A Phase I/II Trial of BMS-986253 in Myelodysplastic Syndromes
Trial Snapshot
- Phase
- Phase 1
- Status
- Terminated
- Enrollment
- 2
- Locations
- 1
- Primary Endpoint
- Phase I: Optimal Biological Dose (OBD) for Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253)
Study Overview
Brief Summary
Background:
The myelodysplastic syndromes (MDS) are a group of bone marrow neoplasms. MDS mostly affect elderly people. The drugs used to treat MDS are not always effective, and the only curative treatment is stem cell transplant. Researchers want to see if a new drug can be used to treat MDS.
Objective:
To learn if HuMax-interleukin 8 (IL-8) BMS-986253 is a safe and effective treatment for MDS.
Eligibility:
Adults aged 18 and older with MDS.
Design:
Participants will be screened with a medical history, medication review, and physical exam. They will answer questions about how well they are able to take care of themselves. Their temperature, blood pressure, breathing rate, and heart rate will be monitored. They will have an electrocardiogram to see how well their heart is working. They will give blood and urine samples. They may have a bone marrow biopsy.
Participants will be assigned to a specific group. They will receive either BMS-986253 alone or in combination with deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi).
Treatment will be given in 28-day cycles. Participants will get BMS-986253 as an infusion on days 1 and 15 of each cycle. Some participants also will take oral DNMTi on days 2-6 of each cycle. They will receive treatment until their disease gets worse or they have bad side effects.
At study visits, some screening tests will be repeated. Some of the samples that are collected will be used for genetic testing.
About 30 days after treatment ends, participants will have a follow-up visit to see how they are doing. After that, follow up will occur via phone every 3-6 months until the study ends.
National Institutes of Health (NIH) will cover the costs for some travel expenses....
Detailed Description
Background:
The myelodysplastic syndromes (MDS) are a group of clonal bone marrow neoplasms characterized by ineffective hematopoiesis, cytopenia, and high risk for transformation to acute myeloid leukemia (AML).
MDS is primarily a disease of the elderly, with about 80% of participants being older than 65-years of age; with 10,000 new diagnoses per year in the United States (U.S.)
The only curative treatment for participants with MDS is allogeneic hematopoietic stem cell transplantation (HSCT) and only a small portion of participants are eligible. Depending on risk stratification, the median survival of high- and low-risk MDS participants is 1.5 to 5.9 years, respectively.
Deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) are the standard of care therapy for high-risk MDS. However, less than half of participants respond to DNMTi, and even the best responses are transient and non-curative. More effective and less toxic therapies are needed.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
Phase I Eligible Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Biopsy (Procedure)
Phase I Eligible Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Aspiration (Procedure)
Phase I Eligible Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) Decitabine (Drug)
Phase I Eligible Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) Cedazuridine (Drug)
Phase I Eligible Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: BMS-986253 (Drug)
Phase I Eligible Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: ECG (Procedure)
Phase I Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: BMS-986253 (Drug)
Phase I Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Biopsy (Procedure)
Phase I Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Aspiration (Procedure)
Phase I Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Escalating doses of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: ECG (Procedure)
Phase II Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) Decitabine (Drug)
Phase II Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) Cedazuridine (Drug)
Phase II Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: BMS-986253 (Drug)
Phase II Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Biopsy (Procedure)
Phase II Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Aspiration (Procedure)
Phase II Higher Risk (HR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) + deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) for higher risk (HR) myelodysplastic syndromes (MDS) participants.
Intervention: ECG (Procedure)
Phase II Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: BMS-986253 (Drug)
Phase II Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Biopsy (Procedure)
Phase II Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: Bone Marrow Aspiration (Procedure)
Phase II Lower Risk (LR) Myelodysplastic Syndromes (MDS) Participants
Phase II dose of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) for lower risk (LR) myelodysplastic syndromes (MDS) participants.
Intervention: ECG (Procedure)
Outcomes
Primary Outcomes
Phase I: Optimal Biological Dose (OBD) for Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253)
Time Frame: First 28 days (C1D28) on up to 30 days.
OBD of BMS-986253 with and without deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi), as determined by dose limiting toxicity (DLT) occurring by cycle 1 day 28 (C1D28). DLT is defined as any of the following: any grade ≥ non-hematologic toxicity that is possibly, probably, or definitely related to study drug. Liver injury as defined by a positive Hy's Law. And adverse reaction that leads to dose reduction or withdrawal. OBD is the lowest tolerated dose level showing optimal biological activity, defined as maximal suppression of serum free IL-8 levels. The goal is to achieve IL-8 levels below the lower limit of detection of the assay in real time by Ultrasensitive immunoassay based on Quanterix Simoa technology. The lower limit of quantification = 0.86 pg/mL by Myriad-Rules Based Medicine (RBM).
Phase II: Overall Response Rate
Time Frame: 6 months
Overall response rate (ORR= Complete Remission (CR) + Partial Remission (PR) + \[marrow CR + hematologic improvement (HI\]) of Human Humax (HuMax)-interleukin 8 (IL-8) (BMS-986253) with and without deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi) after 6 cycles of therapy was assessed by the 2006 International Working Group response criteria for Myelodysplastic Syndromes. Complete Remission (CR) is bone marrow ≤55% myeloblasts with normal maturation of all cell lines. Persistent dysplasia will be noted. Partial Remission (PR) is all CR criteria if abnormal before treatment except bone marrow blasts decreased by ≥50% over pretreatment but still \>5%. And cellularity and morphology not relevant.
Phase I: Recommended Phase 2 Dose (RP2D) of Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253)
Time Frame: First 28 days (C1D28)
RP2D of BMS-986253 with and without deoxyribonucleic acid (DNA) methyltransferase inhibitors (DNMTi), as determined by dose -limiting toxicity (DLT) occurring by cycle 1 day 28 (C1D28). RP2D is defined as the optimal biological dose expected to be safe and of potential efficacy. It serves as a starting point for further investigations in future phase 2 clinical trials. DLT is defined as any of the following: ang grade ≥ non-hematologic toxicity that is possibly, probably, or definitely related to study drug. Liver injury as defined by a positive Hy's Law. And adverse reaction that leads to dose reduction or withdrawal.
Phase I: Number of Grades 1-5 Serious and/or Non-serious Adverse Events Related to Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253) and Deoxyribonucleic Acid (DNA) Methyltransferase Inhibitors (DNMTi)
Time Frame: First 28 days and follow up after the end of the treatment cycle; approximately 2 months.
Safety as measured by incidence of adverse events (AEs) and serious adverse events (SAEs), and AEs leading to discontinuation, death, and laboratory abnormalities. Adverse events were assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned. Grade 1 is mild. Grade 2 is moderate. Grade 3 is severe. Grade 4 if life-threatening. Grade 5 is death related to adverse event.
Phase II: Fraction of Participants With Clinical Response
Time Frame: Study treatment until occurrence of disease progression, death, or unacceptable toxicity or until response assessment on Cycle 7 day 1 (C7D1), a maximum of 6 cycles
Clinical response was assessed by the assessed by the 2006 International Working Group response criteria for Myelodysplastic Syndromes and reported with 95% confidence interval. Complete Remission (CR) is bone marrow ≤55% myeloblasts with normal maturation of all cell lines. Persistent dysplasia will be noted. Partial Remission (PR) is all CR criteria if abnormal before treatment except bone marrow blasts decreased by ≥50% over pretreatment but still \>5%. And cellularity and morphology not relevant. Stable disease is failure to achieve at least PR, but no evidence of progression for \>8 weeks. Progression is less than 5% blasts: ≥50% increase in blasts to \>5% blasts; 5%-10% blasts: ≥50% increase to 10% blasts; transfusion dependence. Relapse after CR or PR is at least 1 of the following: return to pre-treatment bone marrow blast percentage or decrement of ≥50% from maximum remission/response levels in granulocytes or platelets.
Secondary Outcomes
- Phase I: Area Under the Concentration Time Curve (AUC 0-24h) of Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253) in Myelodysplastic Syndromes (MDS) With and Without Deoxyribonucleic Acid (DNA) Methyltransferase Inhibitors (DNMTi)(Before infusion, within 30 minutes, start of infusion, 1, 4, 12, and 24 hours after end of infusion.)
- Phase I: Concentration of Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253) at Steady State With and Without Deoxyribonucleic Acid (DNA) Methyltransferase Inhibitors (DNMTi)(Before infusion, within 30 minutes, start of infusion, 1, 4, 12, and 24 hours after end of infusion.)
- Phase II: Number of Grades 1-5 Serious and/or Non-serious Adverse Events Related to Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253) and Deoxyribonucleic Acid (DNA) Methyltransferase Inhibitors (DNMTi)(1 year)
- Phase II: Cytogenetic Response Rate(Study treatment until occurrence of disease progression, death, or unacceptable toxicity or until response assessment on Cycle 7 day 1 (C7D1), a maximum of 6 cycles)
- Phase II: Time to Best Response (Complete Remission (CR), Partial Remission (PR), Marrow CR + Hematologic Improvement (HI), HI)(Time to best response)
- Phase II: Disease Free Survival (DFS)(Until study closure)
- Phase II: Progression Free Survival (PFS)(Until study closure)
- Phase II: Leukemia Free Survival (LFS)(Until study closure)
- Phase II: Overall Survival (OS)(Until study closure)
- Phase I: Half-life of Human Humax (HuMax)-Interleukin 8 (IL-8) (BMS-986253) With and Without Deoxyribonucleic Acid (DNA) Methyltransferase Inhibitors (DNMTi)(Before infusion, within 30 minutes, start of infusion, 1, 4, 12, and 24 hours after end of infusion.)
Investigators
Najla El Jurdi
Principal Investigator
National Cancer Institute (NCI)
