search
Back to results

Phase I Dose Escalation Trial of Volasertib in Combination With Azacitidine in Patients With MDS or CMML

Primary Purpose

Myelodysplastic Syndromes, Leukemia, Myelomonocytic, Chronic

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Azacitidine
Volasertib
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndromes

Eligibility Criteria

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

Inclusion criteria:

  • Adult patients with previously untreated, intermediate-2 or high- risk MDS or CMML not eligible for hematopoietic stem cell transplantation (HSCT) based on documented patients characteristics like age, performance status, concomitant diagnoses, and organ dysfunctions
  • Further inclusion criteria apply

Exclusion criteria:

  • Prior or concomitant therapy for higher risk MDS (for example, but not limited to, hypomethylating agents like azacitidine). Note: Prior treatment with erythropoetin (EPO) is allowed up to > 1 week before treatment with study medication. Patients must have not received MDS therapy since diagnosis of higher-risk MDS. However, previous lenalidomide treatment could have been administered for lower-risk MDS treatment as long as this therapy was discontinued at least > 4 weeks before initiation of the current study treatment.
  • Treatment with any investigational drug within 2 weeks before first administration of present trial drug or within less than 5 half lives of the investigational drug before treatment with the present trial drug, whichever is longer.
  • Second malignancy currently requiring active therapy (except for hormonal/anti-hormonal treatment, e.g. in prostate or breast cancer).
  • Corrected QT interval according to Fridericia (QTcF) prolongation > 470 ms or QT prolongation deemed clinically relevant by the investigator (e.g., congenital long QT syndrome).The QTcF will be calculated as the mean of the 3 Electrocardiograms (ECGs) taken at screening.
  • Total bilirubin > 1.5 x upper limit of normal not related to Gilberts disease, hemolysis, or secondary to MDS.
  • Aspartate amino transferase (AST) or alanine amino transferase (ALT) > 2.5 x the upper limit of normal (ULN) Creatinine > 1.5 x ULN
  • Active hepatitis B or hepatitis C, or laboratory evidence for a chronic infection (hepatitis test results done in routine diagnostics are acceptable if done within 14 days before first study treatment dose).
  • HIV infection (HIV test results in routine diagnostics are acceptable if done within 14 days before first study treatment dose).
  • Severe illness or organ dysfunction involving the kidney, liver or other organ system (e.g. active uncontrolled infection , unstable angina pectoris or history of severe congestive heart failure, clinically unstable cardiac disease or pulmonary disease), which in the opinion of the investigator would interfere with the evaluation of the safety of the study treatment
  • Further exclusion criteria apply

Sites / Locations

  • 1230.33.33002 Boehringer Ingelheim Investigational Site
  • 1230.33.33001 Boehringer Ingelheim Investigational Site
  • 1230.33.49011 Boehringer Ingelheim Investigational Site
  • 1230.33.49002 Boehringer Ingelheim Investigational Site
  • 1230.33.49001 Boehringer Ingelheim Investigational Site
  • 1230.33.49005 Boehringer Ingelheim Investigational Site
  • 1230.33.49004 Boehringer Ingelheim Investigational Site
  • 1230.33.49010 Boehringer Ingelheim Investigational Site
  • 1230.33.49008 Boehringer Ingelheim Investigational Site
  • 1230.33.49012 Boehringer Ingelheim Investigational Site
  • 1230.33.49014 Boehringer Ingelheim Investigational Site
  • 1230.33.49009 Boehringer Ingelheim Investigational Site
  • 1230.33.49006 Boehringer Ingelheim Investigational Site
  • 1230.33.49003 Boehringer Ingelheim Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Schedule A

Schedule B

Schedule C

Arm Description

Volasertib (d1 - one hour iv.) + Azacitidine 75 mg/m2 once daily on Days 1-7 (7 consecutive days) (28-day cycle)

Volasertib (d 7 - one hour iv.) + Azacitidine 75 mg/m2 once daily on Days 1-7 (7 consecutive days) (28-day cycle)

Volasertib (d 1 and 7 - one hour iv.) + Azacitidine 75 mg/m2 once daily on Days 1-7 (7 consecutive days) (28-day cycle)

Outcomes

Primary Outcome Measures

Determination of the Maximum Tolerated Dose (MTD) Based on the Occurrence of Dose-limiting Toxicity (DLT) in Cycle 1
The primary objective of the dose-escalation part of this study was to determine the MTD of volasertib in combination with azacitidine. The MTD was to be identified based on the DLT information collected during the first treatment cycle of each dosing schedule. DLT was defined as a non-haematological drug-related toxicity of Common Terminology Criteria for Adverse Events (CTCAE) grade ≥3. The MTD corresponded to the highest dose of volasertib and azacitidine at which the incidence of DLT was ≤17% (i.e. 1/6 patients) during Cycle 1. The planned dose escalation schedules of Part 2 were not completed because the trial was prematurely discontinued. Hence, a final conclusion of the MTD of volasertib in combination with azacitidine cannot be drawn in this trial. Number of patients with DLT in cycle 1 in escalation part is presented to determine MTD.
Number of Participants With Dose Limiting Toxicities (DLT) in Cycle 1
Number of participants with Dose Limiting Toxicities (DLT) in Cycle 1 (escalation part to determine MTD) is presented .

Secondary Outcome Measures

Percentage of Patients With Objective Response (OR)
OR was defined as best overall response of complete remission (CR) or partial remission (PR) defined according to the International Working Group (IWG) 2006 criteria. Complete remission (CR): Bone marrow: <5 % myeloblasts with normal maturation of all cell lines* Persistent dysplasia will be noted* Peripheral blood: hemoglobin (Hgb) > 11 Grams Per Decilitre (g/dL) Platelets >100 x 109/L Neutrophils > 1.0 x 109/L Blasts 0 % *Dysplastic changes should consider the normal range of dysplastic changes Partial remission (PR): All CR criteria if abnormal before treatment except: Bone marrow blasts decreased by >50% to pre-treatment but still >5% Cellularity and morphology not relevant

Full Information

First Posted
October 1, 2013
Last Updated
September 11, 2018
Sponsor
Boehringer Ingelheim
search

1. Study Identification

Unique Protocol Identification Number
NCT01957644
Brief Title
Phase I Dose Escalation Trial of Volasertib in Combination With Azacitidine in Patients With MDS or CMML
Official Title
An Open Label Phase I Dose Escalation Trial to Investigate the Maximum Tolerated Dose, Safety, Pharmacokinetics and Efficacy of Intravenous Volasertib in Combination With Subcutaneous Azacitidine in Patients With Previously Untreated High-risk Myelodysplastic Syndrome (MDS) or Chronic Myelomonocytic Leukemia (CMML) and Not Candidates for Haematopoetic Stem Cell Transplant
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Terminated
Study Start Date
November 6, 2013 (Actual)
Primary Completion Date
December 16, 2016 (Actual)
Study Completion Date
December 16, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boehringer Ingelheim

4. Oversight

5. Study Description

Brief Summary
To investigate the maximum tolerated dose (MTD), safety, pharmacokinetics, and efficacy of volasertib in combination with azacitidine in patients with myelodysplastic syndromes (MDS) or chronic myelomonocytic leukemia (CMML) and not candidates for hematopoietic stem cell transplant

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndromes, Leukemia, Myelomonocytic, Chronic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Schedule A
Arm Type
Experimental
Arm Description
Volasertib (d1 - one hour iv.) + Azacitidine 75 mg/m2 once daily on Days 1-7 (7 consecutive days) (28-day cycle)
Arm Title
Schedule B
Arm Type
Experimental
Arm Description
Volasertib (d 7 - one hour iv.) + Azacitidine 75 mg/m2 once daily on Days 1-7 (7 consecutive days) (28-day cycle)
Arm Title
Schedule C
Arm Type
Experimental
Arm Description
Volasertib (d 1 and 7 - one hour iv.) + Azacitidine 75 mg/m2 once daily on Days 1-7 (7 consecutive days) (28-day cycle)
Intervention Type
Drug
Intervention Name(s)
Azacitidine
Intervention Type
Drug
Intervention Name(s)
Volasertib
Primary Outcome Measure Information:
Title
Determination of the Maximum Tolerated Dose (MTD) Based on the Occurrence of Dose-limiting Toxicity (DLT) in Cycle 1
Description
The primary objective of the dose-escalation part of this study was to determine the MTD of volasertib in combination with azacitidine. The MTD was to be identified based on the DLT information collected during the first treatment cycle of each dosing schedule. DLT was defined as a non-haematological drug-related toxicity of Common Terminology Criteria for Adverse Events (CTCAE) grade ≥3. The MTD corresponded to the highest dose of volasertib and azacitidine at which the incidence of DLT was ≤17% (i.e. 1/6 patients) during Cycle 1. The planned dose escalation schedules of Part 2 were not completed because the trial was prematurely discontinued. Hence, a final conclusion of the MTD of volasertib in combination with azacitidine cannot be drawn in this trial. Number of patients with DLT in cycle 1 in escalation part is presented to determine MTD.
Time Frame
4 weeks
Title
Number of Participants With Dose Limiting Toxicities (DLT) in Cycle 1
Description
Number of participants with Dose Limiting Toxicities (DLT) in Cycle 1 (escalation part to determine MTD) is presented .
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Percentage of Patients With Objective Response (OR)
Description
OR was defined as best overall response of complete remission (CR) or partial remission (PR) defined according to the International Working Group (IWG) 2006 criteria. Complete remission (CR): Bone marrow: <5 % myeloblasts with normal maturation of all cell lines* Persistent dysplasia will be noted* Peripheral blood: hemoglobin (Hgb) > 11 Grams Per Decilitre (g/dL) Platelets >100 x 109/L Neutrophils > 1.0 x 109/L Blasts 0 % *Dysplastic changes should consider the normal range of dysplastic changes Partial remission (PR): All CR criteria if abnormal before treatment except: Bone marrow blasts decreased by >50% to pre-treatment but still >5% Cellularity and morphology not relevant
Time Frame
From randomisation until data cut-off (16Dec2016); up to 159 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Adult patients with previously untreated, intermediate-2 or high- risk MDS or CMML not eligible for hematopoietic stem cell transplantation (HSCT) based on documented patients characteristics like age, performance status, concomitant diagnoses, and organ dysfunctions Further inclusion criteria apply Exclusion criteria: Prior or concomitant therapy for higher risk MDS (for example, but not limited to, hypomethylating agents like azacitidine). Note: Prior treatment with erythropoetin (EPO) is allowed up to > 1 week before treatment with study medication. Patients must have not received MDS therapy since diagnosis of higher-risk MDS. However, previous lenalidomide treatment could have been administered for lower-risk MDS treatment as long as this therapy was discontinued at least > 4 weeks before initiation of the current study treatment. Treatment with any investigational drug within 2 weeks before first administration of present trial drug or within less than 5 half lives of the investigational drug before treatment with the present trial drug, whichever is longer. Second malignancy currently requiring active therapy (except for hormonal/anti-hormonal treatment, e.g. in prostate or breast cancer). Corrected QT interval according to Fridericia (QTcF) prolongation > 470 ms or QT prolongation deemed clinically relevant by the investigator (e.g., congenital long QT syndrome).The QTcF will be calculated as the mean of the 3 Electrocardiograms (ECGs) taken at screening. Total bilirubin > 1.5 x upper limit of normal not related to Gilberts disease, hemolysis, or secondary to MDS. Aspartate amino transferase (AST) or alanine amino transferase (ALT) > 2.5 x the upper limit of normal (ULN) Creatinine > 1.5 x ULN Active hepatitis B or hepatitis C, or laboratory evidence for a chronic infection (hepatitis test results done in routine diagnostics are acceptable if done within 14 days before first study treatment dose). HIV infection (HIV test results in routine diagnostics are acceptable if done within 14 days before first study treatment dose). Severe illness or organ dysfunction involving the kidney, liver or other organ system (e.g. active uncontrolled infection , unstable angina pectoris or history of severe congestive heart failure, clinically unstable cardiac disease or pulmonary disease), which in the opinion of the investigator would interfere with the evaluation of the safety of the study treatment Further exclusion criteria apply
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Boehringer Ingelheim
Organizational Affiliation
Boehringer Ingelheim
Official's Role
Study Chair
Facility Information:
Facility Name
1230.33.33002 Boehringer Ingelheim Investigational Site
City
Marseille
Country
France
Facility Name
1230.33.33001 Boehringer Ingelheim Investigational Site
City
Paris
Country
France
Facility Name
1230.33.49011 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
1230.33.49002 Boehringer Ingelheim Investigational Site
City
Dresden
Country
Germany
Facility Name
1230.33.49001 Boehringer Ingelheim Investigational Site
City
Düsseldorf
Country
Germany
Facility Name
1230.33.49005 Boehringer Ingelheim Investigational Site
City
Frankfurt/Main
Country
Germany
Facility Name
1230.33.49004 Boehringer Ingelheim Investigational Site
City
Freiburg
Country
Germany
Facility Name
1230.33.49010 Boehringer Ingelheim Investigational Site
City
Hamburg
Country
Germany
Facility Name
1230.33.49008 Boehringer Ingelheim Investigational Site
City
Hannover
Country
Germany
Facility Name
1230.33.49012 Boehringer Ingelheim Investigational Site
City
Kassel
Country
Germany
Facility Name
1230.33.49014 Boehringer Ingelheim Investigational Site
City
Leipzig
Country
Germany
Facility Name
1230.33.49009 Boehringer Ingelheim Investigational Site
City
Mannheim
Country
Germany
Facility Name
1230.33.49006 Boehringer Ingelheim Investigational Site
City
München
Country
Germany
Facility Name
1230.33.49003 Boehringer Ingelheim Investigational Site
City
Ulm
Country
Germany

12. IPD Sharing Statement

Links:
URL
http://trials.boehringer-ingelheim.com/
Description
Related Info

Learn more about this trial

Phase I Dose Escalation Trial of Volasertib in Combination With Azacitidine in Patients With MDS or CMML

We'll reach out to this number within 24 hrs