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Study of a Novel BET Inhibitor FT-1101 in Patients With Relapsed or Refractory Hematologic Malignancies

Primary Purpose

Acute Myeloid Leukemia, Acute Myelogenous Leukemia, Myelodysplastic Syndrome

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
FT-1101
Azacitidine
Sponsored by
Novo Nordisk A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring AML, BET Inhibitor, FT-1101, Acute Leukemia, Myelodysplastic Syndrome, NHL, Non-Hodgkin Lymphoma

Eligibility Criteria

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

Key Inclusion Criteria:

  • Single agent (SA) Dose Escalation: Histologically or cytologically proven acute leukemia or high-risk MDS as defined by the World Health Organization (WHO) criteria and IPSS-R, respectively, that is relapsed or refractory (R/R) to standard therapy or for whom standard treatments are contraindicated, OR
  • Mature B-Cell non-Hodgkin Lymphoma that is Relapsed/Refractory to standard therapy
  • AML SA expansion group 1: histologically or cytologically proven AML with a FLT3 ITD or TKD mutation previously determined by local testing that is R/R to standard therapy or for whom standard treatments are contraindicated
  • AML SA expansion group 2: histologically or cytologically proven AML with intermediate or unfavorable risk cytogenetics in the absence of a detectable FLT3 ITD or TKD mutation as previously determined by local testing that is R/R to standard therapy or for whom standard treatments are contraindicated
  • NHL SA expansion: Mature B-cell NHL with the following histologies: primary mediastinal lymphoma, DLBCL, and B-cell lymphoma not specified that is R/R to standard therapy and for whom standard treatments are contraindicated or unavailable
  • AML/MDS combination treatment (dose escalation and expansion): histologically or cytologically proven AML or MDS as defined by WHO criteria and IPSS-R, respectively, that is: R/R to standard therapy, or AML: who are unfit for, or unwilling to receive standard induction therapy, or MDS: eligible to receive azacitidine
  • Patients ≥ 18 years old
  • Good kidney and liver function
  • No prior organ allograft
  • For fertile men and women, agreement to use effective contraceptive methods duration of study participation and 90 days after

Key Exclusion Criteria:

  • History of prior malignancy unless disease free for > or equal to 12 months or considered surgically cured.
  • Patients with symptomatic central nervous system (CNS) metastases or other tumor location (such as spinal cord compression, other compressive mass, uncontrolled painful lesion, bone fracture, etc.) necessitating an urgent therapeutic intervention, palliative care, surgery or radiation therapy
  • Treatment with major surgery (requiring general anesthesia) within one month prior to study entry
  • Previous treatment with any prior BET inhibitor therapy
  • Patients unable to swallow oral medications, or patients with gastrointestinal conditions (e.g. malabsorption, gastric or small bowel resection, etc.) deemed to jeopardize intestinal absorption
  • Congestive heart failure (New York Heart Association Class III or IV) or unstable angina pectoris. Previous history of myocardial infarction within 1 year prior to study entry, uncontrolled hypertension or uncontrolled arrhythmias
  • Pulmonary disease (e.g. COPD, asthma, etc) that is not controlled (moderate to severe symptoms) with current medication
  • Known HIV positivity
  • Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy

Sites / Locations

  • Cedars Sinai
  • Florida Cancer Specialists
  • Moffitt Cancer Center
  • Northwestern University
  • University of Maryland, Greenebaum Comprehensive Cancer Center
  • Levine Cancer Institute
  • Sarah Cannon Research Institute
  • MD Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose Escalation FT-1101

Dose Expansion FT-1101

Dose Escalation FT-1101 + azacitidine

Dose Expansion FT-1101 + azacitidine

Arm Description

Following a 3+3 dose escalation strategy, the first cohort of patients will be administered FT-1101 at 10 mg, oral capsules, once weekly on a continuous basis. Subsequent cohorts dose and frequency will be determined by investigators and sponsor following observations of previous cohorts. Dose escalation will continue until the MTD is determined.

Once the MTD is determined, the Recommended Phase 2 Dose (RP2D) will be identified. 3 Expansion cohorts of up to 20 patients each will be treated with the RP2D of FT-1101

Following a 3+3 dose escalation strategy, the first cohort of AML/MDS patients will be administered FT-1101 at approximately 50% or lower than the MTD identified for the single agent FT-1101. Subsequent cohorts dose will be determined by investigators and sponsor following observations of previous cohorts. Dose escalation will not exceed the dose determined to be the single agent MTD for that schedule.

Once the MTD is determined, the Recommended Phase 2 Dose (RP2D) will be identified. 1 Expansion cohorts of up to 20 AML/MDS patients each will be treated with the RP2D of FT-1101 in combination with azacitidine.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD)
Dose Limiting Toxicities (DLT)
Recommended Phase 2 Dose (RP2D)

Secondary Outcome Measures

Area under the plasma concentration versus time curve (AUC)
Peak Plasma Concentration (Cmax)
Time of peak plasma concentration (TMax)
Time for half of the drug to be absent in blood stream following dose (T 1/2)
Rate at which drug is removed from blood stream (CL/F)
Rate of drug distribution within the blood stream (Vd/F)
Observe patients for any evidence of anti-leukemic or anti-myelodysplastic activity of FT-1101

Full Information

First Posted
September 1, 2015
Last Updated
August 8, 2023
Sponsor
Novo Nordisk A/S
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1. Study Identification

Unique Protocol Identification Number
NCT02543879
Brief Title
Study of a Novel BET Inhibitor FT-1101 in Patients With Relapsed or Refractory Hematologic Malignancies
Official Title
A Phase 1/1b Dose Escalation, Multicenter, Open-label, Safety, Pharmacokinetic and Pharmacodynamic Study of FT-1101 as a Single Agent and in Combination With Azacitidine in Patients With Relapsed or Refractory Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
June 2019
Overall Recruitment Status
Completed
Study Start Date
September 2015 (undefined)
Primary Completion Date
March 2019 (Actual)
Study Completion Date
March 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novo Nordisk A/S

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open-label, multicenter, dose-escalation Phase 1/1b study in patients with acute myelogenous leukemia (AML)/MDS or non-Hodgkin Lymphoma (NHL), intended to investigate safety, pharmacokinetics, and the pharmacodynamic effects of FT-1101 administered via one or more intermittent dosing schedules alone and in combination with azacitidine. Once the MTD has been established for a treatment cohort, up to 20 additional patients may be enrolled in up to 4 expansion cohorts each of select populations of patients with either AML/MDS or NHL at the recommended dose for future studies to confirm safety.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia, Acute Myelogenous Leukemia, Myelodysplastic Syndrome, Non-Hodgkin Lymphoma
Keywords
AML, BET Inhibitor, FT-1101, Acute Leukemia, Myelodysplastic Syndrome, NHL, Non-Hodgkin Lymphoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation FT-1101
Arm Type
Experimental
Arm Description
Following a 3+3 dose escalation strategy, the first cohort of patients will be administered FT-1101 at 10 mg, oral capsules, once weekly on a continuous basis. Subsequent cohorts dose and frequency will be determined by investigators and sponsor following observations of previous cohorts. Dose escalation will continue until the MTD is determined.
Arm Title
Dose Expansion FT-1101
Arm Type
Experimental
Arm Description
Once the MTD is determined, the Recommended Phase 2 Dose (RP2D) will be identified. 3 Expansion cohorts of up to 20 patients each will be treated with the RP2D of FT-1101
Arm Title
Dose Escalation FT-1101 + azacitidine
Arm Type
Experimental
Arm Description
Following a 3+3 dose escalation strategy, the first cohort of AML/MDS patients will be administered FT-1101 at approximately 50% or lower than the MTD identified for the single agent FT-1101. Subsequent cohorts dose will be determined by investigators and sponsor following observations of previous cohorts. Dose escalation will not exceed the dose determined to be the single agent MTD for that schedule.
Arm Title
Dose Expansion FT-1101 + azacitidine
Arm Type
Experimental
Arm Description
Once the MTD is determined, the Recommended Phase 2 Dose (RP2D) will be identified. 1 Expansion cohorts of up to 20 AML/MDS patients each will be treated with the RP2D of FT-1101 in combination with azacitidine.
Intervention Type
Drug
Intervention Name(s)
FT-1101
Other Intervention Name(s)
FT1101
Intervention Description
FT-1101 will be supplied as 5 mg, 20 mg or 100 mg capsules and will be administered per the protocol defined frequency and dose level
Intervention Type
Drug
Intervention Name(s)
Azacitidine
Intervention Description
Azacitidine will be administered per site's standard of care
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Time Frame
Within first 4 weeks of treatment
Title
Dose Limiting Toxicities (DLT)
Time Frame
Within first 4 weeks of treatment
Title
Recommended Phase 2 Dose (RP2D)
Time Frame
Participants to be followed for duration of participation, an expected average of 12 weeks
Secondary Outcome Measure Information:
Title
Area under the plasma concentration versus time curve (AUC)
Time Frame
PK collected at multiple visits during the first 30 days of treatment
Title
Peak Plasma Concentration (Cmax)
Time Frame
PK collected at multiple visits during the first 30 days of treatment
Title
Time of peak plasma concentration (TMax)
Time Frame
PK collected at multiple visits during the first 30 days of treatment
Title
Time for half of the drug to be absent in blood stream following dose (T 1/2)
Time Frame
PK collected at multiple visits during the first 30 days of treatment
Title
Rate at which drug is removed from blood stream (CL/F)
Time Frame
PK collected at multiple visits during the first 30 days of treatment
Title
Rate of drug distribution within the blood stream (Vd/F)
Time Frame
PK collected at multiple visits during the first 30 days of treatment
Title
Observe patients for any evidence of anti-leukemic or anti-myelodysplastic activity of FT-1101
Time Frame
Assessed for duration of participation, an expected average of 12 weeks
Other Pre-specified Outcome Measures:
Title
Assessment of on-target activity of FT-1101, as determined by changes in PD biomarkers in bone marrow aspirates and/or peripheral blood
Time Frame
Assessed for duration of participation, an expected average of 12 weeks
Title
To determine if there is any correlation between cancer-associated genetic alterations with response
Time Frame
Assessed for duration of participation, an expected average of 12 weeks
Title
To evaluate PK/PD relationships in dose-escalation and dose-expansion cohorts
Time Frame
Assessed for duration of participation, an expected average of 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Single agent (SA) Dose Escalation: Histologically or cytologically proven acute leukemia or high-risk MDS as defined by the World Health Organization (WHO) criteria and IPSS-R, respectively, that is relapsed or refractory (R/R) to standard therapy or for whom standard treatments are contraindicated, OR Mature B-Cell non-Hodgkin Lymphoma that is Relapsed/Refractory to standard therapy AML SA expansion group 1: histologically or cytologically proven AML with a FLT3 ITD or TKD mutation previously determined by local testing that is R/R to standard therapy or for whom standard treatments are contraindicated AML SA expansion group 2: histologically or cytologically proven AML with intermediate or unfavorable risk cytogenetics in the absence of a detectable FLT3 ITD or TKD mutation as previously determined by local testing that is R/R to standard therapy or for whom standard treatments are contraindicated NHL SA expansion: Mature B-cell NHL with the following histologies: primary mediastinal lymphoma, DLBCL, and B-cell lymphoma not specified that is R/R to standard therapy and for whom standard treatments are contraindicated or unavailable AML/MDS combination treatment (dose escalation and expansion): histologically or cytologically proven AML or MDS as defined by WHO criteria and IPSS-R, respectively, that is: R/R to standard therapy, or AML: who are unfit for, or unwilling to receive standard induction therapy, or MDS: eligible to receive azacitidine Patients ≥ 18 years old Good kidney and liver function No prior organ allograft For fertile men and women, agreement to use effective contraceptive methods duration of study participation and 90 days after Key Exclusion Criteria: History of prior malignancy unless disease free for > or equal to 12 months or considered surgically cured. Patients with symptomatic central nervous system (CNS) metastases or other tumor location (such as spinal cord compression, other compressive mass, uncontrolled painful lesion, bone fracture, etc.) necessitating an urgent therapeutic intervention, palliative care, surgery or radiation therapy Treatment with major surgery (requiring general anesthesia) within one month prior to study entry Previous treatment with any prior BET inhibitor therapy Patients unable to swallow oral medications, or patients with gastrointestinal conditions (e.g. malabsorption, gastric or small bowel resection, etc.) deemed to jeopardize intestinal absorption Congestive heart failure (New York Heart Association Class III or IV) or unstable angina pectoris. Previous history of myocardial infarction within 1 year prior to study entry, uncontrolled hypertension or uncontrolled arrhythmias Pulmonary disease (e.g. COPD, asthma, etc) that is not controlled (moderate to severe symptoms) with current medication Known HIV positivity Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Kelly, MD
Organizational Affiliation
Novo Nordisk A/S
Official's Role
Study Director
Facility Information:
Facility Name
Cedars Sinai
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Florida Cancer Specialists
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34232
Country
United States
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
23985
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Maryland, Greenebaum Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Levine Cancer Institute
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study of a Novel BET Inhibitor FT-1101 in Patients With Relapsed or Refractory Hematologic Malignancies

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