Study of Romiplostim for Chemotherapy-induced Thrombocytopenia in Adult Subjects With Non-small Cell Lung Cancer (NSCLC) Ovarian Cancer or Breast Cancer

  • STATUS
    Recruiting
  • End date
    Mar 29, 2024
  • participants needed
    162
  • sponsor
    Amgen
Updated on 20 October 2021

Summary

To evaluate the efficacy of romiplostim for the treatment of CIT in patients receiving chemotherapy for the treatment of NSCLC, ovarian cancer, or breast cancer measured by the ability to administer on-time, full-dose chemotherapy

Description

This is a phase 3, randomized, placebo-controlled, multicenter, international study for the treatment of CIT in adult subjects receiving chemotherapy for the treatment of NSCLC, ovarian cancer, or breast cancer. Subjects must have a platelet count < 75 x 10^9/L on day 1 of the study. The study will consist of a screening period of up to 4 weeks, a treatment period long enough to allow for assessment of 3 planned cycles of chemotherapy, a follow-up visit, and long-term follow-up (LTFU). Given that subjects are required to have 3 remaining planned cycles of chemotherapy, the chemotherapy cycles may be 3 or 4 weeks in duration, and the investigational product dose adjustment guidelines allow for up to 12 weeks of dosing before a subject is declared a non-responder, the majority of study subjects will receive investigational product for a range of 10-22 weeks.

Details
Condition Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia, Chemotherapy-induced Thrombocytopenia
Treatment Placebo, romiplostim
Clinical Study IdentifierNCT03937154
SponsorAmgen
Last Modified on20 October 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Subject has provided informed consent prior to initiation of any study-specific activities/procedures or subject's legally acceptable representative has provided informed consent prior to any study-specific activities/procedures being initiated when the subject has any kind of condition that, in the opinion of the investigator, may compromise the ability of the subject to give written informed consent
Males or females greater than or equal to 18 years of age at signing of the informed consent
Documented active stage I, II, III or IV locally advanced or metastatic NSCLC, breast cancer, or ovarian cancer, or any stage recurrent disease. Patients with documented locally advanced (stage III) NSCLC should not be amenable to definitive treatment with chemoradiation and/or surgery
Subjects must be receiving cancer treatment with 21- or 28-day cycles, using one of the following carboplatinum-based combination chemotherapy regimens: carboplatin/gemcitabine based, carboplatin/pemetrexed based, carboplatin/liposomal doxorubicin based or carboplatin/taxane based (which includes either paclitaxel, nab-paclitaxel, or docetaxel). Use of combination regimens with one of the above carboplatinum-based regimens is permitted with (1) anti-angiogenic agents (such as bevacizumab); (2) targeted therapy (such as anti-epidermal growth factor agents or anti- human epidermal growth factor receptor 2) or (3) immune checkpoint inhibitors. Cycle duration is based on intervals between day 1 of chemotherapy cycles (overlapping with carboplatin intervals) every 21 or 28 days
Subjects must have a platelet count less than 75 x 10 9/L on day 1 of the study
Subjects must be at least 21 or 28 days removed from the start of the chemotherapy cycle immediately prior to study day 1 if receiving a 21-day or 28-day cycle chemotherapy regimen, respectively
Subjects must have at least 3 remaining planned cycles of chemotherapy at study enrollment
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2

Exclusion Criteria

Acute lymphoblastic leukemia
Acute myeloid leukemia
Any myeloid malignancy
Myelodysplastic syndrome. Baseline bone marrow biopsy is not required to rule out MDS. However, if a bone marrow biopsy and cytogenetics were performed as part of diagnostic or staging work-up, these results will be collected to confirm
Myeloproliferative disease
Multiple myeloma
Within 4 months prior to enrollment, any history of active congestive heart failure (New York Heart Association [NYHA] Class III to IV), symptomatic ischemia, uncontrolled arrhythmias, clinically significant electrocardiogram (ECG) abnormalities, screening ECG with corrected QT (QTc) interval of greater than 470 msec, pericardial disease, or myocardial infarction
Major surgery less than or equal to 28 days or minor surgery less than or equal to 3 days prior to enrollment
New or uncontrolled venous thromboembolism or thrombotic events within 3 months prior to screening. To be eligible, subjects must have received at least 14 days of anticoagulation for a new thrombotic event and considered to be stable and suitable for continued therapeutic anticoagulation during trial participation
History of arterial thrombotic events (eg, myocardial ischemia, transient ischemic attack, or stroke) within 6 months prior to screening
Evidence of active infection within 2 weeks prior to the first dose of study treatment
Known human immunodeficiency virus infection. Subjects without a documented diagnosis in their medical history will require a central. laboratory assessment at screening
Known active of chronic hepatitis C or hepatitis B infection. Subjects without a documented diagnosis in their medical history will require a central laboratory assessment at screening. Hepatitis B and C infection is based on the following
results
Positive for hepatitis B surface antigen (HBsAg) (indicative of chronic hepatitis B or recent acute hepatitis B)
Negative HBsAg and positive for hepatitis B core antibody: hepatitis B virus DNA by polymerase chain reaction (PCR) is necessary. Detectable hepatitis B virus DNA suggests occult hepatitis B
Positive hepatitis C virus antibody: hepatitis C virus RNA by PCR is necessary. Detectable hepatitis C virus RNA suggests chronic hepatitis C
In addition to the conditions listed in exclusion criteria 201 through 206, secondary malignancy within the past 5 years except
Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
Adequately treated cervical carcinoma in situ without evidence of disease
Adequately treated breast ductal carcinoma in situ without evidence of disease
Prostatic intraepithelial neoplasia without evidence of prostate cancer
Adequately treated urothelial papillary noninvasive carcinoma or carcinoma in situ
Malignancy treated with curative intent and with no known active disease present for greater than or equal to 3 years before enrollment and felt to be at low risk for recurrence by the treating physician (excluding malignancies listed in exclusion criteria 201 - 206)
Thrombocytopenia due to another etiology other than CIT (eg, chronic liver disease, prior history of immune thrombocytopenia purpura)
Any combined modality regimen containing radiation therapy or surgery occurring concomitantly with neo-adjuvant chemotherapy or where radiation therapy is planned before the planned chemotherapy
Prior/Concomitant Therapy
Previous use of romiplostim, pegylated recombinant human megakaryocyte growth and development factor, eltrombopag, recombinant human TPO, any other TPO receptor agonist, or any investigational platelet producing agent
Prior/Concurrent Clinical Study Experience
Currently receiving treatment in another investigational device or drug study, or less than 28 days since ending treatment on another investigational device or drug study(ies). Other investigational procedures while participating in this study are excluded
Diagnostic Assessments
Anemia (hemoglobin less than 8 g/dL) on the day of initiation of investigational product as assessed by local labs. Use of red cell transfusions and erythropoietic stimulating agents is permitted throughout the study as per institutional guidelines
Neutropenia (absolute neutrophil count less than 1 x 10 9/L) on the day of initiation of investigational product as assessed by local labs. Use of granulocyte-colony stimulating factor is permitted throughout the study as per institutional guidelines
Abnormal renal function with creatinine clearance less than 30 mL/min using the Cockcroft-Gault estimated creatinine clearance as assessed by central laboratory during screening
Abnormal liver function (total bilirubin greater than 3X ULN; alanine aminotransferase [ALT] or aspartate aminotransferase [AST] greater than 3X ULN for subjects without liver metastases or greater than or equal to 5X ULN for subjects with liver metastases) as assessed by central laboratory during screening
Other Exclusions
Females who are pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 7 months after treatment (and chemotherapy) discontinuation (females of childbearing potential should only be included after a confirmed menstrual period and a negative highly sensitive urine or serum pregnancy test.)
Females of childbearing potential unwilling to use a highly effective method of contraception during treatment and for an additional 7 months after treatment (and chemotherapy) discontinuation. Refer to Appendix 5 for additional contraceptive information
Males unwilling to use contraception (male condom or sexual abstinence) or their female partner(s) of childbearing potential who are unwilling to use a highly effective method of contraception during treatment (and chemotherapy) and for an additional 7 months after treatment (and chemotherapy) discontinuation. If the male's sole partner is of non-childbearing potential, he is not required to use additional forms of contraception during the study
Subject has known sensitivity to any of the products to be administered during dosing
Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures (eg, COAs) to the best of the subject and investigator's knowledge
History or evidence of any other clinically significant disorder, condition or disease (with the exception of those outlined above) that, in the opinion of the investigator or Amgen physician, if consulted, would pose a risk to subject safety or interfere with the study evaluation, procedures or completion
Male subjects with a pregnant partner who are unwilling to practice abstinence or use a condom during treatment (and chemotherapy) and for an additional 7 months after treatment (and chemotherapy) discontinuation
Male subjects unwilling to abstain from donating sperm during treatment (and chemotherapy) and for an additional 7 months after treatment (and chemotherapy) discontinuation
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