Letermovir for Preventing CMV Infection After Bone Marrow Transplant

No longer recruiting at 1 trial location
GP
YJ
Overseen ByYeon Joo Lee, MD
Age: Any Age
Sex: Any
Trial Phase: Phase 2
Sponsor: Memorial Sloan Kettering Cancer Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if letermovir (Prevymis) can prevent the return of Cytomegalovirus (CMV) infection in individuals who have undergone a bone marrow transplant. It targets those who have previously had CMV and completed specific treatments after their transplant no more than a week ago. Individuals concerned about CMV recurrence after a bone marrow transplant might be suitable candidates. Participants will take letermovir for 14 weeks, with regular blood tests to monitor the virus. As a Phase 2 trial, this research focuses on assessing the treatment's effectiveness in an initial, smaller group, allowing participants to contribute to significant findings.

Do I have to stop taking my current medications for the trial?

The trial does not specify that you must stop all current medications, but certain medications are not allowed. You cannot take high doses of acyclovir, valacyclovir, or famciclovir, and some medications like pimozide, ergot alkaloids, and certain statins are not allowed with letermovir. Check with the trial team to see if your current medications are compatible.

Is there any evidence suggesting that letermovir is likely to be safe for humans?

Research has shown that letermovir is generally safe for individuals who have undergone a bone marrow transplant. One study found that letermovir effectively prevents CMV (Cytomegalovirus) infection and has few harmful side effects. Another review confirmed its safety in preventing CMV reactivation after a transplant. These findings suggest that letermovir is well-tolerated and could be a good option for preventing CMV infections.12345

Why do researchers think this study treatment might be promising?

Letermovir is unique because it specifically targets the CMV virus, preventing its reactivation in patients who have undergone bone marrow transplants. Unlike the standard antiviral treatments like ganciclovir or foscarnet, which can have significant side effects like bone marrow suppression, letermovir offers a more tolerable safety profile. Researchers are excited about this treatment because it provides an effective prophylactic option without the common toxicities associated with other antivirals, potentially improving patients' overall quality of life post-transplant.

What evidence suggests that letermovir is effective for preventing CMV infection after a bone marrow transplant?

Research shows that letermovir, which participants in this trial will receive, effectively prevents Cytomegalovirus (CMV) from reactivating after a bone marrow transplant. Studies have found that letermovir significantly reduces the risk of CMV appearing in the blood. Known for its low toxicity, letermovir is safer for long-term use. Real-world data supports its success in preventing serious CMV infections in transplant patients. Overall, letermovir is a promising option for those at risk of CMV reactivation after a transplant.12678

Who Is on the Research Team?

GP

Genovefa Papanicolaou, MD

Principal Investigator

Memorial Sloan Kettering Cancer Center

Are You a Good Fit for This Trial?

This trial is for individuals aged 12 or older who have had a bone marrow transplant, received treatment for CMV infection post-transplant, and are at risk of the infection returning. They must be able to consent (or have a guardian consent), follow trial procedures, and use effective contraception if applicable. People with severe kidney or liver issues, certain drug interactions, HIV/HCV/HBsAg positivity, need for intensive care support, pregnancy/breastfeeding intentions during the trial period cannot join.

Inclusion Criteria

Willing and able to comply with trial instructions and requirements
I've completed treatment for a serious CMV infection within the last 7 days.
I can give my consent, or if under 18, my guardian can and I agree to participate.
See 11 more

Exclusion Criteria

Glomerular filtration rate (GFR) </= mL/min/1.73m^2(equivalent to creatinine clearance </=10 mL/min)
I have received up to two doses of IV cidofovir for ADV.
I use high-dose antiviral medication regularly, but only short treatments for severe infections.
See 15 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive letermovir for 14 weeks to prevent recurrent CMV infection

14 weeks
Weekly visits for monitoring

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 weeks
Visits on day 100 and day 180 for blood sample collection

What Are the Treatments Tested in This Trial?

Interventions

  • Letermovir
Trial Overview The study tests whether Letermovir pills can prevent the recurrence of Cytomegalovirus (CMV) infection in patients who've previously been treated for CMV after receiving a bone marrow transplant. Participants will take Letermovir and undergo regular blood draws to monitor their health.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Hematopoietic cell transplantation/HCTExperimental Treatment2 Interventions

Letermovir is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Prevymis for:
🇪🇺
Approved in European Union as Prevymis for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Memorial Sloan Kettering Cancer Center

Lead Sponsor

Trials
1,998
Recruited
602,000+

Merck Sharp & Dohme LLC

Industry Sponsor

Trials
4,096
Recruited
5,232,000+
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Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

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Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

Citations

Efficacy and safety of letermovir prophylaxis for ...Several studies have reported that letermovir can effectively prevent CMV activation after allogeneic hematopoietic stem cell transplantation ( ...
Letermovir Prophylaxis for Cytomegalovirus in ...Letermovir at a dose of 240 mg per day was highly effective in preventing CMV viremia after engraftment in transplant recipients and had little toxicity.
Letermovir Prophylaxis Guided by Cytomegalovirus Cell ...This study aimed to assess whether CMV-CMI–guided letermovir prophylaxis is more effective than a fixed-duration approach in reducing the ...
4.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/37207713/
Effectiveness of letermovir for cytomegalovirus prophylaxis ...This review aimed to evaluate the real-world effectiveness of LET in preventing clinically significant CMV infection (csCMVi) for allo-HCT recipients and ...
Effectiveness of letermovir in preventing cytomegalovirus ...Letermovir (LTV), a CMV terminase inhibitor, has been reported to prevent clinically significant CMV infection with low toxicity in a randomized phase 3 trial ...
NCT02137772 | Letermovir (MK-8228) Versus Placebo in ...The hypothesis being tested was that MK-8228 is superior to placebo in the prevention of clinically-significant CMV infection through Week 24 post-transplant.
Articles Efficacy and safety of extended duration letermovir ...Extending the duration of letermovir prophylaxis to 200 days following HSCT is efficacious and safe in reducing the incidence of late clinically significant ...
Letermovir for Prevention of Cytomegalovirus Reactivation ...In summary, letermovir was effective in preventing CMV infection in this high-risk population of HLA-mismatched allo-HCT recipients. Key Words. Haploidentiacl ...
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