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The purpose of this study is to compare the immunogenicity of Peg-filgrastim versus Neulasta® as an adjunct to chemotherapy in patients with breast cancer
An open-label, randomized, comparative, parallel group study to assess the Immunogenicity of Lupin's Peg-filgrastim versus Neulasta® as an Adjunct to Chemotherapy in Patients with Breast Cancer
Primary Objective: To assess the immunogenicity of Lupin's Peg-filgrastim with Neulasta® in patients with breast cancer.
Secondary Objectives: To assess the safety of Lupin's Peg-filgrastim with Neulasta® in patients with breast cancer
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lupin's Pegfilgrastim | Experimental | 6 mg, subcutaneous injection on day 2/3 of each 21 ± 3 day cycle. Number of cycles: 4. |
|
| Neulasta® | Experimental | 6 mg, subcutaneous injection on day 2/3 of each 21 ± 3 day cycle. Number of cycles: 4. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lupin's Pegfilgrastim | Drug | Administration of Pegfilgrastim |
|
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of Cumulative Incidence of Anti-pegfilgrastim Antibodies (Binding and Neutralizing) to Pegfilgrastim Between Treatment Groups at the End of Cycle 4 (Day 84). | The difference in cumulative incidence of anti-pegfilgrastim antibodies (binding and neutralizing) (measured as difference in proportion of patients with antibodies) to Pegfilgrastim between study groups at the end of cycle 4 will be calculated. Those samples confirmed to be positive for binding antibodies were analyzed for presence of neutralizing antibodies to Pegfilgrastim. | End of cycle 4, Day 84 |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of Cumulative Incidence of Anti-peg Antibodies (Binding and Neutralizing) Between Treatment Groups at the End of Cycle 4 (Day 84). | The presence of anti-peg antibodies (binding) (measured as difference in proportion of patients with antibodies) between treatment groups at the end of cycle 4 (Day 84) were compared and analysis for the ITT population | Day 84. |
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Inclusion Criteria:
Exclusion Criteria:
1 Male patients
2. Hypersensitivity to any of the study drugs or its components like E.coli proteins or similar product
3. Patients weighing <45 Kg
4. Patients with myeloid malignancies and myelodysplasia or evidence of metastatic disease in bone marrow or brain
5. Patients currently receiving radiation therapy or have completed radiation therapy within 4 weeks before study entry or likely to receive radiotherapy during the study
6. Patients with prior bone marrow or stem cell transplantation
7. Patients with chronic use of oral corticosteroids (Except ≤ 20 mg/day dose of prednisolone/ equivalent steroids), immunotherapy, monoclonal antibody therapy and/or biological therapy or use of any other pegylated drug.
8. Patients with history of systemic antibiotic use within 72 hours prior to chemotherapy
9. Patients with any active infection which may require systemic antimicrobial therapy. Patients with inadequate hepatic and renal function [defined as Alkaline Phosphatase > 2.5 X Upper limits of normal (ULN), serum SGOT > 2.5 X ULN, SGPT > 2.5 X ULN, Total bilirubin > 1.5 X ULN and Creatinine > 1.5 X ULN of the reference range at the screening assessment]
10. Patients with seropositivity for HIV or HBV or HCV
11. Known cases of Sickle Cell Anemia
12. Patients with radiographic evidence of active pulmonary infections and/or recent history of pneumonia within 1 month of screening
13. Patients with clinically evident splenomegaly confirmed subsequently by ultrasonography
14. Patients with any other clinically significant disease(s) which, in the opinion of the investigator, could compromise the patient's involvement in the study or overall interpretation of the data. [for e.g. uncontrolled hematologic, renal, hepatic, endocrine, neurologic, psychiatric, metabolic, pulmonary, cardiovascular disease/impaired functioning or history of any autoimmune disease]
15. Patients who have participated in another therapeutic clinical study within the past 30 days prior to screening, or are likely to simultaneously participate in another therapeutic clinical study
16. Patients who are doubtful to comply with study procedures for mental, psychological or social reasons.
17. Women of child-bearing potential who are not willing to follow a reliable & effective contraceptive measure during the course of the study & at least 3 months after the last dose of study drug.
18. Pregnant and Breast feeding women.
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| Name | Affiliation | Role |
|---|---|---|
| Dhananjay Bakhle, MD | Lupin Limited | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| M S Patel Cancer Centre, | Gokal | Anand | 388325 | India | ||
| City Cancer Center |
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All enrolled population included all screened patients who signed the informed consent. The randomized population included all randomized patients irrespective of whether patient received any study drug.
The treatment group (Lupin pegfilgrastim or Neulasta®) for each patient during the study was determined according to the study randomization list. The treatment was assigned at the time of randomization, after confirming the patient's eligibility. Patients were randomized in a 1:1 ratio to receive either Lupin pegfilgrastim or Neulasta®.
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| ID | Title | Description |
|---|---|---|
| FG000 | Lupin's Pegfilgrastim | 6 mg, subcutaneous injection on day 2 or 3 of each 21 ± 3 day cycle. Number of cycles: 4. Lupin's Pegfilgrastim: Administration of Pegfilgrastim |
| FG001 | Neulasta® |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 2, 2018 |
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| Neulasta® | Drug | Administration of Neulasta® |
|
|
| Comparison of Incidence of Anti-pegfilgrastim Antibodies (Binding & Neutralizing) to Pegfilgrastim Between Treatment Groups on Day 10, Day 21, Day 42, Day 63 and Day 84 | Comparison of incidence of anti-pegfilgrastim antibodies (binding & neutralizing) (measured as difference in proportion of patients with antibodies) to pegfilgrastim between treatment groups on Day 10, Day 21, Day 42, Day 63, Day 84. Analysis population : ITT | Assessment at each study visit on Day 10, Day 21, Day 42, Day 63, Day 84 |
| Secondary Immunogenicity Endpoint | Comparison of incidence of anti-peg antibodies (binding & neutralizing) (measured as difference in proportion of patients with antibodies) between treatment groups on Day 10, Day 21, Day 42, Day 63 and Day 84. Analysis population: ITT population | Day 10, Day 21, Day 42, Day 63 and Day 84. |
| Vijayawada |
| Andhra Pradesh |
| 520002 |
| India |
| Research & Development Department, HCG Cancer Center | Ahmedabad | Gujarat | 380006 | India |
| Apple Hospital | Surat | Gujarat | 395002 | India |
| Nirmal Hospital | Surat | Gujarat | 395002 | India |
| Shree Himalaya Cancer Hospital & Research Institute, | Vadodara | Gujarat | 390007 | India |
| Kailash Cancer Hospital & Research Center | Vadodara | Gujarat | 391760 | India |
| Adhar health Institute | Hisar | Haryana | 125001 | India |
| Sri Venketeshwara Hospital, Dept of Medical oncology | Bengaluru | Karnataka | 560068 | India |
| Curie Manavata Cancer Centre | Mumbai | Maharashtra | Nasik- 422004 | India |
| Government Medical College & Hospital | Nagpur | Maharashtra | 440009 | India |
| Sterling Hospital | Nigdi | Maharashtra | 411044 | India |
| Bhaktivedanta Hospital & Research Institute | Thane | Maharashtra | 401107 | India |
| Clinical Research Department | Bānde | Nagpur | 44026 | India |
| Acharya Tulsi Regional Cancer Treatment & Research Institute | Bīkaner | Rajahstan | 334003 | India |
| Global Clinical Research Services Pvt Ltd. | Hyderabad | Telangana | 500004 | India |
| Apollo Gleneagles Hospitals | Kolkata | West Bengal | 7000054 | India |
6 mg, subcutaneous injection on day 2 or 3 of each 21 ± 3 day cycle. Number of cycles: 4.
Neulasta®: Administration of Neulasta®
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| NOT COMPLETED |
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The enrolled patients were all middle-aged Asian females with a diagnosis of breast cancer.
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| ID | Title | Description |
|---|---|---|
| BG000 | Lupin's Pegfilgrastim | 6 mg, subcutaneous injection on day 2 or 3 of each 21 ± 3 day cycle. Number of cycles: 4. Lupin's Pegfilgrastim: Administration of Pegfilgrastim |
| BG001 | Neulasta® | 6 mg, subcutaneous injection on day 2 or 3 of each 21 ± 3 day cycle. Number of cycles: 4. Neulasta®: Administration of Neulasta® |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||
| ECOG Status at Screening | The scale was developed by the Eastern Cooperative Oncology Group (ECOG). Grade 0: fully active. Grade 1: restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature Grade 2: ambulatory and capable of all self-care but unable to carry out any work activities, up and about more than 50% of waking hours Grade 3: capable of only limited self-care, confined to bed or chair more than 50% of waking hours Grade 4: completely disabled, cannot carry on any self-care, totally confined to bed or chair Grade 5: dead | Count of Participants | Participants |
|
| 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 | Comparison of Cumulative Incidence of Anti-pegfilgrastim Antibodies (Binding and Neutralizing) to Pegfilgrastim Between Treatment Groups at the End of Cycle 4 (Day 84). | The difference in cumulative incidence of anti-pegfilgrastim antibodies (binding and neutralizing) (measured as difference in proportion of patients with antibodies) to Pegfilgrastim between study groups at the end of cycle 4 will be calculated. Those samples confirmed to be positive for binding antibodies were analyzed for presence of neutralizing antibodies to Pegfilgrastim. | Intention-to-treat analysis population | Posted | Number | Proportion of patients with antibodies | End of cycle 4, Day 84 |
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| Secondary | Comparison of Cumulative Incidence of Anti-peg Antibodies (Binding and Neutralizing) Between Treatment Groups at the End of Cycle 4 (Day 84). | The presence of anti-peg antibodies (binding) (measured as difference in proportion of patients with antibodies) between treatment groups at the end of cycle 4 (Day 84) were compared and analysis for the ITT population | Intention to treat population | Posted | Number | Proportion of patients with antibodies | Day 84. |
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| Secondary | Comparison of Incidence of Anti-pegfilgrastim Antibodies (Binding & Neutralizing) to Pegfilgrastim Between Treatment Groups on Day 10, Day 21, Day 42, Day 63 and Day 84 | Comparison of incidence of anti-pegfilgrastim antibodies (binding & neutralizing) (measured as difference in proportion of patients with antibodies) to pegfilgrastim between treatment groups on Day 10, Day 21, Day 42, Day 63, Day 84. Analysis population : ITT | The Intention-to-Treat (ITT) population included all patients who received at least one dose of study medication and subsequently provided immunogenicity variable data. | Posted | Count of Participants | Participants | Assessment at each study visit on Day 10, Day 21, Day 42, Day 63, Day 84 |
|
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| Secondary | Secondary Immunogenicity Endpoint | Comparison of incidence of anti-peg antibodies (binding & neutralizing) (measured as difference in proportion of patients with antibodies) between treatment groups on Day 10, Day 21, Day 42, Day 63 and Day 84. Analysis population: ITT population | The Intention-to-Treat (ITT) population included all patients who received at least one dose of study medication and subsequently provided immunogenicity variable data. | Posted | Count of Participants | Participants | Day 10, Day 21, Day 42, Day 63 and Day 84. |
|
|
3 months
Any ongoing AE at the end of study visit were followed until the outcome was evident and resolved, clinically stabilized, or a plausible explanation had been found.
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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 | Lupin's Pegfilgrastim | 6 mg, subcutaneous injection on day 2/3 of each 21 ± 3 day cycle. Number of cycles: 4. Lupin's Pegfilgrastim: Administration of Pegfilgrastim | 0 | 70 | 0 | 70 | 57 | 70 |
| EG001 | Neulasta® | 6 mg, subcutaneous injection on day 2/3 of each 21 ± 3 day cycle. Number of cycles: 4. Neulasta®: Administration of Neulasta® | 0 | 68 | 2 | 68 | 56 | 68 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Neutropenia | Blood and lymphatic system disorders | MedDRA (20.1) | Systematic Assessment |
| |
| Anaemia | Blood and lymphatic system disorders | MedDRA (20.1) | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Vomiting | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Stomatitis | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Gastritis | Gastrointestinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Alopecia | Skin and subcutaneous tissue disorders | MedDRA (20.1) | Systematic Assessment |
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| Asthenia | General disorders | MedDRA (20.1) | Systematic Assessment |
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| Pain | General disorders | MedDRA (20.1) | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA (20.1) | Systematic Assessment |
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| Mucosal inflammation | General disorders | MedDRA (20.1) | Systematic Assessment |
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| Neutropenia | Blood and lymphatic system disorders | MedDRA (20.1) | Systematic Assessment |
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| Anaemia | Blood and lymphatic system disorders | MedDRA (20.1) | Systematic Assessment |
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| Leukocytosis | Blood and lymphatic system disorders | MedDRA (20.1) | Systematic Assessment |
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| Leukopenia | Blood and lymphatic system disorders | MedDRA (20.1) | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (20.1) | Systematic Assessment |
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| Paraesthesia | Nervous system disorders | MedDRA (20.1) | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Sneezing | Respiratory, thoracic and mediastinal disorders | MedDRA (20.1) | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA (20.1) | Systematic Assessment |
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| Pyuria | Infections and infestations | MedDRA (20.1) | Systematic Assessment |
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| Urinary tract infection | Infections and infestations | MedDRA (20.1) | Systematic Assessment |
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| Bacterial infection | Infections and infestations | MedDRA (20.1) | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (20.1) | Systematic Assessment |
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| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA (20.1) | Systematic Assessment |
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| Decreased appetite | Metabolism and nutrition disorders | MedDRA (20.1) | Systematic Assessment |
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| Hyperglycaemia | Metabolism and nutrition disorders | MedDRA (20.1) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Chirag Shah, Director | Lupin Ltd. (Lupin Research Park), Pune, India | 91-20-67917368 | chiragshah@lupin.com |
| Sep 30, 2020 |
| Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C455861 | pegfilgrastim |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Grade 1 |
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| Grade 2 |
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| Grade 3 |
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| Grade 4 |
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| Grade 5 |
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