A prospective Phase I/IIa, open-label, multicenter trial to evaluate the safety and efficacy of oNKord®, an off-the-shelf, ex vivo-cultured allogeneic NK cell preparation, in subjects with acute myeloid leukemia who are in morphologic complete remission with measurable residual disease and who are currently not proceeding to allogeneic hematopoietic stem cell transplantation.
- Conditions
- bone marrow cancer cellsleukemia10024324
- Registration Number
- NL-OMON52744
- Lead Sponsor
- Glycostem Therapeutics
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- Not specified
- Target Recruitment
- 8
To be eligible to participate in this trial, subjects must meet all of the
following eligibility criteria:
1. Male or female subjects >= 18 years old
2. Subjects with a diagnosis of AML and related precursor neoplasms according
to the World Health Organization (WHO) 2016 classification (excluding acute
promyelocytic leukaemia), including secondary AML after an antecedent
haematological disease (e.g. myelodysplastic syndrome) and therapy-related AML
3. a. For cohorts A1, A2, A3, A5 (and cohort B if applicable): Subjects who
have achieved morphologic CR, including CRi, and complete clinical remission,
with MRD documented at screening, after one or two courses of remission
induction chemotherapy and who have completed consolidation chemotherapy or who
achieved morphologic CR with documented MRD with hypomethylating agents (HMAs)
or other relevant appropriate therapies (e.g. HMAs in combination with
venetoclax)
b. For cohort A4 (and cohort B if applicable): Subjects with newly diagnosed
AML who have achieved morphologic CR, including CRi while undergoing
azacitidine-venetoclax standard of care treatment, and who are MRD-positive on
the 28th day (+/- 7 days) of at least treatment cycle 3 or later cycles (>=3)
4.Subjects who are currently (at the time of screening) not proceeding to
allo-HSCT, i.e.:
a. Subjects who have a contraindication for allo-HSCT (e.g. age > 75 years old,
diffusing capacity of the lung for carbon monoxide [DLCO] < 60%, left
ventricular ejection fraction [LVEF] < 40%, liver cirrhosis, creatinine
clearance < 30 mL/min, hematopoietic stem cell transplantation-specific
comorbidity index [HCT-CI] >= 5); or
b. Subjects who have no contraindication for allo-HSCT but do not proceed:
i. By personal choice; or
ii. Because there is no compatible donor expected to be available in a timely
manner; or
iii. Due to unfavorable patient-specific risk-benefit assessment discussed
between the treating physician and the patient and his/her close relatives.
Factors taken into consideration include the disease-related risk (risk of
relapse, toxicity or other treatment options if any), the patient-related risk
(age, comorbidities including the HCT-CI score) and the curative potential of
allo-HSCT versus toxicity (treatment intensity, graft versus leukemia effect,
non-relapse mortality risk) (Muller and Muller-Tidow 2015)
5. Life expectancy >= 6 months at screening
6. Adequate renal and hepatic functions within 14 days of trial screening,
unless clearly disease-related, as indicated by the following laboratory values:
a. Serum creatinine <= 3 times the upper limit of normal (ULN) and estimated
glomerular filtration rate (eGFR) >= 30 mL/min/1.73 m2
b. Serum total bilirubin < 2.0 mg/dL, unless due to Gilbert*s syndrome
c. Alanine transaminase (ALT) <= 2.5 x ULN
7. Karnofsky Status >= 50%
8.Seropositivity to Epstein-Barr virus (EBV)
9. Male subjects with partners who are women of childbearing potential must use
an effective contraceptive method during the trial and for a minimum of 6
months after trial treatment, or have undergone successful vasectomy at least 6
months prior to entry into the trial (confirmed by semen analysis)
10. Female subjects of childbearing potential must have a negative serum
pregnancy test at screening and agree to use an effective contracept
Subjects who meet any of the following criteria at screening will be excluded
from trial entry:
1. Subjects having received prior allo- HSCT
2. Subjects with acute promyelocytic leukaemia
3. Diagnosis of any previous or concomitant malignancy is an exclusion
criterion, except when the subject completed treatment (chemotherapy and/or
surgery and/or radiotherapy) with curative intent for this malignancy at least
6 months prior to enrolment
4. Blast crisis of chronic myeloid leukaemia
5. Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled
diabetes, uncontrolled infection, hypertension active or controlled infection),
including abnormal laboratory values that could compromise compliance with the
trial protocol or cause unacceptable safety risks.
6. Known allergy to any of the components of oNKord® (e.g., dimethyl sulfoxide
[DMSO]) or to any of the drugs to be administered in the preparative regimen to
oNKord® infusion
7. For cohorts A1, A2, A3, A5 (and cohort B if applicable): contraindication to
any of the drugs to be administered in the lymphodepleting conditioning
regimen. This includes Cy, Flu, and medications associated with prophylaxis of
AEs
8. Cardiac dysfunction as defined by:
a. Myocardial infarction within the last 3 months of trial entry, or
b. Reduced left ventricular function with an ejection fraction < 40% as
measured by multi-gated acquisition (MUGA) scan or echocardiogram (echo) within
28 days before screening, or
c. Unstable angina, or
d. New York Heart Association (NYHA) Class IV congestive heart failure, or
e. Unstable cardiac arrhythmiase trial
9. Pulmonary dysfunction as defined by oxygen saturation < 90% on room air.
Pulmonary function test (PFT) is required only in the case of symptomatic or
prior known impairments within 28 days before screening - with pulmonary
function < 50% corrected (DLCO) and forced expiratory volume in 1 second (FEV1)
10. Major surgery within 4 weeks prior to screening or a major wound that has
not fully healed
11. Vaccination with live, attenuated vaccines within 4 weeks prior to screening
12. Subjects must be able to be off prednisone or other immunosuppressive
medications for concomitant disease for at least 3 days prior to the:
a. Start of the Cy/Flu regimen in cohorts A1, A2, A3, A5 (and cohort B if
applicable)
b. First oNKord® infusion in cohort A4 (and cohort B if applicable)
13. History of stroke or intracranial haemorrhage within 6 months prior to
screening
14. Active infections (viral, bacterial or fungal) that requires specific
therapy. Acute anti-infectious therapy must have been completed within 14 days
prior to trial treatment
15. History of human immunodeficiency virus (HIV) or active infection with
hepatitis B virus (HBV) or hepatitis C virus (HCV)
16. a. For cohorts A1, A2, A3, A5 (and cohort B if applicable): Subjects who
are undergoing or will be undergoing chemotherapy (including HMAs), radiation
therapy, targeted therapy or immunotherapy that cannot be finished or stopped
at least 1 week prior to initiating the Cy/Flu conditioning regimen
b. For cohort A4 (and cohort B if applicable): Subjects who are undergoing or
will be undergoing chemotherapy (excluding HMAs), radiation therapy, targeted
therapy or immunotherapy that cannot be finished or stopped at lea
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method