NCT04682405 · REGISTRY CONDITION SEARCH

Uproleselan (GMI-1271) for GI Toxicity Prophylaxis During Melphalan-Conditioned Autologous Hematopoietic Cell Transplantation (Auto-HCT) for Multiple Myeloma (MM)

Found through the registry condition index, not selected as a treatment recommendation. This discovery collection was restricted to studies with posted results.

Phase: PHASE2
Status at capture: COMPLETED
Registry last update: 2023-12-15

The investigators hypothesize that prophylactic E-selectin inhibition via administration of uproleselan during melphalan conditioning will reduce the gastrointestinal (GI) toxicity in multiple myeloma (MM) patients undergoing auto-transplant, as assessed via diarrhea severity scoring per CTCAE v5.0, while potentially increasing chemosensitivity of malignant MM cells to high-dose melphalan.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

flow

Participant flow

→

baseline

Baseline characteristics

→

outcome · POSTED

Change in Diarrhea as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Oral Mucositis as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Esophagitis as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Gastritis as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Esophageal Pain as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Abdominal Pain as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Nausea as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Vomiting as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Enterocolitis as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Proctitis as Assessed Per CTCAE v5.0

→

outcome · POSTED

Change in Hemorrhoids as Assessed Per CTCAE v5.0

→

outcome · POSTED

Time to Neutrophil Engraftment

→

outcome · POSTED

Change in Nutritional Status as Assessed by Total Parenteral Nutrition (TPN) Days

→

outcome · POSTED

Duration of Hospital Length of Stay

→

outcome · POSTED

Change in Bristol Stool Scale

→

outcome · POSTED

Change in Nutritional Status as Assessed by Change in Standing Weight

→

outcome · POSTED

Incidence of Infection Assessed by Rates of Bacteremia (With Organism Reported When Available)

→

outcome · POSTED

Time to First Antibiotics

→

outcome · POSTED

Incidence of Clostridium Difficile Infections

→

outcome · POSTED

Median Daily Dose of Anti-diarrheal Medications

→

outcome · POSTED

Median Daily Dose of Pain Medications

→

outcome · POSTED

Median Change in Scores of Patient Reported Outcomes as Measured by the CTCAE Pro Form v1.0

→

outcome · POSTED

Median Change in Scores of Quality of Life as Measured by the CTCAE Pro Form v 1.0

→

outcome · POSTED

Median Change in Scores of Patient Reported Outcomes as Measured by the CTCAE Pro Form v1.0

→

adverse events

Adverse events

→

more info

Limitations, agreements, and source contact

→

Who could take part

eligibility Criteria: Inclusion Criteria: * Biopsy-confirmed multiple myeloma (MM) (per IMWG criteria). * Undergoing first auto-HCT for MM in first partial response (PR) or better * Conditioning regimen to be single agent melphalan (200 mg/m\^2) * Adults 18 to 75 years of age, inclusive * ECOG performance status ≤ 2 * Mobilized ≥ 5.0 x 10\^6 CD34+ cells/kg (i.e. sufficient CD34+ HSCs for one auto-HCT, with at least one back-up graft in reserve) * Adequate bone marrow and organ function prior to stem cell mobilization as defined below: * Leukocytes, absolute neutrophil count, and platelets within institutional standard limits for high-dose melphalan autologous stem cell transplant * Total bilirubin ≤ 1.5 x ULN (unless the patient has a history of Gilbert's Syndrome, in which case, total bilirubin must be ≤ 2.5 times the ULN) * AST(SGOT)/ALT(SGPT) ≤ 3.0 x ULN * Creatinine clearance ≥ 30 mL/min by Cockcroft-Gault * Baseline pulmonary function test (PFT) with carbon monoxide diffusion capacity in the lung (DLCO) ≥ 50% and forced expiratory volume in 1 second (FEV1) both within institutional standard limits for high-dose melphalan autologous stem cell transplant * The effects of uproleselan (GMI-1271) on the developing human fetus are unknown. For this reason, women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, prior sterilization procedure, abstinence, etc.) prior to study entry, for the duration of study participation and for 12 weeks after the completion of the study. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately. Should a man who is participating in the study become aware that he has impregnated a partner, he must inform his treating physician immediately. * Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable). Exclusion Criteria: * A history of other malignancy with the exception of malignancies for which all treatment was completed at least 2 years before registration and the patient has no evidence of disease. * Active signs or symptoms of CNS involvement by malignancy (lumbar puncture not required). Prior history of CNS involvement is acceptable, if patient has completed treatment for CNS involvement with documented treatment response. * Prior exposure to uproleselan (GMI-1271) * Currently receiving any other investigational agents * A history of allergic reactions attributed to compounds of similar chemical or biologic composition to uproleselan or melphalan * Known active infection with hepatitis A, B (e.g., HBsAg positive), or C (e.g., anti-HCV positive), or human immunodeficiency virus * Uncontrolled acute life-threatening bacterial, viral, or fungal infection-Myocardial infarction within 6 months of uproleselan/placebo dosing, or subject has current significant cardiovascular disease, such as uncontrolled or symptomatic arrhythmias, congestive heart failure, hemodynamic instability, or any Class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification * Any medical, psychiatric, or other condition which, in the opinion of the investigator, unfavorably alters the risk-benefit of subject participation, is likely to interfere with trial completion, assessments, or interpretation of trial results, or otherwise would make the subject an inappropriate subject for this trial. * Pregnant and/or breastfeeding. * Women of childbearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective contraception during the trial and for 12 weeks following the last dose of uproleselan/placebo. Women who are postmenopausal with amenorrhea for at least 1 year prior to trial entry and follicle stimulating hormone (FSH) serum levels consistent with postmenopausal status (\>28U/L) will be considered NOT of childbearing potential. Highly effective contraception includes: * Total abstinence with a male partner. * Female sterilization (has had surgical bilateral oophorectomy with or without hysterectomy) or tubal ligation at least 6 weeks before uproleselan/placebo. In case of oophorectomy alone, the subject would be eligible only when the reproductive status of the woman has been confirmed by follow up hormone level assessment. * Male sterilization (at least 6 months prior to Screening). For female subjects on the trial, the vasectomized male partner should be the sole partner for that subject. * BOTH of the following forms of contraception consistently used together: * Injected, transdermal, or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy (failure rate \<1%) with the exception of intrauterine devices, which are excluded due to the risk of infection and bleeding. * Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with or without spermicidal foam/gel/film/cream/vaginal suppository. * Men who are sexually active and not willing to use condoms during the trial and for 12 weeks following the last dose of uproleselan/placebo, unless they have undergone vasectomy for sterilization (at least 6 months prior to Screening), are excluded from trial participation. * Men who are sexually active and not willing to use condoms during the trial and for 12 weeks following the last dose of uproleselan/placebo, unless they have undergone vasectomy for sterilization (at least 6 months prior to Screening), are excluded from trial participation.
healthy Volunteers: false
maximum Age: 75 Years
minimum Age: 18 Years
sex: ALL
std Ages: ADULT
OLDER_ADULT

Treatment arms and interventions

arm Groups

description
* On the evening of Day -3, patients will receive dose #1 of uproleselan * On the following morning of Day -2 (12 +/- 2 hours from prior dose), patients will receive dose #2 of uproleselan * On the evening of Day -2 (12 +/- 2 hours from prior dose), patients will receive dose #3 of uproleselan * On Day -2 following completion of dose #3 of uproleselan, the patient will be administered the conditioning dose of melphalan (200mg/m\^2) as per institutional practice. * On the following morning of Day -1 (12 +/- 2 hours from prior dose), patients will receive dose #4 of uproleselan * On the evening of Day -1 (12 +/- 2 hours from prior dose), patients will receive dose #5 of uproleselan * On the following morning of Day 0 (12 +/- 2 hours from prior dose) patients will receive dose #6 (final dose) of uproleselan * On Day 0, 4 hours (+/- 2 hours) after the final dose of uproleselan, the patient will be infused with the HSC product. The patient will remain inpatient until engraftment
intervention Names
Drug: Uproleselan
Drug: Melphalan
label
Uproleselan + Standard of Care Melphalan
type
EXPERIMENTAL
description
* On the evening of Day -3, patients will receive dose #1 of placebo * On the following morning of Day -2 (12 +/- 2 hours from prior dose), patients will receive dose #2 of placebo On the evening of Day -2 (12 +/- 2 hours from prior dose), patients will receive dose #3 of placebo. * On Day -2 following completion of dose #3 of placebo, the patient will be administered the conditioning dose of melphalan (200mg/m\^2) as per institutional practice. * On the following morning of Day -1 (12 +/- 2 hours from prior dose), patients will receive dose #4 of placebo. * On the evening of Day -1 (12 +/- 2 hours from prior dose), patients will receive dose #5 of placebo. * On the following morning of Day 0 (12 +/- 2 hours from prior dose) patients will receive dose #6 (final dose) of placebo. * On Day 0, 4 hours (+/- 2 hours) after the final dose of placebo, the patient will be infused with the HSC product. The patient will remain inpatient until engraftment
intervention Names
Drug: Placebo
Drug: Melphalan
label
Placebo + Standard of Care Melphalan
type
PLACEBO_COMPARATOR

interventions

arm Group Labels
Uproleselan + Standard of Care Melphalan
description
Provided by study
name
Uproleselan
other Names
GM-1271
type
DRUG
arm Group Labels
Placebo + Standard of Care Melphalan
description
Provided by study
name
Placebo
type
DRUG
arm Group Labels
Placebo + Standard of Care Melphalan
Uproleselan + Standard of Care Melphalan
description
-Standard of care
name
Melphalan
type
DRUG

Study design

allocation

RANDOMIZED

intervention Model

PARALLEL

masking Info

masking: QUADRUPLE
who Masked: PARTICIPANT
CARE_PROVIDER
INVESTIGATOR
OUTCOMES_ASSESSOR

primary Purpose

SUPPORTIVE_CARE

Enrollment

count: 51
type: ACTUAL

Registered outcome plans (not posted results)

primary Outcomes

description
Grade 0 is defined as no diarrhea, or no change from baseline. Grade 1 is defined as an increase of \<4 stools per day over baseline; mild increase in ostomy output compared to baseline. Grade 2 is defined as an increase of 4-6 stools per day over baseline; moderate increase in ostomy output compared to baseline; limiting instrumental ADL. Grade 3 is defined as an increase of \>=7 stools per day over baseline; hospitalization indicated; severe increase in ostomy output compared to baseline; limited self care ADL. Grade 4 is defined as life-threatening consequences; urgent intervention indicated. Grade 5 is defined as death.
measure
Change in Diarrhea as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)

secondary Outcomes

description
Grade 0 oral mucositis is defined as no presence of mucositis. Grade 1 oral mucositis is defined as asymptomatic or mild symptoms; intervention not indicated. Grade 2 oral mucositis is defined as moderate pain or ulcer that does not interfere with oral intake; modified diet indicated. Grade 3 oral mucositis is defined as severe pain; interfering with oral intake. Grade 4 oral mucositis is defined as life-threatening consequences; urgent intervention indicated. Grade 5 oral mucositis is defined as death.
measure
Change in Oral Mucositis as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 esophagitis is defined as no presence of esophagitis. Grade 1 esophagitis is defined as asymptomatic; clinical or diagnostic observations only; intervention not indicated. Grade 2 esophagitis is defined as symptomatic; altered GI function; limiting instrumental ADL. Grade 3 esophagitis is defined as severely altered GI function; TPN indicated; elective invasive intervention indicated; limiting self care ADL. Grade 4 esophagitis is defined as life-threatening consequences; urgent operative intervention indicated. Grade 5 esophagitis is defined as death.
measure
Change in Esophagitis as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 gastritis is defined as no presence of esophagitis. Grade 1 gastritis is defined as asymptomatic; clinical or diagnostic observations only; intervention not indicated. Grade 2 gastritis is defined as symptomatic; altered GI function; medical intervention indicated. Grade 3 gastritis is defined as severely altered eating or gastric function; TPN or hospitalization indicated. Grade 4 gastritis is defined as life-threatening consequences; urgent operative intervention indicated. Grade 5 gastritis is defined as death.
measure
Change in Gastritis as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 esophageal pain is defined as no esophageal pain. Grade 1 esophageal pain is defined as mild pain. Grade 2 esophageal pain is defined as moderate pain; limiting instrumental ADL. Grade 3 esophageal pain is defined as severe pain; limiting self care ADL. There is no grade 4 or 5 esophageal pain defined in the CTCAE v5.0.
measure
Change in Esophageal Pain as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 abdominal pain is defined as no abdominal pain. Grade 1 abdominal pain is defined as mild pain. Grade 2 abdominal pain is defined as moderate pain; limiting instrumental ADL. Grade 3 abdominal pain is defined as severe pain; limiting self care ADL. There is no grade 4 or 5 abdominal pain defined in the CTCAE v5.0.
measure
Change in Abdominal Pain as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 nausea is defined as no nausea. Grade 1 nausea is defined as loss of appetite without alteration in eating habits. Grade 2 nausea is defined as oral intake decreased without significant weight loss, dehydration or malnutrition. Grade 3 nausea is defined as inadequate oral caloric or fluid intake; tube feeding, TPN, or hospitalization indicated. There is no grade 4 or 5 nausea defined in the CTCAE v5.0.
measure
Change in Nausea as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 vomiting is defined as no vomiting. Grade 1 vomiting is defined as intervention not indicated. Grade 2 vomiting is defined as outpatient IV hydration; medical intervention indicated. Grade 3 vomiting is defined as tube feeding, TPN, or hospitalization indicated. Grade 4 vomiting is defined as life-threatening consequences. Grade 5 vomiting is defined as death.
measure
Change in Vomiting as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 enterocolitis is defined as no enterocolitis. Grade 1 enterocolitis is defined as asymptomatic; clinical or diagnostic observations only; intervention not indicated. Grade 2 enterocolitis is defined as abdominal pain; mucus or blood in stool. Grade 3 enterocolitis is defined as severe or persistent abdominal pain; fever; ileus; peritoneal signs. Grade 4 enterocolitis is defined as life-threatening consequences; urgent intervention indicated. Grade 5 enterocolitis is defined as death.
measure
Change in Enterocolitis as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 proctitis is defined as no proctitis. Grade 1 proctitis is defined as rectal discomfort, intervention not indicated. Grade 2 proctitis is defined as symptomatic (e.g., rectal discomfort, passing blood or mucus); medical intervention indicated; limiting instrumental ADL. Grade 3 proctitis is defined as severe symptoms; fecal urgency or stool incontinence; limiting self-care ADL. Grade 4 proctitis is defined as life-threatening consequences; urgent intervention indicated. Grade 5 proctitis is defined as death.
measure
Change in Proctitis as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
Grade 0 hemorrhoids is defined as no hemorrhoids. Grade 1 hemorrhoids is defined as asymptomatic; clinical or diagnostic observations only; intervention not indicated. Grade 2 hemorrhoids is defined as symptomatic; banding or medical intervention indicated. Grade 3 hemorrhoids is defined as severe symptoms; invasive intervention indicated. There is no grade 4 or 5 hemorrhoids defined in the CTCAE v5.0.
measure
Change in Hemorrhoids as Assessed Per CTCAE v5.0
time Frame
From day -3 to date of discharge or day 14 (whichever is sooner) (up to be 18 days)
description
-Defined as ANC ≥0.5 x 10\^9/L for 3 consecutive days or ≥1.0 x 10\^9/L for 1 day
measure
Time to Neutrophil Engraftment
time Frame
Through date of discharge (up to be 18 days)
measure
Change in Nutritional Status as Assessed by Total Parenteral Nutrition (TPN) Days
time Frame
Before conditioning and at day +14 or date of discharge (whichever is sooner) (up to be 18 days)

Full study description

brief Summary: The investigators hypothesize that prophylactic E-selectin inhibition via administration of uproleselan during melphalan conditioning will reduce the gastrointestinal (GI) toxicity in multiple myeloma (MM) patients undergoing auto-transplant, as assessed via diarrhea severity scoring per CTCAE v5.0, while potentially increasing chemosensitivity of malignant MM cells to high-dose melphalan.

Source references