Forodesine in the Treatment of Cutaneous T-Cell Lymphoma

• ClinicalTrials.gov Identifier: NCT00501735
• Recruitment Status: Completed
• First Posted: July 16, 2007
• Last Update Posted: January 23, 2012
• Sponsor: BioCryst Pharmaceuticals
• Information provided by (Responsible Party): BioCryst Pharmaceuticals

Tracking Information

• First Submitted Date: July 12, 2007
• First Posted Date: July 16, 2007
• Last Update Posted Date: January 23, 2012
• Study Start Date: July 2007
• Actual Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)
• Current Primary Outcome Measures (submitted: January 19, 2009): The primary objective of this study is to determine the objective response rate to treatment with oral forodesine in subjects with cutaneous manifestations of CTCL subjects, stages IIB, III, and IVA. [ Time Frame: Duration of Study ]
• Original Primary Outcome Measures (submitted: July 13, 2007): The primary objective of this study is to determine the objective response rate to treatment with oral forodesine in subjects with cutaneous manifestations of CTCL subjects, stages IIB, III, and IVA.

Current Secondary Outcome Measures (submitted: January 19, 2009)

• Safety and tolerability [ Time Frame: Duration of Study ]
• Time to and duration of objective response in cutaneous manifestations [ Time Frame: Duration of Study ]
• Time to loss of objective response [ Time Frame: Duration of Study ]
• Objective response rate, time to and duration of extracutaneous manifestations [ Time Frame: Duration of Study ]
• Health related quality of life [ Time Frame: Duration of Study ]

Original Secondary Outcome Measures (submitted: July 13, 2007)

• Safety and tolerability
• Time to and duration of objective response in cutaneous manifestations
• Time to loss of objective response
• Objective response rate, time to and duration of extracutaneous manifestations
• Health related quality of life

• Current Other Pre-specified Outcome Measures: Not Provided
• Original Other Pre-specified Outcome Measures: Not Provided

Descriptive Information

• Brief Title: Forodesine in the Treatment of Cutaneous T-Cell Lymphoma
• Official Title: Single Agent Phase II Study of Forodesine (BCX1777) in the Treatment of Cutaneous T-Cell Lymphoma
• Brief Summary: This is a Phase II, non-randomized, open-label, single-arm trial that will be conducted at up to 50 sites in North America, Europe and Australia. This study is designed to assess objective response (OR) [complete response (CR) or partial response (PR)] in subjects with cutaneous manifestations of CTCL with a requirement for maintenance of such objective response for at least 28 days in subjects with stage IIB, III, and IVA CTCL. Additionally, this study will evaluate the safety and tolerability of CTCL subjects Stages IB, IIA, IIB, III, or IVA treated with oral forodesine.
• Detailed Description: Not Provided
• Study Type: Interventional
• Study Phase: Phase 2
• Study Design: Allocation: Non-Randomized; Intervention Model: Single Group Assignment; Masking: None (Open Label); Primary Purpose: Treatment
• Condition: Cutaneous T-cell Lymphoma (CTCL),

Intervention

Drug: Forodesine 200 mg

2 x 100mg tablets once daily

• Study Arms: Not Provided
• Publications *: Dummer R, Duvic M, Scarisbrick J, Olsen EA, Rozati S, Eggmann N, Goldinger SM, Hutchinson K, Geskin L, Illidge TM, Giuliano E, Elder J, Kim YH. Final results of a multicenter phase II study of the purine nucleoside phosphorylase (PNP) inhibitor forodesine in patients with advanced cutaneous T-cell lymphomas (CTCL) (Mycosis fungoides and Sezary syndrome). Ann Oncol. 2014 Sep;25(9):1807-1812. doi: 10.1093/annonc/mdu231. Epub 2014 Jun 19.

Recruitment Information

• Recruitment Status: Completed
• Actual Enrollment (submitted: January 18, 2012): 144
• Original Estimated Enrollment (submitted: July 13, 2007): 150
• Actual Study Completion Date: December 2011
• Actual Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)

Eligibility Criteria

Inclusion Criteria:

• Males or non-pregnant females aged ≥18 years;
• Histologically confirmed diagnosis of CTCL, including mycosis fungoides and/or Sezary syndrome, documentation of diagnosis by histologic examination should be available;
• Subjects with CTCL stages IB, IIA, IIB, III, or IVA at the screening visit (i.e. stage refers to stage at study entry) and who have persistent, progressive, or recurrent disease during or following treatment with at least three forms of systemic therapy, one of which must have been oral bexarotene, unless treatment with oral bexarotene was not tolerated or was medically contraindicated;
• Anticipated life expectancy greater than 6 months;
• Performance status of 0, 1, or 2 by Eastern Cooperative Oncology Group (ECOG) criteria;
• Females of childbearing potential must have a negative serum pregnancy test within 14 days prior to initiation of study treatment;
• Females of childbearing potential and sexually active males, if indicated, must be willing and able to use method(s) of contraception that are adequate to prevent or minimize the risk of pregnancy for the duration of the study;
• Written informed consent to participate in the study.

Exclusion Criteria:

• Proven or suspected extracutaneous visceral CTCL involvement (M1) (CTCL stage IVB) (note: presence of lymphadenopathy is permitted);
• Previous treatment with Forodesine;
• ECOG performance status >2;
• Concomitant use of any anti-cancer therapy or immune modifier;
• Concomitant use of any investigational agent or device;
• Concurrent treatment with any other anti-CTCL therapy, or radiation therapy [topical corticosteroids (classes 1 and 2 prohibited) or low dose oral corticosteroids (≤10 mg/day prednisone or equivalent) will not be excluded, but if used, must be a stable dose and schedule during the four weeks immediately prior to study entry];

• Use of previous therapies for CTCL within the timeframes specified below:

  1. Phototherapy in the previous 30 days;
  2. Electron beam therapy, photopheresis, systemic anticancer therapy, interferon therapy, or other investigational therapy in the previous 30 days;
  3. Oral retinoid (including bexarotene) in the previous 30 days
  4. Alemtuzumab (Campath) or other monoclonal antibody within the previous 30 days
  5. Vorinostat or other HDAC inhibitor within previous 30 days
  6. Any investigational therapy within the previous 30 days;
• ALT or AST >3 times ULN or alkaline phosphatase >2 times ULN;
• Calculated creatinine clearance ≤50 mL/min or serum creatinine ≥1.8 mg/dL;
• Serum potassium <3.3 mg/dL or >5.5 mg/dL;
• Evidence of clinically significant (uncontrolled) hypo- or hyperthyroidism;
• Recent (in past 6 months) medically significant cardiac event (i.e., myocardial infarction, cardiac surgery);
• Presence of congestive heart failure (NYHA class IV) or angina (NYHA class IV) or presence of a medically significant dysrhythmia;

• Presence of any of the following ECG findings:

  1. Congenital long QT syndrome;
  2. QTc interval >480 msec (Bazett's correction);
• Presence of uncontrolled hypertension manifested by systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥90 mmHg;
• Hemoglobin <9.0 gm/dL (intermittent red blood cell transfusions permitted);
• Absolute neutrophil count <1500 cells/mm3;
• Platelet count <75,000/mm3;
• Requirement for neutrophil or platelet growth factor therapy or administration of such therapy in the previous 30 days;
• CD4 count <200/mm3;
• Documented current active infection with HIV, Hepatitis B, Hepatitis C, and/or CMV;
• Presence of uncontrolled bacterial or viral infection (subject may be receiving chronic antimicrobial therapy); or,
• History of culture-documented bacteremia in the previous 2 weeks;
• Recent (i.e., in past 2 weeks) change in doses or regimens of medications used for any chronic non-oncologic condition for reasons of worsening of the chronic illness (change in doses of chronic medications associated with improvement in a chronic illness are not exclusionary);
• Presence of any acute or chronic non-oncologic disease which, in the opinion of the investigator, is medically uncontrolled;
• Coexistent second malignancy or history of prior malignancy within previous 5 years [excluding basal cell or squamous cell carcinoma of skin and cervical neoplasia (carcinoma-in-situ) that has been treated curatively]. Surgically resected nonmelanomatous skin cancer (non-CTCL) with no evidence of recurrence in previous 6 months is permitted; and,
• Any significant medical or psychiatric condition that, in the opinion of the investigator, might prevent the subject from complying with all required study procedures.

Sex/Gender

• Sexes Eligible for Study: All

• Ages: 18 Years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Contacts: Contact information is only displayed when the study is recruiting subjects
• Listed Location Countries: Australia, Austria, Finland, France, Germany, Italy, Spain, Switzerland, United Kingdom, United States

Administrative Information

• NCT Number: NCT00501735
• Other Study ID Numbers: BCX1777-203
• Has Data Monitoring Committee: Yes
• U.S. FDA-regulated Product: Not Provided
• IPD Sharing Statement: Not Provided
• Current Responsible Party: BioCryst Pharmaceuticals
• Original Responsible Party: Not Provided
• Current Study Sponsor: BioCryst Pharmaceuticals
• Original Study Sponsor: Same as current
• Collaborators: Not Provided

Investigators

• Principal Investigator: Nashat Gabrail, MD; Gabrail Cancer Center
• Principal Investigator: Madeleine Duvic, MD; M.D. Anderson Cancer Center - Dermatology
• Principal Investigator: Youn Kim, MD; Stanford University
• Principal Investigator: Andres Forero-Torres, M.D.; University of Alabama at Birmingham, Comprehensive Cancer Ctr.
• Principal Investigator: Alan B Fleischer, Jr., MD; Wake Forest University Health Sciences
• Principal Investigator: Gary S. Wood, MD; University of Wisconsin-Madison, Dept of Dermatology
• Principal Investigator: Andre Goy, MD; Hackensack Universeity Medical Ctr
• Principal Investigator: Larisa Geskin, MD; Hillman Cancer Ctr., University of Pittsburgh
• Principal Investigator: Nancy Bartlett, MD; Washington University School of Medicine
• Principal Investigator: Francine Foss, MD; Yale University
• Principal Investigator: Miles Prince, MD; Cabrini Hospital
• Principal Investigator: Elise Olsen, MD; Duke University
• Principal Investigator: Sareeta S Parker, MD; Emory University
• Principal Investigator: Neil J Korman, MD, PhD; University Hospitals Case Medical Ctr., Dept. of Dermatology
• Principal Investigator: Francesco Turturro, MD; LSU Health Sciences Ctr., Feist-Weiller Cancer Center
• Principal Investigator: Andrei R Shustov, MD; Seattle Cancer Care Alliance

• PRS Account: BioCryst Pharmaceuticals
• Verification Date: January 2012