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    Clinical Trial Results:
    Open-Label, Multi-Center, Phase 2 Study of Anti-CCR4 Monoclonal Antibody KW 0761 (mogamulizumab) in Subjects with Previously Treated Peripheral T-cell Lymphoma (PTCL)

    Summary
    EudraCT number
    2011-004151-39
    Trial protocol
    GB   DE   ES   DK   NL  
    Global end of trial date
    22 Jul 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Aug 2016
    First version publication date
    13 Aug 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    0761-007
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01611142
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Kyowa Hakko Kirin Pharma, Inc.
    Sponsor organisation address
    212 Carnegie Center, Suite 101, Princeton, United States, NJ 08540
    Public contact
    Clinical Trial Information, Kyowa Hakko Kirin Pharma, Inc., 001 6099191100, KKD.KW-0761@kyowakirin.com
    Scientific contact
    Clinical Trial Information, Kyowa Hakko Kirin Pharma, Inc., 001 6099191100, KKD.KW-0761@kyowakirin.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    16 Dec 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    22 Jul 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    22 Jul 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine the overall response rate of KW-0761 for the treatment of subjects with relapsed or refractory PTCL
    Protection of trial subjects
    The study was conducted in accordance with the principles of the Declaration of Helsinki, the International Conference on Harmonization (ICH) consolidated guideline E6 - Good Clinical Practice (GCP) and any applicable national and local laws and regulations. Subjects were provided with written and oral information about the study (aims, methods, anticipated benefits, potential hazards and insurance arrangements). No procedures were conducted until informed consent was provided. The protocol included wording for the treatment of skin rash and hypersensitivity-like reactions (wording regarding premedication prior to KW-0761 infusion was also included in the protocol).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    06 Jun 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 4
    Country: Number of subjects enrolled
    Spain: 5
    Country: Number of subjects enrolled
    United Kingdom: 8
    Country: Number of subjects enrolled
    Denmark: 2
    Country: Number of subjects enrolled
    France: 15
    Country: Number of subjects enrolled
    Italy: 4
    Worldwide total number of subjects
    38
    EEA total number of subjects
    38
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    23
    From 65 to 84 years
    14
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    Recruitment opened in May 2012 and closed in October 2013.

    Pre-assignment
    Screening details
    All subjects were screened for eligibility to participate in the trial. Subjects that met all inclusion/exclusion criteria as per protocol, were eligible for entry into the study.A total of 59 subjects were screened of which 21 failed the screening process. 38 patients were therefore enrolled into the study.

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Mogamulizumab (KW-0761)
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Mogamulizumab (KW-0761)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    1.0mg/kg over at least 1 hr on Days 1, 8, 15 and 22 of the first cycle and Days 1 and 15 of each subsequent 28-day cycle.

    Number of subjects in period 1
    Mogamulizumab (KW-0761)
    Started
    38
    Completed
    35
    Not completed
    3
         Adverse event, non-fatal
    1
         Patient discretion
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall study
    Reporting group description
    -

    Reporting group values
    Overall study Total
    Number of subjects
    38 38
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    23 23
        From 65-84 years
    15 15
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    57.7 (19 to 87) -
    Gender categorical
    Units: Subjects
        Female
    15 15
        Male
    23 23

    End points

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    End points reporting groups
    Reporting group title
    Mogamulizumab (KW-0761)
    Reporting group description
    -

    Primary: Number of patients achieving overall response

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    End point title
    Number of patients achieving overall response [1]
    End point description
    End point type
    Primary
    End point timeframe
    Disease response was assessed every 8 weeks.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analysis was ultilised for this primary endpoint.
    End point values
    Mogamulizumab (KW-0761)
    Number of subjects analysed
    35
    Units: Participants
    4
    No statistical analyses for this end point

    Secondary: Number of patient achieving progression free survival

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    End point title
    Number of patient achieving progression free survival
    End point description
    End point type
    Secondary
    End point timeframe
    Disease response was assessed every 8 weeks.
    End point values
    Mogamulizumab (KW-0761)
    Number of subjects analysed
    35
    Units: participants
    35
    No statistical analyses for this end point

    Secondary: Duration of Response (days)

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    End point title
    Duration of Response (days)
    End point description
    Four subjects had response durations of >1, 43, 77, >539 study days.
    End point type
    Secondary
    End point timeframe
    Duration of response was measured from the time measurement criteria were met for CR/PR (whichever was first recorded) until the first date that PD or death was objectively documented.
    End point values
    Mogamulizumab (KW-0761)
    Number of subjects analysed
    35
    Units: Days
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From pre-treatment visit until 90 days after the last dose.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    15
    Reporting groups
    Reporting group title
    Baseline
    Reporting group description
    -

    Serious adverse events
    Baseline
    Total subjects affected by serious adverse events
         subjects affected / exposed
    18 / 38 (47.37%)
         number of deaths (all causes)
    16
         number of deaths resulting from adverse events
    2
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Fall
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Septic shock
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cardiac disorders
    Stress cardiomyopathy
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac Failure
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebellar syndrome
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Asthenia
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Xerosis
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Anaemia
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Skin and subcutaneous tissue disorders
    Drug eruption
         subjects affected / exposed
    5 / 38 (13.16%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal impairment
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    1 / 1
    Aspergillosis
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cytomegalovirus infection
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumocystis jiroveci pneumonia
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sialoadenitis
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oral infection
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Inappropriate antidiuretic hormone secretion
         subjects affected / exposed
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Baseline
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    35 / 38 (92.11%)
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Infusion related reaction
         subjects affected / exposed
    3 / 38 (7.89%)
         occurrences all number
    3
    Vascular disorders
    Hypertension
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    3
    Hypotension
         subjects affected / exposed
    5 / 38 (13.16%)
         occurrences all number
    7
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    4 / 38 (10.53%)
         occurrences all number
    4
    Lethargy
         subjects affected / exposed
    3 / 38 (7.89%)
         occurrences all number
    3
    Neuropathy peripheral
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 38 (10.53%)
         occurrences all number
    6
    Lymphadenopathy
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Neutropenia
         subjects affected / exposed
    3 / 38 (7.89%)
         occurrences all number
    3
    Thrombocytopenia
         subjects affected / exposed
    5 / 38 (13.16%)
         occurrences all number
    5
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    5 / 38 (13.16%)
         occurrences all number
    5
    Chills
         subjects affected / exposed
    3 / 38 (7.89%)
         occurrences all number
    3
    Fatigue
         subjects affected / exposed
    3 / 38 (7.89%)
         occurrences all number
    3
    Oedema peripheral
         subjects affected / exposed
    4 / 38 (10.53%)
         occurrences all number
    7
    Pyrexia
         subjects affected / exposed
    8 / 38 (21.05%)
         occurrences all number
    11
    Gastrointestinal disorders
    Abdominal discomfort
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Constipation
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Diarrhoea
         subjects affected / exposed
    7 / 38 (18.42%)
         occurrences all number
    10
    Nausea
         subjects affected / exposed
    4 / 38 (10.53%)
         occurrences all number
    6
    Vomiting
         subjects affected / exposed
    5 / 38 (13.16%)
         occurrences all number
    6
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    6 / 38 (15.79%)
         occurrences all number
    6
    Dyspnoea
         subjects affected / exposed
    3 / 38 (7.89%)
         occurrences all number
    4
    Hypoxia
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Nasopharyngitis
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Pleural effusion
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Drug eruption
         subjects affected / exposed
    10 / 38 (26.32%)
         occurrences all number
    18
    Night sweats
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Pruritus
         subjects affected / exposed
    7 / 38 (18.42%)
         occurrences all number
    10
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    4 / 38 (10.53%)
         occurrences all number
    5
    Back pain
         subjects affected / exposed
    3 / 38 (7.89%)
         occurrences all number
    3
    Bone pain
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    3
    Fungal infection
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Lower respiratory tract infection
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2
    Sepsis
         subjects affected / exposed
    2 / 38 (5.26%)
         occurrences all number
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Mar 2012
    • Added only CCR4-positive subjects and the most common PTCL subtypes who expressed the CCR4 target excluding those with indolent disease and/or lower CCR4 expression; • Excluded subjects with a history of moderate or severe psoriasis or with psoriasis associated with systemic symptoms or with a 1st degree relative with history of psoriasis that required medical intervention; • Allowed subjects with known bone marrow involvement to participate if their platelet count was ≥75,000 and allowed for laboratory retesting if the criteria for hematologic, hepatic, and renal function were not met; • Specified that safety surveillance would be performed on a regular basis by the Sponsor and independent therapeutic experts and extended the safety monitoring period from 30 to 90 days after the last dose of study medication; • The subject was required to use contraception for 3 months after the last dose of study drug; • Provided guidelines for documenting and treating a treatment-emergent skin rash; • Incorporated the mSWAT for subjects with skin disease with the IWG response criteria (definitions added) for assessment of global response; • Included the assessment of AEs from the time of informed consent rather than after the first dose of study drug; • Allowed subjects to continue monthly treatment with mogamulizumab, at the discretion of the investigator, beyond CR; • Updated the guidelines for the treatment of hypersensitivity-like reactions; • Allowed skin biopsies for CCR4 expression in subjects with skin disease.
    16 Apr 2013
    • To modify the Inclusion/Exclusion Criteria; • To increase the number of sites; • To specify the permissible dosing interval for mogamulizumab; • To allow subjects with PD in one disease compartment to continue treatment for a period of up to 8 weeks and allow additional time for the demonstration of an objective response; • To allow subjects who experienced a CR to continue to be treated for a period of 12 months or until progression, whichever occurred first; • To clarify the guidance for the treatment of hypersensitivity-like reactions; • To remove clinical laboratory assessments (i.e., CD4 and CD8 cell counts) not necessary for the conduct of this study. • To lengthen the Screening period; • To clarify the acceptable age of archived lymph node or skin biopsy sample (i.e., collected within 3 months Pretreatment) and to allocate a portion of the sample collected to test a second method of CCR4 analysis in order to establish compatibility between the tests; • To clarify that the SWAT must be performed for all subjects; • To clarify that certain body weight changes requires dose adjustment and to describe the storage conditions of the reconstituted drug product; • To specify that in this study, disease progression and lymphopenia should not be considered adverse events.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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