Acetato de Caspofungin (Cancidas®) in the Treatment of Fungal Infection
Information source: PETHEMA Foundation
Information obtained from ClinicalTrials.gov on February 12, 2009 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Candidiasis; Aspergillosis
Intervention: Caspofungin (Drug)
Phase: Phase 4
Status: Recruiting
Sponsored by: PETHEMA Foundation Official(s) and/or principal investigator(s): Miguel Angel Sanz, Dr, Principal Investigator, Affiliation: Hospital La Fe
Overall contact: Miguel Angel Sanz, Dr, Phone: 34 96 386 27 00, Email: sanz_mig@gva.es
Summary
We wanted to determine the efficacy and the safety of caspofungin acetate (CANCIDAS®) in the
treatment of invader fungal infection (IFI) specifically, Invasive Candidiasis (CI) in adults
patients without neutropenia and Invasive Aspergillosis (AI) in adults patients who are
refractory to or intolerant of other therapies (i. e., amphotericin B, lipid formulations of
amphotericin B, and/or itraconazole).
Clinical Details
Official title: PROCAS: Study Observational Prospective and Multicenter to Determine the Clinic Effectiveness and the Safety of Caspofungin Acetate (CANCIDAS®) in the Treatment of Invader Fungal Infection
Study design: Case-Only, Prospective
Detailed description:
Study post-marketing (observational). It is multicenter and prospective. No masking is used,
without control group neither is randomized
Eligibility
Minimum age: 18 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Female and male with 18 years old at least.
- Diagnosis of AI or CI. It will be based in Clinical History, signs and symptoms that
the patient takes, discovery of studies of radiology and results of cultivation and/or
studies of anatomopathology positives for Candida spp. or Aspergillus spp.
- Patients with AI, must be refractory to or intolerant of other therapies antifungal
used in the hospital.
- Patients with CI, must be or not refractory to or intolerant of other therapies
antifungal used in the hospital.
Exclusion Criteria:
- Patients with diagnosis uncertain based in one or more of next criterions: Cultivation
positive for Candida in an only localization (urine, spittle, end/current of
catheter; osteomyelitis or endocarditis by Candida without treatment appropriated
surgical; infection by Candida of prosthetic material without retired of the same;
positive blood cultive for Candida in appearance of vascular prosthesis; allergic lung
Aspergillosis; and aspergilloma or aspergillosis eye without treatment appropriated
surgical).
- Allergic / hypersensitivity to caspofungin.
- Insufficiency several liver (rate of Chile-Pugh >9).
- Prediction of survival <5 days.
- Pregnant or breast feeding.
- Previous Participation of patient in this study.
- Presence of other disease or any condition that it can mix up the interpretation of
results or create risks.
- Previous Participation of patient in other clinical study that it involve the
administration of a drug in investigation in the 14 days previous to your inclusion in
the study or during the administration of caspofungin. We can include patients took
with antineoplastic drugs in research whenever at lefts a Investigator Coordinator
authorizes it before
Locations and Contacts
Miguel Angel Sanz, Dr, Phone: 34 96 386 27 00, Email: sanz_mig@gva.es
Hospital general de Jerez de la Frontera, Jerez de la Frontera, Spain; Recruiting León Angel, Dr León Angel, Dr, Principal Investigator
Area Hospitalaria Juan Ramón Jimenez, Huelva, Spain; Recruiting Fernández Antonio, Dr Fernández Antonio, Dr, Principal Investigator
Hospital General de Alicante, Alicante, Spain; Recruiting Rivas Concepción Rivas Concepción, Dr, Principal Investigator
Hospital Clínico y Provincial de Barcelona, Barcelona, Spain; Recruiting Rovira Montse, Dr Rovira Montse, Dr, Principal Investigator
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Recruiting Martino Rodrigo, Dr, Principal Investigator
Hospital vall d'Hebrón, Barcelona, Spain; Recruiting Font Julià, Dr, Principal Investigator
Hospital Puerta del Mar, Cádiz, Spain; Recruiting Capote Francisco Javier, Dr Capote Francisco Javier, Dr, Principal Investigator
Complejo Hospitalario Reina Sofía, Córdoba, Spain; Recruiting Torres Antonio, Dr Torres Antonio, DR, Principal Investigator
Hospital Universitario Virgen de las Nieves, Granada, Spain; Recruiting de Pablos José Mª, Dr, Principal Investigator
Hospital Juan Canalejo, La Coruña, Spain; Recruiting Deben Guillermo, Dr Deben Guillermo, Dr, Principal Investigator
. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Recruiting Gema Ramirez Ramirez Gema, Dr, Principal Investigator
Hospital Carlos Haya, Málaga, Spain; Recruiting Cuesta Angeles, Dr Cuesta Angeles, Dr, Principal Investigator
Hospital Son Dureta, Palma de Mallorca, Spain; Recruiting Novo Andrés, Dr Novo Andrés, Dr, Principal Investigator
Hospital Universitario Marqués de Valdecilla, Santander, Spain; Recruiting Lopez Mónica, Dr Lopez Mónica, Dr, Principal Investigator
Hospital Universitario Virgen del Rocío, Sevilla, Spain; Recruiting De Blas José Mª, Dr De Blas José Mª, Dr, Principal Investigator
Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain; Recruiting Llorente Andrés, Dr, Principal Investigator
Hospital Clínico de Valencia, Valencia, Spain; Recruiting Solano Carlos, Dr, Principal Investigator
Hospital La Fe, Valencia, Spain; Recruiting Sanz Miguel Angel Sanz Miguel Angel, Dr, Principal Investigator
Hospital Universitario Dr. Peset, Valencia, Spain; Recruiting Rafecas Javier, Dr Rafecas Javier, Dr, Principal Investigator
Complejo Hospitalario Xeral-Cies, Vigo, Spain; Recruiting Poderós Concepción, Dr Poderós Concepción, Dr, Principal Investigator
Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Recruiting Jospe Mª Ribera, Doctor Ribera Josep Mª, Dr, Principal Investigator
Xarxa assistencial de Manresa, Manresa, Barcelona, Spain; Recruiting Subirà Maricel, Dr, Principal Investigator
Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Recruiting Berlanga Juan Antonio, Dr Berlanga Juan Antonio, Dr, Principal Investigator
Hospital general de Castellón, Castello, Castellón, Spain; Recruiting García Raimundo, Dr Garcia Raimundo, Dr, Principal Investigator
Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain; Recruiting Bello José Luis, Dr Bello José Luis, Dr, Principal Investigator
Hospital Son Llàtzer, Palma de Mallorca, Palma de Mallorca, Spain; Recruiting Joan Bargay, Dr Catalina Forteza, Dr Joan Bargay, Dr, Principal Investigator
Hospital Verge de la Cinta, Tortosa, Tarragona, Spain; Recruiting Rodriguez Marta, Dr, Principal Investigator
Additional Information
Related publications: Keating GM, Jarvis B. Caspofungin. Drugs 2001; 61: 1121-1129 Tkacz JS. Glucan biosynthesis in fungi and its inhibition. In: Sutcliff JA,
Georgopapadaku NH, eds. Emerging Targets in Antibacterial and Antifungal
Chemotherapy. New York: Routledge, Chapman & Hall, 1992; 495-523. Groll AH, Walsh TJ. Potential new antifungal agents. Curr Opin Infect Dis 1997; 10:
449-458 Debono M, Gordee RS. Antibiotics that inhibit fungal cell wall development. Annu Rev Microbiol. 1994;48:471-97. Review. Denning DW. Echinocandins and pneumocandins--a new antifungal class with a novel mode of action. J Antimicrob Chemother. 1997 Nov;40(5):611-4. Review. No abstract available. Arikan S, Lozano-Chiu M, Paetznick V, Rex JH. In vitro synergy of caspofungin and amphotericin B against Aspergillus and Fusarium spp. Antimicrob Agents Chemother. 2002 Jan;46(1):245-7. Graybill JR, Najvar LK, Luther MF, Fothergill AW. Treatment of murine disseminated candidiasis with L-743,872. Antimicrob Agents Chemother. 1997 Aug;41(8):1775-7. Espinel-Ingroff A. Comparison of In vitro activities of the new triazole SCH56592 and the echinocandins MK-0991 (L-743,872) and LY303366 against opportunistic filamentous and dimorphic fungi and yeasts. J Clin Microbiol. 1998 Oct;36(10):2950-6. Bartizal K, Gill CJ, Abruzzo GK, Flattery AM, Kong L, Scott PM, Smith JG, Leighton CE, Bouffard A, Dropinski JF, Balkovec J. In vitro preclinical evaluation studies with the echinocandin antifungal MK-0991 (L-743,872). Antimicrob Agents Chemother. 1997 Nov;41(11):2326-32. Kurtz MB, Heath IB, Marrinan J, Dreikorn S, Onishi J, Douglas C. Morphological effects of lipopeptides against Aspergillus fumigatus correlate with activities against (1,3)-beta-D-glucan synthase. Antimicrob Agents Chemother. 1994 Jul;38(7):1480-9. Erratum in: Antimicrob Agents Chemother 1994 Oct;38(10):2516. Arikan S, Lozano-Chiu M, Paetznick V, Rex JH. In vitro susceptibility testing methods for caspofungin against Aspergillus and Fusarium isolates. Antimicrob Agents Chemother. 2001 Jan;45(1):327-30. Arikan S, Lozano-Chiu M, Paetznick V, Rex JH. In vitro susceptibility testing methods for caspofungin against Aspergillus and Fusarium isolates. Antimicrob Agents Chemother. 2001 Jan;45(1):327-30. Bowman JC, Hicks PS, Kurtz MB, Rosen H, Schmatz DM, Liberator PA, Douglas CM. The antifungal echinocandin caspofungin acetate kills growing cells of Aspergillus fumigatus in vitro. Antimicrob Agents Chemother. 2002 Sep;46(9):3001-12. Pfaller MA, Marco F, Messer SA, Jones RN. In vitro activity of two echinocandin derivatives, LY303366 and MK-0991 (L-743,792), against clinical isolates of Aspergillus, Fusarium, Rhizopus, and other filamentous fungi. Diagn Microbiol Infect Dis. 1998 Apr;30(4):251-5. Del Poeta M, Schell WA, Perfect JR. In vitro antifungal activity of pneumocandin L-743,872 against a variety of clinically important molds. Antimicrob Agents Chemother. 1997 Aug;41(8):1835-6. Scott Hicks P, Dorso K, Gerckens I, et al. Comparative In Vitro Susceptibility of
Clinical Trial Isolates to the Echinocandin Antifungal Caspofungin (Cancidas, MK-
0991) (Abstract: 193). 40th Interscience Conference on Antimicrobial Agents and
Chemotherapy, Toronto (Canada), 2000. Barchiesi F, Schimizzi AM, Fothergill AW, Scalise G, Rinaldi MG. In vitro activity of the new echinocandin antifungal, MK-0991, against common and uncommon clinical isolates of Candida species. Eur J Clin Microbiol Infect Dis. 1999 Apr;18(4):302-4. Marco F, Pfaller MA, Messer SA, Jones RN. Activity of MK-0991 (L-743,872), a new echinocandin, compared with those of LY303366 and four other antifungal agents tested against blood stream isolates of Candida spp. Diagn Microbiol Infect Dis. 1998 Sep;32(1):33-7. Vazquez JA, Lynch M, Boikov D, Sobel JD. In vitro activity of a new pneumocandin antifungal, L-743,872, against azole-susceptible and -resistant Candida species. Antimicrob Agents Chemother. 1997 Jul;41(7):1612-4. Krishnarao TV, Galgiani JN. Comparison of the in vitro activities of the echinocandin LY303366, the pneumocandin MK-0991, and fluconazole against Candida species and Cryptococcus neoformans. Antimicrob Agents Chemother. 1997 Sep;41(9):1957-60. Nelson PW, Lozano-Chiu M, Rex JH. In vitro growth-inhibitory activity of pneumocandins L-733,560 and L-743,872 against putatively amphotericin B- and fluconazole-resistant Candida isolates: influence of assay conditions. J Med Vet Mycol. 1997 Jul-Aug;35(4):285-7. Pfaller MA, Messer SA, Gee S, Joly S, Pujol C, Sullivan DJ, Coleman DC, Soll DR. In vitro susceptibilities of Candida dubliniensis isolates tested against the new triazole and echinocandin antifungal agents. J Clin Microbiol. 1999 Mar;37(3):870-2. Douglas CM, D'Ippolito JA, Shei GJ, Meinz M, Onishi J, Marrinan JA, Li W, Abruzzo GK, Flattery A, Bartizal K, Mitchell A, Kurtz MB. Identification of the FKS1 gene of Candida albicans as the essential target of 1,3-beta-D-glucan synthase inhibitors. Antimicrob Agents Chemother. 1997 Nov;41(11):2471-9. Kurtz MB, Abruzzo G, Flattery A, Bartizal K, Marrinan JA, Li W, Milligan J, Nollstadt K, Douglas CM. Characterization of echinocandin-resistant mutants of Candida albicans: genetic, biochemical, and virulence studies. Infect Immun. 1996 Aug;64(8):3244-51. Douglas CM, Marrinan JA, Li W, Kurtz MB. A Saccharomyces cerevisiae mutant with echinocandin-resistant 1,3-beta-D-glucan synthase. J Bacteriol. 1994 Sep;176(18):5686-96. Osherov N, May GS, Albert ND, Kontoyiannis DP. Overexpression of Sbe2p, a Golgi protein, results in resistance to caspofungin in Saccharomyces cerevisiae. Antimicrob Agents Chemother. 2002 Aug;46(8):2462-9. Abruzzo GK, Flattery AM, Gill CJ, Kong L, Smith JG, Pikounis VB, Balkovec JM, Bouffard AF, Dropinski JF, Rosen H, Kropp H, Bartizal K. Evaluation of the echinocandin antifungal MK-0991 (L-743,872): efficacies in mouse models of disseminated aspergillosis, candidiasis, and cryptococcosis. Antimicrob Agents Chemother. 1997 Nov;41(11):2333-8. Abruzzo GK, Gill CJ, Flattery AM, Kong L, Leighton C, Smith JG, Pikounis VB, Bartizal K, Rosen H. Efficacy of the echinocandin caspofungin against disseminated aspergillosis and candidiasis in cyclophosphamide-induced immunosuppressed mice. Antimicrob Agents Chemother. 2000 Sep;44(9):2310-8. Bernard EM, Ishimaru T, Armstrong D. Low doses of the pneumocandin L-743,872,
are effective for prevention and treatment in an animal model of pulmonary
aspergillosis (abstract: 106). 36th Interscience Conference on Antimicrobial Agents
and Chemotherapy; New Orleans, Louisiana, 1996. Graybill JR, Bocanegra R, Luther M, Fothergill A, Rinaldi MJ. Treatment of murine Candida krusei or Candida glabrata infection with L-743,872. Antimicrob Agents Chemother. 1997 Sep;41(9):1937-9. Abruzzo GK, Flattery AM, Gill CJ, Kong L, Smith JG, Pikounis VB, Balkovec JM, Bouffard AF, Dropinski JF, Rosen H, Kropp H, Bartizal K. Evaluation of the echinocandin antifungal MK-0991 (L-743,872): efficacies in mouse models of disseminated aspergillosis, candidiasis, and cryptococcosis. Antimicrob Agents Chemother. 1997 Nov;41(11):2333-8. Graybill JR, Najvar LK, Luther MF, Fothergill AW. Treatment of murine disseminated candidiasis with L-743,872. Antimicrob Agents Chemother. 1997 Aug;41(8):1775-7. Graybill JR, Najvar LK, Montalbo EM, Barchiesi FJ, Luther MF, Rinaldi MG. Treatment of histoplasmosis with MK-991 (L-743,872). Antimicrob Agents Chemother. 1998 Jan;42(1):151-3. Kohler S, Wheat LJ, Connolly P, Schnizlein-Bick C, Durkin M, Smedema M, Goldberg J, Brizendine E. Comparison of the echinocandin caspofungin with amphotericin B for treatment of histoplasmosis following pulmonary challenge in a murine model. Antimicrob Agents Chemother. 2000 Jul;44(7):1850-4. Powles MA, Liberator P, Anderson J, Karkhanis Y, Dropinski JF, Bouffard FA, Balkovec JM, Fujioka H, Aikawa M, McFadden D, Schmatz D. Efficacy of MK-991 (L-743,872), a semisynthetic pneumocandin, in murine models of Pneumocystis carinii. Antimicrob Agents Chemother. 1998 Aug;42(8):1985-9. Onishi J, Meinz M, Thompson J, et al. Discovery of novel antifungal (1,3)-beta-Dglucan
synthase inhibitors. Antimicrob Agents Chemother 2000; 44: 368-377. Hajdu R, Thompson R, Sundelof JG, Pelak BA, Bouffard FA, Dropinski JF, Kropp H. Preliminary animal pharmacokinetics of the parenteral antifungal agent MK-0991 (L-743,872). Antimicrob Agents Chemother. 1997 Nov;41(11):2339-44. Stone JA, Holland SD, Wickersham PJ, Sterrett A, Schwartz M, Bonfiglio C, Hesney M, Winchell GA, Deutsch PJ, Greenberg H, Hunt TL, Waldman SA. Single- and multiple-dose pharmacokinetics of caspofungin in healthy men. Antimicrob Agents Chemother. 2002 Mar;46(3):739-45. Stone EA, Fung HB, Kirschenbaum HL. Caspofungin: an echinocandin antifungal agent. Clin Ther. 2002 Mar;24(3):351-77; discussion 329. Review. Balani SK, Xu X, Arison BH, Silva MV, Gries A, DeLuna FA, Cui D, Kari PH, Ly T, Hop CE, Singh R, Wallace MA, Dean DC, Lin JH, Pearson PG, Baillie TA. Metabolites of caspofungin acetate, a potent antifungal agent, in human plasma and urine. Drug Metab Dispos. 2000 Nov;28(11):1274-8. . Stone JA, Holland S, Li S, et al. Effect of hepatic insufficiency on the
pharmacokinetics of caspofungin (abstract: 14). 41st Interscience Conference on
Antimicrobial Agents and Chemotherapy, Chicago, Illinois, 2001 Stone JA, Holland S, Wickersham P, et al. Drug interaction between caspofungin and
tacrolimus (abstract: 13). 41st Interscience Conference on Antimicrobial Agents and
Chemotherapy, Chicago, Illinois, 2001. Villanueva A, Arathoon EG, Gotuzzo E, Berman RS, DiNubile MJ, Sable CA. A randomized double-blind study of caspofungin versus amphotericin for the treatment of candidal esophagitis. Clin Infect Dis. 2001 Nov 1;33(9):1529-35. Epub 2001 Oct 4. Arathoon EG, Gotuzzo E, Noriega LM, Berman RS, DiNubile MJ, Sable CA. Randomized, double-blind, multicenter study of caspofungin versus amphotericin B for treatment of oropharyngeal and esophageal candidiases. Antimicrob Agents Chemother. 2002 Feb;46(2):451-7. Villanueva A, Gotuzzo E, Arathoon EG, Noriega LM, Kartsonis NA, Lupinacci RJ, Smietana JM, DiNubile MJ, Sable CA. A randomized double-blind study of caspofungin versus fluconazole for the treatment of esophageal candidiasis. Am J Med. 2002 Sep;113(4):294-9. Mora-Duarte J, Betts R, Rotstein C, Colombo AL, Thompson-Moya L, Smietana J, Lupinacci R, Sable C, Kartsonis N, Perfect J; Caspofungin Invasive Candidiasis Study Group. Comparison of caspofungin and amphotericin B for invasive candidiasis. N Engl J Med. 2002 Dec 19;347(25):2020-9. Maertens J, Raad I, Sable CA, et al. Multicenter, noncomparative study to evaluate
safety and efficacy of caspofungin in adults with invasive aspergillosis refractory or
intolerant to amphotericin B, amphotericin B lipid formulations, or azoles (abstract).
40th Interscience Conference on Antimicrobial Agents and Chemotherapy; Toronto,
Canada, 2000 . Hiemenz J, Raad I, Boogaerts M, et al. Efficacy of caspofungin as salvage therapy for
invasive aspergillosis compared to standard therapy in a historical cohort (abstract).
Focus on Fungal Infections 11, Washington D.C., USA, 2001. . Maertens J, Raad I, Petrikkos G, et al. Update of the multicenter, noncomparative
study of caspofungin in adults with invasive aspergillosis refractory or intolerant to
other antifungal agents: an analysis of 90 patients (abstract). 42th Interscience
Conference on Antimicrobial Agents and Chemotherapy; San Diego, California, USA,
2002. Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F, Denning DW, Donnelly JP, Edwards JE, Erjavec Z, Fiere D, Lortholary O, Maertens J, Meis JF, Patterson TF, Ritter J, Selleslag D, Shah PM, Stevens DA, Walsh TJ; Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer; Mycoses Study Group of the National Institute of Allergy and Infectious Diseases. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis. 2002 Jan 1;34(1):7-14. Epub 2001 Nov 26. Rex JH, Walsh TJ, Sobel JD, Filler SG, Pappas PG, Dismukes WE, Edwards JE. Reply to Dr. Chandrasekar (Clin Infect Dis 2001; 32:320-1) and Drs. Marr and Boeckh (Clin Infect Dis 2001; 32:321). Clin Infect Dis. 2001 Feb 1;32(3):518-9. No abstract available. Stevens DA, Kan VL, Judson MA, Morrison VA, Dummer S, Denning DW, Bennett JE, Walsh TJ, Patterson TF, Pankey GA. Practice guidelines for diseases caused by Aspergillus. Infectious Diseases Society of America. Clin Infect Dis. 2000 Apr;30(4):696-709. Epub 2000 Apr 20.
Starting date: March 2004
Ending date: February 2008
Last updated: November 26, 2008
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