Status:

WITHDRAWN

Lung Transplant Plasmapheresis/Belatacept/Carfilzomib for Antibody Mediated Rejection and Desensitization

Lead Sponsor:

Duke University

Collaborating Sponsors:

Bristol-Myers Squibb

Conditions:

Lung Transplant Rejection

Antibody-mediated Rejection

Eligibility:

All Genders

18+ years

Phase:

PHASE2

Brief Summary

Antibody mediated rejection (AMR) post transplant contributes to poor long term outcomes after lung transplantation. Additionally, high antibodies detected pre transplant in candidates limit donor ava...

Detailed Description

Antibody mediated rejection (AMR) post transplant contributes to poor long term outcomes after lung transplantation. Additionally, high antibodies detected pre transplant in candidates limit donor ava...

Eligibility Criteria

Inclusion

  • Inclusion Criteria:
  • Inclusion criteria for the AMR post-transplant cohort
  • Positive DSAs and allograft dysfunction defined by changes in pulmonary physiology, gas exchange, radiological features or deteriorating functional performance that is highly suspicious for AMR
  • Recipient is Epstein-Barr virus positive (EBV+) by serology
  • Ability to provide signed and dated IRB approved written consent in accordance with regulatory and institutional guidelines prior to any protocol-related procedure
  • Inclusion criteria for the pre-transplant desensitization cohort
  • Elevated HLA antibodies (defined as MFI \>1000) such that the calculated panel reactive antibodies are \>60%
  • At least 2 HLA antibodies with Mean Fluorescent Intensity (MFI) \<10,000 and at least 2 HLA antibodies with MFI \<5,000 on undiluted serum that do not demonstrate an increase in MFI with dilution at 1:16 (no evidence of a prozone effect).
  • EBV+ by serology
  • Clinically stable defined by not on invasive mechanical ventilation, extracorporeal membrane oxygenation support or other invasive life support requiring ICU level of care
  • Ability to provide signed and dated IRB approved written consent in accordance with regulatory and institutional guidelines prior to any protocol-related procedure
  • Exclusion criteria for both AMR post-transplant cohort and pre-transplant cohort
  • Active systemic infection
  • Allergy to carfilzomib or belatacept
  • Known malignancy in the previous 2 years except for non-melanomatous skin cancer
  • Pregnancy
  • Inability to commit to complete treatment protocol at Duke as all procedures must be completed at Duke
  • Prisoners or those who are compulsory detained

Exclusion

    Key Trial Info

    Start Date :

    May 1 2019

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    October 30 2020

    Estimated Enrollment :

    Patients enrolled

    Trial Details

    Trial ID

    NCT03805178

    Start Date

    May 1 2019

    End Date

    October 30 2020

    Last Update

    May 2 2019

    Active Locations (0)

    Enter a location and click search to find clinical trials sorted by distance.

    Page 1 of 0 (0 locations)

    No Results Found

    We couldn’t find results for the location/zipcode entered or within the selected range. Please check your input or adjust your search.