search
Back to results

Open Label Study to Evaluate Safety and Efficacy of 2 Doses of Quizartinib in Patients With Relapsed or Refractory Acute Myeloid Leukemia

Primary Purpose

Leukemia, Myeloid, Acute

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
AC220
Sponsored by
Daiichi Sankyo, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Myeloid, Acute focused on measuring FLT3-ITD positive Acute Myeloid Leukemia (AML), AC220, Relapse, Refractory

Eligibility Criteria

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

Inclusion Criteria:

  • Subject has morphologically documented primary acute myeloid leukemia (AML) or AML secondary to myelodysplastic syndrome (MDS) as defined by the World Health Organization (WHO) criteria, as determined by pathology review at the treating institution and has relapsed or is refractory after 1 second line (salvage) regimen or after hematopoietic stem cell transplantation (HSCT)
  • Subject is positive for FLT3-ITD activating mutation in bone marrow or peripheral blood (>10% allelic ratio)
  • Eastern Cooperative Oncology Group performance status of 0 to 2
  • In the absence of rapidly progressing disease clearly documented by the investigator, the interval from prior treatment to time of AC220 administration will be at least 2 weeks (14 days) for prior cytotoxic agents or at least 5 half-lives for prior noncytotoxic agents, including immunosuppressive therapy post HSCT
  • Persistent chronic clinically significant nonhematological toxicities from prior treatment (including chemotherapy, kinase inhibitors, immunotherapy, experimental agents, radiation, HSCT, or surgery) must be Grade ≤ 1
  • Patients - both males and females - with reproductive potential are eligible

Exclusion Criteria:

  • Subject received previous treatment with AC220
  • Subject has a diagnosis of acute promyelocytic leukemia
  • Subject has a diagnosis of chronic myelogenous leukemia (CML) in blast crisis
  • Subject has AML or antecedent MDS secondary to prior chemotherapy
  • Subject has had HSCT and has either of the following:
  • Donor lymphocyte infusion (DLI) is not permitted during the study or < 30 days prior to study entry
  • Subject has clinically active central nervous system (CNS) leukemia. A subject is considered eligible if CNS leukemia is controlled and subject is receiving intrathecal (IT) therapy at study entry. Subjects should continue to receive IT therapy (or cranial radiation) as clinically indicated
  • Subject has received concurrent chemotherapy, immunotherapy, or radiotherapy within 14 days prior to the first dose of AC220, or any ancillary therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation) within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug
  • Subject requires treatment with concomitant drugs that prolong QT/QTc interval or with strong inhibitors or inducers of cytochrome P450- isozyme3A4 (CYP3A4) with the exception of antibiotics, antifungals, and antivirals that are used as standard of care post-transplant or to prevent or treat infections and other such drugs that are considered absolutely essential for the care of the subject
  • Subject requires treatment with anticoagulant therapy
  • Subject has a known positive test for human immunodeficiency virus, hepatitis C, or hepatitis B surface antigen
  • Subject had major surgery within 4 weeks prior to first dose of AC220
  • Subject has uncontrolled or significant cardiovascular disease, including
  • Subject has a pre-existing disorder predisposing the subject to a serious or life-threatening infection (e.g. cystic fibrosis, congenital or acquired immunodeficiency, bleeding disorder, or cytopenias not related to AML)
  • Subject has an active uncontrolled acute or chronic systemic fungal, bacterial, viral, or other infection
  • Subject has any of the following laboratory values:
  • Subject is a female with a positive pregnancy test, pregnant, or breastfeeding
  • Subject has any medical, psychiatric, addictive or other kind of disorder which compromises the ability of the subject to give written informed consent and/or to comply with procedures

Sites / Locations

  • UCLA School of Medicine
  • Northwestern University
  • University of Chicago
  • University of Maryland Greenebaum Cancer Center
  • John Hopkins University
  • Tufts University School of Medicine-Tufts Medical Center
  • University of Minnesota
  • Mayo Clinic
  • Hackensack University Medical Center
  • Memorial Sloan-Kettering Cancer Center
  • Weill Cornell Medical College
  • Penn State Milton S. Hershey Medical Center
  • Hospital of the University of Pennsylvania
  • Medical University of South Carolina, Hollings Cancer Center
  • Vanderbilt University, Vanderbilt Ingram Cancer Center
  • UT Southwestern Medical Center, Simmons Cancer Center
  • MD Anderson
  • Fred Hutchinson Cancer Research Center
  • CHU d'Angers
  • CHU de Grenoble
  • Hôpital Saint Antoine
  • Hôpital Haut Lévêque
  • Universitaria Policlinico S. Orsola Malpighi, Institute of Hemtology "L. & A. Seragnoli"
  • Nottingham University Hospitals

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

AC220 Dose Level 1

AC220 Dose Level 2

Arm Description

Outcomes

Primary Outcome Measures

Number of Participants Who Achieved Composite Complete Response (CRc) (Intent-to-Treat Population)
CRc is defined as Complete remission (CR) + Complete remission with incomplete platelet recovery (CRp) + Complete remission with incomplete hematological recovery (CRi). Participants with CR must have normal hematopoietic cells and achieved a morphologic leukemia-free state (<5% bone marrow blasts in bone marrow, no blasts with Auer rods and no persistence of extramedullary disease) and must have had an absolute neutrophil count (ANC) ≥1 × 10^9/L and platelet count ≥100 × 10^9/L and were red blood cell (RBC) and platelet transfusion independent. Blasts in the peripheral blood was to be ≤1% (if blood sample was available). Participants with CRp must have achieved CR except for incomplete platelet recovery (< 100 ×10^9/L). Participants with CRi must have fulfilled all the criteria for CR except for incomplete hematological recovery with residual neutropenia <1 × 10^9/L with or without complete platelet recovery. RBC and platelet transfusion independence were not required.

Secondary Outcome Measures

Number of Participants Who Achieved Complete Remission (CR) (Intent-to-Treat Population)
Participant must have bone marrow regenerating normal hematopoietic cells and achieve a morphologic leukemia-free state (< 5% bone marrow blasts in bone marrow, no blasts with Auer rods and no persistence of extramedullary disease) and must have an absolute neutrophil count (ANC) ≥ 1x10^9/L and platelet count ≥ 100 x 10^9/L and they will be red blood cell (RBC) and platelet transfusion independent (defined as 4 weeks without RBC transfusions and 1 week without platelet transfusion).
Overall Survival (OS) After Approximately 3 Years (Intent-to-Treat Population)
OS was defined as the time from the date of randomization until the date of death from any cause.
Event Free Survival (EFS) After Approximately 3 Years (Intent-to-Treat Population)
EFS was defined as the time from the date of randomization until the date of documented relapse or death.
Leukemia Free Survival (LFS) After Approximately 3 Years (Intent-to-Treat Population)
LFS was defined as the time from the date of first CRc until the date of documented relapse or death for participants who achieved CRc.
Duration of Remission After Approximately 3 Years (Intent-to-Treat Population)
Duration of remission was defined as the time from first documented remission until documented relapse. CRc was defined as composite complete remission and CRi was defined as complete remission with incomplete hematological recovery.
Time to Composite Complete Remission (CRc) in Participants Who Achieved CRc After Approximately 3 Years (Intent-to-Treat Population)
Time to CRc was defined as the time from the date of randomization until the first disease assessment of CRc. Time to CRc was only evaluated in participants who achieved CRc.
Percentage of Participants Undergoing Hematopoietic Stem Cell Transplantation (HSCT) After Approximately 3 Years (Intent-to-Treat Population)
Transplantation rate was defined as the percentage of participants who underwent HSCT directly after treatment with quizartinib (no other intervening acute myeloid leukemia therapies other than conditioning regimens for the HSCT).
Percentage of Participants With Grade 2 or Higher QT Interval Corrected for Heart Rate Using Fridericia's Formula (QTcF) Prolongation After Receiving Quizartinib (Safety Analysis Set)
QT interval corrected for heart rate using Fridericia's formula (QTcF) grading was to be done according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 and the definition of Grade 2 or higher prolongation is QTcF more than 480 msec.

Full Information

First Posted
March 27, 2012
Last Updated
December 20, 2019
Sponsor
Daiichi Sankyo, Inc.
Collaborators
Ambit Biosciences Corporation
search

1. Study Identification

Unique Protocol Identification Number
NCT01565668
Brief Title
Open Label Study to Evaluate Safety and Efficacy of 2 Doses of Quizartinib in Patients With Relapsed or Refractory Acute Myeloid Leukemia
Official Title
A Phase 2, Randomized, Open-Label Study of the Safety and Efficacy of Two Doses of Quizartinib (AC220; ASP2689) in Subjects With FLT3-ITD Positive Relapsed or Refractory Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2019
Overall Recruitment Status
Completed
Study Start Date
April 2012 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Daiichi Sankyo, Inc.
Collaborators
Ambit Biosciences Corporation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate two doses of Quizartinib in patients with relapsed or refractory acute myeloid leukemia who are also FMS-like tyrosine kinase - internal tandem duplication ( FLT3-ITD) positive. Patient will be randomly assigned in a 1:1 ratio to one of two treatment arms. Both treatment arms will receive Quizartinib but at different doses. The study treatment is taken orally in 28 day cycles until either disease progression occurs or an unacceptable toxicity occurs. In addition to the study assessments to evaluate the disease, blood will be drawn to measure drug levels and biomarkers. Patients will be followed for survival at three month intervals after the end of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Myeloid, Acute
Keywords
FLT3-ITD positive Acute Myeloid Leukemia (AML), AC220, Relapse, Refractory

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
76 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AC220 Dose Level 1
Arm Type
Experimental
Arm Title
AC220 Dose Level 2
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
AC220
Other Intervention Name(s)
Quizartinib, ASP2689
Intervention Description
oral
Primary Outcome Measure Information:
Title
Number of Participants Who Achieved Composite Complete Response (CRc) (Intent-to-Treat Population)
Description
CRc is defined as Complete remission (CR) + Complete remission with incomplete platelet recovery (CRp) + Complete remission with incomplete hematological recovery (CRi). Participants with CR must have normal hematopoietic cells and achieved a morphologic leukemia-free state (<5% bone marrow blasts in bone marrow, no blasts with Auer rods and no persistence of extramedullary disease) and must have had an absolute neutrophil count (ANC) ≥1 × 10^9/L and platelet count ≥100 × 10^9/L and were red blood cell (RBC) and platelet transfusion independent. Blasts in the peripheral blood was to be ≤1% (if blood sample was available). Participants with CRp must have achieved CR except for incomplete platelet recovery (< 100 ×10^9/L). Participants with CRi must have fulfilled all the criteria for CR except for incomplete hematological recovery with residual neutropenia <1 × 10^9/L with or without complete platelet recovery. RBC and platelet transfusion independence were not required.
Time Frame
At end of Cycle 2 (after two complete 28-day cycles post treatment)
Secondary Outcome Measure Information:
Title
Number of Participants Who Achieved Complete Remission (CR) (Intent-to-Treat Population)
Description
Participant must have bone marrow regenerating normal hematopoietic cells and achieve a morphologic leukemia-free state (< 5% bone marrow blasts in bone marrow, no blasts with Auer rods and no persistence of extramedullary disease) and must have an absolute neutrophil count (ANC) ≥ 1x10^9/L and platelet count ≥ 100 x 10^9/L and they will be red blood cell (RBC) and platelet transfusion independent (defined as 4 weeks without RBC transfusions and 1 week without platelet transfusion).
Time Frame
At end of treatment visit (approximately 3 years post treatment)
Title
Overall Survival (OS) After Approximately 3 Years (Intent-to-Treat Population)
Description
OS was defined as the time from the date of randomization until the date of death from any cause.
Time Frame
Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Title
Event Free Survival (EFS) After Approximately 3 Years (Intent-to-Treat Population)
Description
EFS was defined as the time from the date of randomization until the date of documented relapse or death.
Time Frame
Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Title
Leukemia Free Survival (LFS) After Approximately 3 Years (Intent-to-Treat Population)
Description
LFS was defined as the time from the date of first CRc until the date of documented relapse or death for participants who achieved CRc.
Time Frame
Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Title
Duration of Remission After Approximately 3 Years (Intent-to-Treat Population)
Description
Duration of remission was defined as the time from first documented remission until documented relapse. CRc was defined as composite complete remission and CRi was defined as complete remission with incomplete hematological recovery.
Time Frame
Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Title
Time to Composite Complete Remission (CRc) in Participants Who Achieved CRc After Approximately 3 Years (Intent-to-Treat Population)
Description
Time to CRc was defined as the time from the date of randomization until the first disease assessment of CRc. Time to CRc was only evaluated in participants who achieved CRc.
Time Frame
Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Title
Percentage of Participants Undergoing Hematopoietic Stem Cell Transplantation (HSCT) After Approximately 3 Years (Intent-to-Treat Population)
Description
Transplantation rate was defined as the percentage of participants who underwent HSCT directly after treatment with quizartinib (no other intervening acute myeloid leukemia therapies other than conditioning regimens for the HSCT).
Time Frame
Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Title
Percentage of Participants With Grade 2 or Higher QT Interval Corrected for Heart Rate Using Fridericia's Formula (QTcF) Prolongation After Receiving Quizartinib (Safety Analysis Set)
Description
QT interval corrected for heart rate using Fridericia's formula (QTcF) grading was to be done according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 and the definition of Grade 2 or higher prolongation is QTcF more than 480 msec.
Time Frame
Evaluated at end of study, up to 6 months (approximately 3 years post treatment)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has morphologically documented primary acute myeloid leukemia (AML) or AML secondary to myelodysplastic syndrome (MDS) as defined by the World Health Organization (WHO) criteria, as determined by pathology review at the treating institution and has relapsed or is refractory after 1 second line (salvage) regimen or after hematopoietic stem cell transplantation (HSCT) Subject is positive for FLT3-ITD activating mutation in bone marrow or peripheral blood (>10% allelic ratio) Eastern Cooperative Oncology Group performance status of 0 to 2 In the absence of rapidly progressing disease clearly documented by the investigator, the interval from prior treatment to time of AC220 administration will be at least 2 weeks (14 days) for prior cytotoxic agents or at least 5 half-lives for prior noncytotoxic agents, including immunosuppressive therapy post HSCT Persistent chronic clinically significant nonhematological toxicities from prior treatment (including chemotherapy, kinase inhibitors, immunotherapy, experimental agents, radiation, HSCT, or surgery) must be Grade ≤ 1 Patients - both males and females - with reproductive potential are eligible Exclusion Criteria: Subject received previous treatment with AC220 Subject has a diagnosis of acute promyelocytic leukemia Subject has a diagnosis of chronic myelogenous leukemia (CML) in blast crisis Subject has AML or antecedent MDS secondary to prior chemotherapy Subject has had HSCT and has either of the following: Donor lymphocyte infusion (DLI) is not permitted during the study or < 30 days prior to study entry Subject has clinically active central nervous system (CNS) leukemia. A subject is considered eligible if CNS leukemia is controlled and subject is receiving intrathecal (IT) therapy at study entry. Subjects should continue to receive IT therapy (or cranial radiation) as clinically indicated Subject has received concurrent chemotherapy, immunotherapy, or radiotherapy within 14 days prior to the first dose of AC220, or any ancillary therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation) within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug Subject requires treatment with concomitant drugs that prolong QT/QTc interval or with strong inhibitors or inducers of cytochrome P450- isozyme3A4 (CYP3A4) with the exception of antibiotics, antifungals, and antivirals that are used as standard of care post-transplant or to prevent or treat infections and other such drugs that are considered absolutely essential for the care of the subject Subject requires treatment with anticoagulant therapy Subject has a known positive test for human immunodeficiency virus, hepatitis C, or hepatitis B surface antigen Subject had major surgery within 4 weeks prior to first dose of AC220 Subject has uncontrolled or significant cardiovascular disease, including Subject has a pre-existing disorder predisposing the subject to a serious or life-threatening infection (e.g. cystic fibrosis, congenital or acquired immunodeficiency, bleeding disorder, or cytopenias not related to AML) Subject has an active uncontrolled acute or chronic systemic fungal, bacterial, viral, or other infection Subject has any of the following laboratory values: Subject is a female with a positive pregnancy test, pregnant, or breastfeeding Subject has any medical, psychiatric, addictive or other kind of disorder which compromises the ability of the subject to give written informed consent and/or to comply with procedures
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Global Clinical Leader
Organizational Affiliation
Daiichi Sankyo, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
UCLA School of Medicine
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
University of Maryland Greenebaum Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
John Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Facility Name
Tufts University School of Medicine-Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Hackensack University Medical Center
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Weill Cornell Medical College
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Penn State Milton S. Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Medical University of South Carolina, Hollings Cancer Center
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29403
Country
United States
Facility Name
Vanderbilt University, Vanderbilt Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
UT Southwestern Medical Center, Simmons Cancer Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
MD Anderson
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Fred Hutchinson Cancer Research Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States
Facility Name
CHU d'Angers
City
Angers
ZIP/Postal Code
49033
Country
France
Facility Name
CHU de Grenoble
City
Grenoble
ZIP/Postal Code
38043
Country
France
Facility Name
Hôpital Saint Antoine
City
Paris
ZIP/Postal Code
75571
Country
France
Facility Name
Hôpital Haut Lévêque
City
Pessac
ZIP/Postal Code
33600
Country
France
Facility Name
Universitaria Policlinico S. Orsola Malpighi, Institute of Hemtology "L. & A. Seragnoli"
City
Bologna
ZIP/Postal Code
40138
Country
Italy
Facility Name
Nottingham University Hospitals
City
Nottingham
State/Province
England
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual participant data (IPD) and applicable supporting clinical trial documents may be available upon request at https://vivli.org/. In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address: https://vivli.org/ourmember/daiichi-sankyo/
IPD Sharing Time Frame
Studies for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
IPD Sharing Access Criteria
Formal request from qualified scientific and medical researchers on IPD and clinical study documents from clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.
IPD Sharing URL
https://vivli.org/ourmember/daiichi-sankyo/

Learn more about this trial

Open Label Study to Evaluate Safety and Efficacy of 2 Doses of Quizartinib in Patients With Relapsed or Refractory Acute Myeloid Leukemia

We'll reach out to this number within 24 hrs