E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Steroid resistant severe acute gastrointestinal graft-versus-host disease |
Steroid-refraktäre akute gastrointestinale Graft-versus-Host-Erkrankung |
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E.1.1.1 | Medical condition in easily understood language |
graft-versus-host disease |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10068908 |
E.1.2 | Term | AGVHD |
E.1.2 | System Organ Class | 100000004870 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To examine whether the transfusion of in vitro expanded donor regulatory T cells improves severe gastrointestinal acute GVHD |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives :
To determine
- overall survival and non-relapse mortality at 6 months after Treg cell therapy
- the influence of Treg cell therapy on other sites of GVHD manifestation than the gastrointestinal tract
- the impact of Treg cell transfusion on reactivated viruses, de novo virus reactivation or infection and the occurrence of other life-threatening (°IV WHO) infections
- the frequency of Treg cells in peripheral blood of patients before and at serial time points after Treg treatment
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Histology-proven GVHD
- Clinical stage 2-4 acute gastrointestinal GVHD with or without other GVHD manifestations (overall GVHD grade III-IV)
- Disease resistance to steroid treatment (at least 1 mg/kg bw) - Male and female patients, age 18 - 70y
- Written informed consent of patient |
- Unterschriebene und datierte Patienten- und Spender-Einverständniserklärung
- Männliche und weibliche Patienten im Alter zwischen 18 und 70 Jahren
- Histologisch gesicherte GvHD
- Akute gastrointestinale GvHD - Grad II bis IV mit oder ohne GVHD-Manifestationen in anderen Organen (Grad III-IV)
- Steroid-resistente GvHD ( min. 1mg/kg KG)
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E.4 | Principal exclusion criteria |
- Age <18 y and >70 y
- No previous steroid therapy (first-line treatment)
- No previous second-line therapy
- Severe psychiatric disorders
- Presumed life expectancy < 4 wks
- Lack of informed consent
- Pregnant or nursing woman
- Patients included in other clinical trials interfering with the present study
- Donors from outside EU |
- Fehlende Patienten- und Spender-Einverständniserklärung
- Fehlende Einverständniserklärung der Spender-Datenbank
- Patienten <18 Jahre und > 70 Jahre
- Keine vorherige Steroid -First-Line-Therapie
- schwerwiegenden psychiatrische Krankheit
- Lebenserwartung unter 4 Wochen
- Spender außerhalb der EU
- Einschluss in konkurrierende bzw. überlappende klinische
Studie
- Schwangere oder stillende Frauen
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E.5 End points |
E.5.1 | Primary end point(s) |
Change in gastrointestinal GVHD stage two months after Treg treatment according to modified Glucksberg criteria |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
2 months after therapy. |
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E.5.2 | Secondary end point(s) |
- OS and NRM at 2 and 6 months after Treg treatment
- Relapse of underlying disease at 6 months after Treg therapy in patients transplanted for heamatologic malignancies
- GVHD status according to NIH criteria before and at 1, 2 and 6 months after Treg therapy
- aGVHD activity index before and 1, 2 and 6 months after Treg treatment
- Quantitative titer for reactivated viruses before and 2, 4 and 8 wks after Treg treatment and de novo virus reactivation or infection
- De novo °IV infections after Treg therapy according to WHO classification
- Frequency of Treg cells (defined as CD4+CD25+FOXP3+ by FACS) in peripheral blood at serial time points |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
early phase II proof of concept |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Trial is terminated after the last study visit of the last subject undergoing the trial. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |