Efficacy of NOX-H94 on Anemia of Chronic Disease in Patients With Cancer
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Purpose
This study is conducted to determine the safety, tolerability, and efficacy of NOX-H94 in patients with anemia of chronic disease (ACD). Furthermore, this study is intended to provide data needed to correlate plasma concentrations of NOX-H94 with its efficacy and to choose the appropriate dose and dose schedule of subsequent efficacy studies.
Some chronic diseases, e.g. tumors, inflammation, renal disease, are associated with high hepcidin concentrations in the blood. These hepcidin concentrations cause a reduction in iron concentrations in the blood and subsequently impair formation of red blood cells. Treatment with NOX-H94 is expected to inhibit this patho-mechanism by binding and inactivating hepcidin.
| Condition | Intervention | Phase |
|---|---|---|
|
Anemia of Chronic Disease |
Drug: NOX-H94 Drug: Placebo solution |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Phase IIa Study to Characterize the Effects of the Spiegelmer® NOX H94 on Anemia of Chronic Disease in Patients With Cancer |
- Response rate of anemia [ Time Frame: treatment start to 1 week after treatment end ] [ Designated as safety issue: Yes ]
• Hb increase ≥1 g/dL OR reticulocyte index normalization (≥1%) at any time point until 1 week after the end of treatment
AND absence of all of the following treatment failure criteria until 1 week after the end of treatment:
- Erythrocyte transfusion, ESA or IV iron,
- Hb drop by ≥1 g/dL
- Treatment interruption due to adverse events (AEs)
- Response [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: Yes ]Proportion of treatment responders at study visits V4, V6, V8, and V10 to V14, as defined for the primary efficacy endpoint
- Failure [ Time Frame: Treatment start to 1 week after end of treatment ] [ Designated as safety issue: Yes ]Proportion of treatment failures at study visits V4, V6, V8, and V10, as defined for the primary efficacy endpoint
- Safety and tolerability [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: Yes ]Adverse events, Safety signals derived from laboratory diagnostics, vital signs.
- Pharmacokinetics [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: No ]NOX-H94 plasma concentrations
- Reticulocytes [ Time Frame: Treatment start until 8 weeks after end of treatment ] [ Designated as safety issue: No ]Absolute values and change from baseline
- Red blood cells [ Time Frame: Treatment start until 8 weeks after end of treatment ] [ Designated as safety issue: Yes ]Absolute values and change from baseline
- Transferrin [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: No ]Absolute concentrations and change from baseline
- Serum iron [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: No ]Absolute concentrations and change from baseline
- Ferritin [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: No ]Absolute concentrations and change from baseline
- Transferrin saturation [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: No ]Absolute concentrations and change from baseline
- Hemoglobin [ Time Frame: Treatment start to 8 weeks after end of treatment ] [ Designated as safety issue: Yes ]Absolute concentrations and change from baseline
- Exploratory analyses [ Time Frame: Treatment start to 1 week after end of treatment ] [ Designated as safety issue: No ]Soluble transferrin receptor
- Exploratory analyses [ Time Frame: Treatment start to 1 week after end of treatment ] [ Designated as safety issue: No ]Reticulocyte hemoglobin content
| Estimated Enrollment: | 48 |
| Study Start Date: | September 2012 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Open-label pilot group
Twice weekly administration of NOX-H94
|
Drug: NOX-H94
intravenous injection
|
|
Placebo Comparator: Blind Placebo
Twice weekly treatment with placebo solution
|
Drug: Placebo solution
intravenous injection
Other Name: Glucose 5%
|
|
Experimental: Blind once weekly NOX-H94
twice weekly administrations, of which the first is NOX-H94 and the subsequent is placebo solution
|
Drug: NOX-H94
intravenous injection
Drug: Placebo solution
intravenous injection
Other Name: Glucose 5%
|
|
Experimental: Blind twice weekly NOX-H94
Twice weekly administrations of NOX-H94
|
Drug: NOX-H94
intravenous injection
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Written informed consent
- Female or male aged >18 years
- Clinically significant anemia of chronic disease (ACD) attributed to histologically or cytologically proven malignancy, either hematological or solid tumor, of any grade or stage: Hemoglobin (Hb) 7.0 g/dL to 10 g/dL, Transferrin saturation (TSAT) <50%, Serum iron <50 µg/dL (SI: <9.0 µmol/L), AND Ferritin >30 ng/mL (SI: >30 µg/L)
- Previous treatment with systemic anti-cancer therapy / regimen
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤2
- Estimated life expectancy ≥12 weeks
- Men must agree to follow effective contraception methods during treatment and for 3 months after completion of treatment. Women of childbearing potential must agree to use two forms of effective contraception during treatment and for 3 months after completion of treatment.
Exclusion Criteria:
- Inability to personally provide written informed consent or to understand and collaborate throughout the study
- History of pure red cell aplasia, thalassemia major or sickle cell disease History of anemia unrelated to cancer <10 g/dL within 6 months prior to screening
- Uncorrected iron deficiency
- Regular need for blood transfusions at intervals <6 weeks
- Acute or myeloid leukemia
- Known or suspected chronic bleeding
- Tumor with gastro-intestinal involvement without negative test for fecal occult blood
- Suspected or known history of hemochromatosis
- Known infection with human immunodeficiency virus, hepatitis B, or hepatitis C
- Impaired liver function with bilirubin ≥2.0 mg/dL (26 μmol/L), AST or ALT ≥2 times upper limit
- History or risk of significant hepatic disease, e.g. chronic alcohol abuse, hepatic steatosis, hepatic cirrhosis, or organ transplantation
- Severe renal impairment: estimated glomerular filtration rate (eGFR) <30 mL/min (Cockcroft-Gault)
- Known central nervous system malignancy or metastasis
- Significant cardiac disease (e.g. uncontrolled hypertension: systolic blood pressure [BP] >150 mmHg or diastolic BP >100 mmHg; myocardial infarction or unstable angina pectoris) within 6 months prior to screening
- Positive pregnancy test (serum ß-hCG at screening, urine pregnancy test prior to first treatment) or lactation
- Previous participation in this study or treatment with an investigational agent <21 days prior to treatment start
- Hemolysis or bleeding >500 mL (measured or estimated) within 6 weeks prior to treatment start
- Treatment with erythropoiesis-stimulating agents (ESAs) or red blood cell (RBC) transfusions <21 days prior to treatment start
- Cytotoxic anti-tumor treatment <21 days prior to treatment start or planned during the anticipated study period (within 3 months from treatment start or randomization). Maintenance therapy is permitted throughout the study (e.g. lenalidomide, interferon)
Contacts and Locations| Contact: Kai Riecke, MD | +49 30 72 62 47 100 |
| Austria | |
| University Hospital | Recruiting |
| Graz, Austria, 8036 | |
| Wilhelminenspital | Recruiting |
| Vienna, Austria, 1160 | |
| AKH Vienna | Recruiting |
| Vienna, Austria, 1090 | |
| Bulgaria | |
| University Hospital | Recruiting |
| Plovdiv, Bulgaria, 4000 | |
| Tokuda Hospital | Recruiting |
| Sofia, Bulgaria, 1407 | |
| University Hospital | Not yet recruiting |
| Varna, Bulgaria, 9010 | |
| Romania | |
| Spitalul Judetean | Recruiting |
| Brasov, Romania, 500326 | |
| Institutul Oncologic | Recruiting |
| Cluj-Napoca, Romania, 400124 | |
| Spitalul Municipal | Recruiting |
| Craiova, Romania, 208028 | |
| Spitalul Judetean | Not yet recruiting |
| Targu-Mures, Romania, 540136 | |
| Oncomed | Recruiting |
| Timisoara, Romania, 300239 | |
| Study Director: | Kai Riecke, MD | Noxxon Pharma AG |
More Information
No publications provided
| Responsible Party: | Noxxon Pharma AG |
| ClinicalTrials.gov Identifier: | NCT01691040 History of Changes |
| Other Study ID Numbers: | SNOXH94C201, 2012-001525-27 |
| Study First Received: | September 4, 2012 |
| Last Updated: | April 12, 2013 |
| Health Authority: | Austria: Federal Office for Safety in Health Care Romania: National Agency for Medicines and Medical Devices Bulgaria: Bulgarian Drug Agency |
Keywords provided by Noxxon Pharma AG:
|
Hepcidin Iron Anemia of Chronic Disease Anemia Cancer Interleukin-6 |
Iron restriction Lymphoma CLL Multiple Myeloma Hodgkin anti-hepcidin |
Additional relevant MeSH terms:
|
Anemia Chronic Disease Hematologic Diseases Disease Attributes Pathologic Processes |
ClinicalTrials.gov processed this record on May 21, 2013