of 0.01, 0.1, 0.5 or 1.0 mg/kg in patients with CCR4 positive ATL or CCR4 positive PTCL |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Incidence of Dose-Limiting Toxicities (DLTs) | Subjects who were properly monitored for DLTs were to be analyzed to determine the number of subjects with a DLT by dose level. | Posted | Number | participants | 28 days |
|
|
28 days
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | KW-0761 0.01mg | IV infusions of KW-0761 once/week for 4 weeks |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Herpes zoster | Infections and infestations | MedDRA (11.1) |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Febrile neutropenia | Blood and lymphatic system disorders | MedDRA (11.1) |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Project Management Department, Development Division | Kyowa Hakko Kirin | clinical.info@kyowa-kirin.co.jp |
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| ID | Term |
|---|---|
| D015459 | Leukemia-Lymphoma, Adult T-Cell |
| D016411 | Lymphoma, T-Cell, Peripheral |
| ID | Term |
|---|---|
| D015458 | Leukemia, T-Cell |
| D007945 | Leukemia, Lymphoid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| C549035 | mogamulizumab |
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| 50 days |
| Time to Progression (TTP) | TTP was defined as the period from the day starting the first KW-0761 dosing to the day of PD identification (or the day of death if the subject died before PD was documented). Subjects were to be censored at the time of starting post-treatment, if it was started before PD identification. | Baseline to response |
| 17278106 | Background | Yano H, Ishida T, Inagaki A, Ishii T, Kusumoto S, Komatsu H, Iida S, Utsunomiya A, Ueda R. Regulatory T-cell function of adult T-cell leukemia/lymphoma cells. Int J Cancer. 2007 May 1;120(9):2052-7. doi: 10.1002/ijc.22536. |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Diagnosis | Number | participants |
|
|
| Primary | Maximum Tolerated Dose (MTD) | The dose level at which Dose-Limiting Toxicity (DLT) was recognized was to be regarded as Maximum Tolerated Dose (MTD), and the dose level below MTD by one level was to be regarded as the recommended dose level (when MTD was not reached, 1.0 mg/kg was to be regarded as the recommended dose level) and 3 more subjects were to be newly added to the recommended dose level. | Posted | Number | mg/kg | 28 days |
|
|
|
| Secondary | Antitumor Effect | The antitumor response criteria (Complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD)) were created based on the criteria for non-Hodgkin's lymphoma and chronic lymphocytic leukemia provided in the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology as well as the criteria for non-Hodgkin's lymphoma by the Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG). | Posted | Number | participants | 50 days |
|
|
|
| Primary | Pharmacokinetics-Plasma KW-0761 Concentrations | Plasma KW-0761 concentrations were to be summarized in tabular form with the descriptive statistics on a dose-by-dose basis. Individual and mean (+ standard deviation) plasma KW-0761 concentrations on an actual or logarithmic scale were to be plotted against the time of blood sampling. | Posted | Mean | Standard Deviation | ng/mL | 0-7 days post final dose |
|
|
|
| Primary | Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (AUC0-7 Days) | The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis. | AUC0-7 days | Posted | Mean | Standard Deviation | ng·h/mL | 0-7 days post final dose |
|
|
|
| Primary | Pharmacokinetics-Pharmacokinetic Parameters of KW-0761 (t1/2) | The pharmacokinetic parameters of the subjects were to be individually calculated, and their descriptive statistics were to be calculated on a dose-by-dose basis. | t1/2 | Posted | Mean | Standard Deviation | hours | 0 to 28 days post final dose and follow-up examinations (1 month and 2 months after the end of the post-dosing observation period). |
|
|
|
| Secondary | Time to Progression (TTP) | TTP was defined as the period from the day starting the first KW-0761 dosing to the day of PD identification (or the day of death if the subject died before PD was documented). Subjects were to be censored at the time of starting post-treatment, if it was started before PD identification. | Posted | Median | Full Range | days | Baseline to response |
|
|
|
| 1 |
| 3 |
| 3 |
| 3 |
| EG001 | KW-0761 0.1mg | IV infusions of KW-0761 once/week for 4 weeks | 1 | 4 | 4 | 4 |
| EG002 | KW-0761 0.5mg | IV infusions of KW-0761 once/week for 4 weeks | 0 | 3 | 3 | 3 |
| EG003 | KW-0761 1.0mg | IV infusions of KW-0761 once/week for 4 weeks | 1 | 6 | 6 | 6 |
| Hypoxia | Respiratory, thoracic and mediastinal disorders | MedDRA (11.1) |
|
| Rash | Skin and subcutaneous tissue disorders | MedDRA (11.1) |
|
| Lymph node pain | Blood and lymphatic system disorders | MedDRA (11.1) |
|
| Tachycardia | Cardiac disorders | MedDRA (11.1) |
|
| Left ventricular dysfunction | Cardiac disorders | MedDRA (11.1) |
|
| Constipation | Gastrointestinal disorders | MedDRA (11.1) |
|
| Nausea | Gastrointestinal disorders | MedDRA (11.1) |
|
| Chills | General disorders | MedDRA (11.1) |
|
| Fatigue | General disorders | MedDRA (11.1) |
|
| Malaise | General disorders | MedDRA (11.1) |
|
| Pyrexia | General disorders | MedDRA (11.1) |
|
| Infusion-related reaction | General disorders | MedDRA (11.1) |
|
| Cytokine release syndrome | Immune system disorders | MedDRA (11.1) |
|
| Nasopharyngitis | Infections and infestations | MedDRA (11.1) |
|
| Skin infection | Infections and infestations | MedDRA (11.1) |
|
| Alanine aminotransferase increased | Investigations | MedDRA (11.1) |
|
| Aspartate aminotransferase increased | Investigations | MedDRA (11.1) |
|
| Blood albumin decreased | Investigations | MedDRA (11.1) |
|
| Blood lactate dehydrogenase increased | Investigations | MedDRA (11.1) |
|
| Blood pressure increased | Investigations | MedDRA (11.1) |
|
| Blood sodium increased | Investigations | MedDRA (11.1) |
|
| Electrocardiogram QT prolonged | Investigations | MedDRA (11.1) |
|
| Blood urine present | Investigations | MedDRA (11.1) |
|
| Haemoglobin decreased | Investigations | MedDRA (11.1) |
|
| Heart rate increased | Investigations | MedDRA (11.1) |
|
| Lymphocyte count decreased | Investigations | MedDRA (11.1) |
|
| Neutrophil count decreased | Investigations | MedDRA (11.1) |
|
| Neutrophil count increased | Investigations | MedDRA (11.1) |
|
| Platelet count decreased | Investigations | MedDRA (11.1) |
|
| Protein total decreased | Investigations | MedDRA (11.1) |
|
| Weight decreased | Investigations | MedDRA (11.1) |
|
| Weight increased | Investigations | MedDRA (11.1) |
|
| White blood cell count decreased | Investigations | MedDRA (11.1) |
|
| White blood cell count increased | Investigations | MedDRA (11.1) |
|
| Eosinophil percentage increased | Investigations | MedDRA (11.1) |
|
| Blood alkaline phosphatase increased | Investigations | MedDRA (11.1) |
|
| Platelet function test abnormal | Investigations | MedDRA (11.1) |
|
| Anorexia | Metabolism and nutrition disorders | MedDRA (11.1) |
|
| Hypoalbuminaemia | Metabolism and nutrition disorders | MedDRA (11.1) |
|
| Dizziness | Nervous system disorders | MedDRA (11.1) |
|
| Sensory disturbance | Nervous system disorders | MedDRA (11.1) |
|
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (11.1) |
|
| Acne | Skin and subcutaneous tissue disorders | MedDRA (11.1) |
|
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA (11.1) |
|
| Hypertension | Vascular disorders | MedDRA (11.1) |
|
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| D009369 |
| Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D016399 | Lymphoma, T-Cell |
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| Uncertain Complete Response (CRu) |
|
| Partial Response (PR) |
|
| Stable Disease (SD) |
|
| Progressive Disease (PD) |
|
| Not Evaluable (NE) |
|
| Ctrough |
|