A Modular Phase I/II, Open-label, Multi-center Study to Evaluate the Safety, Tolerability, Pharmacokinetics, Immunogenicity, and Preliminary Efficacy of AZD4512 Monotherapy or in Combination With Anticancer Agent(s) in Participants With Acute Lymphoblastic Leukemia
试验速览
- 阶段
- 1 期
- 状态
- 招募中
- 发起方
- AstraZeneca
- 入组人数
- 83
- 试验地点
- 26
- 主要终点
- Module 1 (Dose Escalation): Number of participants with dose-limiting toxicities (DLTs).
研究概览
简要总结
The study is intended to assess the safety, tolerability, pharmacokinetics, pharmacodynamics, and efficacy of AZD4512 in patients with relapsed/refractory B-Cell acute lymphoblastic leukemia (r/r B-ALL).
详细描述
In this Phase I/II, open-label multi-center study AZD4512 will be administered to adult/young adult patients (Module 1: >=16 years; Module 2: >=12 years) with relapsed/refractory B-Cell acute lymphoblastic leukemia (B-ALL). This study will have 2 parts: Module 1 - Dose Escalation and Module 2 - Dose Optimization.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 12 Years 至 —(Child, Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •16 years old in Module 1 (US only: ≥18year)
- •12 years old in Module 2
- •2. Diagnosis: Known Diagnosis of CD22-positive B-ALL based on criteria established by WHO (Alaggio et al. 2022).
- •Participants must have relapsed or refractory B-ALL ('relapsed' defined as bone marrow blasts > 5% or reappearance of blasts in PB)
- •Module 1 (DE): Ph(-) B-ALL and Ph(+) B-ALL - R/R
- •Backfill of Module 1 and Module 2 (DO): R/R Ph(-) B-ALL
- •3. Performance status (ECOG ≤ 2; KPS ≥ 50; LPS ≥ 50)
- •4. Peripheral lymphoblast count < 10,000/µL (may receive cytoreduction prior to C1D1 per protocol-specified criteria)
- •5. At least 2 prior therapies with refractoriness or relapse, or 1 prior therapy with refractoriness or relapse and no standard options available. Participants who have received prior CD22 targeted therapies are eligible.
- •Ph+ B-ALL (Module 1 DE only): intolerant to or have contraindications to TKI therapy or R/R disease despite treatment with at least 2 prior TKIs or at least one 3rd generation TKI
- •6. Prior DLI >4 weeks, prior cell therapy or autoHSCT >8 weeks, alloHSCT >12 weeks
排除标准
- •Burkitt lymphoma and leukemia
- •Isolated extramedullary disease; Active testicular or CNS (> CNS1) involvement
- •Unresolved non-heme toxicities Grade ≥ 2 (except alopecia, stable Grade ≤ 2 neuropathy, vitiligo, endocrine disorders controlled with therapy)
- •History of drug-induced non-infectious ILD/pneumonitis requiring oral or IV steroids or supplemental oxygen or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening
- •Prior/concomitant therapy
- •Cytotoxic treatment within 14 days (except ALL maintenance medications or cytoreduction)
- •Biologic (immuno-oncology) treatment within 28 days or 5 half-lives (whichever is shorter)
- •Non-CNS radiation within 2 weeks & CNS radiation within 4 weeks
- •Medications known to prolong QTc and/or associated with Torsades de Pointes within 5 half-lives
- •Strong inhibitors of CYP 3A4 within 14 days or 5 half-lives (whichever is longer)
- •Investigational agents or study interventions in the last 30 days or 5 half-lives prior to the first dose of AZD4512 whichever is longer. If the investigational product is an agent to treat B-ALL and meets the modality criteria, then a specific washout period must be adhered to instead.
研究组 & 干预措施
Module 1 Dose Escalation
Module 1 will evaluate escalating doses of AZD4512 as monotherapy to determine the maximum tolerated dose (MTD) and/or doses of AZD4512 for subsequent evaluation in Module 2 (dose optimization), in participants with relapsed/refractory (R/R) Philadelphia chromosome positive (Ph[+]) and negative (Ph[-]) B-ALL, R/R as defined by National Comprehensive Cancer Network (NCCN) guidelines.
干预措施: AZD4512 monotherapy (Combination Product)
Module 2 Dose Optimization
Module 2 will randomize participants with R/R (as defined by NCCN guidelines) Ph(-) BALL only across 2 to 3 dose levels identified in Module 1 to receive AZD4512 monotherapy for further exploration of the doses. The aim of Module 2 is to identify the recommended Phase 2 dose (RP2D) of AZD4512 monotherapy, evaluate the efficacy and further define the safety profile of AZD4512.
干预措施: AZD4512 monotherapy (Combination Product)
结局指标
主要结局
Module 1 (Dose Escalation): Number of participants with dose-limiting toxicities (DLTs).
时间窗: From first dose up to 21 days (DLT period).
DLTs are dose-limiting toxicities as defined in the study protocol.
Module 1 (Dose Escalation): Frequency, duration and severity of treatment-emergent adverse events (TEAEs), treatment-related adverse events (TRAEs), and serious adverse events (SAEs)
时间窗: From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months)
Assessed by the CTCAE criteria version 5.0
Module 1 (Dose Escalation): Frequency of dose interruptions, modifications, delays, and discontinuations due to AEs
时间窗: From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months)
Module 1 (Dose Escalation): Number of participants with clinically significant changes in laboratory values, ECGs, performance status, and vital signs
时间窗: From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months)
Module 2 (Dose Optimization): Overall response rate (ORR) in participants with R/R Ph(-) B-ALL
时间窗: From date of first dose of AZD4512 up until end of study, up to 38 months
To evaluate the efficacy based on NCCN response criteria, measured by ORR (CR/CRh)
Module 2 (Dose Optimization): Frequency, duration and severity of treatment-emergent adverse events (TEAEs), treatment-related adverse events (TRAEs), and serious adverse events (SAEs)
时间窗: From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months)
Assessed by the CTCAE criteria version 5.0
Module 2 (Dose Optimization): Frequency of dose interruptions, modifications, delays, and discontinuations due to AEs
时间窗: From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months)
Module 2 (Dose Optimization): Number of participants with clinically significant changes in laboratory values, ECGs, performance status, and vital signs
时间窗: From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months)
次要结局
- Module 1 (Dose Escalation): Objective Response Rate (ORR): proportion of participants with CR or CRh(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Composite Complete Remission (CRc) rate: proportion of participants with CR, CRh, or CRi(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Complete Remission (CR) rate(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Time to Response (TTR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Duration of Response (DoR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Event-Free Survival (EFS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Overall Survival (OS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Percentage of participants who receive subsequent allogeneic hematopoietic stem cell transplant (HSCT)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Complete Remission (CR) rate(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization):Composite Complete Remission (CRc) rate: proportion of participants with CR, CRh, or CRi(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization):Time to Response (TTR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Duration of Response (DoR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization):Event-Free Survival (EFS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Overall Survival (OS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Percentage of participants who receive subsequent allogeneic hematopoietic stem cell transplant (HSCT)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): MRD-negative CR rate, CR/CRh (ORR), CR/CRi/CRh (CRc) rate(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Plasma PK parameters of AZD4512(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): total antibody and total unconjugated payload(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Area Under Curve (AUC)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimzation): Peak Plasma Concentration (Cmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Time to max concentration (Tmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Half life (T1/2)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Clearance (CL)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Volume of distribution (Vz)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Summary of of pre-existing and treatment induced ADAs for AZD4512 (positive or negative, titers)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Volume of distribution (Vz)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Number and percentage of participants who develop anti-drug antibodies (ADAs)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Plasma PK parameters of AZD4512(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Total antibody and total unconjugated payload(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Area Under Curve (AUC)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Peak Plasma Concentration (Cmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Time to max concentration (Tmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Half life (T1/2)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Clearance (CL)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimzation): Peak Plasma Concentration (Cmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Plasma PK parameters of AZD4512(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Total antibody and total unconjugated payload(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Area Under Curve (AUC)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Peak Plasma Concentration (Cmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Time to max concentration (Tmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Half life (T1/2)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Clearance (CL)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Volume of distribution (Vz)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Number and percentage of participants who develop anti-drug antibodies (ADAs)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 1 (Dose Escalation): Objective Response Rate (ORR): proportion of participants with CR or CRh(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Composite Complete Remission (CRc) rate: proportion of participants with CR, CRh, or CRi(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Complete Remission (CR) rate(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Time to Response (TTR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Duration of Response (DoR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Event-Free Survival (EFS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Overall Survival (OS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 1 (Dose Escalation): Percentage of participants who receive subsequent allogeneic hematopoietic stem cell transplant (HSCT)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Complete Remission (CR) rate(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization):Composite Complete Remission (CRc) rate: proportion of participants with CR, CRh, or CRi(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization):Time to Response (TTR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Duration of Response (DoR)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization):Event-Free Survival (EFS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Overall Survival (OS)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Percentage of participants who receive subsequent allogeneic hematopoietic stem cell transplant (HSCT)(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): MRD-negative CR rate, CR/CRh (ORR), CR/CRi/CRh (CRc) rate(From date of first dose of AZD4512 up until end of study, up to 38 months)
- Module 2 (Dose Optimization): Plasma PK parameters of AZD4512(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): total antibody and total unconjugated payload(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Area Under Curve (AUC)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Time to max concentration (Tmax)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Half life (T1/2)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Clearance (CL)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Volume of distribution (Vz)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
- Module 2 (Dose Optimization): Summary of of pre-existing and treatment induced ADAs for AZD4512 (positive or negative, titers)(From date of first dose of AZD4512 up until 30 days post last dose of AZD4512 (on average 6 months))
