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A Phase 1 Study Evaluating CPI-0610 in Patients With Previously Treated Multiple Myeloma

Phase 1
Completed
Conditions
Multiple Myeloma
Interventions
Registration Number
NCT02157636
Lead Sponsor
Constellation Pharmaceuticals
Brief Summary

Open-label, sequential dose escalation and expansion study of CPI-0610 in patients with previously treated multiple myeloma. CPI-0610 is a small molecule inhibitor of bromodomain and extra-terminal (BET) proteins.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Adults (aged ≥ 18 years)
  • Histologically or cytologically confirmed diagnosis of multiple myeloma that has progressed despite at least one line of standard therapy
  • Must have measurable disease, defined by one or more of following: (i) a serum M protein > 0.5 g/dl measured by serum protein electrophoresis; (ii) urinary M protein excretion > 200 mg/24 hours; (iii) serum free light chain (FLC) measurement > 10 mg/dl, provided that the serum FLC ratio is abnormal
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤2
  • Adequate hematological, renal, hepatic, and coagulation laboratory assessments
  • Written informed consent to participate in this study before the performance of any study-related procedure
Exclusion Criteria
  • Current infection with HIV, Hepatitis B or Hepatitis C

  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of CPI-0610, including any unresolved nausea, vomiting, or diarrhea that is CTCAE grade >1

  • Impaired cardiac function or clinically significant cardiac diseases, including any of the following:

    • Acute myocardial infarction or angina pectoris ≤ 6 months prior to starting study drug
    • Serum cardiac troponin (cTn) level ≥ 99% percentile of the upper reference limit
    • QTcF > 470 msec on the screening ECG
    • Left ventricular ejection fraction (LVEF) < 50%
  • Uncontrolled cardiac arrhythmia (patients with rate-controlled atrial fibrillation are not excluded.)

  • Any other concurrent severe and/or uncontrolled concomitant medical condition that could compromise participation in the study (e.g., clinically significant pulmonary disease, clinically significant neurological disorder, active or uncontrolled infection)

  • Systemic anti-cancer treatment or radiotherapy less than 2 weeks before the first dose of CPI-0610

  • Treatment with an investigational small molecule less than 2 weeks before the first dose of CPI-0610. In addition, the first dose of CPI-0610 should not occur before a period equal to or greater than 5 half-lives of the small molecule investigational agent has elapsed

  • Treatment with a therapeutic antibody less than 4 weeks before the first dose of CPI-0610. A minimum 2-week period between the last treatment with a therapeutic antibody and the first dose of CPI-0610 may be permitted in patients with rapidly progressive myeloma, following discussion with the medical monitor

  • Treatment with medications that are known to be strong inhibitors or inducers of CYP450 enzymes

  • Treatment with medications that are known to carry a risk of Torsades de Pointes

  • Immunosuppressive treatment that cannot be discontinued both prior to study entry and for the duration of the study. Oral prednisone at a dose of 10 mg or less per day is allowed, as are other oral corticosteroids given at glucocorticoid-equivalent doses. Topical, nasal and inhaled corticosteroids are also allowed

  • Pregnant or lactating women

  • Women of child-bearing potential and men with reproductive potential, if they are unwilling to use adequate contraception while on study therapy and for 3 months thereafter

  • Patients unwilling or unable to comply with the study protocol

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
CPI-0610CPI-0610-
Primary Outcome Measures
NameTimeMethod
Frequency of dose-limiting toxicities (DLTs) associated with CPI-0610 administration during the first cycle (first 21 days) of treatmentDLTs asessed during Cycle 1 (first 21 days on study)
Secondary Outcome Measures
NameTimeMethod
Pharmacokinetic parameters of CPI-0610: AUC(0-t), AUC(0-inf), AUCtau,ss, Tmax, Cmax, Ctrough, T1/2, Vd/F, CL/FAssessed during cycle 1 (first 21 days on study); and on cycle 2, day 1
Safety and tolerability of CPI-0610 as assessed by: frequency of adverse events and serious adverse events; changes in hematology and clinical chemistry values; changes in physical examination, vital signs, electrocardiogram, ECHO and ECOG scoreAssessed from Day 1 of Cycle 1 through 30 days after patient's last dose of study drug
Pharmacodynamic effects of CPI-0610: Changes in the expression of MYC and other genes in malignant tumor cells; changes in cellular proliferation and in the extent of apoptosisAssessed during cycle 1 (first 21 days on study); and on cycle 2, day 1

This outcome measure is a composite measure

Changes in the expression of a set of genes in peripheral blood mononuclear cells (PBMCs) that are sensitive to BET inhibitionAssessed during cycle 1 (first 21 days on study)
Anti-myeloma activity associated with CPI-0610 treatmentAssessed after every cycle of treatment; assessed up to approximately 12 months

Anti-myeloma activity will be assessed using the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma

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