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A Study of HMPL-306 in Advanced Hematological Malignancies With mIDH

Phase 1
Terminated
Conditions
Isocitrate Dehydrogenase Gene Mutation
Interventions
Registration Number
NCT04764474
Lead Sponsor
Hutchmed
Brief Summary

An open label single-arm clinical trial to evaluate the safety, tolerability, PK, PD, and preliminary efficacy of HMPL-306 in subjects with advanced relapsed, refractory, or resistant hematological malignancies that harbor IDH mutations.

Detailed Description

HMPL-306 is a dual IDH1/2 inhibitor

This is a phase 1, open-label, multicenter, single-arm study to evaluate safety, tolerability, PK, PD, and preliminary efficacy of HMPL-306 administered orally in treatment of subjects with advanced relapsed, refractory, or resistant hematological malignancies that harbor IDH mutations (or co-mutations).

The study consists of 2 parts: a dose-escalation part (Part 1) and a dose-expansion part (Part 2). The dose-escalation part will determine the MTD/R2PD. The dose-expansion part will administer the MTD/RP2D to subjects with mIDH-positive AML

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
46
Inclusion Criteria

Subjects may be enrolled in this study only if they satisfy all the following criteria (NOTE: This is not an exhaustive list):

  • Subjects aged ≥18 years.
  • ECOG performance status ≤ 2
  • Subjects with advanced relapsed, refractory, or resistant hematological malignancies, as defined below:

Part 1:

  • Subjects with documented IDH mutation per local or institutional next generation sequence (NGS).
  • Subjects must be refractory to or intolerant of established therapies.
  • Subjects who have received prior IDH inhibitor treatment may be enrolled in the escalation phase.

Part 2:

  • Subjects with documented IDH mutation of any of these subsets: IDH1 (R132C), IDH1 (R132H), IDH (R140Q), and IDH2 (R172K), including co-mutations and any combination thereof per local and institutional NGS.

  • Patients must have received at least 1 prior line of therapy with an IDH inhibitor. An established standard of care with proven benefit for which the patient is eligible, must not be available at the time of enrollment.

  • Patients with AML must not have standard therapeutic options available (including IDH inhibitors where approved) and have the following:

    • i. Relapsed AML unsuitable for intensive chemotherapy or venetoclax-based regimen or target agents;
    • ii. Primary refractory AML unsuitable for intensive chemotherapy or venetoclax-based regimen or target agents.
    • iii. Relapsed/refractory AML that has progressed on prior IDH treatment

Key

Exclusion Criteria

Subjects are not eligible for enrollment into this study if they meet any of the following criteria (NOTE: This is not an exhaustive list):

  • Subjects who received an investigational agent <14 days prior to their first day of study drug administration.
  • Subjects who are pregnant or breastfeeding.
  • Subjects with an active severe infection, some treated infections and with an expected or with an unexplained fever >38.3°C during screening visits or on their first day of study drug administration.
  • Subjects with some current or prior heart conditions.
  • Subjects taking medications that are known to prolong the QT interval may not be eligible.
  • Subjects with immediately life-threatening, severe complications of leukemia such as uncontrolled bleeding, pneumonia with hypoxia or shock, and/or disseminated intravascular coagulation.
  • Some subjects with some current or prior gastrointestinal or liver diseases.
  • Subjects with inadequate organ function as defined by the protocol.
  • Subjects with a medical condition, physical examination finding, or clinical laboratory finding that, in the Investigators opinion, contraindicates the use of an investigational drug or that may affect the interpretation of the results or renders the subject at high risk from treatment complications.
  • Subjects with a known hypersensitivity to HMPL-306 or to any of its excipients.
  • Subjects with presence of second primary malignant tumors within the last 2 years, with the exception of the following, if medically controlled: basal cell carcinoma of the skin, squamous cell carcinoma of the skin, carcinoma in situ of the cervix, and carcinoma in situ of the breast.
  • Part 2 Only: The time since the last dose of prior IDH inhibitor treatment is within 30 days prior to the first day of study drug administration

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
TreatmentHMPL-306All patients will be administered HMPL-306 orally QD
Primary Outcome Measures
NameTimeMethod
Part 1 and Part 2: Frequency and severity of AEsFrom the first dose of the study drug to 37 days after the last dose of study drug
Part 1: Number of Subjects with Dose Limiting Toxicities (DLTs)Up to 28 days after first dose of study drug

DLT is defined as an adverse event (AE) that meets protocol defined DLT criteria during cycle 1 and is at least possibly related to study drug.

Secondary Outcome Measures
NameTimeMethod
Time to maximum concentrationPK weeks at screening through end of treatment, assessed up to 36 months

Blood samples will be obtained from all patients for determination time to maximum concentration of HMPL-306.

Number of Subjects with best overall responseFrom 1st dose of study drug to the time of progressive disease, assessed up to 36 months

Subjects with AML will be evaluated according to the 2017 ELN criteria

Progression-free survival (PFS)From first dose of study drug to earlier of progression or death, assessed up to 36 months

PFS is defined as the time from the start of study treatment to disease progression, or death due to any cause, whichever occurs first.

Maximum serum drug concentrationPK weeks at screening through end of treatment, assessed up to 36 months

Blood samples will be obtained from all patients for determination of the maximum serum concentration of HMPL-306.

Area under the concentration-time curve (AUC)PK weeks at screening through safety follow-up, assessed up to 36 months

Blood samples will be obtained from all patients for determination of the AUC of HMPL-306

Concentration of 2-HG in plasma and/or bone marrowPK weeks at screening through safety follow-up, assessed up to 36 months

Blood or bone marrow sample to determine the concentration of 2-HG

Objective Response rate (ORR)From 1st dose of study drug to the time of progressive disease, assessed up to 36 months

It is defined to include subjects who have the objective response.

Clinical Benefit Rate (CBR)From 1st dose of study drug to the time of progressive disease, assessed up to 36 months

CBR is defined as the proportion of subjects achieving objective response or SD.

Overall survival (OS)From 1st dose of study drug to the time of progressive disease, assessed up to 36 months

OS is defined as the time from the start of the study drug until death from any cause.

Subjects with baseline transfusion dependenceFrom the first dose of study drug to last dose of study drug, assessed up to 36 months

It is defined as requiring transfusions of red blood cells (RBCs) or platelets within 56 days prior to the first dose of treatment.

Subjects with post-baseline transfusion independenceFrom 1st dose of study drug to the time of progressive disease, assessed up to 36 months

It is defined as no RBC or platelet transfusion for at least ≥4 weeks (and separately ≥8 weeks) during treatment period.

Trial Locations

Locations (15)

University of California Irvine Medical Center (UCIMC) - Chao Family Comprehensive Cancer Center

🇺🇸

Orange, California, United States

Institut Catala d'Oncologia de l'Hospitalet de Llobregat - Hospital Duran i Reynals

🇪🇸

Barcelona, Spain

Hospital Universitario de Salamanca

🇪🇸

Salamanca, Spain

Hospital Universitario La Fe

🇪🇸

Valencia, Spain

Winship Cancer Institute - Emory University

🇺🇸

Atlanta, Georgia, United States

University of Massachusetts Medical School

🇺🇸

Worcester, Massachusetts, United States

Froedtert-Medical College of WI

🇺🇸

Milwaukee, Wisconsin, United States

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

The Ohio State University Comprehensive Cancer Center

🇺🇸

Columbus, Ohio, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Clinica Universidad de Navarra

🇪🇸

Pamplona, Navarra, Spain

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

START Madrid - Hospital Universitario Fundacion Jimenez Diaz

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Clinico Universitario de Valencia

🇪🇸

Valencia, Spain

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