Extension of Letermovir (LET) From Day 100 to Day 200 Post-transplant for the Prevention of Cytomegalovirus (CMV) Infection in Hematopoietic Stem Cell Transplant (HSCT) Participants (MK-8228-040)

Completed · Phase 3 · Has a placebo group

Conditions studied: Cytomegalovirus Infection

In brief

The purpose of this study was to evaluate the safety and efficacy of letermovir (LET) versus placebo when cytomegalovirus (CMV) prophylaxis was extended from 100 days to 200 days post-transplant in CMV seropositive participants who received an allogenic hematopoietic stem cell transplant (HSCT). It was hypothesized that LET is superior to placebo in the prevention of clinically-significant CMV infection when LET prophylaxis is extended from 100 to 200 days.

Key facts

Study ID

NCT03930615

Run by

Merck Sharp & Dohme LLC

People needed

220

Starts

2019-06-21

Expected to finish

2022-03-16

Last updated by the study team

2024-08-22

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• have documented positive CMV serostatus (CMV immunoglobulin G [IgG] seropositive) for recipient (R+) at the time of transplant
• has a history of allogeneic HSCT (bone marrow, peripheral blood stem cell, or cord blood transplant) within \~100 days prior to randomization
• has undetectable CMV deoxyribonucleic acid (DNA) or detectable/not quantifiable CMV DNA from a plasma sample collected within 14 days prior to randomization
• has received LET as primary prophylaxis that started within 28 days of HSCT and continued through Week 14 post-transplant (± 1 week) prior to randomization
• is at high risk of CMV disease, defined as meeting one or more of the following criteria:
• has a related donor with at least 1 mismatch at 1 of the specified 3 human leukocyte antigen (HLA) gene loci (HLA-A, B, or DR)
• has an unrelated donor with at least one mismatch at one of the specified four HLA gene loci (HLA-A, B, C, and DRB1)
• has a haploidentical donor
• has umbilical cord blood as the stem-cell source
• has ex-vivo T-cell-depleted grafts
• has received anti-thymocyte globulin
• has received alemtuzumab
• has graft versus host disease (GVHD) or other conditions, requiring the use of systemic prednisone (or equivalent) at a dose of ≥1 mg/kg of body weight per day within 6 weeks of randomization
• for female participants, is not pregnant or breastfeeding, and is either not a woman of childbearing potential (WOCBP) or is a WOBCP who agrees to use acceptable contraception during the treatment period and for ≥28 days after the last dose of study drug.

You may not qualify if…

• has a history of CMV end-organ disease or preemptive treatment therapy for CMV after HSCT prior to randomization
• has a history of >14 days total of LET interruption during the first 100 days post-transplant prior to randomization
• has suspected or known hypersensitivity to active or inactive ingredients of LET formulations
• has severe hepatic insufficiency defined as Child-Pugh Class C within 14 days prior to randomization.
• has serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >5× the upper limit of normal (ULN) within 14 days prior to randomization
• has end-stage renal impairment with a creatinine clearance less than 10 mL/min, as calculated by the Cockcroft-Gault equation using serum creatinine within 14 days prior to randomization
• has both moderate hepatic insufficiency AND moderate-to-severe renal insufficiency
• has an uncontrolled infection on the day of enrollment
• requires mechanical ventilation or is hemodynamically unstable at the time of enrollment
• has a documented positive result for a human immunodeficiency virus antibody (HIV-Ab) test at any time prior to screening, or for hepatitis C virus antibody (HCV-Ab) with detectable HCV ribonucleic acid (RNA), or hepatitis B surface antigen (HBsAg) within 6 months prior to screening.
• has active solid tumor malignancies with the exception of localized basal cell or squamous cell skin cancer or the condition under treatment (eg, lymphomas)
• has received cidofovir or CMV immunoglobulin with 30 days prior to screening
• is currently participating or has participated in a study with an unapproved investigational compound, monoclonal antibody, or device within 28 days or 5× half-life of the investigational compound or monoclonal antibody, whichever is longer, of initial dosing in this study
• has previously participated in this study or any other study involving LET, or is currently participating in any study involving administration of a CMV vaccine or another CMV investigational agent, or is planning to participate in a study of a CMV vaccine or another CMV investigational agent during the course of this study
• is pregnant or expecting to conceive, is breastfeeding, or plans to breastfeed from the time of consent through 28 days after the last dose of study therapy
• is expecting to donate eggs starting from the time of consent through 28 days after the last dose of study therapy
• has clinically relevant drug or alcohol abuse within 12 months of screening that may interfere with participant treatment, assessment, or compliance with the protocol as assessed by the investigator
• has a history or current evidence of any condition, therapy, lab abnormality, or other circumstance that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or would be put at undue risk as judged by the investigator, such that it is not in the best interest of the participant to participate in this study

Where it is running

• City of Hope National Medical Center ( Site 0158) — Duarte, California, United States
• University of California Davis Medical Center ( Site 0156) — Sacramento, California, United States
• University of Miami, Sylvester Comprehensive Cancer Center ( Site 0160) — Miami, Florida, United States
• Indiana Blood and Marrow Transplantation ( Site 0175) — Indianapolis, Indiana, United States
• Brigham & Women's Hospital ( Site 0161) — Boston, Massachusetts, United States
• John Theurer Cancer Center at Hackensack University Med Ctr ( Site 0174) — Hackensack, New Jersey, United States
• Memorial Sloan Kettering Cancer Center ( Site 0164) — New York, New York, United States
• Duke University Medical Center ( Site 0169) — Durham, North Carolina, United States
• The University of Texas MD Anderson Cancer Center ( Site 0154) — Houston, Texas, United States
• Fred Hutchinson Cancer Research Center ( Site 0152) — Seattle, Washington, United States
• Centre Hospitalier Universitaire Dupuytren ( Site 0182) — Limoges, Haute-Vienne, France
• Hopital Saint Eloi ( Site 0031) — Montpellier, Herault, France
• Centre Hopitalier Lyon Sud ( Site 0039) — Pierre-Bénite, Rhone, France
• CHU Henri Mondor ( Site 0032) — Créteil, Val-de-Marne, France
• Institut Gustave Roussy ( Site 0038) — Villejuif, Val-de-Marne, France
• CHU Hopital Saint Antoine ( Site 0036) — Paris, France
• Universitaetsklinikum Heidelberg-Medizinische Klinik V ( Site 0042) — Heidelberg, Baden-Wurttemberg, Germany
• Universitaetsklinik Koeln ( Site 0041) — Cologne, North Rhine-Westphalia, Germany
• Universitaetsklinikum Muenster ( Site 0043) — Münster, North Rhine-Westphalia, Germany
• ASST Spedali Civili di Brescia ( Site 0052) — Brescia, Lombardy, Italy
• IRCCS Ospedale San Raffaele ( Site 0051) — Milan, Italy
• Fondazione PTV Policlinico Tor Vergata ( Site 0054) — Roma, Italy
• Policlinico Umberto I ( Site 0056) — Roma, Italy
• Policlinico Universitario Agostino Gemelli ( Site 0055) — Roma, Italy
• Jichi Medical University Hospital ( Site 0123) — Shimotsuke, Tochigi, Japan

Full record on ClinicalTrials.gov

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