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Graft Versus Host DiseasePhase 3NCT00366145

Efficacy and Safety of Adult Human Mesenchymal Stem Cells to Treat Steroid Refractory Acute Graft Versus Host Disease (GVHD)

A Phase 3 study testing Prochymal® in people with Graft Versus Host Disease, run by Mesoblast, Inc. at 70 sites in 6 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to evaluate the efficacy and gather additional safety information for Prochymal® in participants who have failed to respond to steroid treatment of Grades B-D acute GVHD. Read more about this study

Who is it for?
Ages 6 months to 70 years
Conditions the study is for
Graft Versus Host Disease
What is being tested?
Prochymal®
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
260 participants
Where
70 sitesin 6 countries
Study dates
17 Aug 2006to 28 May 2009
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 months to 70 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Participant must be 6 months to 70 years of age, inclusive.
  • Participants who have failed to respond to steroid treatment.
  • Failure to respond to steroid treatment is defined as any grade B-D (IBMTR) grading of acute GVHD that shows:
  • No improvement after 3 days and a duration of no greater than 2 weeks while receiving treatment with methylprednisolone (greater than or equal to 1 mg/kg/day) or equivalent.
  • Participant must be treated within 4 days of randomization. In urgent situations 2nd line therapy may be started 24 hours prior to randomization, and Prochymal® must be initiated within the following 3 days.
  • Participants who have received an increase in their steroid dose treatment prior to randomization will be eligible for enrollment. An increase in steroid dose will not be considered as second line therapy.
Show all 11Show fewer
  • Participant must have adequate renal function as defined by: Calculated Creatinine Clearance of >30 milliliters per minute (mL/min) using the Cockcroft-Gault equation.
  • For pediatric participants: Schwartz equation: (Participant population: infants over 1 week old through adolescence (<18 years old).
  • Participants who are women of childbearing potential must be non-pregnant, not breast-feeding, and use adequate contraception. Male participants must use adequate contraception.
  • Participant must have a minimum Karnofsky Performance Level of at least 30 at the time of study entry.
  • Participant (or legal representative where appropriate) must be capable of providing written informed consent.

Who cannot join

  • Participant has started treatment with second line therapy >24 hours prior to randomization.
  • Participant has received agents other than steroids for primary treatment of acute GVHD.
  • Participant is participating in the CTN Protocol 0302.
  • Participant has any underlying or current medical or psychiatric condition that, in the opinion of the Investigator, would interfere with the evaluation of the participant including uncontrolled infection, heart failure, pulmonary hypertension, etc.
  • Participant may not receive any other investigational agents (not approved by the FDA) concurrently during study participation or within 30 days of randomization.
  • Participant has a known allergy to bovine or porcine products.
  • Participant has received a transplant for a solid tumor disease.

Trial locations and contacts

70 sites in 6 countries.

70 sites in 6 countries

United States47 sites
  • Emory University

    Atlanta, Georgia, 30322

  • Northside Hospital

    Atlanta, Georgia, 30342

  • University of Maryland/Greenbaum

    Baltimore, Maryland, 21201

  • Indiana Blood and Bone Marrow Transplant Center

    Beech Grove, Indiana, 46107

  • University of Alabama at Birmingham

    Birmingham, Alabama, 35249

  • Tufts-New England Medical Center

    Boston, Massachusetts, 02111

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

  • Dana-Farber Cancer Institute

    Boston, Massachusetts, 02215

  • Roswell Park

    Buffalo, New York, 14263

  • Medical University of South Carolina

    Charleston, South Carolina, 29425

  • Northwestern Center for Clinical Research

    Chicago, Illinois, 60611

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • University of Illinois - Chicago

    Chicago, Illinois, 60612

  • Texas Cancer Center at Medical City

    Dallas, Texas, 75230

  • Baylor University

    Dallas, Texas, 75246

  • Univeristy of Texas Southwestern Medical Center

    Dallas, Texas, 75390

  • Karmanos/Wayne State University

    Detroit, Michigan, 48201

  • City of Hope

    Duarte, California, 91010

  • Duke University

    Durham, North Carolina, 27710

  • Hackensack University Medical Center

    Hackensack, New Jersey, 07601

  • Penn State Hershey Medical Center

    Hershey, Pennsylvania, 17033

  • MD Anderson Cancer Center

    Houston, Texas, 77030

  • Univeristy of Iowa Hospitals and Clinics

    Iowa City, Iowa, 52242

  • Univeristy of Mississippi Medical Center

    Jackson, Mississippi, 39216

  • University of Kansas Medical Center

    Kansas City, Kansas, 66160

  • University of Louisville

    Louisville, Kentucky, 40202

  • University of Wisconsin Madison

    Madison, Wisconsin, 53792

  • University of Miami

    Miami, Florida, 33136

  • Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

  • Yale New Haven Hospital

    New Haven, Connecticut, 06520

  • New York Presbyterian Hospital

    New York, New York, 10021

  • Mount Sinai Medical Center

    New York, New York, 10029

  • Columbia University/New York Presbyterian Hospital

    New York, New York, 10032

  • University of Nebraska

    Omaha, Nebraska, 68198

  • Western Pennsylvania Cancer Institute

    Pittsburgh, Pennsylvania, 15224

  • Oregon Health and Science University

    Portland, Oregon, 97239

  • Virginia Commonwealth/Massey Cancer Center

    Richmond, Virginia, 23298

  • Mayo Clinic Rochester

    Rochester, Minnesota, 55905

  • University of Rochester

    Rochester, New York, 14642

  • Texas Research Center

    San Antonio, Texas, 78229

  • Univeristy of California San Francisco

    San Francisco, California, 94143

  • Fred Hutchinson Cancer Research Center

    Seattle, Washington, 98109-1024

  • Louisiana State University

    Shreveport, Louisiana, 71130

  • All Children's Hospital

    St. Petersburg, Florida, 33701

  • Arizona Cancer Center

    Tucson, Arizona, 85724

  • New York Medical College

    Valhalla, New York, 10595

  • Wake Forest Univeristy School of Medicine

    Winston-Salem, North Carolina, 27157

Other trials in United States

Canada12 sites
  • Co-Medica Research Network

    Calgary, Alberta, T1Y6J4

  • Queen Elizabeth II Health Sciences Centre

    Halifax, Nova Scotia, B3H2Y9

  • Hamilton Health Sciences Centre

    Hamilton, Ontario, L8N3Z5

  • London Health Sciences Centre- Westminster Campus

    London, Ontario, N6A4G5

  • Maisonneuve-Rosemont Hospital

    Montreal, Quebec, H1T 2M4

  • Ottawa Hospital

    Ottawa, Ontario, K1H8L6

  • Hopital Enfant-Jesus

    Québec, G1J 1Z4

  • Hopital du Saint-Sacrement

    Québec, G1S4L8

  • Toronto General Hospital

    Toronto, Ontario, M5G 1X8

  • Princess Margaret Hospital

    Toronto, Ontario, M5G1X8

  • British Columbia's Children's Hospital

    Vancouver, British Columbia, V6H3V4

  • Cancer Care Manitoba

    Winnipeg, Manitoba, R3E0V9

Other trials in Canada

United Kingdom5 sites
  • Bristol Royal Hospital for Children

    Bristol, UK, BS2 8BJ

  • Glasgow Royal Infirmary

    Glasgow, UK, G4 OSF

  • John Radcliffe Hospital

    Headington, Oxford, OX3 0Du

  • Leeds General Infirmary

    Leeds, UK, LS1 3EX

  • Barts & London School of Medicine

    London, England, EC1M 6BQ

Other trials in United Kingdom

Australia3 sites
  • Royal Brisbane Hospital

    Herston, Queensland, 4029

  • Royal Melbourne Hospital

    Parkville, Victoria, 3050

  • Royal Perth Hospital

    Perth, Western Australia, 6100

Other trials in Australia

Italy2 sites
  • IRCCS Policlinico San Matteo

    Pavia, 27100

  • Universia degli Studi di Pesaro

    Pesaro, PU, 61100

Other trials in Italy

Switzerland1 site
  • Kantonsspital Basel

    Basel, 4031

Other trials in Switzerland

About this study

Official title: A Phase III, Randomized, Double Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Prochymal® (Ex-vivo Cultured Adult Human Mesenchymal Stem Cells) Infusion for the Treatment of Patients Who Have Failed to Respond to Steroid Treatment for Acute GVHD

The purpose of this study is to evaluate the efficacy and gather additional safety information for Prochymal® in participants who have failed to respond to steroid treatment of Grades B-D acute GVHD.

Read the detailed description

Approximately 6300 patients receive allogeneic hematopoietic stem cell transplants in the United States each year (International Bone Marrow Transplant Registry [IBMTR], 2003). Nearly 50% (approximately 3,150) of these patients develop acute GVHD (Goker et al). A fraction of these patients (approximately 870) will progress to the severe stages of the disease, Grades III-IV. It is estimated that nearly 82% of those patients with severe acute GVHD will be steroid refractory (Przepiorka et al., 1995) and of these, only 50% of steroid-refractory patients will respond to secondary and tertiary treatments (Greinix et al., 2000). Thus, roughly 350 patients each year face tremendous odds against survival. In addition, most patients who initially responded to secondary and tertiary treatments have a high risk of dying within the first year (Remberger et al., 2001; Anasetti et al., 1994). Development of new therapeutic agents and strategies to rescue patients with steroid refractory, acute GVHD would provide a significant benefit in an area of unmet medical need. Participants will receive standard of care in addition to adult mesenchymal stem cells or placebo.

Being tested
Prochymal®, Placebo, Standard of Care for GVHD
Keywords
Acute GVHD, Steroid refractory GVHD, Severe steroid refractory acute GVHD, Steroid refractory, Steroid Refractory Acute Graft Versus Host Disease
Medical subject headings
Graft vs Host Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Prochymal®Biological

    Also called Mesenchymal Stem Cells

    2 infusions of 2 million cells/kg per week for 4 weeks

  • PlaceboDrug

    Also called excipients without adult human mesenchymal stem cells

    2 infusions per week for 4 weeks

  • Standard of Care for GVHDDrug

    Institutionally defined standard of care (e.g., maintenance of steroid treatment and the addition of a second-line therapy)

Study groups in NCT00366145
Study groupRoleWhat they receive
Prochymal®Active comparatorParticipants who receive standard of care plus treatment with ex vivo cultured adult human mesenchymal stem cells.
Receives: Biological: Prochymal®; Drug: Standard of Care for GVHD
PlaceboPlacebo comparatorParticipants who receive standard of care and do not receive treatment with ex vivo cultured adult human mesenchymal stem cells.
Receives: Drug: Placebo; Drug: Standard of Care for GVHD

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants achieving Complete Response of Greater Than or Equal to 28 Days Duration

    A complete response was defined as complete resolution of all clinical signs of Graft versus host disease (GVHD)- that had to be maintained for at least 28 consecutive days (durable complete response [DCR]) within 100 days post first infusion.

    Measured: up to 100 Days post first infusion

Secondary outcomes (1)
  1. Overall Survival at 180 days Post First Infusion

    Percentage of participants who survived at 180 days post first infusion.

    Measured: Day 180

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Aug 2006 (estimated)
  2. Study start17 Aug 2006
  3. Primary completion26 Dec 2008
  4. Study completion28 May 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
260 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00366145
Sponsor's protocol ID
280
Status last verified
Feb 2022
First submitted
17 Aug 2006
Last updated
10 Feb 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Bartholomew A, Sturgeon C, Siatskas M, Ferrer K, McIntosh K, Patil S, Hardy W, Devine S, Ucker D, Deans R, Moseley A, Hoffman R. Mesenchymal stem cells suppress lymphocyte proliferation in vitro and prolong skin graft survival in vivo. Exp Hematol. 2002 Jan;30(1):42-8. doi: 10.1016/s0301-472x(01)00769-x.

    PubMed 11823036
  • Deans RJ, Moseley AB. Mesenchymal stem cells: biology and potential clinical uses. Exp Hematol. 2000 Aug;28(8):875-84. doi: 10.1016/s0301-472x(00)00482-3.

    PubMed 10989188
  • Lazarus HM, Koc ON, Devine SM, Curtin P, Maziarz RT, Holland HK, Shpall EJ, McCarthy P, Atkinson K, Cooper BW, Gerson SL, Laughlin MJ, Loberiza FR Jr, Moseley AB, Bacigalupo A. Cotransplantation of HLA-identical sibling culture-expanded mesenchymal stem cells and hematopoietic stem cells in hematologic malignancy patients. Biol Blood Marrow Transplant. 2005 May;11(5):389-98. doi: 10.1016/j.bbmt.2005.02.001.

    PubMed 15846293
  • Le Blanc K, Rasmusson I, Sundberg B, Gotherstrom C, Hassan M, Uzunel M, Ringden O. Treatment of severe acute graft-versus-host disease with third party haploidentical mesenchymal stem cells. Lancet. 2004 May 1;363(9419):1439-41. doi: 10.1016/S0140-6736(04)16104-7.

    PubMed 15121408
  • Le Blanc K, Pittenger M. Mesenchymal stem cells: progress toward promise. Cytotherapy. 2005;7(1):36-45. doi: 10.1080/14653240510018118.

    PubMed 16040382
  • Camilleri ET, Gustafson MP, Dudakovic A, Riester SM, Garces CG, Paradise CR, Takai H, Karperien M, Cool S, Sampen HJ, Larson AN, Qu W, Smith J, Dietz AB, van Wijnen AJ. Identification and validation of multiple cell surface markers of clinical-grade adipose-derived mesenchymal stromal cells as novel release criteria for good manufacturing practice-compliant production. Stem Cell Res Ther. 2016 Aug 11;7(1):107. doi: 10.1186/s13287-016-0370-8.

    PubMed 27515308

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Prochymal® in people with Graft Versus Host Disease, run by Mesoblast, Inc. at 70 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 70 sites in United States, Canada, United Kingdom, Australia, Italy and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants achieving Complete Response of Greater Than or Equal to 28 Days Duration (time frame: up to 100 Days post first infusion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00366145, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Feb 2022.

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