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    Clinical Trial Results:
    A phase I/II feasibility study of panoninostat alone and the combination of panobinostat and decitabine prior to donor lymphocyte infusion in recipients of allogeneic stem cell transplantation with poor and very poor risk AML

    Summary
    EudraCT number
    2012-003344-74
    Trial protocol
    NL   BE  
    Global end of trial date
    02 Aug 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    17 Nov 2023
    First version publication date
    17 Nov 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    HO116
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    EC number: MEC-2013-310, Nederland Trila Register: NTR4269, CCMO dossier number: NL41789.078.13
    Sponsors
    Sponsor organisation name
    HOVON
    Sponsor organisation address
    De Boelelaan 1117, Amsterdam, Netherlands,
    Public contact
    HOVON Data Center, HOVON, +31 (0)107041560, hdc@erasmusmc.nl
    Scientific contact
    HOVON Data Center, HOVON, +31 (0)107041560, hdc@erasmusmc.nl
    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
    17 Sep 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    17 Aug 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Aug 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    *Phase I part - To asses the safety and feasibility of post-transplant panobinostat combined with decitabine to a regimen of T-cell replete RIC alloHSCT in patient with (very) poor-risk AML/RAEB, and select the recommended dose level for part II of the study *Phase II part - To assess the feasibility and efficacy of addition of post-transplant panobinostat combined with decitabine to a regimen of T-cell replete RIC alloHSCT and DLI in patients with (very) poor-risk AML/RAEB *Phase III part - To assess the feasibility and efficacy of post-transplant panobinostat monotherapy to a regimen of T-cell replete RIC alloHSCT and DLI in patients with (very) poor-risk AML
    Protection of trial subjects
    Monitoring and Insurance
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    29 Nov 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 132
    Country: Number of subjects enrolled
    Belgium: 8
    Worldwide total number of subjects
    140
    EEA total number of subjects
    140
    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)
    103
    From 65 to 84 years
    37
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    All subjects gave written informed consent and were screened according to the inclusion- and exclusion criteria

    Period 1
    Period 1 title
    Overall period
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Experimental group
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Panobinostat
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    4 cycles of panobinostat (20 mg on days 1, 4, 8, 11). Cycle 1 and 2 after alloHSCT, cycle 3 and 4 after first DLI during part II of the study.

    Investigational medicinal product name
    Decitabine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    4 cycles of decitabine as indicated by dose level (0-20 mg/m2 on days 1-3/5). Cycle 1 and 2 after alloHSCT, cycle 3 and 4 after first DLI during part II of the study.

    Number of subjects in period 1
    Experimental group
    Started
    140
    Completed
    48
    Not completed
    92
         Adverse reactions
    7
         At patient's request
    6
         Lack of efficacy
    7
         not specified
    72

    Baseline characteristics

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

    Reporting group values
    Overall period Total
    Number of subjects
    140 140
    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)
    103 103
        From 65-84 years
    37 37
        85 years and over
    0 0
    Age continuous
    Units: years
        median (full range (min-max))
    59 (18 to 71) -
    Gender categorical
    Units: Subjects
        Female
    59 59
        Male
    81 81

    End points

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    End points reporting groups
    Reporting group title
    Experimental group
    Reporting group description
    -

    Primary: Primary endpoint

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    End point title
    Primary endpoint [1]
    End point description
    End point type
    Primary
    End point timeframe
    See publication.
    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: See attached chart/documents for results.
    End point values
    Number of subjects analysed
    Units: Whole
    Attachments
    Statistical data section from publication
    List of reported non-SAE's
    List of reported SAE's
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events will be reported from the first study-related procedure until 30 days following the last dose of any drug from the protocol treatment schedule or until the start of subsequent systemic therapy for the disease under study, if earlier.
    Adverse event reporting additional description
    Adverse events occurring after 30 days should also be reported if considered at least possibly related to the investigational medicinal product by the investigator.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4
    Reporting groups
    Reporting group title
    Experimental group
    Reporting group description
    -

    Serious adverse events
    Experimental group
    Total subjects affected by serious adverse events
         subjects affected / exposed
    48 / 110 (43.64%)
         number of deaths (all causes)
    83
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vascular disorders
    Vascular disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    General disorders and administrative site conditions
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 110 (3.64%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Immune system disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    11 / 110 (10.00%)
         occurrences causally related to treatment / all
    5 / 11
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory, thoracic and mediastinal disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    7 / 110 (6.36%)
         occurrences causally related to treatment / all
    3 / 7
         deaths causally related to treatment / all
    2 / 3
    Investigations
    Investigations
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiac disoders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    3 / 110 (2.73%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Nervous system disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Blood and lymphatic system disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 110 (1.82%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    1 / 1
    Gastrointestinal disorders
    Gastrointestinal disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    12 / 110 (10.91%)
         occurrences causally related to treatment / all
    5 / 12
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin and subcutaneous tissue disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal and urinary disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    3 / 110 (2.73%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Infections and infestations
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    21 / 110 (19.09%)
         occurrences causally related to treatment / all
    8 / 23
         deaths causally related to treatment / all
    1 / 2
    Metabolism and nutrition disorders
    Metabolism and nutrition disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 110 (1.82%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Experimental group
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    100 / 110 (90.91%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 110 (0.91%)
         occurrences all number
    1
    Vascular disorders
    Vascular disorders
    Additional description: All combined, see non-SAE chart for detail
         subjects affected / exposed
    20 / 110 (18.18%)
         occurrences all number
    20
    General disorders and administration site conditions
    General disorders and administration site conditions
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    22 / 110 (20.00%)
         occurrences all number
    23
    Reproductive system and breast disorders
    Reproductive system and breast disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 110 (1.82%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Respiratory, thoracic and mediastinal disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    11 / 110 (10.00%)
         occurrences all number
    11
    Psychiatric disorders
    Psychiatric disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    3 / 110 (2.73%)
         occurrences all number
    3
    Investigations
    Investigations
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    47 / 110 (42.73%)
         occurrences all number
    91
    Injury, poisoning and procedural complications
    Injury, poisoning and procedural complications
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 110 (1.82%)
         occurrences all number
    2
    Cardiac disorders
    Cardiac disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    13 / 110 (11.82%)
         occurrences all number
    14
    Nervous system disorders
    Nervous system disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    16 / 110 (14.55%)
         occurrences all number
    18
    Blood and lymphatic system disorders
    Blood and lymphatic system disorder
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    36 / 110 (32.73%)
         occurrences all number
    41
    Ear and labyrinth disorders
    Ear and labyrinth disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 110 (0.91%)
         occurrences all number
    1
    Eye disorders
    Eye disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    5 / 110 (4.55%)
         occurrences all number
    5
    Gastrointestinal disorders
    Gastrointestinal disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    29 / 110 (26.36%)
         occurrences all number
    48
    Hepatobiliary disorders
    Hepatobiliary disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 110 (1.82%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Skin and subcutaneous tissue disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    16 / 110 (14.55%)
         occurrences all number
    18
    Renal and urinary disorders
    Renal and urinary disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    15 / 110 (13.64%)
         occurrences all number
    15
    Endocrine disorders
    Endocrine disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 110 (1.82%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Musculoskeletal and connective tissue disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    4 / 110 (3.64%)
         occurrences all number
    5
    Infections and infestations
    Infections and infestations
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    54 / 110 (49.09%)
         occurrences all number
    85
    Metabolism and nutrition disorders
    Metabolism and nutrition disorders
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    23 / 110 (20.91%)
         occurrences all number
    31

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    08 Jul 2014
    New protocol version (v6) and change of several local investigators. Submitted & approved in NL + BE.
    23 Jun 2015
    New protocol version (v7) and change of an independent physician in NL. Submitted & approved in NL + BE.
    28 Jul 2016
    New protocol version (v8), new ICF, and change of some investigators in NL. Submitted and approved in NL+BE.
    13 Mar 2017
    New protocol version (v9) due to changes in risk tables appendix C & D. Submitted and approved in NL+BE
    16 Dec 2021
    New protocol version (v10) and change of several local investigators. Submitted & approved in NL + BE.

    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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/32936907
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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