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Acute Lymphoblastic LeukemiaPhase 4NCT02670564

ALL SCTped FORUM - Pharmacogenomic Study (add-on Study)

A Phase 4 study testing Pharmacogenomics and Busulfan plasma level measurements in people with Acute Lymphoblastic Leukemia, run by Swiss Pediatric Oncology Group at 4 sites in Switzerland.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Pharmacogenomics (PG) offers the opportunity to individualize treatment according to patient genetic variations which influence activity of enzyme metabolizing or acting in the pathway of prescribed chemotherapy drugs. Read more about this study

Who is it for?
Ages Up to 18 years
Conditions the study is for
Acute Lymphoblastic Leukemia
What is being tested?
Pharmacogenomics and Busulfan plasma level measurements
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,000 participants
Where
4 sitesSwitzerland
Study dates
Apr 2013to Apr 2026
Phase
Phase 4
Are there results?
None posted in the registry

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 Up to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Patients with ALL (except for patients with B-ALL)
  • indication for allogeneic HSCT
  • complete remission (CR) before HSCT
  • written consent of the parents (legal guardian) and, if necessary, the minor patient via "Informed Consent Form"
  • no pregnancy
  • no secondary malignancy
  • no previous HSCT
  • HSCT is performed in a study participating centre

Who cannot join

  • Non Hodgkin-Lymphoma
  • ALL with extramedullary involvement with indication for TBI
  • CNS involvement at the timepoint of screening
  • Trisomy 21
  • The whole protocol or essential parts are declined either by patient himself/herself or the respective legal guardian
  • No consent is given for saving and propagation of anonymous medical data for study reasons
Show all 9Show fewer
  • Severe concomitant disease that does not allow treatment according to the protocol at the investigator's discretion (e.g. malformation syndromes, cardiac malformations, metabolic disorders)
  • Karnofsky / Lansky score < 50%
  • Subjects unwilling or unable to comply with the study procedures

Trial locations and contacts

4 sites in 1 country.

Patricia Huezo-Diaz Curtis, PhD contact

+41 22 372 99 65

research@cansearch.ch

Switzerland4 sites, 4 recruiting
  • Universitäts-Kinderspital beider Basel (UKBB), Onkologie/Hämatologie

    Basel, 4056

    Nicolas Von der Weid, + 41 61 704 12 12, nicolas.vonderweid@ukbb.ch

    Recruiting
  • Hôpital Cantonal de Genève, Département de Pédiatrie

    Geneva, Cansearch Laboratory, 1211

    Marc Ansari, MD, PD, +41 22 382 47 31, Marc.Ansari@hcuge.ch

    Recruiting
  • HUG Hôpitaux Universitaire de Genève, Unité d'onco-hématologie pédiatrique

    Geneva, 1211

    Marc Ansari, +41 22 372 47 31, Marc.Ansari@hcuge.ch

    Recruiting
  • Universitäts-Kinderspital

    Zurich, 8032

    Güngör Tayfun, +41 44 266 74 92, tayfun.guengoer@kispi.uzh.ch

    Recruiting

Other trials in Switzerland

About this study

Official title: Allogeneic Stem Cell Transplant for Children and Adolescents With Acute Lymoblastic Leukemia FORUM - Pharmacogenomic Study (add-on Study)

Pharmacogenomics (PG) offers the opportunity to individualize treatment according to patient genetic variations which influence activity of enzyme metabolizing or acting in the pathway of prescribed chemotherapy drugs.

This add-on research aims to prospectively investigate variations in several candidate genes related to all types of chemotherapeutic drugs and TBI used in the main related study NCT 01949129, THE ALL SCTped FORUM study for their potential role as predictive biomarkers of PK variability and outcome of myeloablative therapy for pediatric patients receiving an allogeneic hematopoietic stem cell transplantation in acute lymphoblastic leukemia.

Read the detailed description

Note this is an add-on study to NCT 01949129, THE ALL SCTped FORUM study. Please refer to the main study for further details.

Busulfan (Bu) is a key compound in conditioning myeloablative regimens for patients undergoing hematopoietic stem cell transplantation (HSCT). Bu has been long used for the treatment of patients with leukemia and some congenital disorders; advantages and disadvantages of such treatment are well described. However, although Bu treatment has been shown to be effective, its use may be limited by related adverse events such as veno-occlusive disease (VOD), interstitial pneumonitis, acute Graft vs Host Disease (GVHD), and seizures. Thus, novel therapies are being investigated as well as the pharmacogenetics of these drugs. One of alternative drugs that may replace Bu due to its lower toxicity profile is Treosulfan (Treo). Fludarabine (Flu) is usually used in combination with Bu or Treo as an alternative to cyclophosphamide (Cy) also due to its lower toxicity. Thus, the Bu/Flu regimen is now being used more often than the previously more common Bu/Cy regimen. However, improvement to the regimen is still needed for reducing adverse drug effects. Pharmacogenomics (PG) offers the opportunity to individualize treatment according to patient genetic variations which influence activity of enzyme metabolizing or acting in the pathway of prescribed chemotherapy drugs.

This add-on research aims to prospectively investigate variations in several candidate genes (e.g GST, DCK and DNA repair pathway genes) related to all types of chemotherapeutic drugs (Bu/Flu/Thio; Treo/Flu/Thio and TBI/VP16) used in this protocol for their potential role as predictive biomarkers of pharmacokinetics (PK) variability and outcome of myeloablative therapy for pediatric patients receiving an allogeneic HSCT in acute lymphoblastic leukemia

For the busulfan arm countries: a cross-validation of busulfan quantification is performed. All Bu Therapeutic Drug Monitoring participating at the main ALL SCTped FORUM study will be assessed for the accuracy (%) and trueness (%) of 8 blinded Bu Quality Control samples. Criteria of acceptance are set according to FDA and ICH guidelines.

Blood samples will be collected prior to initiation of therapy for DNA banking and DNA analysis (for all patients), for DNA analysis (TBI/VP16, Bu/Flu/Thiotepa and Treo/Flu/Thiotepa groups) and PK analysis (only for the Bu group). PK and pharmacogenomic data will then be correlated with the studied outcomes (e.g.Veno-occlusive disease, Graft vs host disease, Treatment Related Mortality, Events Free Survival, Overall Survival).

Recruitment:

Patients (children) age 0-18 will be recruited in each arm. No oral Bu is allowed in this study.

Shipment (when there is a minimum of 10 patients) Send all the materials listed to: Dr Marc Ansari, Plateforme d'Hématologie et Oncologie Pédiatrique (CANSEARCH research laboratory), Faculté de Médecine, Bâtiment Tulipe, 5th floor, Av De La Roseraie 64, GENEVE 1205 Switzerland.

Contact Dr. Ansari's laboratory prior to shipment: Phone (+41 79 55 36 100) and e-mail (research@cansearch.ch). All shipments must be sent frozen by a carrier guaranteeing overnight delivery with the indication "Pharmacogenomic study" on the face of the parcel.

Being tested
Pharmacogenomics, Busulfan plasma level measurements
Keywords
pharmacogenetics, busulfan, treosulfan, hematopoietic stem cell transplantation, fludarabine, pediatric patients, TBI, leukemia, leukemia, lymphoid, precursor cell lymphoblastic Leukemia-Lymphoma, Immune System disease, Immunoproliferative Disorders, stem cell transplantation, children and adolescent, high risk acute lymphoblastic leukemia, NCT01949129 add-on, ALL SCTped FORUM
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma, Leukemia, Leukemia, Lymphoid, Immune System Diseases, Immunoproliferative Disorders

What participants receive

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

  • PharmacogenomicsGenetic

    Also called DNA analyses

    Blood samples (2x5ml EDTA tubes) should be collected just before the start of the conditioning regimen from every patient regardless of therapeutic arm by every centre and stored ≤-20°C Patient should be in remission (MRD negative) for this sampling, otherwise the sample should be taken using a mouth swab/saliva (not intravenously).

    For second transplant patients, please provide DNA taken before first transplant or a fresh saliva samples.

  • Busulfan plasma level measurementsOther

    Bu PK analysis after the first dose of IV Bu (+potential subsequent ones).

    Blood sampling:

    ->For Bu 4 X/d: Before the first Bu dose (Time 0), then straight after the end of infusion (Time 1), then at 15 min (Time 2), 30 min (Time 3), 1 hour (Time 4) and 4 hour (Time 5) after the end of infusion

    ->For Bu 1 X/d: Before the first Bu dose (Time 0), then straight after the end of infusion (Time 1), then at 1 hour (Time 2), 3 hour (Time 3), 5 hour (Time 4), 7 hour (Time 5) and 11 hour (Time 6) after the end of infusion.

    For centers not performing BU TDM, perform Dried Blood Sampling (DBS) analysis:

    -> 0.5ml blood sample should be collected and 5µl spotted onto DBS cards in duplicate. Dry them max 5 hours and then keep in a sealed envelope and store at -80°C, as below

Study groups in NCT02670564
Study groupRoleWhat they receive
Total body irradiation (TBI)ExperimentalThe Pharmacogenomics add-on requires 2X 5ml blood EDTA for further DNA analyses. Note this is an add-on study to NCT 01949129, THE ALL SCTped FORUM study. Please refer to the main study for further details.
Receives: Genetic: Pharmacogenomics
BusulfanExperimentalThe Pharmacogenomics add-on requires 2X 5ml blood EDTA for further DNA analyses. Note this is an add-on study to NCT 01949129, THE ALL SCTped FORUM study. Please refer to the main study for further details.
Receives: Genetic: Pharmacogenomics; Other: Busulfan plasma level measurements
TreosulfanExperimentalThe Pharmacogenomics add-on requires 2X 5ml blood EDTA for further DNA analyses. Note this is an add-on study to NCT 01949129, THE ALL SCTped FORUM study. Please refer to the main study for further details.
Receives: Genetic: Pharmacogenomics

What is being measured

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

  1. Genetic variants in participants as a marker of risk of Adverse events and/or Efficacy of the studied agents

    Genotyping of candidates genes related to pharmacokinetics and pharmacodynamics of the studied agents.

    Association study between the herein genetic variants and the below mentioned phenotypes (odd ratio).

    Measured: through study completion, an average of 2 years

Secondary outcomes (10)
  1. Number of participants with acute Graft-versus-host disease (aGvHD) according to the Glucksberg scale and Seattle criteria

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  2. Number of participants with chronic Graft-versus-host disease (cGvHD) according to the Glucksberg scale and Seattle criteria

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  3. Number of participants with VOD/SOS according to the Seattle criteria

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  4. Number of participants with Neutrophil recovery as a measure of Safety and Tolerability

    defined as the first of 3 consecutive days with an absolute neutrophil count of 0.5x10^9/L or higher

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  5. Number of participants with Platelet recovery as a measure of Safety and Tolerability

    Defined as the first of 3 consecutive days with platelet counts higher that 20x10^9/L without transfusion

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  6. Number of participants with Primary graft failure or rejection as a measure of Safety and Tolerability

    Defined by persistent pancytopenia with no evidence of hematologic recovery of donor cells beyond 28 days after transplantation, and secondary graft failure by a rapid decrease in neutrophil count after successful engraftment

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  7. Transplant related mortality (TRM)

    the time of transplant until all causes of death after transplant not related to relapse

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  8. Event free survival (EFS)

    the time of transplant until death, relapse or graft failure, whichever occurs first.

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  9. Overall survival (OS)

    the time between transplantation and death due to any causes

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

  10. Cumulative incidence of relapse

    Measured: 18 months after inclusion of first patient, afterwards, annually up to 10 years

Timeline

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

  1. First posted2 Feb 2016 (estimated)
  2. Study startApr 2013
  3. Primary completionApr 2021 (estimated)
  4. Study completionApr 2026 (estimated)

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 4
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02670564
Sponsor's protocol ID
ZH 2014-0535
Other IDs
NZ 2015-069, GE 15-034
Status last verified
Apr 2019
First submitted
3 Jul 2015
Last updated
16 Apr 2019
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Pharmacogenomics and Busulfan plasma level measurements in people with Acute Lymphoblastic Leukemia, run by Swiss Pediatric Oncology Group at 4 sites in Switzerland.

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 8 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: status not confirmed, as of the sponsor's last update on 16 Apr 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Switzerland. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

Results are not available in the source record.

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

Contact Marc Ansari, MD, PD (+41 22 382 47 31 ext. +41 79 502 338, Marc.Ansari@hcuge.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Genetic variants in participants as a marker of risk of Adverse events and/or Efficacy of the studied agents (time frame: through study completion, an average of 2 years). 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 16 Apr 2019.

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