E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Virus-Associated Hemorrhagic Cystitis After Allogeneic Hematopoietic Cell Transplant. |
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E.1.1.1 | Medical condition in easily understood language |
Inflammation of the bladder caused by viral infection following bone marrow transplant. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10059348 |
E.1.2 | Term | Viral hemorrhagic cystitis |
E.1.2 | System Organ Class | 100000004862 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare the time to resolution of macroscopic hematuria in recipients of Posoleucel (PSL) to that in recipients of placebo. |
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E.2.2 | Secondary objectives of the trial |
1) To compare the time to resolution of bladder pain as measured by Clinical Outcome Assessments (COAs) in recipients of PSL to that in recipients of placebo. 2) To assess number of days in the hospital. 3) To assess the incidence and severity of acute graft versus host disease (GVHD) and cytokine release syndrome (CRS) 4) To assess time to resolution of viremia for all target viruses. 5) To assess average daily bladder pain. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Participants must meet all of the following criteria in order to be eligible to participate in the study: 1. Male or female but enrollment of participants <1 year of age at the time of informed consent will occur only once preliminary safety data are available from 5 participants ≥1 and ≤6 years of age. 2. Had an allogeneic hematopoietic cell transplant (HCT) performed ≥ 21 days and ≤ 1 year prior to randomization. 3. Myeloid engraftment confirmed. 4. Diagnosed with Hemorrhagic Cystitis. 5. At least 1 identified, suitably matched PSL cell line for infusion is available. 6. Willing and able to provide written informed consent to participate in the study, or a parent or legal guardian is willing and able to provide written informed consent and the potential pediatric patient is able to provide assent in a manner approved by the Institutional Review Board/Independent Ethics Committee and local regulations. 7. Women of childbearing potential (WOCBP) and men whose sexual partners are WOCBP must agree to use contraception during the study and for a minimum of 90 days after study treatment; participants must also refrain from donating sperm or eggs during the study and for at least 90 days after treatment completion. 8. Has a negative serum pregnancy test for female participants of childbearing potential. |
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E.4 | Principal exclusion criteria |
Participants who meet any of the following criteria will be excluded from participation in the study: 1. Ongoing therapy with high-dose systemic corticosteroids. 2. Therapy with antithymocyte globulin, alemtuzumab (Campath-1H), or other immunosuppressive T cell-targeted monoclonal antibodies ≤ 28 days before randomization. 3. Evidence of active Grade >2 acute GVHD. 4. Uncontrolled or progressive bacterial or fungal infections. 5. Uncontrolled or progressive viral infections not targeted by PSL. 6. Uncontrolled or progressive EBV-associated post-transplant lymphoproliferative disorder. 7. Known or presumed pneumonia secondary to any organism. 8. Donor lymphocyte infusion performed ≤ 21 days before randomization. 9. Hemodynamic or respiratory instability. 10. Hemoglobin <7 g/dL despite red blood cell transfusions. 11. Clinically significant coagulopathy. 12. Ongoing use of systemic anticoagulant drugs or antiplatelet drugs. 13. Evidence of active hepatic sinusoidal obstruction syndrome. 14. Liver dysfunction. 15. Requiring renal replacement therapy ≤7 days prior to randomization. 16. Evidence of encephalopathy. 17. Relapse of primary malignancy. 18. Receipt of other investigational antiviral treatments (eg, brincidofovir) within 7 days prior to randomization. 19. Pregnant, lactating, planning to become pregnant. 20. History of severe allergy to any component of PSL. 21. Any condition that would compromise the safety of the participant. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint is the time to resolution of macroscopic hematuria in participants with documented BK viruria. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Until the participant reaches the primary endpoint, the assessments will be performed daily up to Week 12. After Week 12, the assessments will be performed twice per week until Week 24. |
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E.5.2 | Secondary end point(s) |
1) Time to resolution of bladder pain as measured by age-appropriate COAs. 2) Number of days in the hospital. 3) Time to resolution of viremia for all target viruses. 4) Average daily bladder pain. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
For the 1st secondary end point – the assessments will be performed daily up to Week 12. After Week 12, the assessments will be performed weekly until Week 24. For 2nd and 3rd secondary end points - Week 24. For 4th secondary end point - Week 6.
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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) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 32 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Canada |
Korea, Republic of |
United States |
France |
Sweden |
Spain |
Italy |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | Yes |
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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Last visit last subject (LVLS) or when the Sponsor receives the last laboratory result, whichever comes last. |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 18 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 2 |
E.8.9.2 | In all countries concerned by the trial days | 18 |