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Study of AO-176 as Monotherapy and in Combination With Bortezomib/Dexamethasone in Relapsed/Refractory Multiple Myeloma

Phase 1
Completed
Conditions
Multiple Myeloma
Interventions
Registration Number
NCT04445701
Lead Sponsor
Arch Oncology
Brief Summary

Open-label, dose escalation study to evaluate the safety, tolerability, pharmacokinetics (PK)/pharmacodynamics and initial efficacy of AO-176 as monotherapy and in combination with dexamethasone and bortezomib in adults with relapsed/refractory multiple myeloma (MM).

Detailed Description

An open-label, multicenter, dose escalation study to evaluate the safety, tolerability and PK/pharmacodynamics of AO-176 in adults with relapsed/refractory multiple myeloma whose disease has progressed following at least 3 prior systemic lines of treatment and must have progressed on the final line of therapy received before being considered for this study.

The study will be conducted in 2 phases; Phase 1 is an ascending-dose study of AO-176 monotherapy utilizing the classic 3+3 design, with enrollment of 3 patients per cohort and expansion of the cohort in the event of a dose-limiting toxicity (DLT). Following the dose escalation portion and determination of the monotherapy recommended phase 2 dose (RP2D), an ascending dose escalation study of AO-176 and dexamethasone combined with bortezomib will be evaluated utilizing the same 3+3 dose escalation design.

Phase 2 will evaluate the clinical activity of AO-176 plus dexamethasone and bortezomib at the RP2D as determined in Phase 1 Part 2.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  1. Confirmed diagnosis of symptomatic MM per IMWG criteria
  2. Measurable disease
  3. Relapsed or refractory to at least 3 prior systemic lines of therapy for MM
  4. Eastern Cooperative Oncology Group (ECOG) status 0-2
  5. Resolution of prior therapy-related adverse events
  6. Minimum of 2 weeks since last dose of cancer therapy or radiotherapy

Key

Exclusion Criteria
  1. Previous Grade 3-4 infusion or hypersensitivity reaction
  2. Severe asthma or chronic obstructive pulmonary disease exacerbations requiring hospital admission or steroids
  3. Prior treatment with a checkpoint inhibitor (anti-PD-1, PD-L1 or CTLA-4) within 4 weeks.
  4. Prior treatment with a therapeutic agent that targets the CD47 axis.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
AO-176 + DEX Expansion CohortAO-176 + DexOnce the monotherapy RP2D has been established, an expansion cohort of AO-176 + dexamethasone will be enrolled.
AO-176 + DEX + BORT Dose EscalationAO-176 + Dex + BortFollowing evaluation of AO-176 + dexamethasone, dose escalation cohorts of AO-176 + dexamethasone + bortezomib will be enrolled. Each dose escalation cohort will initially recruit 3 patients in a standard 3+3 design; cohorts will be expanded in the event of a DLT. The Phase 2 portion of the study will further evaluate the RP2D of AO-176 + DEX + BORT.
AO-176 Dose Escalation MonotherapyAO-176The dose escalation monotherapy cohorts will initially recruit 3 patients to receive AO-176 in a standard 3+3 design; cohorts will be expanded in the event of a DLT.
Primary Outcome Measures
NameTimeMethod
Phase 1: MTD / RP2D of AO-176 assessed by incidence of dose-limiting toxicities and incidence of treatment-related adverse events (TEAEs) as assessed by CTCAE v5.012 months

Safety and tolerability of AO-176 when administered as monotherapy and in combination with dexamethasone or with dexamethasone plus bortezomib in adult patients with R/R MM as assessed by incidence of DLTs and TEAEs as assessed by CTCAE v5.0

Phase 2: Objective response rate (ORR) of AO-176 + DEX + BORT12 months

Evaluate the clinical activity of AO-176 + dexamethasone + bortezomib based on ORR using International Myeloma Working Group (IMWG) uniform response criteria

Secondary Outcome Measures
NameTimeMethod
Phase 1: Disease control rate (DCR) of single agent AO-17612 months

Evaluate the clinical activity of single agent AO-176 based on DCR using IMWG uniform response criteria

Phase 1: Progression-free survival (PFS) of single agent AO-17612 months

Evaluate the clinical activity of single agent AO-176 based on PFS using IMWG uniform response criteria

Phase 1: ORR of single agent AO-17612 months

Evaluate the clinical activity of single agent AO-176 based on ORR using IMWG uniform response criteria

Phase 1: Overall survival (OS) of single agent AO-17612 months

Evaluate the clinical activity of single agent AO-176 based on OS

Phase 2: DCR of AO-176 + DEX + BORT12 months

Evaluate the clinical activity of AO-176 + dexamethasone + bortezomib based on DCR using IMWG uniform response criteria

Phase 2: PFS of AO-176 + DEX + BORT12 months

Evaluate the clinical activity of AO-176 + dexamethasone + bortezomib based on PFS using IMWG uniform response criteria

Phase 2: OS of AO-176 + DEX + BORT12 months

Evaluate the clinical activity of AO-176 + dexamethasone + bortezomib based on OS

Phase 1: Duration of response (DOR) of single agent AO-17612 months

Evaluate the clinical activity of single agent AO-176 based on DOR using IMWG uniform response criteria

Phase 2: DOR of AO-176 + DEX + BORT12 months

Evaluate the clinical activity of AO-176 + dexamethasone + bortezomib based on DOR using IMWG uniform response criteria

Trial Locations

Locations (4)

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Medical College of Wisconsin and Froedtert Hospital

🇺🇸

Milwaukee, Wisconsin, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

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