保留 | ||
平成23年8月2日 | ||
令和3年11月25日 | ||
平成29年9月28日 | ||
再発又は難治性の多発性骨髄腫患者を対象としたONO-7057の第1/2相試験(ONO-7057-01) | ||
ONO-7057 第1/2相試験(ONO-7057-01) | ||
再発又は難治性の多発性骨髄腫患者を対象に、ONO-7057の有効性、安全性、薬物動態及び薬力学を検討する。 | ||
1-2 | ||
再発又は難治性の多発性骨髄腫 | ||
参加募集終了 | ||
ONO-7057、- | ||
- | ||
2021年11月24日 |
2017年09月28日 | ||
50 | ||
/ | 試験全体の被験者背景について,性別は男性26名(52.0%),女性24名(48.0%),年齢の平均値は67.4歳であった.Performance Status(ECOG)は0が29名(58.0%),1が21名(42.0%)であり,2の被験者はいなかった.国際病期分類基準(ISS)による病期は1が16名(35.6%),2が18名(40.0%),3が11名(24.4%)であった.神経障害を有する被験者は35名(70.0%)であり,程度はGrade 1が26名(52.0%),Grade 2が9名(18.0%)であった.前治療回数の中央値は5.0回であり,3回が9名(18.0%),4回が12名(24.0%),5回が8名(16.0%),6回以上が21名(42.0%)であった.予後不良の染色体異常[t(4;14)転座,t(14;16)転座,若しくはdel(17)短腕欠失が陽性,若しくはGバンド法で異常所見があった場合]を有する被験者は,44.7%に認められた. | Participants' baseline characteristics of the whole study are as follows: 26 participants (52.0%) were male and 24 participants (48.0%) were female, with the mean age of 67.4 years. Performance Status (ECOG) was 0 in 29 participants (58.0%) and 1 in 21 participants (42.0%). There was no patient with Performance Status of 2. International Staging System (ISS) stage was Stage I in 16 participants (35.6%), Stage II in 18 participants (40.0%), and Stage III in 11 participants (24.4%). Thirty-five participants (70.0%) had a nerve disorder, consisting of 26 participants (52.0%) with Grade 1 and 9 participants (18.0%) with Grade 2. The participants had previously received a median of 5.0 therapies. Previous lines of therapy was 3 lines in 9 participants (18.0%), 4 lines in 12 participants (24.0%), 5 lines in 8 participants (16.0%), and >= 6 lines in 21 participants (42.0%). Participants with poor-prognosis abnormal chromosome [positive for t(4;14), t(14;16), or del (17p), or abnormality from G-banding] accounted for 44.7% of the population. |
/ | 第I相試験パートでは17名が登録され,全被験者にONO-7057が投与された.コホート1(15 mg/m2)では最初に登録された3名中1名がDLT評価不能例と判断された.1名を追加で登録した結果,DLTが評価可能な3名にDLTは認められなかったため,コホート2(20 mg/m2)へ移行した.コホート2では最初に登録された3名中1名にDLTが認められたが,追加で登録した3名にDLTは認められず,DLT発現者数がDLT評価対象集団6名中1名であったため,コホート3(20/27 mg/m2)へ移行した.コホート3では最初に登録された3名中1名がDLT評価不能例と判断された.1名を追加で登録した結果,DLTが評価可能な3名にDLTは認められず,本コホートに更に3名を追加して試験を継続した.追加で登録した3名にDLTは認められなかったため, 20/27 mg/m2を第II相試験パートの用量とすることは可能と判断した. 第II相試験パートには33名が登録され,全被験者にONO-7057が投与された.第I相及び第II相試験パートにおいて,ONO-7057が投与された全被験者50名のうち32名(64.0%)が治験を中止した.中止理由の内訳は,「病勢進行のため」が20名(40.0%),「有害事象発現により継続困難と判断されたため」が6名(12.0%),「その他,治験責任医師が継続は適当でないと判断したため」が4名(8.0%),「治験中止の申し出があったため」が1名(2.0%),「用量制限毒性が発現したため」が1名(2.0%)であった. |
Phase 1 part enrolled 17 participants. All of them were treated with ONO-7057. In Cohort 1 (15 mg/m2), 1 of 3 participants enrolled first was not evaluable for DLT(dose-limiting toxicity). An additional 1 participant was enrolled into the cohort, and the 3 participants evaluable for DLT did not experience DLT. Then, Cohort 2 (20 mg/m2) was started. In Cohort 2, 1 of 3 participants enrolled first experienced DLT, but no further DLT was observed in 3 participants additionally added. As the number of participant who experienced DLT was only 1 of the 6 participants in the DLT evaluable population, Cohort 3 (20/27 mg/m2) was started. In Cohort 3, 1 of 3 participants enrolled first was not evaluable for DLT. An additional 1 participant was enrolled into the cohort, and the 3 participants evaluable for DLT did not experience DLT. The study was continued with an additional 3 participants enrolled in the cohort. No DLT was observed in the additional 3 participants; therefore, 20/27 mg/m2 was determined to be the dose usable in Phase 2 part. Phase 2 part enrolled 33 participants, all of whom were treated with ONO-7057. Of all the 50 participants treated with ONO-7057 across Phase 1 and 2 parts, 32 participants (64.0%) discontinued the study. The reasons of discontinuation were as follows: "Progressive disease" in 20 participants (40.0%), "Inability to continue further study procedures because of adverse event" in 6 participants (12.0%), "Other reasons leading to investigator's decision of being ineligible to continue further study procedures" in 4 participants (8.0%), "Request for discontinuation of the study" in 1 participants (2.0%), and "An onset of dose-limiting toxicity" in 1 participants (2.0%). |
/ | 第I相試験パート又は第II相試験パートでONO-7057を投与された全被験者50名のうち,有害事象は50名(100%)に認められ,そのうち副作用は47名(94.0%)に認められた.Grade 3以上の有害事象は44名(88.0%)に認められ,そのうちGrade 3以上の副作用は38名(76.0%)に認められた.第I相試験パートにおいてONO-7057を20/27 mg/m2の用量で投与された被験者7名及び第II相試験パートでONO-7057を投与された33名を含む20/27 mg/m2投与例40名のうち,有害事象は40名(100%),副作用は39名(97.5%),Grade 3以上の有害事象は37名(92.5%),Grade 3以上の副作用は34名(85.0%)に認められた. 治験薬投与期間中若しくは治験薬最終投与後30日以内に死亡した被験者は認められなかった.重篤な有害事象は全被験者で7名(14.0%),20/27 mg/m2投与例で5名(12.5%)に認められた.重篤な副作用は全被験者で5名(10.0%),20/27 mg/m2投与例で4名(10.0%)に認められた.有害事象により投与を中止した被験者は全被験者で8名(16.0%),20/27 mg/m2投与例で4名(10.0%)であった.副作用により投与を中止した被験者は全被験者で4名(8.0%),20/27 mg/m2投与例で3名(7.5%)であった. |
Of the 50 participants treated with ONO-7057 across Phase 1 part and Phase 2 part, 50 participants (100.0%) experienced adverse events, of whom 47 participants (94.0%) had adverse drug reactions. Grade >= 3 adverse events were observed in 44 participants (88.0%), of whom 38 participants (76.0%) had Grade >= 3 adverse drug reactions. A total of 40 participants receiving the 20/27 mg/m2 dose consists of the 7 participants treated with ONO-7057 at a dose of 20/27 mg/m2 in Phase 1 part and the 33 participants treated with ONO-7057 in Phase 2 part. Of them, 40 participants (100.0%) experienced adverse events as well as 39 participants (97.5%) with adverse drug reactions, 37 participants (92.5%) with Grade >= 3 adverse events, and 34 participants (85.0%) with Grade >= 3 adverse drug reactions. No participant died during the administration period of ONO-7057 or within 30 days after the final administration of ONO-7057. Serious adverse events occurred in 7 participants (14.0%) of all participants and in 5 participants (12.5%) of the participants receiving the 20/27 mg/m2 dose. Serious adverse drug reactions were observed in 5 participants (10.0%) of all participants and in 4 participants (10.0%) of the participants receiving the 20/27 mg/m2 dose. The treatment with ONO-7057 was discontinued due to adverse events in 8 participants (16.0%) of all participants and in 4 participants (10.0%) of the participants receiving the 20/27 mg/m2 dose. The treatment with ONO-7057 was discontinued due to adverse drug events in 4 participants (8.0%) of all participants and in 3 participants (7.5%) of the participants receiving the 20/27 mg/m2 dose. |
/ | ・全奏効率(ORR) International Myeloma Working Group(IMWG)によるORR(sCR(厳密な完全奏効), CR(完全奏効),VGPR(非常に良い部分奏効)又はPR(部分奏効)と判定された被験者の割合)は20.0%(10/50名)であった.第II相試験パートの主要評価項目である20/27 mg/m2投与例でのORRは22.5%(9/40名)であった.20/27 mg/m2投与例におけるORRは,閾値奏効率5%に対して,95%信頼区間の下限が上回った(95%信頼区間[12.3,37.5])ことから,再発又は難治性の多発性骨髄腫患者に対してONO-7057が有効であることが示された. |
- Overall response rate (ORR) The ORR (the proportion of participants with a best response of stringent complete response [sCR], complete response [CR], very good partial response [VGPR], or partial response [PR]) according to the International Myeloma Working Group (IMWG) was 20.0% (10/50 participants). The ORR according to IMWG in the participants receiving the 20/27 mg/m2 dose, the primary endpoint of Phase 2 part, was 22.5% (9/40 participants). In the participants receiving the 20/27 mg/m2 dose, the lower limit of the 95% confidence interval (95% CI [12.3, 37.5]) of the ORR exceeded the threshold response rate of 5.0%, showing ONO-7057 effective for patients (pts) with relapsed and/or refractory multiple myeloma (RRMM). |
副次的評価項目の解析結果 / Secondary Outcome Measures | ・最良抗腫瘍効果 IMWGによる最良抗腫瘍効果は,全被験者ではVGPRが2名(4.0%),PRが8名(16.0%),SD(安定)が22名(44.0%),20/27 mg/m2投与例ではVGPRが2名(5.0%),PRが7名(17.5%),SDが18名(45.0%)であった.European Group for Blood and Marrow Transplantation(EBMT)による最良抗腫瘍効果は,全被験者ではPRが9名(18.0%),MR(最少奏効)が4名(8.0%),NC(不変)が27名(54.0%),20/27 mg/m2投与例ではPRが8名(20.0%),MRが2名(5.0%),NCが23名(57.5%)であった. ・臨床的有用率(CBR) CBR(sCR,CR,VGPR,PR又はMRと判定された被験者の割合)は,全被験者では28.0%(14/50名,95%信頼区間[17.5,41.7]),20/27 mg/m2投与例では27.5%(11/40名,95%信頼区間[16.1,42.8])であった. ・病勢コントロール率(DCR) DCR(sCR,CR,VGPR,PR,MR,又は8週以上持続するSDと判定された被験者の割合)は,全被験者では48.0%(24/50名,95%信頼区間[34.8,61.5]),20/27 mg/m2投与例では52.5%(21/40名,95%信頼区間[37.5,67.1])であった. ・無増悪生存期間(PFS) Kaplan-Meier法を用いて推定したPFSの中央値は,全被験者では156.0日(95%信頼区間[85.0,212.0]),20/27 mg/m2投与例では156.0日(95%信頼区間[85.0,212.0])であった. ・全生存期間(OS) Kaplan-Meier法を用いて推定したOSの中央値は,全被験者では710.0日(95%信頼区間[312.0, - ])であり,20/27 mg/m2投与例では中央値は未達であった. ・無増悪期間(TTP) Kaplan-Meier法を用いて推定したTTPの中央値は,全被験者では156.0日(95%信頼区間[85.0,212.0]),20/27 mg/m2投与例では156.0日(95%信頼区間[85.0,212.0])であった. ・奏効期間(DOR) Kaplan-Meier法を用いて推定したDORの中央値は,全被験者では288.0日(95%信頼区間[71.0,288.0])であり,20/27 mg/m2投与例では中央値は未達であった. ・薬物動態の結果 血漿中ONO-7057濃度は静脈内投与後速やかに低下し,T1/2は0.424~0.706時間であった.CL及びVssはいずれの投与量においても同程度であった.1日目と16日目の薬物動態パラメータは同程度の値であり,反復投与による蓄積は認められなかった. 各薬物動態パラメータの1日目及び16日目の傾き(β)の95%信頼区間は1を含んだ.各薬物動態パラメータの1日目と16日目の併合データの傾き(β)の95%信頼区間は1を含んでおり,薬物動態パラメータは15~27 mg/m2の範囲において用量に比例して増加した. 投与終了直前の血漿中ONO-7057濃度はサイクル間で大きな差異は認められず,ONO-7057の薬物動態はサイクルを経ることによる影響を受けないと考えられた. ・薬力学の結果 末梢血単核球細胞のプロテアソーム活性は,治験薬のいずれの用量においても,第1サイクル1日目,2日目,8日目及び第2サイクル1日目の投与1時間後に抑制され,その阻害率の中央値は80%以上であった.また,第1サイクル2日目,8日目及び第2サイクル1日目の治験薬投与前のプロテアソーム活性の阻害率は,総じて直近の治験薬投与後の阻害率に比べて低値であった. 全血のプロテアソーム活性は,治験薬のいずれの用量においても,第1サイクル1日目,2日目,8日目及び第2サイクル1日目の投与1時間後に抑制され,その阻害率の中央値は80%以上であった.また,第2サイクル1日目の治験薬投与前のプロテアソーム活性の阻害率は,やや回復したが(阻害率70%以上),第1サイクルの2日目及び8日目の投与前のプロテアソーム活性の阻害率の中央値は80%以上であった. | - Best overall response The best overall response according to the IMWG was VGPR in 2 participants (4.0%), PR in 8 participants (16.0%), and stable disease (SD) in 22 participants (44.0%) of all participants; was VGPR in 2 participants (5.0%), PR in 7 participants (17.5%), and SD in 18 participants (45.0%) of the participants receiving the 20/27 mg/m2 dose. The best overall response according to the European Group for Blood and Marrow Transplantation (EBMT) was PR in 9 participants (18.0%), minimal response (MR) in 4 participants (8.0%), and no change (NC) in 27 participants (54.0%) of all participants; was PR in 8 participants (20.0%), MR in 2 participants (5.0%), and NC in 23 participants (57.5%) of the participants receiving the 20/27 mg/m2 dose. - Clinical benefit rate (CBR) The CBR (the proportion of participants with a best response of sCR, CR, VGPR, PR, or MR) was 28.0% in all participants (14/50 participants, 95% CI [17.5, 41.7]) and 27.5% in the participants receiving the 20/27 mg/m2 dose (11/40 participants, 95% CI [16.1, 42.8]). - Disease control rate (DCR) The DCR (the proportion of participants with a best response of sCR, CR, VGPR, PR, MR, or >= 8 weeks lasting SD) was 48.0% in all participants (24/50 participants, 95% CI [34.8, 61.5]) and 52.5% in the participants receiving the 20/27 mg/m2 dose (21/40 participants, 95% CI [37.5, 67.1]). - Progression-free survival (PFS) The Kaplan-Meier estimate of median PFS was 156.0 days (95% CI [85.0, 212.0]) in all participants and 156.0 days (95% CI [85.0, 212.0]) in the participants receiving the 20/27 mg/m2 dose. - Overall survival (OS) The Kaplan-Meier estimate of median OS was 710.0 days (95% CI [312.0, -]) in all participants and the median OS was not reached in the participants receiving the 20/27 mg/m2 dose. - Time to progression (TTP) The Kaplan-Meier estimate of median TTP was 156.0 days (95% CI [85.0, 212.0]) in all participants and 156.0 days (95% CI [85.0, 212.0]) in the participants receiving the 20/27 mg/m2 dose. - Duration of response (DOR) The Kaplan-Meier estimate of median DOR was 288.0 days (95% CI [71.0, 288.0]) in all participants and the median DOR was not reached in the participants receiving the 20/27 mg/m2 dose. - Results of pharmacokinetics (PK) The plasma ONO-7057 concentration showed a rapid decrease after intravenous administration with terminal half-lives (T1/2) of 0.424-0.706 h. The clearance (CL) and volume of distribution at steady state (Vss) were similar over the dose range. The PK parameters were similar on Days 1 and 16. No accumulation with multiple doses was observed. The 95% CI of the slope (beta) of each PK parameter included the value 1 on Days 1 and 16. The 95% CI of the slope (beta) of the pooled data of each PK parameter on Days 1 and 16 included the value 1, and the PK parameters increased in a dose-dependent manner in the dose range of 15-27 mg/m2. There was no major difference in plasma ONO-7057 concentration just before the end of administration between cycles, therefore, the PK of ONO-7057 was not considered to be affected by an increase in number of cycle. - Results of pharmacodynamics (PD) The proteasome activities in peripheral blood mononuclear cells for all dosing levels of ONO-7057 were reduced 1 h after administration on Days 1, 2, and 8 of Cycle 1 and on Day 1 of Cycle 2 with the median inhibition of >= 80%. Furthermore, the inhibitions of proteasome activities before the administration on Days 2 and 8 of Cycle 1 and Day 1 of Cycle 2 were generally lower than the latest inhibitions after the administration. The proteasome activities in whole blood for all dosing levels of ONO-7057 were reduced 1 h after administration on Days 1, 2, and 8 of Cycle 1 and on Day 1 of Cycle 2 with the median inhibition of >= 80%. Although the inhibition of proteasome activities before the administration on Day 1 of Cycle 2 slightly recovered (>= 70% inhibition), the median inhibition of proteasome activities before the administration of Days 2 and 8 of Cycle 1 was >= 80%. |
/ | 本試験と海外第II相試験(PX-171-003-A1:非日本人の再発又は難治性の多発性骨髄腫患者に28日間を1サイクルとし,1,2,8,9,15及び16日目にONO-7057単剤を第1サイクルは20 mg/m2の用量で,第2サイクルは27 mg/m2の用量で2~10分かけて静脈内投与)の結果を比較した結果,日本人と非日本人の間で有効性,安全性プロファイルに大きな差異はないと考えられた. 以上より,再発又は難治性の多発性骨髄腫患者に対するONO-7057の20/27 mg/m2までの忍容性,安全性,有効性,薬物動態及び薬力学的パラメータが確認され,ONO-7057は当該患者に対して有効であると考えられた. |
Comparison of the study with an overseas phase 2 study (PX-171-003-A1: ONO-7057 alone IV for 2-10 min at 20 mg/m2 dose in Cycle 1 and 27 mg/m2 in Cycle 2 on Days 1, 2, 8, 9, 15 and 16 of each 28-day cycle in non-Japanese pts with RRMM) showed no major difference in efficacy and safety profile between Japanese and non-Japanese. In conclusion, tolerability, safety, efficacy, PK and PD parameters of ONO-7057 at up to 20/27 mg/m2 dose were verified in RRMM pts and ONO-7057 was considered effective for such pts. |
出版物の掲載 / Posting of iournal publication | 有 | presence |
2016年01月05日 | ||
https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.13900 |
/ | 有 | Yes |
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/ | https://www.ono.co.jp/company/policies/clinical_trial_data_transparency_policy.html | https://www.ono-pharma.com/company/policies/clinical_trial_data_transparency_policy.html |
研究の種別 | 保留 |
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登録日 | 2021年11月24日 |
jRCT番号 | jRCT2080221530 |
再発又は難治性の多発性骨髄腫患者を対象としたONO-7057の第1/2相試験(ONO-7057-01) | A Phase 1/2 study of ONO-7057 in patients with relapsed and/or refractory multiple myeloma (ONO-7057-01) | ||
ONO-7057 第1/2相試験(ONO-7057-01) | Phase 1/2 study of ONO-7057 (ONO-7057-01) |
小野薬品工業株式会社 | ONO PHARMACEUTICAL CO.,LTD. | ||
開発本部 | Development Headquarters | ||
clinical_trial@ono.co.jp |
小野薬品工業株式会社 | ONO PHARMACEUTICAL CO.,LTD. | ||
くすり相談室 | Medical Information Center | ||
0120-626-190(受付時間:土・日・祝日を除く9:00−17:00) | |||
clinical_trial@ono.co.jp |
2011年08月03日 |
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再発又は難治性の多発性骨髄腫患者を対象に、ONO-7057の有効性、安全性、薬物動態及び薬力学を検討する。 | The objective of the study is to investigate the efficacy, safety, pharmacokinetics and pharmacodynamics of ONO-7057 in patients with relapsed and/or refractory multiple myeloma. | ||
1-2 | 1-2 | ||
2011年09月22日 | |||
2011年08月01日 | |||
2017年06月01日 | |||
42 | |||
介入研究 | Interventional | ||
非盲検試験 |
An open-label study |
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治療 |
treatment purpose |
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/ | 日本 | Japan | |
/ | 1. 20歳以上 |
1. 20 years or older of age |
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/ | 1. ワルデンストレーム・マクログロブリン血症又はIgM型骨髄腫を有する患者 |
1. Waldenstrom's macroglobulinemia or IgM myeloma |
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/ | 20歳以上 |
20age old over |
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/ | 上限なし |
No limit |
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/ | 男性・女性 |
Both |
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/ | 再発又は難治性の多発性骨髄腫 | Relapsed and/or refractory multiple myeloma | |
/ | |||
/ | 試験対象薬剤等 一般的名称等:ONO-7057 薬剤・試験薬剤:carfilzomib 薬効分類コード:429 その他の腫瘍用薬 用法・用量、使用方法:静脈内投与 対象薬剤等 一般的名称等:- 薬剤・試験薬剤:- 薬効分類コード: 用法・用量、使用方法:- |
investigational material(s) Generic name etc : ONO-7057 INN of investigational material : carfilzomib Therapeutic category code : 429 Other antitumor agents Dosage and Administration for Investigational material : Intravenous administration control material(s) Generic name etc : - INN of investigational material : - Therapeutic category code : Dosage and Administration for Investigational material : - |
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/ | 安全性 有効性 薬物動態 薬力学 安全性,有効性,薬物動態,薬力学 |
safety efficacy pharmacokinetics pharmacodynamics Safety, efficacy, pharmacokinetics and pharmacodynamics |
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/ | - | - |
医薬品 | medicine | |||
ONO-7057 | ONO-7057 | |||
carfilzomib | carfilzomib | |||
429 その他の腫瘍用薬 | 429 Other antitumor agents | |||
静脈内投与 | Intravenous administration | |||
- | - | |||
- | - | |||
- | - |
参加募集終了 | completed | |
/ | 試験完了 |
completed |
小野薬品工業株式会社 | ||
ONO PHARMACEUTICAL CO.,LTD. |
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- | - | |
- | - |
- | - | |
- | - | |
承認 | approved |
無 | absence | |
JapicCTI-111570 | ||
設定されていません |
||
設定されていません |
設定されていません |
設定されていません |
||
設定されていません |
|||
設定されていません |