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Childhood Acute Lymphoblastic Leukemia in RemissionPhase 3NCT01305200

Supersaturated Calcium Phosphate Rinse in Preventing Oral Mucositis in Young Patients Undergoing Autologous or Donor Stem Cell Transplant

A Phase 3 study testing supersaturated calcium phosphate rinse, questionnaire administration and quality-of-life assessment in people with Childhood Acute Lymphoblastic Leukemia in Remission and Childhood Acute Myeloid Leukemia in Remission, run by Children's Oncology Group at 35 sites in 3 countries.

Completed

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

Official record
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Trial summary

This randomized phase III trial is studying how well Caphosol rinse works in preventing mucositis in young patients undergoing autologous or donor stem cell transplant. Supersaturated calcium phosphate (Caphosol) rinse may be able to prevent mucositis, or mouth sores, in patients undergoing stem cell transplant. Read more about this study

Who is it for?
Ages 4 to 21 years
What is being tested?
supersaturated calcium phosphate rinse, questionnaire administration and quality-of-life assessment
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
226 participants
Where
35 sitesin 3 countries
Study dates
Mar 2011to 30 Jun 2015
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 4 to 21 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Patients undergoing myeloablative autologous or allogeneic hematopoietic stem cell transplantation (HSCT) for any indication
  • One or more of the following donor stem cell sources (autologous or allogeneic):
  • Bone marrow
  • Placental blood (umbilical cord blood)
  • Cytokine-mobilized peripheral blood
  • Patients eligible for allogeneic HSCT must have one of the following types of donor stem cells:
Show all 14Show fewer
  • Human leukocyte antigen (HLA)-matched sibling or parent
  • Partially matched family donor (mismatched for a single HLA locus [Class I])
  • Fully matched unrelated marrow or peripheral blood stem cell donor
  • HLA-matched or partially mismatched (at least 4 of 6 match) cord blood (Class I or II)
  • Patients expecting to receive any type of myeloablative HSCT conditioning regimen are eligible
  • No non-myeloablative or reduced-intensity conditioning regimens
  • Eligible patients must not have received palifermin within 30 days prior to enrollment
  • Eligible patients must not have received prior treatment with Caphosol

Who cannot join

  • Females of childbearing potential must have a negative pregnancy test; patients must agree to use an effective birth control method; lactating patients must agree not to nurse a child while on this trial

Trial locations and contacts

35 sites in 3 countries.

35 sites in 3 countries

United States31 sites
  • C S Mott Children's Hospital

    Ann Arbor, Michigan, 48109

  • Children's Oncology Group

    Arcadia, California, 91006-3776

  • Children's Healthcare of Atlanta - Egleston

    Atlanta, Georgia, 30322

  • Floating Hospital for Children at Tufts Medical Center

    Boston, Massachusetts, 02111

  • Dana-Farber Cancer Institute

    Boston, Massachusetts, 02115

  • Lurie Children's Hospital-Chicago

    Chicago, Illinois, 60614

  • University of Chicago

    Chicago, Illinois, 60637

  • Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • City of Hope

    Duarte, California, 91010

  • Riley Hospital for Children

    Indianapolis, Indiana, 46202

  • University of Mississippi Medical Center

    Jackson, Mississippi, 39216

  • The Childrens Mercy Hospital

    Kansas City, Missouri, 64108

  • Kosair Children's Hospital

    Louisville, Kentucky, 40202

  • Miami Children's Hospital

    Miami, Florida, 33155

  • Midwest Children's Cancer Center

    Milwaukee, Wisconsin, 53226

  • Children's Hospital-Main Campus

    New Orleans, Louisiana, 70118

  • Columbia University Medical Center

    New York, New York, 10032

  • Children's Hospital and Research Center at Oakland

    Oakland, California, 94609-1809

  • University of Oklahoma Health Sciences Center

    Oklahoma City, Oklahoma, 73104

  • University of Nebraska Medical Center

    Omaha, Nebraska, 68198

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Children's Hospital of Pittsburgh of UPMC

    Pittsburgh, Pennsylvania, 15224

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • Methodist Children's Hospital of South Texas

    San Antonio, Texas, 78229

  • Rady Children's Hospital - San Diego

    San Diego, California, 92123

  • University of California San Francisco Medical Center-Parnassus

    San Francisco, California, 94143

  • All Children's Hospital

    St. Petersburg, Florida, 33701

  • Montefiore Medical Center

    The Bronx, New York, 10467-2490

  • Ny Cancer%

    Valhalla, New York, 10595

  • Children's National Medical Center

    Washington D.C., District of Columbia, 20010

  • Alfred I duPont Hospital for Children

    Wilmington, Delaware, 19803

Other trials in United States

Australia2 sites
  • Royal Childrens Hospital

    Herston, Queensland, 4029

  • Princess Margaret Hospital for Children

    Perth, Western Australia, 6008

Other trials in Australia

Canada2 sites
  • The Montreal Children's Hospital of the MUHC

    Montreal, Quebec, H3H 1P3

  • Hospital for Sick Children

    Toronto, Ontario, M5G 1X8

Other trials in Canada

About this study

Official title: A Randomized Double Blinded Trial of Topical Caphosol to Prevent Oral Mucositis in Children Undergoing Hematopoietic Stem Cell Transplantation

This randomized phase III trial is studying how well Caphosol rinse works in preventing mucositis in young patients undergoing autologous or donor stem cell transplant. Supersaturated calcium phosphate (Caphosol) rinse may be able to prevent mucositis, or mouth sores, in patients undergoing stem cell transplant.

Read the detailed description

PRIMARY OBJECTIVES:

  1. To determine if topically administered supersaturated calcium phosphate (Caphosol), rinsed orally four times daily at the initiation of conditioning for hematopoietic stem cell transplantation (HSCT), reduces oral mucositis as demonstrated by a decrease in duration of severe oral mucositis (World Health Organization [WHO] grade 3 or 4), compared to placebo.

SECONDARY OBJECTIVES:

  1. To determine whether Caphosol administration, when compared to placebo, reduces oral mucositis as demonstrated by a decrease in incidence of severe oral mucositis (WHO grade 3 or 4); severity of mucositis according to mouth pain categorical rating scale and Oral Mucositis Daily Questionnaire (OMDQ); incidence, total dose, and duration of parenteral opioid analgesic use (morphine equivalents); and incidence and duration of total parenteral nutrition (TPN) administration.

II. To determine whether Caphosol administration, when compared to placebo, reduces the incidence of febrile neutropenia and invasive bacterial infections.

III. To validate a new pediatric measure of oral mucositis termed the Children's International Mucositis Evaluation Scale (ChIMES).

OUTLINE: This is a multicenter study. Patients are stratified according to conditioning regimen (total-body irradiation (TBI) or melphalan vs neither TBI nor melphalan) and hematopoietic stem cell transplantation (HSCT) (autologous vs allogeneic). Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute four* times daily (QID) beginning on the first day (about day -7) of the conditioning regimen.

ARM II: Patients rinse and gargle with placebo over 1 minute QID* beginning the first day (about day -7) of the conditioning regimen.

NOTE: * Patients who reach WHO grade 3 or 4 mucositis have the option to request a total of 6 rinses daily.

In both arms, treatment continues until day 20 post-transplantation OR until mucositis resolves to WHO grade =< 2 for two consecutive days OR on day 12 in patients who do not experience oral mucositis of at least WHO grade >= 1. Patients are assessed daily by trained healthcare professionals using the Oral Mucositis Daily Questionnaire (OMDQ), the Pain Rating Scale, the WHO Mucositis Scale, and the Children's International Mucositis Evaluation Scale (ChIMES) from day -1 and continuing until day 20. Patients are also observed for the incidence of total dose and duration of parenteral opioid analgesic use, duration of total parenteral nutrition (TPN) administration, febrile neutropenia, and invasive bacterial infections.

After completion of study therapy, patients are followed up for 30 days.

Being tested
supersaturated calcium phosphate rinse, placebo, questionnaire administration, quality-of-life assessment
Medical subject headings
Pdgfra-Associated Chronic Eosinophilic Leukemia, Leukemia, Myelomonocytic, Chronic, Leukemia, Neutrophilic, Chronic, Leukemia, Myelomonocytic, Juvenile, Mucositis, Myeloproliferative Disorders, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Dendritic Cell Sarcoma, Interdigitating

What participants receive

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

  • supersaturated calcium phosphate rinseDrug

    Also called Caphosol

    Mouth rinse

  • placeboOther

    Also called PLCB

    Mouth rinse

  • questionnaire administrationOther

    Ancillary studies

  • quality-of-life assessmentProcedure or surgery

    Also called quality of life assessment

    Ancillary studies

Study groups in NCT01305200
Study groupRoleWhat they receive
Arm I (placebo)Placebo comparatorPatients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation.
Receives: Other: placebo; Other: questionnaire administration; Procedure: quality-of-life assessment
Arm II (supersaturated calcium phosphate rinse)ExperimentalPatients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation.
Receives: Drug: supersaturated calcium phosphate rinse; Other: questionnaire administration; Procedure: quality-of-life assessment

What is being measured

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

  1. Duration of Severe Oral Mucositis (WHO Grade 3 or 4)

    Mean days of severe (WHO Grade 3 or 4) Mucositis.

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

Secondary outcomes (10)
  1. Incidence of Severe Oral Mucositis

    Percentage of patients with Severe Oral Mucositis (WHO Grade 3 or 4) per arm.

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  2. Oral Mucositis Daily Questionnaire (OMDQ)

    Area under the curve (AUC) of the Oral Mucositis Daily Questionnaire (OMDQ) subscales

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation

  3. Incidence of Parenteral Opioid Analgesic Use (Morphine Equivalents).

    Opioid Administration = yes

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  4. Duration of Parenteral Opioid Analgesic Use (Morphine Equivalents).

    Mean days of parenteral opioid analgesic use.

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  5. Total Dose of Parenteral Opioid Analgesic Used (Morphine Equivalents).

    Morphine equivalent dose in mg/kg/day

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  6. Incidence of Total Parenteral Nutrition (TPN) Administration.

    Total Parenteral Nutrition = yes

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  7. Duration of Total Parenteral Nutrition (TPN) Administration.

    Mean days of total parenteral nutrition (TPN) administration.

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  8. Incidence of Febrile Neutropenia

    Fever and Neutropenia = yes

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  9. Incidence of Invasive Bacterial Infections

    Invasive Bacterial Infection = yes

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

  10. Severity of Mucositis

    Area Under the Curve of Severity of Mucositis. According to mouth pain categorical rating scale ranges 0-10 with higher scores reflecting more severe pain.

    Measured: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation

Timeline

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

  1. First posted28 Feb 2011 (estimated)
  2. Study startMar 2011
  3. Primary completionJun 2015
  4. Study completion30 Jun 2015

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
226 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01305200
Sponsor's protocol ID
ACCL1031
Other IDs
NCI-2011-02635, CDR0000695718, ACCL1031, COG-ACCL1031, ACCL1031, U10CA095861
Status last verified
Nov 2016
First submitted
25 Feb 2011
Last updated
17 Sep 2019
Data monitoring committee
Yes

Publications

  • Treister N, Nieder M, Baggott C, Olson E, Chen L, Dang H, Krailo M, August A, Sung L. Caphosol for prevention of oral mucositis in pediatric myeloablative haematopoietic cell transplantation. Br J Cancer. 2017 Jan 3;116(1):21-27. doi: 10.1038/bjc.2016.380. Epub 2016 Nov 22.

    PubMed 27875526

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing supersaturated calcium phosphate rinse, questionnaire administration and quality-of-life assessment in people with Childhood Acute Lymphoblastic Leukemia in Remission and Childhood Acute Myeloid Leukemia in Remission, run by Children's Oncology Group at 35 sites in 3 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 14 inclusion and 1 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 17 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 35 sites in United States, Australia, Canada. 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?

Yes. Results are posted in the registry (first posted 9 May 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Duration of Severe Oral Mucositis (WHO Grade 3 or 4) (time frame: Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.). 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 NCT01305200, which also lists 1 linked publication.

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 17 Sep 2019.

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