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Study of a Novel BET Inhibitor FT-1101 in Patients With Relapsed or Refractory Hematologic Malignancies

Phase 1
Completed
Conditions
Acute Myeloid Leukemia
Acute Myelogenous Leukemia
Non-Hodgkin Lymphoma
Myelodysplastic Syndrome
Interventions
Registration Number
NCT02543879
Lead Sponsor
Forma Therapeutics, Inc.
Brief Summary

This is an open-label, multicenter, dose-escalation Phase 1/1b study in patients with acute myelogenous leukemia (AML)/MDS or non-Hodgkin Lymphoma (NHL), intended to investigate safety, pharmacokinetics, and the pharmacodynamic effects of FT-1101 administered via one or more intermittent dosing schedules alone and in combination with azacitidine. Once the MTD has been established for a treatment cohort, up to 20 additional patients may be enrolled in up to 4 expansion cohorts each of select populations of patients with either AML/MDS or NHL at the recommended dose for future studies to confirm safety.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
94
Inclusion Criteria
  • Single agent (SA) Dose Escalation: Histologically or cytologically proven acute leukemia or high-risk MDS as defined by the World Health Organization (WHO) criteria and IPSS-R, respectively, that is relapsed or refractory (R/R) to standard therapy or for whom standard treatments are contraindicated, OR
  • Mature B-Cell non-Hodgkin Lymphoma that is Relapsed/Refractory to standard therapy
  • AML SA expansion group 1: histologically or cytologically proven AML with a FLT3 ITD or TKD mutation previously determined by local testing that is R/R to standard therapy or for whom standard treatments are contraindicated
  • AML SA expansion group 2: histologically or cytologically proven AML with intermediate or unfavorable risk cytogenetics in the absence of a detectable FLT3 ITD or TKD mutation as previously determined by local testing that is R/R to standard therapy or for whom standard treatments are contraindicated
  • NHL SA expansion: Mature B-cell NHL with the following histologies: primary mediastinal lymphoma, DLBCL, and B-cell lymphoma not specified that is R/R to standard therapy and for whom standard treatments are contraindicated or unavailable
  • AML/MDS combination treatment (dose escalation and expansion): histologically or cytologically proven AML or MDS as defined by WHO criteria and IPSS-R, respectively, that is: R/R to standard therapy, or AML: who are unfit for, or unwilling to receive standard induction therapy, or MDS: eligible to receive azacitidine
  • Patients ≥ 18 years old
  • Good kidney and liver function
  • No prior organ allograft
  • For fertile men and women, agreement to use effective contraceptive methods duration of study participation and 90 days after

Key

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Exclusion Criteria
  • History of prior malignancy unless disease free for > or equal to 12 months or considered surgically cured.
  • Patients with symptomatic central nervous system (CNS) metastases or other tumor location (such as spinal cord compression, other compressive mass, uncontrolled painful lesion, bone fracture, etc.) necessitating an urgent therapeutic intervention, palliative care, surgery or radiation therapy
  • Treatment with major surgery (requiring general anesthesia) within one month prior to study entry
  • Previous treatment with any prior BET inhibitor therapy
  • Patients unable to swallow oral medications, or patients with gastrointestinal conditions (e.g. malabsorption, gastric or small bowel resection, etc.) deemed to jeopardize intestinal absorption
  • Congestive heart failure (New York Heart Association Class III or IV) or unstable angina pectoris. Previous history of myocardial infarction within 1 year prior to study entry, uncontrolled hypertension or uncontrolled arrhythmias
  • Pulmonary disease (e.g. COPD, asthma, etc) that is not controlled (moderate to severe symptoms) with current medication
  • Known HIV positivity
  • Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dose Escalation FT-1101FT-1101Following a 3+3 dose escalation strategy, the first cohort of patients will be administered FT-1101 at 10 mg, oral capsules, once weekly on a continuous basis. Subsequent cohorts dose and frequency will be determined by investigators and sponsor following observations of previous cohorts. Dose escalation will continue until the MTD is determined.
Dose Expansion FT-1101FT-1101Once the MTD is determined, the Recommended Phase 2 Dose (RP2D) will be identified. 3 Expansion cohorts of up to 20 patients each will be treated with the RP2D of FT-1101
Dose Escalation FT-1101 + azacitidineAzacitidineFollowing a 3+3 dose escalation strategy, the first cohort of AML/MDS patients will be administered FT-1101 at approximately 50% or lower than the MTD identified for the single agent FT-1101. Subsequent cohorts dose will be determined by investigators and sponsor following observations of previous cohorts. Dose escalation will not exceed the dose determined to be the single agent MTD for that schedule.
Dose Expansion FT-1101 + azacitidineAzacitidineOnce the MTD is determined, the Recommended Phase 2 Dose (RP2D) will be identified. 1 Expansion cohorts of up to 20 AML/MDS patients each will be treated with the RP2D of FT-1101 in combination with azacitidine.
Dose Escalation FT-1101 + azacitidineFT-1101Following a 3+3 dose escalation strategy, the first cohort of AML/MDS patients will be administered FT-1101 at approximately 50% or lower than the MTD identified for the single agent FT-1101. Subsequent cohorts dose will be determined by investigators and sponsor following observations of previous cohorts. Dose escalation will not exceed the dose determined to be the single agent MTD for that schedule.
Dose Expansion FT-1101 + azacitidineFT-1101Once the MTD is determined, the Recommended Phase 2 Dose (RP2D) will be identified. 1 Expansion cohorts of up to 20 AML/MDS patients each will be treated with the RP2D of FT-1101 in combination with azacitidine.
Primary Outcome Measures
NameTimeMethod
Maximum Tolerated Dose (MTD)Within first 4 weeks of treatment
Dose Limiting Toxicities (DLT)Within first 4 weeks of treatment
Recommended Phase 2 Dose (RP2D)Participants to be followed for duration of participation, an expected average of 12 weeks
Secondary Outcome Measures
NameTimeMethod
Rate at which drug is removed from blood stream (CL/F)PK collected at multiple visits during the first 30 days of treatment
Area under the plasma concentration versus time curve (AUC)PK collected at multiple visits during the first 30 days of treatment
Peak Plasma Concentration (Cmax)PK collected at multiple visits during the first 30 days of treatment
Time for half of the drug to be absent in blood stream following dose (T 1/2)PK collected at multiple visits during the first 30 days of treatment
Time of peak plasma concentration (TMax)PK collected at multiple visits during the first 30 days of treatment
Rate of drug distribution within the blood stream (Vd/F)PK collected at multiple visits during the first 30 days of treatment
Observe patients for any evidence of anti-leukemic or anti-myelodysplastic activity of FT-1101Assessed for duration of participation, an expected average of 12 weeks

Trial Locations

Locations (8)

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

Cedars Sinai

🇺🇸

Los Angeles, California, United States

Florida Cancer Specialists

🇺🇸

Sarasota, Florida, United States

University of Maryland, Greenebaum Comprehensive Cancer Center

🇺🇸

Baltimore, Maryland, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Sarah Cannon Research Institute

🇺🇸

Nashville, Tennessee, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

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