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NeutropeniaPhase 2NCT02190721

A Study to Evaluate 5 μg/kg Tbo-filgrastim in Infants, Children and Adolescents With Solid Tumors Without Bone Marrow Involvement

A Phase 2 study testing tbo-filgrastim in people with Neutropenia, run by Teva Branded Pharmaceutical Products R&D, Inc. at 33 sites in 8 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of the study is to evaluate the safety, pharmacokinetics, pharmacodynamics, and efficacy of daily subcutaneous administration of 5 μg/kg tbo-filgrastim in infants, children and adolescents with solid tumors without bone marrow involvement. Read more about this study

Who is it for?
Ages 1 month to 16 years
Conditions the study is for
Neutropenia
What is being tested?
tbo-filgrastim
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
33 sitesin 8 countries
Study dates
12 May 2015to 4 Apr 2017
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 month to 16 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Male or female infants, children and adolescents aged 1 month to <16 years.
  • Patients with solid tumors without bone marrow involvement, who are scheduled to receive myelosuppressive CTX.
  • Body weight ≥5 kg.
  • Patients must have an initial diagnosis and histologic proof of their malignancy. All enrolled subjects should have signed consent for a CTX regimen that is known to be myelotoxic, with counts expected to drop below the absolute neutrophil count (ANC) of 0.5 × 109/L for at least 3 days. These regimens would include at least one of the following:
  • Etoposide
  • doxorubicin
Show all 13Show fewer
  • ifosfamide
  • cyclophosphamide
  • ANC and platelet count: Patients must have an ANC >1 × 109/L and a platelet count >100 × 109/L to be eligible for therapy at the start of CTX.
  • Normal cardiac, renal, and hepatic function.
  • All subjects must have a life expectancy of 12 weeks or more.
  • Performance Status: Lansky performance score >60 (age 1 to <16 years).
  • More criteria may apply, please contact the investigator for more information.

Who cannot join

  • Bone marrow involvement.
  • Active myelogenous leukemia or history of myelogenous leukemia.
  • Previous treatment with colony-stimulating factors (granulocyte colony-stimulating factor [G-CSF], granulocyte-macrophage colony-stimulating factor, interleukin 11 [IL-11]) less than 6 weeks prior to study entry.
  • History of congenital neutropenia or cyclic neutropenia.
  • Pregnant or nursing female patients.
  • Fertile patients who do not agree to use highly reliable contraceptive measures Prior bone marrow or stem cell transplant, or prior radiation to ≥25% of bone marrow within the 4 weeks prior to the first tbo-filgrastim dose.
Show all 9Show fewer
  • Ongoing active infection or history of infectious disease within 2 weeks prior to the screening visit.
  • Treatment with lithium at screening or planned during the study
  • More criteria may apply, please contact the investigator for more information.

Trial locations and contacts

33 sites in 8 countries.

33 sites in 8 countries

United States7 sites
  • Teva Investigational Site 12960

    Columbus, Ohio, 43205

  • Teva Investigational Site 12957

    Houston, Texas, 77030

  • Teva Investigational Site 12954

    Jackson, Mississippi, 39216

  • Teva Investigational Site 12953

    Las Vegas, Nevada, 89109

  • Teva Investigational Site 12958

    Long Beach, California, 90806

  • Teva Investigational Site 12951

    Los Angeles, California, 90024

  • Teva Investigational Site 12959

    Valhalla, New York, 10595

Other trials in United States

Poland5 sites
  • Teva Investigational Site 53249

    Gdansk, 80-952

  • Teva Investigational Site 53248

    Lublin, 20-093

  • Teva Investigational Site 53245

    Warsaw, 01-211

  • Teva Investigational Site 53246

    Warsaw, 04-730

  • Teva Investigational Site 53247

    Wroclaw, 50-556

Other trials in Poland

Russia5 sites
  • Teva Investigational Site 50282

    Chelyabinsk, 454076

  • Teva Investigational Site 50281

    Krasnodar, 350007

  • Teva Investigational Site 50284

    Moscow, 117198

  • Teva Investigational Site 50280

    Saint Petersburg, 197110

  • Teva Investigational Site 50283

    Volgograd, 400138

Other trials in Russia

Ukraine5 sites
  • Teva Investigational Site 58147

    Kharkiv, 61070

  • Teva Investigational Site 58145

    Kyiv, 03022

  • Teva Investigational Site 58148

    Lviv, 79035

  • Teva Investigational Site 58146

    Vinnytsia, 21029

  • Teva Investigational Site 58149

    Vinnytsia, 21029

Other trials in Ukraine

Croatia3 sites
  • Teva Investigational Site 60015

    Rijeka, 51000

  • Teva Investigational Site 60014

    Zagreb, 10000

  • Teva Investigational Site 60016

    Zagreb, 10000

Other trials in Croatia

Hungary3 sites
  • Teva Investigational Site 51186

    Budapest, 1089

  • Teva Investigational Site 51185

    Budapest, 1094

  • Teva Investigational Site 51184

    Szeged, 6725

Other trials in Hungary

Romania3 sites
  • Teva Investigational Site 52063

    Bucharest, 022328

  • Teva Investigational Site 52064

    Cluj-Napoca, Cluj, 400015

  • Teva Investigational Site 52065

    Timișoara, 300383

Other trials in Romania

Bulgaria2 sites
  • Teva Investigational Site 59104

    Sofia, 15257

  • Teva Investigational Site 59105

    Varna, 9010

Other trials in Bulgaria

About this study

Official title: A Multicenter, Open-Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, Efficacy, and Immunogenicity of Daily Subcutaneous Administration of 5 ?g/kg Tbo-filgrastim in Infants, Children and Adolescents With Solid Tumors Without Bone Marrow Involvement

The purpose of the study is to evaluate the safety, pharmacokinetics, pharmacodynamics, and efficacy of daily subcutaneous administration of 5 μg/kg tbo-filgrastim in infants, children and adolescents with solid tumors without bone marrow involvement.

Conditions
Neutropenia
Being tested
tbo-filgrastim
Keywords
Neutropenia
Medical subject headings
Neutropenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • tbo-filgrastimDrug

    5 μg/kg

Study groups in NCT02190721
Study groupRoleWhat they receive
tbo-filgrastimExperimentalPatients will receive subcutaneous doses of tbo-filgrastim 5 μg/kg body weight daily; each daily dose, to be administered at the investigative site
Receives: Drug: tbo-filgrastim

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Participants With Adverse Events (AEs)

    An adverse event was defined as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug. A treatment-emergent AE (TEAE) is an AE occurring during the timeframe. A non-TEAE is any AE not considered a TEAE.

    Severity was rated by the investigator using the NCI Common Terminology Criteria for Adverse Events (NCI-CTCAE) scale where 3=severe but not life-threatening, 4=life-threatening and 5=death. Relation of AE to treatment was determined by the investigator (related=reasonable possibility). Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical intervention to prevent the previously listed serious outcomes.

    Measured: Non-TEAE: signing of informed consent to Day -1 (last day of CTX in week 1). And > 30 days after last dose of tbo-filgrastim (Day 46+). TEAE timeframe: Day 1 (start of tbo-filgrastim) to <= 30 days after the last dose (up to Day 45)

  2. Participants With Potentially Clinically Significant Abnormal Serum Chemistry Results

    Serum chemistry tests included alkaline phosphatase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), direct bilirubin, indirect bilirubin, total bilirubin, calcium, creatinine, gammaglutamyl transpeptidase (GGT), glucose, potassium, lactate dehydrogenase (LDH), phosphate, sodium and uric acid.

    Only tests with potentially clinically significant abnormal results are reported.

    ULN = upper limit of normal

    Measured: Day 1 (start of tbo-filgrastim administration) up to Day 21

  3. Participants With Potentially Clinically Significant Abnormal Hematology Results

    Hematology tests included Basophils ABS (x 10^9/L), Basophils (%), Eosinophils ABS (x 10^9/L), Eosinophils (%), Hematocrit (%), Hemoglobin (g/L), Lymphocytes Absolute Count (ABS) (x 10^9/L), Lymphocytes (%), Monocytes ABS (x 10^9/L), Monocytes (%), Neutrophils ABS (x 10^9/L), Neutrophils (%), Platelets (x 10^9/L), Red Blood Cell (RBC) (x 10^12/L), White Blood Cell (WBC) (x 10^9/L).

    Only tests with potentially clinically significant abnormal results are reported.

    ULN = upper limit of normal

    Measured: Day 1 (start of tbo-filgrastim administration) up to Day 21

  4. Participants With Potentially Clinically Significant Abnormal Vital Signs

    Vital sign tests included Pulse Rate (bpm), Systolic BP (mmHg), Diastolic BP (mmHg), Respiratory Rate (bpm), and Temperature (°C).

    Only tests with potentially clinically significant abnormal results are reported.

    Measured: Day 1 (start of tbo-filgrastim administration) up to Day 21

  5. Participants With Potentially Clinically Significant Abnormal Electrocardiogram Results

    Triplicate 12-lead ECGs were conducted at screening, predose, 4 and 6 hours postdose on day 1 of tbo-filgrastim administration, and at the end-of-study visit. The ECGs were interpreted by both the investigator and a qualified physician at the central diagnostic center as normal, abnormal not clinically significant, or abnormal clinically significant. The following parameters were measured/derived for each ECG assessment: heart rate, PR interval, RR interval, QT interval, corrected QT interval according to Fridericia's formula (QTcF), corrected QT interval according to Bazett's formula (QTcB), QRS duration, and QRS axis.

    The count of participants with potentially clinically significant ECG findings is reported.

    Measured: Day 1 (start of tbo-filgrastim administration) pre-dose, 4 hours post dose and 6 hours post dose; Day 21 (end of study visit)

  6. Participants With Negative Shifts From Baseline to End of Study in Physical Exam Findings

    Physical examination was performed at screening and at the end-of-study visit. The following body systems were marked as normal or abnormal and if abnormal, whether clinically significant: Head, ears, eyes, nose and throat (HEENT), chest and lungs, heart, abdomen, skin, lymph nodes and neurological.

    Any physical examination finding that is judged by the investigator as a clinically significant change (worsening) compared with a baseline value were considered as an adverse event.

    Counts of participants with a negative shift from baseline in any of the body systems (including shifts from normal to abnormal, not clinically significant) are presented.

    Measured: Baseline: Day -21, Day 21 (end of study visit)

  7. Participants With Injection Site Reactions to Tbo-Filgrastim Administration

    Using Local Tolerability Assessment Scale ranging from Pain severity 0 (Absent) to 3 (Spontaneously painful)

    Measured: Day 1 (start of tbo-filgrastim administration) up to Day 14

  8. Participants With Negative Shifts From Baseline to End of Study in Spleen Sonography Findings

    The investigator assessed spleen sonography findings as normal, abnormal not clinically significant, or abnormal clinically significant.

    Data representing counts of participants with a negative shift from baseline in spleen sonography findings (including shifts from normal to abnormal, not clinically significant) are presented.

    Measured: Baseline: Day -21, Day 21 (end of study visit)

  9. Participants Who Were Alive at the 90 Day Follow-Up

    Summary of participant survival at 90 day follow-up.

    Measured: 90 days post end of study visit (111 days from start of tbo-filgrastim administration)

Secondary outcomes (24)
  1. Participants With Positive Immunogenicity Findings Tested at Four Study Timepoints

    Blood was drawn for the assessment of anti-drug antibody (ADA) at screening, at the end-of-study visit, and at 30 and 90 days after the last administration of tbo-filgrastim in chemotherapy (CTX) cycle 1.

    The main endpoint from the assessment was the presence of antibodies in the sample, reported as positive or negative. Participants with positive results are summarized.

    Measured: Baseline (Day -21), Day 21 (end of study visit), Day 51 (30 Day follow-up) and Day 111 (90 Day follow-up)

  2. Maximum Observed Serum Concentration (Cmax) of Tbo-Filgrastim

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  3. Time to Maximum Observed Serum Concentration (Tmax) of Tbo-Filgrastim

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  4. Area Under The Serum Concentration-Time Curve From Time 0 To Time Of Last Quantifiable Concentration (AUClast)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  5. Area Under The Serum Concentration-Time Curve From Time 0 To 12 Hours Postdose (AUC0-12)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  6. AUC From Time 0 to Infinity (AUC0-inf)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  7. Elimination Half-life (t1/2)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  8. Apparent Clearance (CL/F)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose of Day 1

  9. Apparent Volume of Distribution During the Terminal Phase (Vz/F)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  10. Percentage of the AUC0-∞ That Is Due To the Extrapolation (%AUCext)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  11. Terminal Elimination Rate (Lambda-z)

    Measured: Within 1 hour before the tbo-filgrastim dose and at 2, 4, 6, 8, and 12 hours after the tbo-filgrastim dose on Day 1

  12. Participants With Severe Neutropenia

    Count of participants who had an incidence of severe neutropenia, defined as any value of absolute neutrophil count (ANC) <0.5 * 10^9/L at any time.

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  13. Duration of Severe Neutropenia

    The duration of severe neutropenia was derived by counting the number of days with absolute neutrophil count (ANC) values <0.5 * 10^9/L.

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  14. Area Under The Serum Drug Concentration By Time Curve Of Absolute Neutrophil Count (AUC ANC)

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  15. Absolute Neutrophil Count (ANC) Nadir

    ANC nadir (measured in 10^9/L) is the lowest ANC recorded.

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  16. Time to Absolute Neutrophil Count (ANC) Nadir From Beginning of Tbo-filgrastim Administration

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  17. Time to Absolute Neutrophil Count (ANC) Nadir From Beginning of Chemotherapy

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  18. Time to ANC Recovery To ≥1.0 * 10^9/L From ANC Nadir

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  19. Time to ANC Recovery To ≥2.0 * 10^9/L From ANC Nadir

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  20. Time to ANC Recovery To ≥1.0 * 10^9/L From Start of Tbo-filgrastim Administration

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  21. Time to ANC Recovery To ≥2.0 * 10^9/L From Start of Tbo-filgrastim Administration

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  22. Time to ANC Recovery To ≥1.0 * 10^9/L From Start of Chemotherapy

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  23. Time to ANC Recovery To ≥2.0 * 10^9/L From Start of Chemotherapy

    Measured: ANC blood samples collected within 1 hour before the tbo-filgrastim dose on Day 1, and on Days 5, 6, 7, 10, 12, 15 and at the end of study visit (up to Day 21)

  24. Participants With Febrile Neutropenia During the First Cycle of Chemotherapy

    Febrile neutropenia was defined as an axillary or external ear temperature >38.3°C (100.94°F) or 2 consecutive readings >37.8°C (100.04°F) at least 2 hours apart and an ANC <0.5 * 10^9/L. The efficacy variable was evaluated for up to 21 days from the start of the first cycle of chemotherapy.

    Measured: (relative to tbo-filgrastim therapy) Days -7 to Day 14

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Jul 2014 (estimated)
  2. Study start12 May 2015
  3. Primary completion4 Apr 2017
  4. Study completion4 Apr 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02190721
Sponsor's protocol ID
XM02-ONC-201
Other IDs
2014-001772-55, 2014
Status last verified
Dec 2021
First submitted
11 Jul 2014
Last updated
10 Dec 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing tbo-filgrastim in people with Neutropenia, run by Teva Branded Pharmaceutical Products R&D, Inc. at 33 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 33 sites in United States, Poland, Russia, Ukraine, Croatia and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 31 Jul 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Participants With Adverse Events (AEs) (time frame: Non-TEAE: signing of informed consent to Day -1 (last day of CTX in week 1). And > 30 days after last dose of tbo-filgrastim (Day 46+). TEAE timeframe: Day 1 (start of tbo-filgrastim) to <= 30 days after the last dose (up to Day 45)). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Dec 2021.

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