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A Study of IMM01 Combined With Azacitidine in Patients With Acute Myeloid Leukemia and Myelodysplastic Syndrome

Phase 1
Recruiting
Conditions
Acute Myeloid Leukemia
Myelodysplastic Syndromes
Interventions
Registration Number
NCT05140811
Lead Sponsor
ImmuneOnco Biopharmaceuticals (Shanghai) Inc.
Brief Summary

This trial is an open-lable , multi-center, Phase 1/Phase 2 study that will evaluate the safety, tolerability, Pharmacokinetics, Pharmacodynamics and and immunogenicity of IMM01 combined with Azacitidine in patients with Acute Myeloid Leukemia (AML) and Myelodysplastic Syndrome (MDS).

Detailed Description

Main study purpose:

* To evaluate the safety and tolerability of IMM01 combined with Azacitidine in patients with AML and MDS.

* To explore the Maximum Tolerated Dose (MTD) of IMM01 combined with Azacitidine, and determine the phase 2 clinical recommended dose (RP2D) of IMM01 combined with Azacitidine.

Secondary study purpose:

* To evaluate the efficacy of IMM01 combined with Azacitidine in patients with AML and MDS.

* To evaluate the Pharmacokinetics and Pharmacodynamics of IMM01 combined with Azacitidine, in patients with AML and MDS.

Exploratory study purpose:

• To evaluate the immunogenicity of IMM01 combined with Azacitidine in patients with AML and MDS.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
126
Inclusion Criteria
  1. Voluntary participation and written informed consent.
  2. Males and females ≥18 years of age
  3. The Eastern Oncology Collaboration (ECOG) Status of ≤2
  4. Life expectancy of at least 3 months.
  5. Women and men of reproductive age must agree and use effective contraception during the study period and for three months after the last administration of IMM01, and women of reproductive age must have negative pregnancy test results within seven days prior to administration.
  6. White blood cell count ≤ 20×10⁹/L before the first treatment of the study drug (treatment with hydroxyurea is permitted, but not within 3 days before the first treatment of the study drug).
  7. Bone marrow aspiration and bone marrow biopsy were agreed during screening and treatment.
  8. For those who have received previous chemotherapy or targeted drug therapy, the interval between the first drug administration should be more than 2 weeks;Prior treatment with chimeric antigen receptor T cells (CAR T cells) should be discontinued for at least 12 weeks after initial dosing(for Cohort 1 and 2).
  9. Non-hematological adverse reactions have been restored to grade 1 and below (NCI-CTC AE v5.0, except residual hair loss effect),in patients with previous chemotherapy and targeted drug therapy. Hematologic adverse reactions recovered to investigatory-determined acceptance of study drug administration (for cohort 1 and 2).
  10. Appropriate organ functions.
Exclusion Criteria
  1. Received anti-CD47 antibody or SIRPα fusion protein research drugs.

  2. Who has received allogeneic hematopoietic stem cell transplantation and other organ transplants; Autologous hematopoietic stem cell transplantation less than six months.

  3. Central nervous system leukemia orcentral nervous system invasion.

  4. Developed other malignant tumors within 5 years prior to enrollment.Except:

    Cured carcinoma in situ and non-melanoma skin cancer of the cervix; Complete remission of disease at least 2 years prior to initial administration and no need for antineoplastic therapy.

  5. Patients with a history of active autoimmune diseases;

  6. Major surgery within 4 weeks prior to initial treatment;

  7. Subjects requiring systemic corticosteroids (equivalent to >10 mg prednisone/day) or other immunosuppressive agents within 14 days prior to initial treatment or during the study period;

  8. Hypertension (systolic blood pressure ≥ 140mmHg and/or diastolic blood pressure ≥ 90mmHg) or pulmonary hypertension or unstable angina that is also not controlled by medication;

  9. Patients with a history of arterial or deep vein thrombosis within the 6 months prior to enrollment, or evidence or history of bleeding tendency within the 2 months prior to enrollment, regardless of severity.

  10. Severe gastrointestinal diseases;

  11. With acute lung disease, pulmonary fibrosis, Severe dyspnea, lung insufficiency or continuous oxygen inhalation.

  12. Patients who have been severely infected within 4 weeks prior to initial administration;

  13. Active hepatitis B or hepatitis C ; human immunodeficiency virus (HIV) antibody is positive.

  14. Live attenuated vaccine should be administered within 4 weeks prior to initial administration.

  15. Patients with a history of severe allergy to protein drugs (CTCAE V5.0 grade > 3); Or the patient is allergic to azacytidine.

  16. Participate in clinical trials of other drugs 28 days prior to initial dosing.

  17. A history of prior neurological or mental disorders, such as epilepsy, dementia, or alcohol, drug or substance abuse, affects compliance.

  18. Other conditions that the investigator considers inappropriate for participation in this clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Relapse/Refractory AMLAzacitidineIMM01 and Azacitidine in Relapse/Refractory AML Interventions: Drug: IMM01 Drug: Azacitidine
Relapsed or Refractory MDSIMM01IMM01 and Azacitidine in Relapse/Refractory MDS Interventions: Drug: IMM01 Drug: Azacitidine
Relapsed or Refractory MDSAzacitidineIMM01 and Azacitidine in Relapse/Refractory MDS Interventions: Drug: IMM01 Drug: Azacitidine
Treatment naive AMLIMM01IMM01 and Azacitidine in treatment naive AML Interventions: Drug: IMM01 Drug: Azacitidine
Treatment naive AMLAzacitidineIMM01 and Azacitidine in treatment naive AML Interventions: Drug: IMM01 Drug: Azacitidine
Treatment naive MDS and naive CMMLIMM01IMM01 and Azacitidine in treatment naive MDS and naive CMML Interventions: Drug: IMM01 Drug: Azacitidine
Treatment naive MDS and naive CMMLAzacitidineIMM01 and Azacitidine in treatment naive MDS and naive CMML Interventions: Drug: IMM01 Drug: Azacitidine
Relapse/Refractory AMLIMM01IMM01 and Azacitidine in Relapse/Refractory AML Interventions: Drug: IMM01 Drug: Azacitidine
Primary Outcome Measures
NameTimeMethod
Incidence rate and the grade (severity) of dose-limiting toxicities (DLTs) of IMM01 combination azacitidineThough end of DLT evaluation period,up to approximately 28 days.

To be summarized using descriptive statistics

Maximum Tolerated Dose (MTD)Dose-limiting toxicities will be evaluated during the first cycle (28 days) of treatment.

MTD is the highest dose in patients with DLT incidence \<1/3.For a dose group to be assessed as MTD, at least 6 DLT data must be available to evaluate the subject.

Secondary Outcome Measures
NameTimeMethod
Pharmacokinetics - AUCWithin 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).

Area under the serum concentration - time curve

Pharmacokinetics - CmaxWithin 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).

Maximum observed concentration in serum

Pharmacokinetics - tmaxWithin 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).

Time to peak (maximum) serum concentration

Pharmacokinetics - T1/2Within 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).

Terminal half-life (T1/2)

Response RateWhen the last subject enrolled completes approximately 12 months of treatment

Response determined per European LeukemiaNet response criteria:

CR = bone marrow blasts \<5%; absence of blasts with Auer rods; absence of extramedullary disease; absolute neutrophil count \> 1.0 x 10e9/L; platelet count \> 100 x 10e9/L; and independence of red cell transfusions.

CRi = all CR criteria except for residual neutropenia (\< 1.0 x 10e9/L) or thrombocytopenia (\< 100 x 10e9/L)\].

To evaluate clinical benefit defined as CR, CRi, morphologic leukemia-free state, and partial remission (PR).

Overall Remission (OR):When the last subject enrolled completes approximately 12 months of treatment

Response Criteria are according to the Modified IWG (International Working Group) Response Criteria in Myelodysplasia.CR: bone marrow evaluation shows less than or equal to (\<=) 5% blasts; normal maturation of all cells lines (mCR), peripheral blood evaluation shows hemoglobin \>= 11 gram per deciliter (g/dL), neutrophils \>= 1000/mL, platelets \>= 100,000/mL, 0% blasts; PR: Same as CR, except blasts decrease by \>=50%, still greater than 5% in bone marrow. Hematologic improvement are measured in participants with pretreatment abnormal values: hemoglobin level less than 110 g/L (11 g/dL) or red blood count (RBC)-transfusion dependence, platelet count \<100 x 10\^9/L or platelet-transfusion dependence, absolute neutrophil count (ANC) less than 1.0 x 10\^9/L.

Trial Locations

Locations (22)

The first affiliated hospital of nanchang University

🇨🇳

Nanchang, China

Shanghai sixth's hospital

🇨🇳

Shanghai, China

Ganzhou People's Hospital

🇨🇳

Ganzhou, China

Guangdong provincial people hospital

🇨🇳

Guangzhou, China

Nanfang Hospital, Southern Medical University

🇨🇳

Guangzhou, China

The first affiliated hospital zhejiang university school of medicine

🇨🇳

Hangzhou, China

Beijing gobroad boren hospital

🇨🇳

Beijing, China

Second Affliated Hospital of Army Medical University

🇨🇳

Chongqing, China

Fujian medical university union hospital

🇨🇳

Fuzhou, China

Zhujiang Hospital, Southern Medical University/The Second School of Clinical Medicine, Southern Medical University

🇨🇳

Guangzhou, China

Ruijin Hospital, Shanghai Jiaotong University School of Medicine

🇨🇳

Shanghai, China

Tongren hospital shanghai jiaotong university school of medicine

🇨🇳

Shanghai, China

Shengjing Hospital Affiliated to China Medical University

🇨🇳

Shenyang, China

The First Hospital of China Medical University

🇨🇳

Shenyang, China

Tianjin Blood Disease Hospital

🇨🇳

Tianjin, China

Union Hospital Tongji Medical College Huazhong University of Science and Technology

🇨🇳

Wuhan, China

Henan Cancer Hospital

🇨🇳

Zhengzhou, China

Peking university third hospital

🇨🇳

Beijing, China

Chongqing university cancer hospital

🇨🇳

Chongqing, China

Xuanwu Hospital, Capital Medical University

🇨🇳

Beijing, China

The affiliated hospital of Xuzhou medical university

🇨🇳

Xuzhou, China

The first affiliated hospital of Zhengzhou University

🇨🇳

Zhengzhou, China

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