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Feasibility Study to Evaluate Outpatient Blinatumomab in Subjects With Minimal Residual Disease (MRD) of B-precursor Acute Lymphoblastic Leukemia (ALL)

Trial Status: In Review

The purpose of this study is to determine the safety and feasibility of outpatient blinatumomab administration for subjects with Minimal Residual Disease of B-precursor Acute Lymphoblastic Leukemia.

Inclusion Criteria

  • Subject has provided informed consent prior to initiation of any study-specific activities/procedures OR subject's legally acceptable representative has provided informed consent prior to any study-specific activities/procedures being initiated when the subject has any kind of condition that, in the opinion of the Investigator, may compromise the ability of the subject to give written informed consent
  • Age greater than or equal to 18 years
  • B-precursor ALL in hematologic CR defined as less than 5% bone marrow blasts with MRD positive disease and meet clinical eligibility criteria to receive blinatumomab as outlined below
  • Presence of MRD <0,1%. Documented after an interval of at least 1 week from last systemic chemotherapy
  • Hematologic criteria for remission as defined below:
  • Less than 5% bone marrow blasts
  • Absolute neutrophil count greater than or equal to 1.0 x10^9 L
  • Platelets greater than or equal to 50 x10^9/L (transfusion permitted)
  • Hemoglobin level greater than or equal to 90 g/L (transfusion permitted)
  • Renal and hepatic function as defined below:
  • Aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase less than 3x upper limit of normal (ULN)
  • Total bilirubin less than 1.5x ULN unless related to Gilbert's or Meulengracht disease
  • Serum creatinine less than or equal to 1.5x ULN. If serum creatinine is greater than 1.5x ULN, then measure Glomerular Filtration Rate (GFR) in mL/min/1.73m^2 or mL/s/m^2; subject will be eligible only if measured GFR is within normal limits
  • Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1
  • Negative pregnancy test in women of childbearing potential
  • Ability and willingness to wear and comply with the instructions for the use of and monitoring of the digital monitoring devices as outlined in informed consent
  • Subject resides within 1 hour of ground transportation to an advanced medical care facility for the duration of the mandatory device monitoring period (MDMP)
  • Adequate cellular service available during MDMP.
  • Presence of an adult (greater than or equal to 18 years) caregiver(s) in the same dwelling, for 24 hours/day for the entire MDMP. Caregiver will be expected to have access to transportation
  • Ability and willingness to participate in the health management of the subject and to assist with the requirements of remote digital monitoring devices during the blinatumomab infusion within the MDMP

Exclusion Criteria

  • Presence of circulating blasts
  • Presence of extramedullary disease
  • History of relevant central nervous system (CNS) pathology or current relevant CNS pathology (seizure, paresis, aphasia, cerebrovascular ischemia/hemorrhage, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, psychosis, or coordination or movement disorders
  • Current infiltration of cerebrospinal fluid (CSF) by ALL. If screening CSF demonstrates leukemic blasts, subjects must receive intrathecal treatment and demonstrate negative CSF before enrollment and starting blinatumomab infusion
  • Current autoimmune disease or history of autoimmune disease with potential CNS involvement
  • Allogeneic HSCT within 12 weeks before blinatumomab treatment
  • Active acute or chronic graft versus host disease (GvHD) requiring systemic treatment with immunosuppressive medication
  • Systemic chemotherapy within 2 weeks prior to study treatment (except for intrathecal prophylaxis)
  • Radiotherapy within 4 weeks prior to study treatment
  • Known hypersensitivity to blinatumomab or to any component of the product formulation
  • Active malignancy other than ALL with the exception of basal cell or squamous cell carcinoma of the skin, or carcinoma in situ of the cervix
  • History of other malignancy within the past 2 years, with the following exception[s]:
  • Malignancy treated with curative intent and with no known active disease present for greater than or equal to 2 years before enrollment and felt to be at low risk for recurrence by the treating physician
  • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
  • Adequately treated cervical carcinoma in situ without evidence of disease
  • Adequately treated breast ductal carcinoma in situ without evidence of disease
  • Prostatic intraepithelial neoplasia without evidence of prostate cancer
  • Adequately treated urothelial papillary non-invasive carcinoma or carcinoma in situ
  • Currently receiving treatment with an investigational device or drug study or less than 30 days since ending treatment on an investigational device or drug study(ies)
  • Active uncontrolled infection requiring therapy
  • Known infection or chronic infection with hepatitis B virus (hepatitis B surface antigen [HBsAg] positive) or hepatitis C virus (HCV) (anti-HCV positive)
  • Known positive test for human immunodeficiency virus (HIV)
  • Any concurrent disease or medical condition deemed to interfere with the conduct of the study and remote digital monitoring as judged by the investigator
  • Any acutely ill cardiac patients with the potential to develop life threatening arrhythmias eg, very fast atrial fibrillation
  • Subjects with no cellular signal in their home
  • Subjects with bi-lateral upper arm tattoos directly under the area of CWHMS application (Current Health wearable device)
  • Subjects with a known allergy to any of the device component materials
  • Subjects with open wounds on both arms directly under the area of CWHMS application (Current Health wearable device) or with injuries to both arms
  • Subjects with an upper arm circumference of less than 20 cm or greater than 50 cm
  • Subjects with an implantable defibrillator
  • Subjects unwilling to wear the CWHMS (Current Health wearable device, axillary temperature patch) during the MDMP in cycles 1 and 2
  • Subjects with excessive scarring directly under the area of CWHMS (Current Health wearable device) application
  • Subjects who cannot have their BP measured in both arms (or wrists) eg due to atrio-venous shunt, risk of lymphedema or peripherally inserted central catheter line
  • Female subject is pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 48 hours after the last dose of protocol-specified therapy
  • Female subjects of childbearing potential unwilling to use 1 highly effective method of contraception during treatment and for an additional 48 hours after the last dose of protocol-specified therapy Refer to Section 11.5 for additional contraceptive information
  • Female subjects of childbearing potential with a positive pregnancy test assessed at Screening by a serum pregnancy test and/or urine pregnancy test
  • Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures (eg, PROs) to the best of the subject and investigator's knowledge

California

Los Angeles
UCLA / Jonsson Comprehensive Cancer Center
Status: IN_REVIEW
Contact: Bruck Habtemariam
Phone: 310-794-0242

North Carolina

Winston-Salem
Wake Forest University Health Sciences
Status: APPROVED

Trial Phase Phase IV

Trial Type Treatment

Lead Organization
Amgen, Inc.

  • Primary ID 20190014
  • Secondary IDs NCI-2020-06780
  • Clinicaltrials.gov ID NCT04506086