Graft Versus Host Disease, Graft Vs Host Disease, Hematologic Malignancy
Conditions
Keywords
Graft Versus Host Disease, Graft Vs Host Disease, Hematologic Malignancy, Hematologic malignancy in morphologic remission, Belumosudil, Stem Cell Transplant, Memorial Sloan Kettering Cancer Center, 25-033
Brief summary
The purpose of this study is to find out whether adding belumosudil to a usual approach for reducing the risk of graft-versus-host disease (GVHD) may be an effective GVHD prevention approach for people with blood cancer who have a stem cell transplant. The investigators will also look at the safety of the study approach.
Interventions
DRUGBelumosudil
Belumosudil is an oral selective inhibitor of Rho-GTPase-associated coiled-coil kinase 2 (ROCK2)
Sponsors
Memorial Sloan Kettering Cancer Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients ≥ 18 years-old at time of consent. * Diagnosis: hematologic malignancy in morphologic remission who will be treated with RI or NMA conditioning and GVHD prophylaxis CNI-based (CNI without PTCY) plus abatacept or PTCY-based (CNI with PTCY). * Recipients of 7-8/8 related or unrelated HLA-matched or related haploidentical donor. * Peripheral blood stem cell graft * Allo-HCT day \<120 at time of consent Post-HCT inclusion criteria (within 3 weeks before start of belumosudil treatment) * Patient has received an allo-HCT transplant and is in morphologic remission (blasts \<5%, no evidence of extramedullary disease in AML or MDS). Patients with CR with incomplete count recovery (CRp or CRi) or minimal residual disease are allowed. * Patient has achieved engraftment. Engraftment is defined as ANC≥500/μL and platelets ≥ 20000/μL on 3 consecutive measurements (each occurring at least 1 day apart). The patient must not have had a platelet transfusion within 7 days before the first measurement. * Patient is ≥ 80 days and ≤ 20 days from allo-HCT infusion. * Karnofsky score ≥ 70%. * Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3x upper limit of normal (ULN) * Total bilirubin ≤1.5 x ULN (unless benign congenital hyperbilirubinemia). * Glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m2 * Female subjects of childbearing potential (≤ 50 years old) have a negative serum or urine pregnancy test. Females of childbearing potential are defined as females without prior hysterectomy or who have had any evidence of menses in the past 12 months. ° Sexually active females of childbearing potential enrolled in the study must agree to consistently use two forms of accepted methods of contraception during the course of the study and for 3 months after their last dose of study drug. Effective birth control includes: \* Intrauterine device (IUD) plus one barrier method \* Stable doses of hormonal contraception for at least 3 months (eg, oral, injectable, implant, transdermal) plus one barrier method \* 2 barrier methods. Effective barrier methods are male or female condoms, diaphragms, and spermicides (creams or gel that contain a chemical to kill sperm); or \* A vasectomized partner * For male subjects who are sexually active and who are partners of females of childbearing potential: Agreement to use two forms of contraception as per above and to not donate sperm during the treatment period and for at least 3 months after the last dose of study drug.
Exclusion criteria
* Recipient of CD34+ selected or engineered stem cell graft. * Treatment with in vivo T cell depletion (e.g. anti-thymocyte globulin). * Evidence of current uncontrolled cardiovascular conditions, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure, unstable angina, or myocardial infarction within the past 6 months. * Pulmonary dysfunction with DLCO \<50% corrected for hemoglobin Post-HCT
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in GVHD/relapse-free survival (GRFS) at 1-year post-Hematopoietic Cell Transplantation (HCT) | 1 year | The primary objective is to assess the efficacy of belumosudil in the improvement of GRFS at 1-year post-HCT for patients receiving PTCY GVHD prophylaxis and separately for participants receiving CNI-based (CNI without PTCY) plus abatacept GVHD prophylaxis. |
Countries
United States
Contacts
CONTACTDoris Ponce, MD
CONTACTGajan Raju, MD
PRINCIPAL_INVESTIGATORDoris Ponce, MD
Memorial Sloan Kettering Cancer Center
Outcome results
None listed