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Evaluate the efficacy and safety for the prevention of oral mucositis and PK of MIT-001 for lymphoma or multiple myeloma patients receiving conditioning chemotherapy for autologous hematopoietic stem cell transplantation(auto-HSCT).
In Part 1, it was to determine Recommended Part 2 Dose(RP2D) the prevention effect of MIT-001 in combination with conditioning regimen in autologous hematopoietic stem cell transplantation(auto-HSCT) and to evaluate the pharmacokinetic characteristics of MIT-001.
In Part 2, it's to determine the optimal dose of MIT-001 in combination with conditioning regimen in auto-HSCT.
This clinical trial consists of a 28-days of screening period, 4 to 9 days of conditioning chemotherapy with MIT-001 treatment, auto-HSCT and a 14-days of follow-up and recovery period.
MIT-001 group consists of 5 mg (group 1), 10 mg (group 2), and 20mg (group 3), and the subject will be assigned to from 5 mg of MIT-001 sequentially.
After completion of MIT-001 administration from all 3 MIT-001 groups, Steering Committee (SC) was convened and reviewed the safety and efficacy to determine one of the followings.
In Part 2, the subjects are randomly assigned to either one of MIT-001 treatment groups (high-dose, low-dose among RP2D) and placebo at a ratio of 1: 1: 1. If two or more conditioning regimen are determined, conditioning regimen can be considered the stratification factor. Subject will be randomly assigned to either group in blinded method.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part 1, MIT-001 5 mg group | Experimental | Part 1, MIT-001 5 mg, once a day IV administration for 30 minutes before conditioning regimen administration 0.5~1 hr. 5 subject were enrolled sequentially. |
|
| Part 1, MIT-001 10 mg group | Experimental | Part 1, MIT-001 10 mg, once a day IV administration for 30 minutes before conditioning regimen administration 0.5~1 hr. 6 subjects were enrolled sequentially. |
|
| Part 1, MIT-001 20 mg group | Experimental | Part 1, MIT-001 20 mg, once a day IV administration for 30 minutes before conditioning regimen administration 0.5~1 hr. 5 subjects were enrolled sequentially. |
|
| Part 1, MIT-001 30 mg group | Experimental | Part 1, MIT-001 30 mg, once a day IV administration for 30 minutes before conditioning regimen administration 0.5~1 hr. It was optional but did not ptoceed according to Steering committee's decision because low level of MIT-001 is enough to show the efficacy and safety of MIT-001. |
|
| Part 2, 5mg of MIT-001 low dose group | Experimental | Part 2, MIT-001 low dose, once a day IV administration for 30 minutes before conditioning regimen administration 0.5~1 hr. 15 subject will be enrolled parallelly. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MIT-001 | Drug | Corresponding dose of MIT-001 IV injection during 0.5~1hr |
|
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of Severe Oral Mucositis(SOM). | OM is evaluated using the World Health Organization (WHO) OM grading scale that uses a scale of 0 to 4. SOM is defined as a WHO score of greater than or equal to 3. OM grading scale Grade 0 = Normal Grade 1 = Erythema and Soreness Grade 2 = Ulceration but can eat solid foods Grade 3 = Ulceration,diet limited to liquid (due to mucositis) Grade 4 = Ulceration of severity that patient requires parenteral feeding (due to mucositis) | up to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of oral mucositis by WHO OM grading scale | ① Grade 1 or higher, ② Grade 2 or higher, ③ Grade 4 or higher OM grading scale Grade 0 = Normal Grade 1 = Erythema and Soreness Grade 2 = Ulceration but can eat solid foods Grade 3 = Ulceration,diet limited to liquid (due to mucositis) Grade 4 = Ulceration of severity that patient requires parenteral feeding (due to mucositis) | up to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Events(AEs) | The number and incidence rate of AEs will be investigated. | From baseline to 28 day after discharge |
| Auto hematopoietic stem cell engraftment |
|
Inclusion Criteria:
Men and women aged 19 to 70 years old
Patients with lymphoma or multiple myeloma planned for receiving one of the following conditioning chemotherapy followed by autologous hematopoietic stem cell transplantation
Patients who have not received a hematopoietic stem cell transplant before
Patients with Body Mass Index (BMI) 35 or less
Patients who have prepared at least 2 x 10^6 CD34+ cell/kg
Patients whose hematologic, kidney and liver functions were confirmed to be proper through the following laboratory test results last measured within 8 days prior to the investigational product(IP) administration Laboratory endpoint Required limit for inclusion Absolute neutrophil count (ANC) ≥ 1,000/mm^3 Hemoglobin (Hb) ≥ 9.0 g/dL Platelet count ≥ 100,000/mm^3 Total bilirubin (TB) ≤ 2 mg/Dl AST and ALT ≤ 3.0 x ULN(if liver metastasis, ≤ 5 x ULN) Prothrombin time (PT) INR ≤ 1.5 (if taking warfarin, < 3) Serum creatinine or creatinine clearance (CrCl) < 2 mg/dL or≥ 60 mL/min
Patients with Eastern Cooperative Oncology Group performance status (ECOG-PS) of 0 or 1
Patients who voluntarily decided to participate in this study after being informed of the study information, and provided written consent to faithfully comply with the study requirements
Exclusion Criteria:
Patients who has the following medical history or concomitant diseases at screening
If the following therapy has been administered or received, or when the need for administration is expected
Pregnant and lactating women or women or childbearing potential and men who have a pregnancy plan up to 30 days after the end of the IP administration or who do not intend to use appropriate contraception: ① Hormonal contraceptives, ② Implantation of an intrauterine device or intrauterine system, ③ Double blocking method with spermicide (both male condom and closed cap (contraceptive diaphragm or neck cap) are used), ④ Infertility procedures (e.g., vasectomy, bilateral tubal ligation, etc.)
Patients who participated in other clinical trials within 30 days from the start of IP administration and received other study drug (or medical devices)
Patient who are judged to be difficult to participate in the study according to the opinions of investigators
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| Name | Affiliation | Role |
|---|---|---|
| Seok-Goo Cho, MD, PhD | Seoul St. Mary's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul ST. Mary's Hospital | Seoul | 06591 | South Korea | |||
| Yeouido ST. Mary's Hospital |
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| ID | Term |
|---|---|
| D013280 | Stomatitis |
| D008223 | Lymphoma |
| D009101 | Multiple Myeloma |
| D019337 | Hematologic Neoplasms |
| ID | Term |
|---|---|
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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Part 1 was completed with 16 patients and open label design to to evaluate the pharmacokinetic characteristics, efficacy, and safety of MIT-001 on prevention effect of MIT-001 in combination with conditioning regimen in auto-HSCT. 5mg as low dose and 20mg as high dose of MIT-001 were determined as RP2D through steering comittee and optional group of 30mg was not needed at Part 1 because low level of MIT-001 was enough to show efficacy and safety of MIT-001.
In Part 2, it's to determine the optimal dose (recommended part 2 dose (RP2D)) of MIT-001 in combination with conditioning regimen in auto-HSCT.
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Part I: open label
Part II: double blind, randomized, and Placebo controlled
|
| Part 2, 20mg of MIT-001 high dose group | Experimental | Part 2, MIT-001 high dose, once a day IV administration for 30 minutes before conditioning regimen administration 0.5~1 hr. 15 subject will be enrolled parallelly. |
|
| Part 2, placebo(normal saline) group | Placebo Comparator | Part 2, placebo(normal saline), once a day IV administration for 30 minutes before conditioning regimen administration 0.5~1 hr. 15 subject will be enrolled parallelly. |
|
| normal saline | Drug | normal saline IV injection |
|
|
| The incidence of oral mucositis based on the maximum severity by WHO OM grading scale | ① Grade 1 ② Grade 2 ③ Grade 3 ④ Grade 4 OM grading scale Grade 0 = Normal Grade 1 = Erythema and Soreness Grade 2 = Ulceration but can eat solid foods Grade 3 = Ulceration,diet limited to liquid (due to mucositis) Grade 4 = Ulceration of severity that patient requires parenteral feeding (due to mucositis) | up to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| The average grade of oral mucositis by WHO OM grading scale | The average grade of each point OM grading scale Grade 0 = Normal Grade 1 = Erythema and Soreness Grade 2 = Ulceration but can eat solid foods Grade 3 = Ulceration,diet limited to liquid (due to mucositis) Grade 4 = Ulceration of severity that patient requires parenteral feeding (due to mucositis) | Each 1, 5, 7, 14, 21 and 28 day after the end of therapy |
| The duration of oral mucositis by WHO OM grading scale | ① Grade 2 or higher, ② Grade 3 or higher, ③ Grade 4 or higher OM grading scale Grade 0 = Normal Grade 1 = Erythema and Soreness Grade 2 = Ulceration but can eat solid foods Grade 3 = Ulceration,diet limited to liquid (due to mucositis) Grade 4 = Ulceration of severity that patient requires parenteral feeding (due to mucositis) | up to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| The incidence of oral mucositis by NCI-CTCAE v5.0 criteria | ① Grade 1 or higher, ② Grade 2 or higher, ③ Grade 3 or higher, ④ Grade 4 or higher Grade 0 = Normal Grade 1 = Asymptomatic or mild symptoms; intervention not indicated Grade 2 = Moderate pain or ulcer that does not interfere with oral intake; modified diet indicated Grade 3 = Severe pain; interfering with oral intake Grade 4 = Life-threatening consequences; urgent intervention indicated Grade 5 = Death | up to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| The average grade of oral mucositis by NCI-CTCAE v5.0 criteria | The average grade of each point Grade 0 = Normal Grade 1 = Asymptomatic or mild symptoms; intervention not indicated Grade 2 = Moderate pain or ulcer that does not interfere with oral intake; modified diet indicated Grade 3 = Severe pain; interfering with oral intake Grade 4 = Life-threatening consequences; urgent intervention indicated Grade 5 = Death | Each 1, 5, 7, 14, 21 and 28 day after the end of therapy |
| The mean area under curve(AUC) of score for each question in oral mucositis daily questionnaire(OMDQ) | Q1: General health condition scale: 0(worst possible) to 10(perfect health) Q2: Mouth and throat pain: 0(no soreness) to 4(extreme soreness) Q3: Salvia swallowing, drinking water, eat rice, speaking ans sleeping: 0(no soreness) to 4(extreme soreness) Q4: General mouth and throat pain: 0(no soreness) to 10(worst possible) | up to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| The proportion of using opioid analgesics | The proportion of patients who used opioid analgesics up to 14 days after the end of therapy. | From the baseline to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| Total cumulative dose of opioid analgesics | It will be calculated as morphine equivalents dose | From the baseline to 14 days after the end of therapy( or discharge if hospitalization extension is necessary) |
| From auto-HSCT to 28 day |
| Seoul |
| South Korea |
| D008232 |
| Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D054219 | Neoplasms, Plasma Cell |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006402 | Hematologic Diseases |
| D006474 | Hemorrhagic Disorders |
| D009371 | Neoplasms by Site |