Clinical trial NCT03749252: Pharmacokinetics, Safety and Efficacy of P03277 in Pediatric Patients Undergoing Central Nervous System Contrast-enhanced MRI
Official title: Pharmacokinetics, Safety and Efficacy of a New Gadolinium-based Contrast Agent, P03277, in Pediatric Patients From 2 to 17 Years of Age Undergoing Central Nervous System Contrast-enhanced MRI
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Central Nervous System Indication
Pediatric Patients
Body Indication
Lead sponsor: Guerbet
Sponsor class: INDUSTRY
First posted: 2018-11-21
Enrollment: 80
Sex: ALL
Minimum age (years): 2
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: DIAGNOSTIC

Brief summary: This is a pharmacokinetics (PK), open-label, uncontrolled, multicenter phase II trial with age-staggered approach.

The primary objective is to evaluate the PK profile of gadopiclenol in plasma following single IV injection of 0.05 mmol/kg body weight (BW) in pediatric population aged from 2 to 17 years undergoing CNS contrast-enhanced MRI (CNS cohort).

Detailed description: A population PK approach and an age-down staggered approach will be used. Patients will be recruited into 3 predefined age groups: 12-17, 7-11 and 2-6 years. The inclusions will start with the older group (Adolescents, 12-17 years), followed by Preadolescents (7-11 years) and finally Young Children (2-6 years of age).

Eligibility criteria: Inclusion Criteria:

To be included in the study, the patient had to meet all the following criteria:

1. Female or male pediatric patient aged 2 to 17 years,
2. Patient with known or suspected lesion(s) scheduled to undergo routine contrast-enhanced MRI of CNS or of other organs including at least one organ among head and neck, thorax, abdomen, pelvis or musculoskeletal system (including extremities),
3. Patient whose parent(s) or legal guardian having read the information, provided their consent to patient's participation in writing by dating and signing the informed consent prior to any trial related procedure being conducted,
4. Patient with capacity of understanding who received age- and maturity-appropriate information and provided his/her assent to participate in the trial (as required by national regulations),
5. Patient affiliated to national health insurance according to local regulatory requirements.

Non-inclusion Criteria:

Patients could not be included in the study if they presented with one or more of the following non-inclusion criteria:

1. Patient planned for treatment or procedure (e.g., surgery) that would prevent obtaining the required blood samples or performing other trial procedures between the screening visit and up to 1 day after gadopiclenol administration,
2. Patient undergoing treatment or procedure (e.g., diuretics, clinically significant blood loss or blood transfusion) preceding or subsequent to gadopiclenol administration that would alter gadopiclenol PK parameters,
3. Patient with acute or chronic renal insufficiency defined as estimated Glomerular Filtration Rate (eGFR) out of age-adjusted normal ranges (eGFR calculated with bedside Schwartz equation),
4. Patients referred for MR Angiography,
5. Patient with history of bleeding disorder,
6. Patient with known severe liver disease,
7. Patient with known cardiac disease (e.g., heart rhythm anomalies, long QT syndrome),
8. Patient with any clinically significant abnormal 12-lead ECG that in the Investigator's opinion would affect the safety evaluation or place the patient at risk,
9. Patient with electrolyte or fluid imbalance that at Investigator's judgment presents undue risk assessed within 1 month prior to gadopiclenol administration,
10. Patient undergoing a change in chemotherapy within 1 day prior to or 1 day after gadopiclenol administration,
11. Patient who received any other contrast agent for CT and/or MRI within 1 week prior to or 1 week after gadopiclenol administration,
12. Patient with contraindication for MRI such as iron metal implants (e.g., aneurysm clips, pacemaker),
13. Patient with history of anaphylactoid or anaphylactic reaction to any allergen including drugs,
14. Patient with history of hypersensitivity caused by any contrast media / agents (iodinated or gadolinium-based),
15. Patient with known contraindication(s) to the use of any GBCA,
16. Pregnant or breast-feeding female patient (female patient with childbearing potential \[who experienced menarche\] must have a negative urine pregnancy test within 24 hours prior to gadopiclenol administration and must be using medically approved contraception\* if sexually active),
17. Patient with anticipated, current or past condition (medical, psychological, social or geographical) that would compromise the patient's safety or her/his ability to participate to the whole trial,
18. Patient unlikely to comply with the protocol, e.g., uncooperative attitude of parent(s) or legal guardian, inability to return for follow-up visits and unlikelihood of completing the trial,
19. Having participated in a clinical trial and having received any investigational product within 7 days prior to gadopiclenol administration or planned during the trial,
20. Patient previously included in this trial,
21. Patient related to the Investigator or any other trial staff or relative directly involved in the trial conduct.

    * medically approved contraception methods include: female sterilization, use of oral, injected or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy (failure rate \<1%), for example hormone vaginal ring or transdermal hormone contraception, placement of an Intrauterine Device (IUD) or Intrauterine System (IUS), barrier methods of contraception (condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/ vaginal suppository).

Primary outcomes:
measure: Elimination Half-life
timeFrame: 4 blood samples per patient were taken post-injection for PK analysis, one within each window: 1 min to 20 min, 30 min to 45 min, 2 to 3 hours and 7 to 8 hours
measure: Total Clearance
timeFrame: 4 blood samples per patient were taken post-injection for PK analysis, one within each window: 1 min to 20 min, 30 min to 45 min, 2 to 3 hours and 7 to 8 hours
measure: Central Volume of Distribution
timeFrame: 4 blood samples per patient were taken post-injection for PK analysis, one within each window: 1 min to 20 min, 30 min to 45 min, 2 to 3 hours and 7 to 8 hours
measure: Peripheral Volume of Distribution
timeFrame: 4 blood samples per patient were taken post-injection for PK analysis, one within each window: 1 min to 20 min, 30 min to 45 min, 2 to 3 hours and 7 to 8 hours
measure: Area Under the Curve
timeFrame: 4 blood samples per patient were taken post-injection for PK analysis, one within each window: 1 min to 20 min, 30 min to 45 min, 2 to 3 hours and 7 to 8 hours
measure: Simulated Concentrations 10 Minutes Post-injection
timeFrame: 10 minutes post-injection
measure: Simulated Concentrations 20 Minutes Post-injection
timeFrame: 20 minutes post-injection
measure: Simulated Concentrations 30 Minutes Post-injection
timeFrame: 30 minutes post-injection
Secondary outcomes:
Other outcomes:
Locations:
city: Plovdiv
country: Bulgaria
facility: MHAT Central Onco Hospital Ltd
city: Sofia
country: Bulgaria
facility: Acibadem City Clinic Tokuda Hospital
city: Stara Zagora
country: Bulgaria
facility: MHAT Dr. Stoyan Kirkovich
city: Budapest
country: Hungary
facility: Semmelweis Egyetem II. sz Gyermekgyogyaszati Klinika
city: Eger
country: Hungary
facility: Markhot Ferenc Oktatokorhaz es Rendelointezet
city: Miskolc
country: Hungary
facility: B.-A.-Z. Megyei Korhaz Gyermek-Egeszsegugyi Kozpont
city: Bydgoszcz
country: Poland
facility: Szpital Uniwersytecki nr 1 w Bydgoszczy im. dr Jurasza, Oddział Kliniczny Chirurgii Ogólnej i Onkologicznej Dzieci i Młodzieży
city: Lublin
country: Poland
facility: Uniwersytecki Szpital Dziecięcy w Lublinie
city: Rzeszów
country: Poland
facility: Klinika Chirurgii Dziecięcej
city: Warsaw
country: Poland
facility: Instytut "Pomnik -Centrum Zdrowia Dziecka"
city: Warsaw
country: Poland
facility: Zakład Radiologii PediatrycznejSamodzielny Publ. Dziecięcy Szp. Kliniczny w Warszawie
city: Łódź
country: Poland
facility: Instytut Centrum Zdrowia Matki Polki
city: Banská Bystrica
country: Slovakia
facility: II. Detská klinika SZU, Detská fakultná nemocnica s poliklinikou Banská Bystrica
city: Martin
country: Slovakia
facility: Klinika detí a dorastu JLF UK a UNM, Univerzitná nemocnica Martin
city: Nitra
country: Slovakia
facility: Faculty hospital Nitra, Clinic of neonates, children and adolescents
city: Dnipro
country: Ukraine
facility: Children's City Clinical Hospital
Study officials:
affiliation: Instytut Pomnik
name: Elżbieta Jurkiewicz, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Jurkiewicz E, Tsvetkova S, Grinberg A, Pasquiers B. Pharmacokinetics, Safety, and Efficacy of Gadopiclenol in Pediatric Patients Aged 2 to 17 Years. Invest Radiol. 2022 Aug 1;57(8):510-516. doi: 10.1097/RLI.0000000000000865. Epub 2022 Mar 2.