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An Ascending Dose Study of KW-2449 in Acute Leukemias, Myelodysplastic Syndromes, and Chronic Myelogenous Leukemia

Primary Purpose

Acute Myelogenous Leukemia, Acute Lymphoblastic Leukemia, Myelodysplastic Syndromes

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
KW-2449
Sponsored by
Kyowa Kirin, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myelogenous Leukemia focused on measuring AML, ALL, MDS, CML, Kinase Inhibitor

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically confirmed diagnosis of: AML (including APL refractory to all-trans retinoic acid and arsenic) that has relapsed or was not responsive to prior chemotherapy; Relapsed/refractory ALL; CML that has failed to respond or has lost a response to imatinib; and Advanced MDS (INT-2 and High risk by IPSS) with failure or intolerance to approved therapy. ECOG Performance Status score of 0, 1, or 2; Male or female, at least 18 years of age; Signed written informed consent; Serum creatinine ≤ 2.0 mg/dL; Serum SGOT (AST) and SGPT (ALT) ≤ 5x ULN; serum bilirubin ≤ 2 mg/dL (serum bilirubin may be ≤ 3.0 mg/dL in any subject with Gilbert's Syndrome); and For females of childbearing potential, a negative serum pregnancy test. Subjects, of childbearing potential, must use an Investigator-approved method of birth control. Exclusion Criteria: Candidates for approved therapies; Concomitant treatment with any investigational agent, chemotherapy, radiotherapy, or immunotherapy; Active CNS leukemia; Previous or concurrent malignancy except noninvasive non-melanomatous skin cancer, in situ carcinoma of the cervix, or other solid tumor treated curatively, and without evidence of recurrence for at least 2 years prior to study entry; Uncontrolled systemic infection (viral, bacterial, or fungal); Uncontrollable disseminated intravascular coagulation; Major surgery within the 28 days preceding the first dose KW-2449; Radiotherapy, or lack of recovery of any radiotherapy-related acute toxicity, within the 28 days preceding the first dose KW-2449; Treatment with systemic therapy for the underlying hematologic condition, or lack of recovery of toxicity from such treatment, within 28 days of the first dose of KW-2449, with the following exceptions: hydroxyurea for treatment of hyperleukocytosis (discontinued for at least 48 hours prior to the first dose of KW-2449); imatinib (discontinued for at least 48 hours prior to the first dose of KW-2449); and interferon (discontinued for at least 7 days prior to the first dose of KW-2449); Treatment with any other investigational agent, or lack of recovery of toxicity from such treatment, within the 28 days preceding the first dose of KW-2449; Positive serology for HIV; Clinically significant cardiac dysfunction (New York Heart Association Class 3 or 4) at the time of screening, or a history of myocardial infarction or heart failure within 3 months preceding the first dose of KW-2449; Any evidence of chronic Graft versus Host Disease; Active autoimmune disease requiring immunosuppressive therapy; Female subjects who are pregnant or breast feeding; Subjects of childbearing potential, unwilling to use an approved, effective means of contraception in accordance with the institution's standards; Known current drug or alcohol abuse; Other severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that may compromise the safety of the subject during the study, affect the subject's ability to complete the study, or interfere with interpretation of study results; or For any reason is judged by the Investigator to be inappropriate for study participation, including an inability to communicate or cooperate with the Investigator. Hematopoietic growth factors (i.e., such as erythropoietin or darbepoetin alpha, filgrastim [granulocyte colony-stimulating factor {G-CSF }], sargramostim [granulocyte-macrophage colony-stimulating factor {GM-CSF}], or other thrombopoietic agents) and corticosteroids within 14 days of study entry.

Sites / Locations

  • Johns Hopkins Hospital
  • Contact Kyowa
  • Weill Cornell/New York Presbyterian Hospital
  • M.D. Anderson Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

KW-2449

Arm Description

Treatment with ascending doses of KW-2449

Outcomes

Primary Outcome Measures

Safety of KW-2449 - Number of Participants With Treatment-related Adverse Events (TEAEs) as Assessed by NCI-CTCAE v3.0
In addition to the number of TEAEs, the number of serious TEAEs, the number of related TEAEs, the number of Grade 3-4 TEAEs, and the number of subjects who died or discontinued due to TEAEs were also assessed. The maximally tolerated dose (MTD) was also to be determined, but it was not actually reached in either arm.

Secondary Outcome Measures

Observed Peak Plasma Concentration (Cmax)
Time to Peak Plasma Concentration (Tmax)
Area Under the Plasma Concentration-time Curve From 0 to Tau (AUC (0-tau, Tau is the Dosing Interval))
Terminal Half Life (t 1/2)
Accumulation Ratio (AUC 0-tau Day 14 or 28 / AUC 0-tau Day 1)
Disease Response
Disease response (i.e., complete or partial remission) based on standard criteria: Cheson BD, Bennett JM, Kopecky KJ, Buchner T, Willman CL, Estey EH, et al. Revised recommendations of the International Working Group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia. J Clin Oncol. 2003 Dec 15;21(24):4642-4649. Cheson BD, Bennett JM, Kantarjian H, Pinto A, Schiffer CA, Nimer SD, et al. Report of an international working group to standardize response criteria for myelodysplastic syndromes. Blood. 2000 Dec 1;96(12):3671-3674. VHA Pharmacy Benefits Management Strategic Healthcare Group and the Medical Advisory Panel. Criteria for use of Imatinib Mesylate (Gleevec®) [updated March 2002; cited 2005 Nov 16]. Available from: http://www.pbm.va.gov/archive/imatinibcriteria.pdf

Full Information

First Posted
June 28, 2006
Last Updated
August 16, 2016
Sponsor
Kyowa Kirin, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00346632
Brief Title
An Ascending Dose Study of KW-2449 in Acute Leukemias, Myelodysplastic Syndromes, and Chronic Myelogenous Leukemia
Official Title
Phase I Safety, Pharmacokinetic, and Pharmacodynamic Study of KW-2449 in Acute Leukemias (AML), Myelodysplastic Syndromes (MDS), and Chronic Myelogenous Leukemia (CML)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Terminated
Why Stopped
Terminated due to suboptimal dosing schedule
Study Start Date
June 2006 (undefined)
Primary Completion Date
April 2008 (Actual)
Study Completion Date
April 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kyowa Kirin, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Non-randomized, open, dose ranging and dose scheduling study of ascending doses of KW-2449 in subjects with AML, ALL, MDS and CML.
Detailed Description
This is a Phase I open-label dose escalation study of KW-2449 in subjects with acute leukemias, high risk MDS, and CML who are not candidates for approved therapy. Over an 18-month period, the investigative sites collectively will enroll up to a total of 96 subjects. Subjects will be enrolled sequentially into 1 of 7 dose groups to evaluate 2 dosing schedules (Arm A = 14 consecutive days of dosing followed by a 7-28 day rest period as determined by recovery from any acute hematologic and non-hematologic toxicities, or Arm B = 28 consecutive days of dosing followed by a 7-28 day rest period, as determined by recovery from any acute hematologic and non-hematologic toxicities). The safety of a dose level in Arm A (14-day dosing regimen) will be established prior to enrollment of subjects in the same dose level in Arm B (28-day dosing regimen). In April 2007 the protocol was amended to discontinue Arm B (28 consecutive days of dosing). The protocol will continue as planned for Arm A (14 days of consecutive dosing). Enrollment will proceed until a maximum tolerated dose (MTD) has been established for each study Arm. Once the MTD has been reached, 12 additional subjects, with 1 or more of the hematologic conditions included in this study, may be enrolled at the MTD as an expanded safety cohort.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myelogenous Leukemia, Acute Lymphoblastic Leukemia, Myelodysplastic Syndromes, Chronic Myelogenous Leukemia
Keywords
AML, ALL, MDS, CML, Kinase Inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
37 (Actual)

8. Arms, Groups, and Interventions

Arm Title
KW-2449
Arm Type
Experimental
Arm Description
Treatment with ascending doses of KW-2449
Intervention Type
Drug
Intervention Name(s)
KW-2449
Intervention Description
Sequential ascending oral doses of KW-2449 given for 14 or 28 days (modified by protocol amendment to only 14 days dosing).
Primary Outcome Measure Information:
Title
Safety of KW-2449 - Number of Participants With Treatment-related Adverse Events (TEAEs) as Assessed by NCI-CTCAE v3.0
Description
In addition to the number of TEAEs, the number of serious TEAEs, the number of related TEAEs, the number of Grade 3-4 TEAEs, and the number of subjects who died or discontinued due to TEAEs were also assessed. The maximally tolerated dose (MTD) was also to be determined, but it was not actually reached in either arm.
Time Frame
Baseline up to Cycle 2, Day 1
Secondary Outcome Measure Information:
Title
Observed Peak Plasma Concentration (Cmax)
Time Frame
Days 1 and 14 (and Day 28 for Arm B) of Cycle 1
Title
Time to Peak Plasma Concentration (Tmax)
Time Frame
Days 1 and 14 (and Day 28 for Arm B) of Cycle 1
Title
Area Under the Plasma Concentration-time Curve From 0 to Tau (AUC (0-tau, Tau is the Dosing Interval))
Time Frame
Days 1 and 14 (and Day 28 for Arm B) of Cycle 1
Title
Terminal Half Life (t 1/2)
Time Frame
Days 1 and 14 (and Day 28 for Arm B) of Cycle 1
Title
Accumulation Ratio (AUC 0-tau Day 14 or 28 / AUC 0-tau Day 1)
Time Frame
Day 1 and either Day 14 or Day 28 of Cycle 1
Title
Disease Response
Description
Disease response (i.e., complete or partial remission) based on standard criteria: Cheson BD, Bennett JM, Kopecky KJ, Buchner T, Willman CL, Estey EH, et al. Revised recommendations of the International Working Group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia. J Clin Oncol. 2003 Dec 15;21(24):4642-4649. Cheson BD, Bennett JM, Kantarjian H, Pinto A, Schiffer CA, Nimer SD, et al. Report of an international working group to standardize response criteria for myelodysplastic syndromes. Blood. 2000 Dec 1;96(12):3671-3674. VHA Pharmacy Benefits Management Strategic Healthcare Group and the Medical Advisory Panel. Criteria for use of Imatinib Mesylate (Gleevec®) [updated March 2002; cited 2005 Nov 16]. Available from: http://www.pbm.va.gov/archive/imatinibcriteria.pdf
Time Frame
Day 14 (Arm A) or Day 28 (Arm B) for all cycles

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed diagnosis of: AML (including APL refractory to all-trans retinoic acid and arsenic) that has relapsed or was not responsive to prior chemotherapy; Relapsed/refractory ALL; CML that has failed to respond or has lost a response to imatinib; and Advanced MDS (INT-2 and High risk by IPSS) with failure or intolerance to approved therapy. ECOG Performance Status score of 0, 1, or 2; Male or female, at least 18 years of age; Signed written informed consent; Serum creatinine ≤ 2.0 mg/dL; Serum SGOT (AST) and SGPT (ALT) ≤ 5x ULN; serum bilirubin ≤ 2 mg/dL (serum bilirubin may be ≤ 3.0 mg/dL in any subject with Gilbert's Syndrome); and For females of childbearing potential, a negative serum pregnancy test. Subjects, of childbearing potential, must use an Investigator-approved method of birth control. Exclusion Criteria: Candidates for approved therapies; Concomitant treatment with any investigational agent, chemotherapy, radiotherapy, or immunotherapy; Active CNS leukemia; Previous or concurrent malignancy except noninvasive non-melanomatous skin cancer, in situ carcinoma of the cervix, or other solid tumor treated curatively, and without evidence of recurrence for at least 2 years prior to study entry; Uncontrolled systemic infection (viral, bacterial, or fungal); Uncontrollable disseminated intravascular coagulation; Major surgery within the 28 days preceding the first dose KW-2449; Radiotherapy, or lack of recovery of any radiotherapy-related acute toxicity, within the 28 days preceding the first dose KW-2449; Treatment with systemic therapy for the underlying hematologic condition, or lack of recovery of toxicity from such treatment, within 28 days of the first dose of KW-2449, with the following exceptions: hydroxyurea for treatment of hyperleukocytosis (discontinued for at least 48 hours prior to the first dose of KW-2449); imatinib (discontinued for at least 48 hours prior to the first dose of KW-2449); and interferon (discontinued for at least 7 days prior to the first dose of KW-2449); Treatment with any other investigational agent, or lack of recovery of toxicity from such treatment, within the 28 days preceding the first dose of KW-2449; Positive serology for HIV; Clinically significant cardiac dysfunction (New York Heart Association Class 3 or 4) at the time of screening, or a history of myocardial infarction or heart failure within 3 months preceding the first dose of KW-2449; Any evidence of chronic Graft versus Host Disease; Active autoimmune disease requiring immunosuppressive therapy; Female subjects who are pregnant or breast feeding; Subjects of childbearing potential, unwilling to use an approved, effective means of contraception in accordance with the institution's standards; Known current drug or alcohol abuse; Other severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that may compromise the safety of the subject during the study, affect the subject's ability to complete the study, or interfere with interpretation of study results; or For any reason is judged by the Investigator to be inappropriate for study participation, including an inability to communicate or cooperate with the Investigator. Hematopoietic growth factors (i.e., such as erythropoietin or darbepoetin alpha, filgrastim [granulocyte colony-stimulating factor {G-CSF }], sargramostim [granulocyte-macrophage colony-stimulating factor {GM-CSF}], or other thrombopoietic agents) and corticosteroids within 14 days of study entry.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matt Fujimori, MD
Organizational Affiliation
Kyowa Kirin, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Contact Kyowa
City
Princeton
State/Province
New Jersey
ZIP/Postal Code
08540
Country
United States
Facility Name
Weill Cornell/New York Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
M.D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
19029442
Citation
Pratz KW, Cortes J, Roboz GJ, Rao N, Arowojolu O, Stine A, Shiotsu Y, Shudo A, Akinaga S, Small D, Karp JE, Levis M. A pharmacodynamic study of the FLT3 inhibitor KW-2449 yields insight into the basis for clinical response. Blood. 2009 Apr 23;113(17):3938-46. doi: 10.1182/blood-2008-09-177030. Epub 2008 Nov 24.
Results Reference
derived

Learn more about this trial

An Ascending Dose Study of KW-2449 in Acute Leukemias, Myelodysplastic Syndromes, and Chronic Myelogenous Leukemia

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