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Safety, Tolerability, and Pharmacokinetic/Pharmacodynamic Study of KW-2449 in Acute Myelogenous Leukemia (AML) (Protocol Number: 2449-US-002)

Primary Purpose

Acute Myelogenous Leukemia (AML)

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

About this trial

This is an interventional treatment trial for Acute Myelogenous Leukemia (AML) focused on measuring Acute Myelogenous Leukemia, Safety, Dose Tolerance, Pharmacokinetics/Pharmacodynamics, FLT-3

Eligibility Criteria

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

Inclusion Criteria:

  1. Histologically confirmed diagnosis of AML (excluding acute promyelocytic leukemia) that has relapsed or was not responsive to prior chemotherapy.

    Phase 2: Only subjects with the FLT3/ITD mutation will be enrolled in Phase 2.

  2. Eastern Cooperative Oncology Group (ECOG) Scale score17 of 0, 1, or 2 (refer to Appendix 1);
  3. Male or female, at least 18 years of age;
  4. Signed written informed consent;
  5. Serum creatinine ≤ 2.0 mg/dL;
  6. Serum SGOT (AST) and SGPT (ALT) ≤ 5x the upper limits of normal (ULN); serum bilirubin ≤ 2 mg/dL (serum bilirubin must be ≤ 3.0 mg/dL in any subject with Gilbert's Syndrome); and
  7. For women of childbearing potential, a negative serum pregnancy test must be obtained prior to administration of KW-2449.

Exclusion Criteria:

  1. Subjects who are candidates for approved therapies for their underlying condition;
  2. Prior treatment with KW-2449;
  3. Concomitant treatment with chemotherapy (systemic or intrathecal), radiotherapy, immunotherapy, or any investigational agent;
  4. Evidence of active central nervous system (CNS) leukemia;
  5. 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;
  6. Uncontrolled systemic infection (viral, bacterial, or fungal);
  7. Uncontrolled disseminated intravascular coagulopathy;
  8. Major surgery within the 28 days preceding the first dose KW-2449;
  9. Radiotherapy within the 28 days preceding the first dose KW-2449, or lack of recovery from any radiotherapy-related acute adverse event;
  10. Treatment with approved systemic therapy for the underlying hematologic condition within 14 days of the first dose of KW-2449 with the exception of hydroxyurea (Hydrea®) or leukapheresis for hyperleukocytosis and/or thrombocytosis (see Concomitant Medication and Treatment), or lack of recovery from any adverse event from prior systemic therapy.
  11. Treatment with another investigational agent within the 28 days preceding the first dose of KW-2449, or lack of recovery from any adverse event from such treatment;
  12. Known positive serology for human immunodeficiency virus (type 1 and/or 2);
  13. 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;
  14. Chronic Graft versus Host Disease (GVHD) with the exception of mild (Grade 1) skin GVHD;
  15. Phase 1 only: ≥ Grade 2 nausea or vomiting within 7 days preceding the first dose KW 2449;
  16. Active autoimmune disease requiring immunosuppressive therapy;
  17. Female subjects who are pregnant or breast feeding; Pregnant women are excluded from this study because the embryotoxic potential of KW-2449 is unknown. It is not known whether KW-2449 passes into human breast milk. Nursing mothers should not use KW-2449.
  18. Male or female subjects of childbearing potential, unwilling to use an approved, effective means of contraception in accordance with the institution's standards; Pregnancy should be avoided in women receiving KW 2449 and in female partners of men receiving KW-2449. All subjects receiving KW-2449 should implement appropriate contraceptive methods.
  19. Known current drug or alcohol abuse;
  20. 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;
  21. Subject is judged by the Investigator to be inappropriate for study participation for any reason, including an inability to communicate or cooperate with the Investigator;
  22. Use of hematopoietic growth factors (i.e., such as erythropoietin or darbepoetin alfa, filgrastim [granulocyte colony-stimulating factor {G-CSF}], sargramostim [granulocyte-macrophage colony-stimulating factor {GM-CSF}], or thrombopoietic agents) within 14 days preceding the first dose of KW-2449; or
  23. Monoamine oxidase-B (MAO-B) or aldehyde oxidase (AOX) inhibitors within 7 days preceding the first dose KW-2449.

Sites / Locations

  • University of Maryland, Greenebaum Cancer Center
  • Johns Hopkins University
  • University of Pennsylvania
  • St. Francis Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

KW-2449

Arm Description

Sequential dose escalation in separate cohorts of 3+3 design from 450 mg/day to 800 mg/day total daily dose.

Outcomes

Primary Outcome Measures

Safety as determine by adverse event rate and dose limiting toxicity

Secondary Outcome Measures

Hematologic activity/improvement, Pharmacokinetics/Pharmacodynamics

Full Information

First Posted
October 22, 2008
Last Updated
June 14, 2016
Sponsor
Kyowa Hakko Kirin Pharma, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00779480
Brief Title
Safety, Tolerability, and Pharmacokinetic/Pharmacodynamic Study of KW-2449 in Acute Myelogenous Leukemia (AML) (Protocol Number: 2449-US-002)
Official Title
Safety, Tolerability, and Pharmacokinetic/Pharmacodynamic Study of KW-2449 in Acute Myelogenous Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
April 2012
Overall Recruitment Status
Terminated
Why Stopped
Failure to demonstrate a tolerable dose that had potential for efficacy.
Study Start Date
January 2009 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
December 2010 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To determine the maximum tolerated dose of KW-2449 in people with acute myelogenous leukemia who are not candidates for approved therapy. As well, the study will determine the response rate to KW-2449.
Detailed Description
Phase 1: To determine the maximum tolerated daily dose (MTDD) of KW 2449 when administered to subjects with AML who are not candidates for approved therapy. This was originally a Phase 1/Phase 2 study. However, a tolerable dose that had the potential for efficacy could not be identified in Phase 1. Therefore, Phase 2 was never conducted.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myelogenous Leukemia (AML)
Keywords
Acute Myelogenous Leukemia, Safety, Dose Tolerance, Pharmacokinetics/Pharmacodynamics, FLT-3

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
KW-2449
Arm Type
Experimental
Arm Description
Sequential dose escalation in separate cohorts of 3+3 design from 450 mg/day to 800 mg/day total daily dose.
Intervention Type
Drug
Intervention Name(s)
KW-2449
Intervention Description
KW-2449 50 mg capsules administered 3 or 4 times per day for 21-day cycles up to 6 cycles
Primary Outcome Measure Information:
Title
Safety as determine by adverse event rate and dose limiting toxicity
Time Frame
Approximately 6 months
Secondary Outcome Measure Information:
Title
Hematologic activity/improvement, Pharmacokinetics/Pharmacodynamics
Time Frame
Approximately 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed diagnosis of AML (excluding acute promyelocytic leukemia) that has relapsed or was not responsive to prior chemotherapy. Phase 2: Only subjects with the FLT3/ITD mutation will be enrolled in Phase 2. Eastern Cooperative Oncology Group (ECOG) Scale score17 of 0, 1, or 2 (refer to Appendix 1); 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 the upper limits of normal (ULN); serum bilirubin ≤ 2 mg/dL (serum bilirubin must be ≤ 3.0 mg/dL in any subject with Gilbert's Syndrome); and For women of childbearing potential, a negative serum pregnancy test must be obtained prior to administration of KW-2449. Exclusion Criteria: Subjects who are candidates for approved therapies for their underlying condition; Prior treatment with KW-2449; Concomitant treatment with chemotherapy (systemic or intrathecal), radiotherapy, immunotherapy, or any investigational agent; Evidence of active central nervous system (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); Uncontrolled disseminated intravascular coagulopathy; Major surgery within the 28 days preceding the first dose KW-2449; Radiotherapy within the 28 days preceding the first dose KW-2449, or lack of recovery from any radiotherapy-related acute adverse event; Treatment with approved systemic therapy for the underlying hematologic condition within 14 days of the first dose of KW-2449 with the exception of hydroxyurea (Hydrea®) or leukapheresis for hyperleukocytosis and/or thrombocytosis (see Concomitant Medication and Treatment), or lack of recovery from any adverse event from prior systemic therapy. Treatment with another investigational agent within the 28 days preceding the first dose of KW-2449, or lack of recovery from any adverse event from such treatment; Known positive serology for human immunodeficiency virus (type 1 and/or 2); 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; Chronic Graft versus Host Disease (GVHD) with the exception of mild (Grade 1) skin GVHD; Phase 1 only: ≥ Grade 2 nausea or vomiting within 7 days preceding the first dose KW 2449; Active autoimmune disease requiring immunosuppressive therapy; Female subjects who are pregnant or breast feeding; Pregnant women are excluded from this study because the embryotoxic potential of KW-2449 is unknown. It is not known whether KW-2449 passes into human breast milk. Nursing mothers should not use KW-2449. Male or female subjects of childbearing potential, unwilling to use an approved, effective means of contraception in accordance with the institution's standards; Pregnancy should be avoided in women receiving KW 2449 and in female partners of men receiving KW-2449. All subjects receiving KW-2449 should implement appropriate contraceptive methods. 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; Subject is judged by the Investigator to be inappropriate for study participation for any reason, including an inability to communicate or cooperate with the Investigator; Use of hematopoietic growth factors (i.e., such as erythropoietin or darbepoetin alfa, filgrastim [granulocyte colony-stimulating factor {G-CSF}], sargramostim [granulocyte-macrophage colony-stimulating factor {GM-CSF}], or thrombopoietic agents) within 14 days preceding the first dose of KW-2449; or Monoamine oxidase-B (MAO-B) or aldehyde oxidase (AOX) inhibitors within 7 days preceding the first dose KW-2449.
Facility Information:
Facility Name
University of Maryland, Greenebaum Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
St. Francis Hospital
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29601
Country
United States

12. IPD Sharing Statement

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
background
PubMed Identifier
19541823
Citation
Shiotsu Y, Kiyoi H, Ishikawa Y, Tanizaki R, Shimizu M, Umehara H, Ishii K, Mori Y, Ozeki K, Minami Y, Abe A, Maeda H, Akiyama T, Kanda Y, Sato Y, Akinaga S, Naoe T. KW-2449, a novel multikinase inhibitor, suppresses the growth of leukemia cells with FLT3 mutations or T315I-mutated BCR/ABL translocation. Blood. 2009 Aug 20;114(8):1607-17. doi: 10.1182/blood-2009-01-199307. Epub 2009 Jun 18.
Results Reference
background

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Safety, Tolerability, and Pharmacokinetic/Pharmacodynamic Study of KW-2449 in Acute Myelogenous Leukemia (AML) (Protocol Number: 2449-US-002)

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