Neutropenia is the most serious hematologic toxicity of cancer chemotherapy, often limiting the doses and density of chemotherapy that can be tolerated. The degree and duration of neutropenia determine the risk of infection. Myelo001, a small orally bioavailable molecule, has been shown in chemotherapy- or radiotherapy-induced myelosuppression to stimulate differentiation of peripheral white blood cells (WBC) and bone marrow cells of the leucocytic, lymphocytic, and erythrocytic lineage. The purpose of the MyeloConcept study is to determine the safety and effectiveness of Myelo001 in preventing or reducing chemotherapy-induced neutropenia and myelosuppression in patients receiving chemotherapy due to breast cancer.
Phase IIa study, 1:1 randomized, double-blind, placebo-controlled, parallel-design, multi-center study. Each breast cancer patient will be randomly assigned into one of two treatment arms receiving either Myelo001 or placebo as a tablet. Investigational medicinal product is taken as supportive care for 23 consecutive days during chemotherapy treatment. Hematologic and safety parameters as well as actual begin and doses of following chemotherapy cycles will be assessed. A single primary variable will be analyzed with test statistics based on frequent absolute neutrophil measurements. Additionally, in a subgroup of patients biomarkers and pharmacokinetics of Myelo001 will be investigated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
137
Site 20
Aachen, Germany
Site 16
Aurich, Germany
Site 21
Dresden, Germany
Site 26
Dresden, Germany
Site 05
Erlangen, Germany
Site 09
Esslingen am Neckar, Germany
Site 02
Frankfurt a.M., Germany
Site 13
Frankfurt a.M., Germany
Site 01
Friedrichshafen, Germany
Site 25
Goslar, Germany
...and 13 more locations
Threshold area over the curve (AOC1) of ANC: Area below the threshold line (ANC 2.0x10^9/L classified as grade 1 neutropenia) and above the individual ANC trajectory
Time frame: visit 3 to visit 10 (22 days)
Threshold area over the curve (AOC3) of ANC: Area below the threshold line (ANC 1.0x10^9/L classified as grade 3 neutropenia) and above the individual ANC trajectory
Time frame: visit 3 to visit 10 (22 days)
Duration of ANC < 1.0x10^9/L classified as grade 3 neutropenia
Time frame: visit 3 to visit 10 (22 days)
Treatment success rate: a) Neutropenia grade ≤2, b) No need for G-CSF rescue therapy, c) No early withdrawal (drop-out).
Time frame: visit 3 to visit 10 (22 days)
Threshold AOC of ANC (AOC4): Area below the threshold line (ANC 0.5x10^9/L classified as grade 4 neutropenia) and above the individual ANC trajectory
Time frame: visit 3 to visit 10 (22 days)
Change of Threshold Area over the Curve of lymphocytes
Time frame: visit 3 to visit 10 (22 days)
Change of Threshold Area over the Curve of leukocytes
Time frame: visit 3 to visit 10 (22 days)
Change of Threshold Area over the Curve of thrombocytes
Time frame: visit 3 to visit 10 (22 days)
Proportion of patients with neutropenia grade 1 and higher; 3 and higher, 4, and ANC ≤0.1x 10^9/L
Time frame: visit 3 to visit 10 (22 days)
Duration of neutropenia grade 1 and higher; 3 and higher, 4, and ANC ≤0.1x 10^9/L
Time frame: visit 3 to visit 10 (22 days)
ANC at nadir
Time frame: visit 3 to visit 10 (22 days)
Time to ANC nadir (from start of chemotherapy)
Time frame: visit 3 to visit 10 (22 days)
Time to ANC recovery from grade 3 neutropenia, i. e. time from onset to time of reaching neutropenia grade ≤2 (ANC ≥ 1.5x10^9/L)
Time frame: visit 3 to visit 10 (22 days)
Time to ANC recovery from grade 4 neutropenia, i. e. time from onset to time of reaching neutropenia grade ≤2 (ANC ≥ 1.5x10^9/L)
Time frame: visit 3 to visit 10 (22 days)
Time to ANC recovery from profound neutropenia (ANC ≥ 0.1x10^9/L), i. e. time from onset to time of reaching neutropenia grade ≤2 (ANC ≥1.5x10^9/L)
Time frame: visit 3 to visit 10 (22 days)
Proportion of patients with rescue therapy
Time frame: visit 3 to visit 10 (22 days)
Proportion of patients developing febrile neutropenia (body temperature ≥38.3°C by single tympanic or oral measurement) and ANC ≤0.5x 10^9/L (Grade 4)
Time frame: visit 3 to visit 10 (22 days)
Proportion of patients with CTX dose reduction and/or delay of CTX cycle 2
Time frame: visit 10 to visit 11
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