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A Study of H3B-8800 (RVT-2001) in Participants With Lower Risk Myelodysplastic Syndromes

Phase 1
Terminated
Conditions
Leukemia, Myelomonocytic, Chronic
Leukemia, Myeloid, Acute
Myelodysplastic Syndromes
Interventions
Registration Number
NCT02841540
Lead Sponsor
Hemavant Sciences GmbH
Brief Summary

A Phase 1, an Open-label, Multicenter Phase 1 Trial to Evaluate the Safety, Pharmacokinetics and Pharmacodynamics of Splicing Modulator H3B-8800 (RVT-2001) for Subjects With Myelodysplastic Syndromes, Acute Myeloid Leukemia, and Chronic Myelomonocytic Leukemia

Detailed Description

This study is a Phase 1, open-label, first-in-human (FIH) study designed to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary antitumor activity of H3B-8800 (RVT-2001) in subset of participants with Myelodysplastic Syndromes (MDS), Acute Myeloid Leukemia (AML), or Chronic Myelomonocytic Leukemia (CMML). The study consists of three parts, the dose escalation part (Part 1) exploring multiple once daily (QD) schedules and MDS Expansion part (Part 2) and Dose Optimization part (Part 3) exploring dosing schedules in lower-risk MDS.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
127
Inclusion Criteria
  1. Confirmed diagnosis of MDS, CMML, or AML.

    For the MDS Expansion cohort, participants must be lower-risk MDS, defined as low or intermediate-1 risk categorization per International Prognostic Scoring System (IPSS) criteria that carries a missense SF3B1 mutation.

    For the Dose Optimization cohort, participants must be transfusion-dependent, lower-risk MDS, defined as very-low to intermediate risk categorization per IPSS-R criteria that carries a missense SF3B1 mutation.

  2. Participants must meet the following criteria relevant to their specific diagnosis:

    A. Participants with higher-risk MDS/CMML must be intolerant of hypomethylating agents (HMAs) or not have responded to 4 treatment cycles of decitabine or 6 treatment cycles of azacitidine, or must have progressed at any point after initiation of an HMA.

    B. For the Dose Escalation portion, participants with lower-risk MDS/CMML must be transfusion-dependent for red blood cells or platelets.

    For the MDS expansion cohort, lower risk MDS participants must be RBC transfusion dependent according to IWG 2006 criteria and must also have failed erythropoiesis stimulating agents (ESA) or have serum erythropoietin (EPO) levels greater than (>) 500 units per liter (U/L).

    C. For the Dose Optimization cohort, lower-risk MDS participants must be RBC transfusion-dependent at baseline defined as ≥3 RBC units (concentrates) in 16-weeks in at least 2 transfusion episodes prior to the first dose of H3B-8800 (RVT-2001) and must also have failed ESA or have serum EPO levels > 500 U/L. Any ESA use should be discontinued ≥6 weeks prior to enrollment.

    D. Participants with AML must either refuse or not be considered candidates for intensive induction chemotherapy using consensus criteria for defining such participants.

    E. Participants with CMML must have been treated with at least one prior therapy (hydroxyurea or a hypomethylating agent [HMA]).

  3. Eastern Cooperative Oncology Group (ECOG) performance score of 0-2.

  4. For MDS expansion and Dose optimization cohorts - absolute neutrophil count (ANC) greater than or equal to (>=) 500/ microliter (mcL) (0.5*10^9/L).

  5. For expansion and Dose optimization cohorts- platelet count >50,000/mcL (50*10^9/L).

  6. For Dose-optimization cohort: No prior HMA or lenalidomide in participants with lower-risk MDS.

  7. Adequate baseline organ function.

Exclusion Criteria
  1. Diagnosis of a core binding factor leukemia (t(8;21), t(16;16) or inv(16)). Diagnosis of acute promyelocytic leukemia (t(15;17))
  2. Participants are deemed candidate for hematopoietic stem cell transplants at the time of enrollment (for AML participants only).
  3. Known prior or current retinal or optic nerve disease (example, Retinitis Pigmentosa, diabetic retinopathy, optic neuritis) not stable for at least 6 months.
  4. History of clinically significant, uncorrected vitamin B12 or folate deficiency.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
H3B-8800 (RVT-2001) MDS ExpansionH3B-8800 (RVT-2001)Transfusion-dependent, lower-risk MDS subjects (very-low to intermediate risk categorization per IPSS-R) with missense mutations in SF3B1.
H3B-8800 (RVT-2001) Dose OptimizationH3B-8800 (RVT-2001)Transfusion-dependent, lower-risk MDS subjects (very-low to intermediate risk categorization per IPSS-R) with missense mutations in SF3B1, and who have not been exposed to HMA's or lenalidomide in a prior line of therapy.
H3B-8800 (RVT-2001) Dose EscalationH3B-8800 (RVT-2001)H3B-8800 Acute Myeloid Leukemia or High Risk Myelodysplastic Syndromes/ Low Risk Myelodysplastic Syndromes/ Chronic Myelomonocytic Leukemia.
Primary Outcome Measures
NameTimeMethod
Number of Participants with Dose-limiting Toxicities (DLTs)Escalation Cycle 1 (28 days)
Number of Participants with Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)From the first dose of study drug until 30 days after final dose of study drug (up to approximately 50 months)

The type and frequency of AEs and SAEs using CTCAE v4.03, as well as changes in clinical laboratory values, ECG parameters, ophthalmologic examinations, and vital sign measurements.

Secondary Outcome Measures
NameTimeMethod
Area Under the Plasma Concentration-time Curve From Time 0 Through the Last Measurable Point (AUC0-t)Up to Cycle 6 Day 15 (each cycle length=28 days)

Plasma samples for PK analyses will be collected at predetermined timepoint and analyzed

Maximum Observed Plasma Concentration (Cmax)Up to Cycle 6 Day 15 (each cycle length=28 days)

Plasma samples for PK analyses will be collected at predetermined timepoint and analyzed

Time of Maximum Observed Plasma Concentration (Tmax)Up to Cycle 6 Day 15 (each cycle length=28 days)

Plasma samples for PK analyses will be collected at predetermined timepoint and analyzed

Number of Participants who Achieve Red Blood Cell (RBC) Transfusion IndependenceUp to approximately 50 months
Number of Participants with Hematologic ImprovementUp to approximately 50 months
Objective Response Rate (ORR)Up to approximately 50 months

ORR will be defined as the percentage of participants achieving a best overall response of partial remission (PR) or complete remission (CR) (PR + CR), from first dose date until disease progression/recurrence. CR includes CR with incomplete blood count recovery (CRi) in AML participants and marrow CR in MDS participants and optimal marrow response in CMML participants. Response will be assessed by the Investigator and the independent central review based on 2006 International Working Group (IWG) response criteria for MDS, 2003 IWG criteria for AML, and the international consortium proposal of uniform response criteria for CMML published in 2015.

Duration of Response (DOR)Up to approximately 50 months

DOR will be defined as the time from the date of first documented CR/PR until the first documentation of confirmed relapse, or death, whichever comes first.

Time to ProgressionUp to approximately 50 months
Overall Survival (OS)Up to approximately 50 months

Overall Survival is defined as the time from first dose date to the date of death from any cause.

Mortality Rate at 3 and 6 MonthsMonths 3 and 6

Trial Locations

Locations (48)

City of Hope

🇺🇸

Irvine, California, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Virginia Cancer Specialist

🇺🇸

Fairfax, Virginia, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

University Hospitals Leuven

🇧🇪

Leuven, Belgium

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital General Universitario Gregorio Marañon

🇪🇸

Madrid, Spain

AZ Sint-Jan Brugge Oostende AV

🇧🇪

Brugge, Belgium

Clinica Universidad de Navarra

🇪🇸

Pamplona, Navarra, Spain

Algemeen Ziekenhuis Klina

🇧🇪

Brasschaat, Belgium

Fondazione IRCCS Cà Granda Ospedale Policlinico Maggiore

🇮🇹

Milano, Italy

Centre Hospitalier - Le Mans

🇫🇷

Le Mans, France

Hanyang University Seoul Hospital

🇰🇷

Seoul, Korea, Republic of

Changhua Christian Hospital

🇨🇳

Changhua, Taiwan

Centre Hospitalier Universitaire d'Angers (CHU d'Angers)

🇫🇷

Angers, France

Universiteit Gent

🇧🇪

Gent, Belgium

Azienda Ospedaliera Universitaria di Bologna - Policlinico S. Orsola Malpighi

🇮🇹

Bologna, Italy

Fondazione IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

IRCCS Istituto Clinico Humanitas Cancer Center

🇮🇹

Rozzano, Italy

Hospital Universitario Fundación Jiménez Díaz

🇪🇸

Madrid, Spain

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Hôpital Claude Huriez

🇫🇷

Lille, France

Gachon University Gil Medical Center

🇰🇷

Incheon, Korea, Republic of

Chang-Gung Memorial Hospital, Chiayi

🇨🇳

Chiayi City, Taiwan

Hospital Universitario Valle de Hebrón

🇪🇸

Barcelona, Spain

Complejo Asistencial Universitario de Salamanca

🇪🇸

Salamanca, Spain

CHU Amiens-Picardie

🇫🇷

Amiens, France

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiwan

Institut Gustave Roussy

🇫🇷

Villejuif, Val-de-Marne, France

National Cancer Center

🇰🇷

Gyeonggi-do, Goyang-si, Korea, Republic of

China Medical University Hospital

🇨🇳

Taichung, Taiwan

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

University of Miami

🇺🇸

Miami, Florida, United States

Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Centre Hospitalier Universitaire (CHU) de Bordeaux

🇫🇷

Bordeaux, France

Hospital Universitario y Politécnico La Fe de Valencia

🇪🇸

Valencia, Spain

Mayo Clinic Jacksonville

🇺🇸

Jacksonville, Florida, United States

Arizona Oncology Associates

🇺🇸

Tucson, Arizona, United States

Oncology Associates of Oregon

🇺🇸

Eugene, Oregon, United States

Centre Hospitalier Lyon Sud

🇫🇷

Pierre-Bénite, France

Daegu Catholic University Medical Center

🇰🇷

Daegu, Korea, Republic of

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Texas Oncology

🇺🇸

Austin, Texas, United States

The Catholic University of Korea Seoul St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Rocky Mountain Cancer Center

🇺🇸

Aurora, Colorado, United States

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