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MEN1703 (SEL24) in Participants With Acute Myeloid Leukemia

Phase 1
Completed
Conditions
Acute Myeloid Leukemia
Interventions
Registration Number
NCT03008187
Lead Sponsor
Menarini Group
Brief Summary

The purpose of the clinical trial is to identify the maximum tolerated dose of MEN1703 and to further investigate its safety profile in participants with acute myeloid leukemia (AML).

Detailed Description

Phase I/II, open-label, multi-center, dose escalation study to estimate the maximum tolerated dose of MEN1703 in participants with acute myeloid leukemia.

The clinical trial will investigate the safety profile and anti-leukemic activity of MEN1703 in participants with AML and that have no standard therapeutic options available.

The clinical trial encompasses 2 parts:

* Part 1: Ascending dose levels - the main purpose of this part of the clinical trial is to determine the highest dose of MEN1703 considered to be well tolerated.

* Part 2: Expansion cohort - the main purpose of this part of the clinical trial is to assess the safety and anti-leukemia activity of MEN1703 given at the highest tolerated dose in participant with relapsed/refractory acute myeloid leukemia, either all comers as well as harboring isocitrate dehydrogenase (IDH1/IDH2) mutations.

Participants participating to the clinical trial will take the study drug as oral capsules once daily for 14 consecutive days over a 21-day treatment cycle.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
73
Inclusion Criteria
  • Participants with diagnosis of AML, all comers or bearing IDH1 or IDH2 mutation (completed)
  • Participant has no standard therapeutic options available and has either relapsed AML unsuitable for intensive chemotherapy, with no standard therapeutic options and/or not eligible for any approved targeted therapy or primary refractory AML unsuitable for intensive chemotherapy, with no standard therapeutic options and/or not eligible for any approved targeted therapy
Exclusion Criteria
  • Anti-cancer treatments (including cytotoxic chemotherapy, radiotherapy, hormonal therapy, biologic, immunotherapy or investigational drugs) received within 14 days or 5 half-lives for targeted therapies (whichever is shorter) before first dose of study drug (to be supplemented)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Cohort 1 (25 mg)MEN1703Participants received MEN1703 (25 milligrams \[mg\]) orally once daily for 14 consecutive days in cycles of 21 days.
Cohort 2 (50 mg)MEN1703Participants received MEN1703 (50 mg) orally once daily for 14 consecutive days in cycles of 21 days.
Cohort 3 (75 mg)MEN1703Participants received MEN1703 (75 mg) orally once daily for 14 consecutive days in cycles of 21 days.
Cohort 4 (100 mg)MEN1703Participants received MEN1703 (100 mg) orally once daily for 14 consecutive days in cycles of 21 days.
Cohort 5 (125 mg)MEN1703Participants received MEN1703 (125 mg) orally once daily for 14 consecutive days in cycles of 21 days.
Cohort 6 (150 mg)MEN1703Participants received MEN1703 (150 mg) orally once daily for 14 consecutive days in cycles of 21 days.
Primary Outcome Measures
NameTimeMethod
Part 1 and Part 2: Number of Participants Experiencing Treatment-emergent Adverse EventsUp to 21 months

An adverse event (AE) was defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a participant or clinical investigation participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not considered related to the investigational medicinal product. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse events module.

Part 1: Number of Participants Experiencing Dose-limiting Toxicity (DLT)Day 1 through Day 21 (first treatment cycle)

AEs were graded according to the National Cancer Institute common terminology criteria for adverse events, version 4.03. The following AEs were considered as DLT unless they were clearly and incontrovertibly attributable to the underlying disease or to an extraneous cause: Grade 5 toxicity; Grade 4 neutropenia lasting ≥42 days from the start of the therapy cycle in absence of evidence of active acute myeloid leukemia (AML) (\<5% blasts); Grade 3 or 4 non-hematologic toxicity (with protocol-define exceptions). Only clinically significant abnormalities in laboratory findings, physical examination, vital signs, weight, or electrocardiogram were considered for DLT assessment.

Secondary Outcome Measures
NameTimeMethod
Part 1 and Part 2: Overall Response Rate (ORR)Up to 32 months

ORR was defined as the percentage of participants who had a complete remission (CR), complete remission with incomplete hematologic recovery (CRi), complete remission with partial hematologic recovery (CRh), or morphologic leukemia-free state (MLFS) response to therapy.

Part 1 and Part 2: Partial Remission (PR) RateUp to 32 months

PR rate was defined as the percentage of participants who had a partial remission response to therapy.

Part 1 and Part 2: Duration of Response (DoR)Up to 32 months

DoR was defined as the time from the date of first CR, CRi, CRh, CR without minimal residual disease (CRMRD-), MLFS or PR until the date of documented relapse of any type, progressive disease or death due to disease progression for participants who achieve CR, CRi, CRh, CRMRD-, MLFS or PR. Results are reported in days.

Part 1 and Part 2: Relapse Free Survival (RFS)Up to 32 months

RFS was defined as the time from the date of first CR, CRi, CRh, or CRMRD- until the date of documented relapse or death from any cause. Results are reported in days.

Part 1 and Part 2: Overall Survival (OS)Up to 32 months

OS was defined as the number of days between the first study drug administration and death from any cause. Results are reported in days.

Part 1 and Part 2: Event Free Survival (EFS)Up to 32 months

EFS was defined as the time from the date of first study drug intake until the date of documented relapse, treatment failure, or death from any cause. Results are reported in days.

Part 1 and Part 2: Transfusion Conversion RateUp to 21 months

Transfusion conversion rate was defined as the percentage of participants who were transfusion dependent at baseline but became transfusion independent post-baseline. Participants were classified as baseline transfusion independent if there were no red blood cells (RBC) or platelet transfusions at baseline; otherwise, the participant was considered as baseline transfusion dependent. Participants were classified post-baseline transfusion independent in the event of 56 consecutive days without any RBC or platelet transfusion post-baseline; otherwise, the participant was considered post-baseline transfusion dependent.

Part 1 and Part 2: Transfusion Maintenance RateUp to 21 months

Transfusion maintenance rate was defined as the percentage of participants who were transfusion independent at baseline and still maintained to be transfusion independent post-baseline. Participants were classified as baseline transfusion independent if there were no RBC or platelet transfusions at baseline; otherwise, the participant was considered as baseline transfusion dependent. Participants were classified post-baseline transfusion independent in the event of 56 consecutive days without any RBC or platelet transfusion post-baseline; otherwise, the participant was considered post-baseline transfusion dependent.

Part 1 and Part 2: Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) RateUp to 21 months

Allogeneic HSCT rate was defined as the percentage of participants undergoing allogeneic stem cell transplant during the study period of each participant.

Part 1 and Part 2: Percentage of Participants With ≥ 50% Bone Marrow Blast ReductionUp to 20 months

Bone marrow aspirates/biopsies were taken at designated timepoints for evaluation of leukemic blast proportion in the bone marrow. A reduction in bone marrow blast proportion indicates increased anti-leukemic activity of the study drug.

Part 1 and Part 2: Maximum Observed Concentration (Cmax) for MEN1703Day 1 and Day 14 of Cycle 1 (pre-dose, up to 120 hours post dose) (21 days/cycle)

Nominal blood samples were taken at designated timepoints for evaluation of concentration levels of MEN1703 in plasma. Results are reported as nanograms/milliliter (ng/mL). Standard error not reported, arithmetic coefficient of variation (CV%) reported instead.

Part 1 and Part 2: Area Under the Concentration Versus Time Curve From Time Zero to the Last Quantifiable Concentration (AUClast) for MEN1703Day 1 of Cycle 1 (pre-dose, up to 24 hours post dose) (21 days/cycle)

Nominal blood samples were taken at designated timepoints for evaluation of concentration levels of MEN1703 in plasma. AUClast was calculated by the linear trapezoidal rule. Results are reported in hour times nanograms/milliliter (h\*ng/mL). Standard error not reported, arithmetic CV% reported instead.

Part 1 and Part 2: Area Under the Concentration Versus Time Curve From Time Zero to 24 Hours (AUC0-24) for MEN1703Day 14 of Cycle 1 (pre-dose, up to 120 hours post dose) (21 days/cycle)

Nominal blood samples were taken at designated timepoints for evaluation of concentration levels of MEN1703 in plasma. AUC0-24 was calculated by the linear trapezoidal rule. Results are reported in h\*ng/mL. Standard error not reported, arithmetic CV% reported instead.

Trial Locations

Locations (15)

Northside Hospital

🇺🇸

Atlanta, Georgia, United States

Cleveland Clinic, Taussig Cancer Institute

🇺🇸

Cleveland, Ohio, United States

Texas Oncology - Baylor Charles A. Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Vanderbilt Ingram Cancer Center

🇺🇸

Nashville, Tennessee, United States

Institute of Haematology and Blood Transfusion

🇵🇱

Warsaw, Poland

Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori

🇮🇹

Meldola, Italy

ASST Monza - Ospedale San Gerardo

🇮🇹

Monza, Italy

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

Istituto Clinico Humanitas

🇮🇹

Milano, Italy

Fred Hutchinson Cancer Research Center

🇺🇸

Seattle, Washington, United States

Wojewodzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika w Lodzi, Oddzial Hematologii z Pododdzialem Chemioterapi

🇵🇱

Łódź, Poland

Hospital Universitari i Politecnic La Fe

🇪🇸

Valencia, Spain

Institut Català d'Oncologia

🇪🇸

Badalona, Spain

Hospital 12 de Octubre

🇪🇸

Madrid, Spain

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