A Phase 1/2 Open Label, Multicenter, Dose Escalation and Expansion Study of the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of HM43239 in Patients With Relapsed or Refractory Acute Myeloid Leukemia (AML)

Who is this study for? Adult patients with Acute Myeloid Leukemia
What treatments are being studied? HM43239
Status: Recruiting
Location: See all (34) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

The main purpose of this study is to identify a safe and potentially effective dose of tuspetinib to be used in future studies in study participants diagnosed with acute myeloid leukemia (AML), myelodysplastic syndromes with increased blasts grade 2 (MDS-IB2), or chronic myelomonocytic leukemia (CMML) that is relapsed or refractory after at least one line of prior therapy, or in study participants with newly diagnosed AML. Tuspetinib will be administered as a single agent or in combination with other drugs (venetoclax or venetoclax plus azacitidine), as specified for each part of the study.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Study participant is defined as having morphologically documented primary or secondary AML, MDS-IB2 (≥ 10% bone marrow blasts), or CMML by the World Health Organization (WHO) criteria (2016), and fulfills one of the following:

∙ Refractory to at least 1 cycle of prior therapy

‣ Relapsed after achieving remission with a prior therapy

• Study participant has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.

• Study participant's interval from prior treatment to time of study drug administration is at least 2 weeks for cytotoxic agents (except hydroxyurea given for controlling blast cells), at 4 weeks for biologic or cellular immunotherapies, or least 5 half-lives for prior experimental agents or noncytotoxic agents, including immunosuppressive therapy post hematopoietic stem cell transplantation (HSCT). Upon discussion with the Medical Monitor, a shorter than stated washout period may be considered provided that the study participant has recovered from any clinically relevant safety issue and recovered to Grade ≤ 1 toxicity from prior therapies.

• Study participant must meet the following criteria as indicated on the clinical laboratory tests.

∙ Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3× institutional upper limit normal (ULN)

‣ Total serum bilirubin ≤ 1.5× institutional ULN

‣ Creatinine clearance as calculated by the Cockcroft-Gault formula or measured by 24-h urine collection of \> 45 mL/min.

• Study participant is suitable for oral administration of study drug and has minimum life expectancy (≥ 3 months)

• Female study participants must be either:

• Of non-childbearing potential

∙ Post-menopausal (defined as at least 1 year without any menses) prior to screening, or

‣ Documented surgically sterile or status post hysterectomy (at least 1 month prior to screening)

• Or, if of childbearing potential,

∙ Must have a negative serum or urine pregnancy test at screening (within 72 hours prior to start of treatment), and

‣ Must use an acceptable highly effective method of birth control starting at screening and throughout the study period and for 90 days after the final study drug administration.

• Female study participants must not be breastfeeding at screening and during the study period, and for 90 days after the final study drug administration

• Female study participants must not donate ova starting at screening and throughout the study period, and for 90 days after the final study drug administration.

• Male study participants and their female spouse/partners who are of childbearing potential must be using highly effective contraception starting at screening and continue throughout the study period and for 90 days after the final study drug administration.

• Male study participants must not donate sperm starting at screening and throughout the study period and for 90 days after the final study drug administration.

• Study participant agrees not to participate in another interventional study while on treatment.

• Study participant is defined as having morphologically documented newly diagnosed previously untreated primary or secondary AML by the World Health Organization (WHO) criteria (2016) and considered ineligible to receive intensive chemotherapy.

• Study participants ≥ 75 years of age are considered ineligible to receive intensive chemotherapy if they meet any of the following criteria:

⁃ ECOG Performance Status of 2 or 3;

⁃ Cardiac history of congestive heart failure (CHF) requiring treatment or ejection fraction ≤ 50% or chronic stable angina;

⁃ Diffusing capacity of the lung for carbon monoxide (DLCO) ≤ 65% or forced expiratory volume during the first second (FEV1) ≤ 65%;

⁃ Creatinine clearance ≥ 30 mL/min to \< 45 ml/min;

⁃ Moderate hepatic impairment with total bilirubin \> 1.5 to ≤ 3.0×ULN;

⁃ Any other comorbidity that the Investigator judges to be incompatible with intensive chemotherapy must be reviewed and approved by the Medical Monitor during screening and prior to treatment.

• Study participants are considered ineligible to receive intensive chemotherapy based on their age being ≥ 75 years.

• Study participant \< 75 years has an ECOG performance status ≤ 2; study participant ≥ 75 years has an ECOG performance status 0-2.

• Study participant must meet the following criteria as indicated on the clinical laboratory tests:

∙ Serum AST and ALT ≤ 3× institutional ULN unless considered due to leukemic organ involvement.

‣ Total serum bilirubin ≤ 3x institutional ULN unless considered due to leukemic organ involvement for study participants \< 75 years; total serum bilirubin ≤ 1.5x institutional ULN (or ≤ 3x institutional ULN if documented history of Gilbert's syndrome) unless considered due to leukemic organ involvement for study participants ≥ 75 years.

‣ Creatinine clearance as calculated by the Cockcroft-Gault formula or measured by 24-h urine collection of ≥ 30 mL/min for study participants \< 75 years; creatinine clearance as calculated by the Cockcroft-Gault formula or measured by 24-h urine collection of ≥ 45 mL/min for study participants ≥ 75 years.

• Study participant is suitable for oral administration of study drug and has minimum life expectancy (≥ 3 months)

• Female study participants must be either:

• Of non-childbearing potential

∙ Post-menopausal (defined as at least 1 year without any menses) prior to screening, or

‣ Documented surgically sterile or status post hysterectomy (at least 1 month prior to screening)

• Or, if of childbearing potential,

∙ Must have a negative serum or urine pregnancy test at screening (within 72 hours prior to start of treatment), and

‣ Must use an acceptable highly effective contraception starting at screening and throughout the study period and for 90 days after the final study drug administration.

• Female study participants must not be breastfeeding at screening and during the study period, and for 90 days after the final study drug administration.

• Female study participants must not donate ova starting at screening and throughout the study period, and for 90 days after the final study drug administration.

• Male study participants and their female spouse/partners who are of childbearing potential must be using highly effective contraception starting at screening and continue throughout the study period and for 90 days after the final study drug administration.

• Male study participants must not donate sperm starting at screening and throughout the study period and for 90 days after the final study drug administration.

• Study participant agrees not to participate in another interventional study while on treatment.

Locations
United States
Alabama
The Kirklin Clinic of UAB Hospital
RECRUITING
Birmingham
California
City of Hope Comprehensive Cancer Center
ACTIVE_NOT_RECRUITING
Duarte
University of California Irvine
RECRUITING
Irvine
UCSD Moores Cancer Center
ACTIVE_NOT_RECRUITING
La Jolla
USC/Norris Comprehensive Cancer Center
RECRUITING
Los Angeles
Stanford Cancer Center
RECRUITING
Palo Alto
University of California, Davis
RECRUITING
Sacramento
Connecticut
Yale University
RECRUITING
New Haven
Florida
University of Miami - Miller School of Medicine
RECRUITING
Miami
Georgia
Emory University
ACTIVE_NOT_RECRUITING
Atlanta
Massachusetts
Massachusetts General Hospital
ACTIVE_NOT_RECRUITING
Boston
North Carolina
Duke University Medical Center
RECRUITING
Durham
Ohio
Cleveland Clinic - Taussig Cancer Center
ACTIVE_NOT_RECRUITING
Cleveland
The Ohio State University Wexner Medical Center
RECRUITING
Columbus
Texas
MD Anderson Cancer Center
RECRUITING
Huston
Other Locations
Australia
Border Medical Oncology
ACTIVE_NOT_RECRUITING
Albury
St Vincent's Hospital Melbourne
ACTIVE_NOT_RECRUITING
Fitzroy
Royal Brisbane and Women's Hospital
ACTIVE_NOT_RECRUITING
Herston
Sir Charles Gairdner Hospital
ACTIVE_NOT_RECRUITING
Nedlands
Townsville University Hospital
ACTIVE_NOT_RECRUITING
Townsville
Germany
Charité Universitätsmedizin Berlin
ACTIVE_NOT_RECRUITING
Berlin
Universitätsklinikum Leipzig
ACTIVE_NOT_RECRUITING
Leipzig
New Zealand
Auckland City Hospital
ACTIVE_NOT_RECRUITING
Grafton
Republic of Korea
Kyungpook National University Hospital
ACTIVE_NOT_RECRUITING
Daegu
Pusan National University Hospital
ACTIVE_NOT_RECRUITING
Pusan
Seoul National University Bundang Hospital
ACTIVE_NOT_RECRUITING
Seongnam
Asan Medical Center
ACTIVE_NOT_RECRUITING
Seoul
Samsung Medical Center
ACTIVE_NOT_RECRUITING
Seoul
Seoul National University Hospital
COMPLETED
Seoul
Spain
Hospital Universitario Vall d'Hebron
ACTIVE_NOT_RECRUITING
Barcelona
Hospital Universitario Central de Asturias
ACTIVE_NOT_RECRUITING
Oviedo
Hospital Quirón Madrid
ACTIVE_NOT_RECRUITING
Pozuelo De Alarcón
Hospital Clinico Universitario de Valencia
ACTIVE_NOT_RECRUITING
Valencia
Hospital Universitari i Politècnic La Fe
ACTIVE_NOT_RECRUITING
Valencia
Contact Information
Primary
Rafael Bejar, MD, PhD
rbejar@aptose.com
858-401-6852
Time Frame
Start Date: 2019-03-11
Estimated Completion Date: 2027-04
Participants
Target number of participants: 240
Treatments
Experimental: Part A Dose Escalation [COMPLETED]
Part A dose escalation of tuspetinib as a single agent is planned for up to 6 dose levels. If a study participant in dose escalation at any dose level achieves clinical response, then the dose level will continue to enroll in Part B. If one DLT or less is observed in the 6 participants (\<1/6 DLT observed) in Part A, up to 20 evaluable participants can be enrolled in Part B at that dose level.
Experimental: Part B Dose Exploration [ACTIVE, NOT RECRUITING]
Part B dose exploration of tuspetinib as a single agent is planned for up to 4 dose levels.
Experimental: Part C Dose Expansion (tuspetinib as a single agent) [COMPLETE]
Part C dose expansion of tuspetinib as a single agent is planned for 2 dose levels. Study participants will be randomly assigned to either arm based on the number of slots available. The initial tuspetinib dose will be 120 mg.
Experimental: Part C Dose Expansion (tuspetinib plus venetoclax) [COMPLETE]
Part C dose expansion of tuspetinib in combination with venetoclax is planned for 2 dose levels. The initial tuspetinib dose will be 80 mg.
Experimental: Part D Dose Exploration (tuspetinib plus venetoclax and azacitidine) [ACTIVE, RECRUITING - US Sites]
Part D dose exploration of tuspetinib in combination with venetoclax and azacitidine is planned for up to 6 dose levels. The initial tuspetinib dose will be 40 mg.
Sponsors
Leads: Aptose Biosciences Inc.

This content was sourced from clinicaltrials.gov

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