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Prospective Evaluation of Xerava™ (Eravacycline) Prophylaxis in Hematological Malignancy Patients With Prolonged Neutropenia


Description

Antibacterial prophylaxis is recommended in patients at high risk of infection, specifically patients undergoing acute leukemia induction therapy or hematopoietic stem cell transplant (HSCT) who are expected to have profound neutropenia (ANC\<100 neutrophils/milliliter) for more than seven days. Xerava™ (eravacycline) has a broad spectrum of activity including many multi-drug resistant strains of bacteria. It is not an agent used for treatment of febrile neutropenia, making eravacycline a very attractive alternative to consider in this prophylactic setting. Eravacycline has activity against MRSA, VRE, and Clostridioides difficile, all of which are common problems in this patient population. It also covers the majority of enteric gram-negative pathogens while also producing satisfactory tissue penetration and adequate plasma concentrations, which has classically been a concern with prior agents. Eravacycline has activity against coagulase-negative staphylococcus, which is a common cathet

Trial Eligibility

Inclusion Criteria: * All patients receiving induction chemotherapy for treatment of acute leukemia or receiving preparative regimen for HSCT * Patient must provide informed consent. * Bilirubin ≤ 3 x the ULN and AST/ALT ≤ 5 x ULN Exclusion Criteria: * Uncontrolled bacterial, viral or fungal infection at the time of study enrollment. * Urinary tract infection receiving active treatment * Acute pancreatitis (not necessary to work-up unless symptomatic) * History of known hypersensitivity to eravacycline, tetracycline, doxycycline, minocycline, tigecycline, sarecycline, oxytetracycline, or omadacycline * Pseudomonas infection within 30 days prior to study enrollment * Receiving strong inhibitors or inducers of cytochrome P450 3A4 will be excluded from the study (see Appendix B for complete list of medications) * Pregnant or lactating women

Study Info

Organization

West Virginia University


Primary Outcome

Incidence of Documented Breakthrough Infections


Outcome Timeframe Up to 21 days

NCTID NCT05537896

Phases PHASE2

Primary Purpose TREATMENT

Start Date 2024-02-19

Completion Date 2028-02

Enrollment Target 55

Interventions

DRUG Eravacycline

Locations Recruiting

Aaron Cumpston

United States, West Virginia, Morgantown


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