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EvAluation of the efficacy of MaaT013 as salvage theRapy in acute GVHD patiEntS with gastrointestinal involvement, refractory to ruxolitinib; a multi-center open-label phase III trial.
EU CTIS ID: 2024-513023-17-00
What this study is testing
To evaluate the efficacy of MaaT013 assessed by the overall response rate (ORR) of gastrointestinal (GI) acute graft-versus-host disease (aGVHD) response at day 28 (D28).
- Therapeutic confirmatory (Phase III)
A plain-language read of the study's public EU CTIS listing. The study team confirms the details.
Who can take part
You may be able to join if
- Age ≥ 18 years old
- Allo-HSCT with any type of donor, stem cell source, GvHD prophylaxis or conditioning regimen.
- Acute GvHD episode with GI involvement per MAGIC guidelines (= grades II to IV), with or without involvement of other organs (Harris et al. 2016).
- Patients resistant to steroids AND either resistant to OR with intolerance to ruxolitinib (intolerant patients: who had grade 3 or higher treatment-emergent and ruxolitinib-attributed adverse event that did not resolve within 7 days of discontinuing ruxolitinib): Resistance to steroids is defined as any of the following: - Lack of improvement (i.e., no decrease in stage in at least 1 involved organ system) after ≥ 5 days of treatment with CS at 2mg/kg/d methylprednisolone equivalent dose, - Progression (i.e., increase in any organ system or any new organ involvement) after ≥ 3 days of treatment with CS at 2 mg/kg/d methylprednisolone equivalent dose, - Patients treated with 1 mg/kg/d of CS because the physician deemed they would not tolerate 2 mg/kg/d and who correspond to the definition of SR patients, - Patients who previously began CS therapy at a lower dose (at least 1 mg/kg/d methylprednisolone equivalent) for skin or upper GI GvHD but develop new GvHD in another organ system, - Patients who cannot tolerate corticosteroid tapering, i.e., begin of CS at 2.0 mg/kg/d, demonstrate response, but show disease progress before a 50% decrease from the initial starting dose of CS is achieved. Resistance to ruxolitinib is defined as any of the following (Mohty et al. 2020): - Progression of GvHD compared to baseline after at least 5 days of treatment with ruxolitinib, based either on objective increase in stage/grade, or new organ involvement; - Lack of improvement in GvHD (partial response or better) compared to baseline after at least 14 days of treatment with ruxolitinib; - Loss of response, defined as objective worsening of GvHD determined by increase in stage, grade or new organ involvement at any time after initial improvement - Absence of complete response or very good partial response at day 28 after ruxolitinib Intolerance to ruxolitinib is defined as: - GvHD manifestations that persist without improvement in patients who had grade 3 or higher treatment-emergent and ruxolitinib-attributed adverse event that did not resolve within 7 days of discontinuing ruxolitinib.
- Signature of informed and written consent by the subject or by the subject’s legally acceptable representative for patients under guardianship or trusteeship.
You likely can't join if
- Patients with known hypersensitivity to vancomycin or to any of the excipients listed in the corresponding SmPC
- Absolute neutrophil count <500/μL, confirmed within 3 days prior to pre-treatment start. Use of growth factor supplementation is allowed.
- Absolute platelet count < 10 000/μL, confirmed within 3 days prior to pre-treatment start. Use of platelet infusion is allowed.
- Patient with negative IgG EBV serology.
- Current or past (< 6 months) evidence of toxic megacolon, bowel obstruction or gastrointestinal perforation.
- Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the subject; or interfere with interpretation of study data.
See the full eligibility criteria
Who can join
- Age ≥ 18 years old
- Allo-HSCT with any type of donor, stem cell source, GvHD prophylaxis or conditioning regimen.
- Acute GvHD episode with GI involvement per MAGIC guidelines (= grades II to IV), with or without involvement of other organs (Harris et al. 2016).
- Patients resistant to steroids AND either resistant to OR with intolerance to ruxolitinib (intolerant patients: who had grade 3 or higher treatment-emergent and ruxolitinib-attributed adverse event that did not resolve within 7 days of discontinuing ruxolitinib): Resistance to steroids is defined as any of the following: - Lack of improvement (i.e., no decrease in stage in at least 1 involved organ system) after ≥ 5 days of treatment with CS at 2mg/kg/d methylprednisolone equivalent dose, - Progression (i.e., increase in any organ system or any new organ involvement) after ≥ 3 days of treatment with CS at 2 mg/kg/d methylprednisolone equivalent dose, - Patients treated with 1 mg/kg/d of CS because the physician deemed they would not tolerate 2 mg/kg/d and who correspond to the definition of SR patients, - Patients who previously began CS therapy at a lower dose (at least 1 mg/kg/d methylprednisolone equivalent) for skin or upper GI GvHD but develop new GvHD in another organ system, - Patients who cannot tolerate corticosteroid tapering, i.e., begin of CS at 2.0 mg/kg/d, demonstrate response, but show disease progress before a 50% decrease from the initial starting dose of CS is achieved. Resistance to ruxolitinib is defined as any of the following (Mohty et al. 2020): - Progression of GvHD compared to baseline after at least 5 days of treatment with ruxolitinib, based either on objective increase in stage/grade, or new organ involvement; - Lack of improvement in GvHD (partial response or better) compared to baseline after at least 14 days of treatment with ruxolitinib; - Loss of response, defined as objective worsening of GvHD determined by increase in stage, grade or new organ involvement at any time after initial improvement - Absence of complete response or very good partial response at day 28 after ruxolitinib Intolerance to ruxolitinib is defined as: - GvHD manifestations that persist without improvement in patients who had grade 3 or higher treatment-emergent and ruxolitinib-attributed adverse event that did not resolve within 7 days of discontinuing ruxolitinib.
- Signature of informed and written consent by the subject or by the subject’s legally acceptable representative for patients under guardianship or trusteeship.
What rules you out
- Patients with known hypersensitivity to vancomycin or to any of the excipients listed in the corresponding SmPC
- Absolute neutrophil count <500/μL, confirmed within 3 days prior to pre-treatment start. Use of growth factor supplementation is allowed.
- Absolute platelet count < 10 000/μL, confirmed within 3 days prior to pre-treatment start. Use of platelet infusion is allowed.
- Patient with negative IgG EBV serology.
- Current or past (< 6 months) evidence of toxic megacolon, bowel obstruction or gastrointestinal perforation.
- Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the subject; or interfere with interpretation of study data.
- Known allergy or intolerance to trehalose or maltodextrin.
- Vulnerable patients such as: minors, persons deprived of liberty, persons in Intensive Care Unit unable to provide informed consent prior to the intervention.
- Females of childbearing potential should have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study medication.
- Breastfeeding females. Females of childbearing potential should be willing to use an acceptable method of birth control such as hormonal contraception (progestogen-only may be sufficient), male or female condom with or without spermicide, cap, diaphragm or sponge with spermicide for the course of the study. A combination of male condom with either cap, diaphragm or sponge with spermicide (double barrier methods) are also considered acceptable. Females of childbearing potential are those who have not been surgically sterilized or have not been free from menses for >1 year.
- Other ongoing interventional protocol that might interfere with the current study’s primary endpoint.
- Patients with active CMV colitis
- Patients who had previously received other lines of systemic aGvHD treatment other than CS and ruxolitinib.
- Grade II-IV hyper-acute GvHD as defined by the MD Anderson’s criteria (Saliba et al. 2007) (aGvHD onset within 14 days after allo-HSCT)
- Overlap chronic GvHD as defined by the NIH Consensus Criteria (Jagasia et al. 2015)
- Relapsed/persistent malignancy requiring rapid immune suppression withdrawal
- Active uncontrolled infection according to the attending physician
- Severe organ dysfunction unrelated to underlying GvHD, including: - Cholestatic disorders or unresolved veno-occlusive disease of the liver (defined as persistent bilirubin abnormalities not attributable to GvHD and ongoing organ dysfunction, with the exception of Gilbert syndrome). - Clinically significant or uncontrolled cardiac disease including unstable angina, acute myocardial infarction within 6 months before Day 1 of study drug administration, New York Heart Association Class III or IV congestive heart failure, circulatory collapse requiring vasopressor or inotropic support that requires therapy. - Clinically significant respiratory disease that requires mechanical ventilation support or 50% oxygen.
- Current or past (< 6 months) veno-occlusive disease or other uncontrolled complication unless otherwise agreed in writing by the sponsor.
The study team makes the final eligibility decision.
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 65+ years, 18-64 years. The study team makes the final eligibility decision.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.