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CTRI Number  CTRI/2022/06/043430 [Registered on: 22/06/2022] Trial Registered Prospectively
Last Modified On: 07/10/2023
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Biological 
Study Design  Other 
Public Title of Study   The Study will be conducted in Paediatric Patients Under 6 Years of Age with Rhabdomyosarcoma or Wilms’ Tumour on Myelosuppressive Chemotherapy Regimen by giving Pegfilgrastim PFS Against Neupogen® Injection. 
Scientific Title of Study   A Randomized, Active-Controlled, Multicenter, Open label, Two Arm Study to Assess Safety, Efficacy, Pharmacodynamics, and Pharmacokinetics with Pegfilgrastim PFS of Intas Pharmaceutical Limited Compared with Neupogen® Injection in Paediatric Patients Under 6 years of Age with Rhabdomyosarcoma or Wilms’ Tumour on Myelosuppressive Chemotherapy (CmT) Regimen 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
0298-21, Version 2.0 dated 25 August 2021  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Prashant Modi 
Designation  Sr. General Manager 
Affiliation  Lambda Therapeutic Research Ltd. 
Address  Lambda house, Plot No. 38, Survey no. 388, Near Silver Oak Club,S.G. Highway, Gota,

Ahmadabad
GUJARAT
382481
India 
Phone  07940202375  
Fax  07940202021  
Email  prashantmodi@lambda-cro.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Naman Shah 
Designation  Sr. General Manager 
Affiliation  Lambda Therapeutic Research Ltd. 
Address  Lambda house, Plot No. 38, Survey no. 388, Near Silver Oak Club, S.G. Highway, Gota,

Ahmadabad
GUJARAT
382481
India 
Phone  07940202389  
Fax  07940202021  
Email  namanshah@lambda-cro.com  
 
Details of Contact Person
Public Query
 
Name  Prashant Modi 
Designation  Sr. General Manager 
Affiliation  Lambda Therapeutic Research Ltd. 
Address  Lambda House, Plot No. 38, Survey no. 388, Near Silver Oak Club, S. G. Highway, Gota,

Ahmadabad
GUJARAT
382481
India 
Phone  07940202214  
Fax  07940202021  
Email  prashantmodi@lambda-cro.com  
 
Source of Monetary or Material Support  
Intas Pharmaceuticals Limited India,Corporate House, Nr. Sola Bridge, S. G. Highway,Thaltej, Ahmedabad – 380054. Gujarat, India 
 
Primary Sponsor  
Name  Intas Pharmaceuticals Limited India 
Address  Corporate House,Nr. Sola Bridge, S. G. Highway, Thaltej,Ahmedabad – 380 054. Gujarat, India 
Type of Sponsor  Pharmaceutical industry-Indian 
 
Details of Secondary Sponsor  
Name  Address 
NA  NA 
 
Countries of Recruitment     India  
Sites of Study
Modification(s)  
No of Sites = 14  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Shailesh Kanvinde  Deenanath Mangeshkar Hospital  Department of Clinical Research, Room No. NA, Deenanath Mangeshkar Hospital and Research centre, Erandwane, Pune-411004.
Pune
MAHARASHTRA 
8087004425

skanvin@gmail.com 
Dr Anupam Sachdeva  Department of Pediatrics, Sir Ganga Ram Hospital  Department of Clinical Research, Room No. NA, Sir Ganga Ram Hospital, Sir Ganga Ram Hospital marg, Rajinder nagar, New Delhi, Delhi 110060, India.
New Delhi
DELHI 
9811043476

anupamace@yahoo.co.in 
Prof Sameer Bakhshi  Dr. BRA IRCH, AIIMS, New Delhi  Department of medical oncology, DR BRA IRCH, NEW DELHI
Central
DELHI 
9958828763

sambakh@hotmail.com 
Dr Vikramjit S Kanwar  HBCH Varanasi  Homi Bhabha cancer Hospital, Ghanti Mill road, Lahartara, Varanasi UP 2201005
Varanasi
UTTAR PRADESH 
7355635969

vikramjit.kanwar@gmail.com 
Dr Harsha Prasad L  Kasturba Medical college Hospital  Kasturba medical college Hospital, NG Road, Attavar, Mangalore-575001, Karnataka, India
Bangalore
KARNATAKA 
9480157864

drlhprasad@yahoo.com 
Dr Anshul Agrawal  Kiran Hospital Multisuper speciality hospital & research Centre  Department of Clinical Research,Room No. NA, Kiran Hospital Multisuper speciality hospital & research Centre, Near Sumul Dairy, Surat-395004,India
Surat
GUJARAT 
9824196710

anshul.onco@gmail.com 
DrRajani Priya Yedla  Mahatma Gandhi Cancer Hospital & research Institute, Andra Pradesh, India  Department of Clinical Research, Room No. NA, 1/7 MVP colony,Visakhapatnam-530017, Andra Pradesh, India.
Visakhapatnam
ANDHRA PRADESH 
9824389004

drrajnipriya@gmail.com 
Dr Ramandeep Singh Arora  Max Super speciality Hospital, Saket  Max Super speciality Hospital, saket(east block) A unit of Devki Devi Foundation,2 press enclave road, Saket, New Delhi-110017
New Delhi
DELHI 
8375017305

childhoodcancer@gmail.com 
Dr PK Chaithanya  MNJ Institute of Oncology & Regional Cancer Center  MNJ Institute of Oncology & Regional Cancer Center, Red Hills, Hyderabad Telengana 500004
Hyderabad
TELANGANA 
8897199994

mnjiorccchaithanya@gmail.com 
Dr Koushik Saha  NRS Medical College and Hospital Dept. of Pediatric Surgery  Department of clinical research,Room No.N/A,Dept of padeatric surgery NRS Medical College & Hospital 138 A.J.C. Bose road Kolkata 700014
Kolkata
WEST BENGAL 
9831304491

drsahakaushik@yahoo.com 
Dr Ramavath Devendra Naik  Omega Hospital  Omega Hospital,Plot No 04 Healthcity Chinagadili, Hanumanthavaka Vishakhapatnam Andra Pradesh 530040
Visakhapatnam
ANDHRA PRADESH 
9873742322

drramavathdev@gmail.com 
Dr Nita Radhakrishnan  Post Graduate Institute of Child health  Department of Clinical Research,Room No. NA,Post Graduate Institute of Child Health Sector -30 Noida Gautam Budh Nagar Noida Uttar Pradesh 201303
Gautam Buddha Nagar
UTTAR PRADESH 
9999041524

nitark@gmail.com 
Dr Faisal RGuru  SKIMS  Sher-i-Kashmir institute of medical sciences,South, srinagar,J&K 190011
Srinagar
JAMMU & KASHMIR 
9717017022

faisal_guru@yahoo.com 
Dr Nitin Joshi  The Gujrat Cancer & research institute  Department of Clinical Research, Room No. NA, The Gujrat Cancer & research institute New Civil Hospital Campus Asarwa Ahmedabad
Ahmadabad
GUJARAT 
9640953911

nitin.joshi@gcriindia.org 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 14  
Name of Committee  Approval Status 
GCRI/GCS Ethics committee, Dr. Nitin Joshi  Approved 
IEC AIIMS,Dr Sameer Bakshi  Approved 
IEC, Nil Ratan Sircar Medical College and Hospital, Dr Koushik Saha  Approved 
IEC,Post Graduate Institute of Child Health,Dr. Nita Radhakrishnan  Approved 
Institutional Ethics committee, Dr. Faisal .R. Guru  Approved 
Institutional Ethics Committee, Dr. Ramandeep Singh Arora  Approved 
Institutional Ethics committee, Dr. Ramavath Devendra Naik  Submittted/Under Review 
Institutional Ethics Committee, Dr. Shailesh Kanvinde  Submittted/Under Review 
Institutional Ethics Committee, Dr. Vikramjit S. Kanwar  Approved 
Institutional Review board, Mahatma Gandhi Cancer Hospital & research institute, Dr. Rajni Priya Yedla  Approved 
Kiran Hospital Ethics Committee, Dr. Anshul Agrawal  Approved 
MAHE Ethics Committee, Dr. Harsha Prasad L  Approved 
MNJ Institute of Oncology& Regional Cancer Center Ethics Committee, Dr. P.K. Chaithanya  Approved 
Sir Ganga Ram Hospital Ethics committee, Dr. Anupam Sachdeva  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: C499||Malignant neoplasm of connective and soft tissue, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Neupogen Singleject (Filgrastim)  Dose formulation:Solution for injection in a pre-filled syringe Adminitration:Subcutaneous Level(s):5 microgram/kg once per day via SC injection 
Intervention  Pegfilgrastim  Dose formulation:Pre-filled syringe for Injection Adminitration:Subcutaneous Level(s):1.5 mg per 0.15 mL, 2.5 mg per 0.25 mL and 4.0 mg per 0.4 mL Duration: Single SC dose of pegfilgrastim between 24-27 hours after completion each chemotherapy cycle. Dose should be calculated based on the weight of the child before administration of the study intervention. 
 
Inclusion Criteria  
Age From  0.00 Year(s)
Age To  6.00 Year(s)
Gender  Both 
Details  1.Male or female infants and children from under 6 years of age.
2.Children with a pathologically confirmed diagnosis of rhabdomyosarcoma or high-risk Wilms’tumour, planned for treatment with 1 of the following CmT regimens:
3.Rhabdomyosarcoma: Ifosfamide plus vincristine plus actinomycin D (IVA),Ifosfamide plus vincristine plus actinomycin D plus doxorubicin (IVADo),Vincristine plus actinomycin D plus cyclophosphamide (VAC); High-risk Wilms’ tumour: Cyclophosphamide with doxorubicin and/or etoposide with carboplatin.
4.Written informed consent provided by parent(s)/legal representative(s) of the Paediatric participant and participant’s assent if able to understand and/or follow study instructions alone or with parental assistance.
5.Parents/legally acceptable representative should have signed consent for a CmT regimen that is known to be myelotoxic, with counts expected to drop below an absolute neutrophil count (ANC) of 0.5×10 to the power 9/L for at least 3 days.
6.ANC and platelet count: Participants must have an ANC greater than 1×10 to the power 9/L and a platelet count greater than 100×10 to the power 9/L to be eligible for therapy at the start of CmT.
7.Normal cardiac, renal, and hepatic function.
8.All participants must have a life expectancy of greater than 4 months in the opinion of the investigator.
9.On-treatment Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2.
10.Participants with baseline laboratory values acceptable for them to receive chemotherapy. 
 
ExclusionCriteria 
Details  1.Known hypersensitivity to any component of this product.
2.Previous treatment with long acting G-CSF.
3.History of congenital neutropenia or cyclic neutropenia.
4.Any illness or condition that in the opinion of the investigator may affect the safety of the participant or the evaluation of any study endpoint; Bone marrow involvement.
5.Prior bone marrow or stem cell transplant, or prior radiation to greater than or equal to 25% of bone marrow (e.g., whole pelvic radiation) for any reason, or any therapeutic radiation within the 4 weeks prior to the first dose.
6.Ongoing active infection or history of infectious disease within 2 weeks prior to the screening visit.
7.A positive polymerase chain reaction test for COVID-19; Treatment with lithium at screening or planned during the study.
8.Participation in an interventional clinical study within 30 days or 5 half-lives of the investigational product before enrollment, whichever is longer.
9.Participants with autoimmune diseases; Participants with severe liver, kidney, heart, or lung dysfunction precluding the expected delivery of the intended chemotherapy regimen. 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
Assess the efficacy of a subcutaneous (SC) dose administration of pegfilgrastim per chemotherapy cycle compared to daily SC dose administrations of filgrastim in children receiving CmT.
 
Incidence and duration of severe neutropenia (ANC less than 0.5×10 to the power 9/L) in each chemotherapy cycle;
Incidence and duration of very severe neutropenia (ANC less than 0.1×10 to the power 9/L) in each chemotherapy cycle;
Incidence of febrile neutropenia (body temperature greater than 38.3°C or 2 consecutive readings higher than 37.8°C measured at the axilla or external ear at least 2 hours apart. 
 
Secondary Outcome  
Outcome  TimePoints 
Assess the pharmacodynamics, pharmacokinetics, safety, and tolerability including local (injection site) tolerability of a single SC dose administration of pegfilgrastim per chemotherapy cycle compared to daily SC dose administrations of filgrastim in children receiving CmT.  Total time (days) in hospital across all cycles;
Total time (days) in Intensive Care Unit (ICU) across all cycles; Percentage of scheduled chemotherapy dose that was delivered across all cycles;
Proportion with chemotherapy doses reduced, omitted, or delayed across all cycles;
Time in days in hospital and time in the ICU due to FN or associated infections across all cycles;
Number of days of delay of chemotherapy across all cycles. 
 
Target Sample Size   Total Sample Size="12"
Sample Size from India="12" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   30/06/2022 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   Nil. 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary   A Randomized, Active-Controlled, Multicenter, Open label, Two Arm Study to Assess Safety, Efficacy, Pharmacodynamics, and Pharmacokinetics with Pegfilgrastim PFS of Intas Pharmaceutical Limited Compared with Neupogen® Injection in Paediatric Patients Under 6 years of Age with Rhabdomyosarcoma or Wilms’ Tumour on Myelosuppressive Chemotherapy (CmT) Regimen. 
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