Neihulizumab (AbGn-168H) in Patients With Steroid-refractory Acute Graft-versus-host Disease



Status:Recruiting
Conditions:Hematology
Therapuetic Areas:Hematology
Healthy:No
Age Range:18 - Any
Updated:10/25/2018
Start Date:May 31, 2018
End Date:June 2020
Contact:Hazel Cheng, PhD
Email:hazel.cheng@abgenomics.com
Phone:+1 949 786 0390

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A Phase I Study of Neihulizumab (AbGn-168H) in Patients With Steroid-refractory Acute Graft-versus-host Disease (Sr-aGvHD)

To establish the pharmacokinetic, pharmacodynamic, safety and efficacy profiles of
Neihulizumab in patients with steroid-refractory acute graft-versus-host disease(sr-aGvHD)

This study is a Phase I, single dose, dose-escalation study to study the pharmacokinetics,
safety, signs of efficacy, receptor occupancy and pharmacodynamics biomarkers (REG3-alpha and
ST2 of Neihulizumab in patients with steroid-refractory acute GvHD. Up to 24 patients will be
recruited in 4-9 clinical centers in US.

Inclusion Criteria:

1. Patients must have clinical aGvHD and pathologic findings consistent with the
diagnosis by biopsy of at least 1 involved site and treated initially with steroids at
prednisone-equivalent doses ≥1 mg/kg/day, and i) worsening of GvHD manifestations
across any interval of at least 2 days before tapering of steroid doses has begun, or

ii) persistence of grade II to IV aGvHD across any interval of at least 7 days without
improvement during steroid treatment at any prednisone-equivalent dose >0.4 mg/kg/day
or at any lower dose in patients with contraindication to continued treatment at
higher steroid doses because of severe steroid-related toxicity (e.g., myopathy), or

iii) initial response of GvHD manifestations followed by exacerbation of aGvHD across
any interval of at least 3 days while tapering glucocorticoid treatment at any
prednisone-equivalent dose >0.4 mg/kg/day or at any lower dose in patients with
contraindication to continued treatment at higher steroid doses because of severe
steroid-related toxicity (e.g., myopathy).

2. Patients must have erythematous manifestations of cutaneous aGvHD. Characteristics of
the rash must indicate active inflammation (red coloration) as distinct from resolving
inflammation (brown coloration).

3. Providers and patients must be willing to defer new systemic or cutaneous topical
treatment of aGvHD for at least 36 hours after administration of Neihulizumab.

4. Patient must give informed consent and sign an approved consent form prior to any
study procedures.

5. Females of childbearing potential must have a negative pregnancy test result before
enrollment. Males and females of childbearing potential must agree to use a highly
effective method of birth control during the study for at least 30 days after
enrollment in the study.

Exclusion Criteria:

1. Uncontrolled infections not responding to antimicrobial therapy or requiring intensive
critical care or vasopressors

2. Evidence of end-organ Cytomegalovirus (CMV) infection

3. Patients known to have CMV, adenovirus, human herpes virus 6 (HHV6), Epstein Barr
virus (EBV) or any hepatitis viremia from screening according to institutional
standard practice

4. HIV infection or a known HIV-related malignancy.

5. Tuberculosis, history of tuberculosis or a known positive Quantiferon test for
tuberculosis

6. Unplanned donor lymphocyte infusion (DLI) for residual or relapsed malignancy or mixed
chimerism. DLI as part of the planned HCT protocol is allowed.

7. Known relapsed or progressive malignancy after transplant, post-transplant
lymphoproliferative disease or any secondary malignancy diagnosed after HCT

8. Absolute neutrophil count (ANC) <1000/mm3

9. Total serum bilirubin concentration >3.0 mg/dL UNLESS attributed to GvHD

10. Creatinine clearance < 40 mL/min calculated by Cockcroft-Gault equation.

11. Ileus, abdominal pain, extensive denudation of intestinal mucosa or stage 4 GI GvHD.

12. Karnofsky Performance Status (KPS) <50%

13. Intensive care unit (ICU) care, life expectancy of less than 28 days, ongoing or
unresolved hepatic sinusoidal obstruction syndrome, unstable hemodynamics, or evidence
of current or previous clinically significant disease, medical condition or finding
(including vital signs and ECG) that in the opinion of the Investigator, would
compromise the safety of the patient or the quality of the data

14. History of allergy or hypersensitivity to any systemically administered antibody agent
or its excipients

15. Pregnancy or nursing

16. Prior treatment with anti-lymphocyte globulin or anti-thymocyte globulin

17. Patients <18 years of age
We found this trial at
8
sites
Minneapolis, Minnesota 55455
(612) 625-5000
Principal Investigator: Shernan Holtan, MD
Phone: 612-626-0461
Univ of Minnesota With a flagship campus in the heart of the Twin Cities, and...
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201 Dowman Dr
Atlanta, Georgia 30303
(404) 727-6123
Principal Investigator: Edmund Waller
Phone: 404-778-6547
Emory University Emory University, recognized internationally for its outstanding liberal artscolleges, graduate and professional schools,...
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Atlanta, GA
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5801 South Ellis Avenue
Chicago, Illinois 60637
 773.702.1234
Principal Investigator: Michael Bishop
University of Chicago One of the world's premier academic and research institutions, the University of...
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Chicago, IL
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2220 Pierce Ave
Nashville, Tennessee 37232
615-936-8422
Principal Investigator: Madan Jagasia, MD
Phone: 615-343-7190
Vanderbilt-Ingram Cancer Center The Vanderbilt-Ingram Cancer Center, located in Nashville, Tenn., brings together the clinical...
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Nashville, TN
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500 S State St
Ann Arbor, Michigan 48109
(734) 764-1817
Principal Investigator: Sarah Anand, MD
Phone: 734-615-5939
University of Michigan The University of Michigan was founded in 1817 as one of the...
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Ann Arbor, MI
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Duarte, California 91010
Principal Investigator: Haris Ali
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Duarte, CA
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8701 W Watertown Plank Rd
Milwaukee, Wisconsin
(414) 955-8296
Principal Investigator: Sameem Abedin, MD
Phone: 414-805-8926
Medical College of Wisconsin The Medical College (MCW) of Wisconsin is a major national research...
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Milwaukee, WI
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Seattle, Washington 98109
Principal Investigator: Paul Martin, MD
Phone: 206-667-2353
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Seattle, WA
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