Standard of Care vs. Bortezomib in Graft-Versus Host Disease After Hematopoietic Stem Cell Transplant
Status:
Completed
Trial end date:
2016-11-01
Target enrollment:
Participant gender:
Summary
This research study is a Phase II clinical trial. Phase II clinical trials test the
effectiveness of an investigational drug to learn whether the drug works in treating a
specific cancer. "Investigational" means that the drug is still being studied and that
research doctors are trying to find out more about it-such as the safest dose to use, the
side effects it may cause, and if the drug is effective for treating different types of
cancer. It also means that the FDA has not yet approved bortezomib to treat or prevent
graft-versus-host disease. Bortezomib is approved by the FDA to treat other human
malignancies.
Bortezomib is a drug that has an anti-cancer effect that involves inhibiting cell growth and
causing cell death. This drug has been used in other research studies, and information from
thos other research studies suggests that bortezomib may help to lower the risk of GVHD after
allogeneic stem cell transplantation in patients who have matched unrelated, unmatched
related or unrelated donors in this research study.
Allogeneic stem cell transplantation is a procedure in which selected blood cells taken from
your sibling or unrelated donor are given to you. Lower doses of chemotherapy drugs are given
before the donor cells are infused in a process known as reduced-intensity conditioning. Stem
cell transplant destroys cancer in two ways: The conditioning regimen destroys cancer cells
and teh immune cells from the donor can recognize cancer cells and kill them.
A common problem after stem cell transplant is graft-versus-host disease (GVHD). The word
"graft" refers to the donor blood cells that you will receive during your transplant. The
word "host" refers to the person (in this case, you) receiving the cells. GVHD is a
complication of transplantation where the donor graft attacks and damages some of your
tissues. GVHD can cause skin rash, intestinal problems such as nausea, vomiting or diarrhea.
GVHD may also damage your liver and cause hepatitis or jaundice. GVHD may also increase your
risk of infection.
After stem cell transplant, all patients receive prophylactic medications against GVHD. In
this research study we are studying the safety and effectiveness of preventing GVHD using
bortezomib treatment in combination with other drugs versus standard of care prophylaxis
(tacrolimus + methotrexate). If you take part in this study, there is a 33% chance you will
receive any one of the following GVHD prevention treatments:
- tacrolimus + methotrexate (standard of care GVHD prophylaxis)
- bortezomib + tacrolimus + methotrexate
- bortezomib + sirolimus + tacrolimus Sirolimus, tacrolimus and methotrexate are drugs
that suppress the immune system to try to prevent GVHD.