FLYSYN in MRD Positive AML (FLYSYN-101)
Primary Purpose
Acute Myeloid Leukemia
Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
FLYSYN
Sponsored by
About this trial
This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring acute myeloid leukemia, Fms-like receptor tyrosine kinase (FLT3), stem cell transplantation, complete remission, CD135, antibodies, Leukemia, AML, Fc-optimized
Eligibility Criteria
Inclusion Criteria:
- Age ≥18 years at the time of voluntarily signing an IEC-approved informed consent, there is no upper age limit
- Diagnosis of AML according to WHO criteria
- Confirmed FLT3 expression on leukemic cells
- Known mutational status of FLT3 (FLT3-ITD, FLT3-TKD, FLT3 wild type)
- Hematological CR (ANC count >1.000/μL, Thrombocytes > 100.000/μL), but MRD positivity (determined by NGS and NPM1 RT-PCR, where applicable) after any therapy except allogeneic stem cell transplantation
- Life expectancy of > 3 months
- ECOG performance status ≤ 2
- Subject must be willing to receive transfusion of blood products
- Be willing and able to comply with the study protocol for the duration of the study
- Females of childbearing potential (FCBP) must undergo repetitive pregnancy testing (serum or urine) and results must be negative
- Reliable contraception should be maintained throughout the study and for 6 months after study treatment
- Unless practicing complete abstinence from heterosexual intercourse, sexually active FCBP must agree to use adequate contraceptive methods
- Males (including those who have had a vasectomy) must use an effective barrier method of contraception throughout the study and for 6 months after study treatment if sexually active with a female of childbearing potential
All subjects must:
- understand that the investigational product could have a potential teratogenic risk.
- be counseled about pregnancy precautions and risks of fetal exposure.
- be able to comply with all study-related procedures, medication use, and evaluations.
Exclusion Criteria:
The presence of ANY of the following criteria will exclude a patient from study enrollment:
- Patients proceeding to hematopoietic stem cell transplantation (suitable candidate and donor available, informed consent of patient)
- Pregnant or breast feeding females
- >5% blasts in bone marrow or extramedullary disease
- Treatment with monoclonal antibody within 3 months before treatment with FLYSYN or known immunoglobulin intolerance
- Known positivity for HIV, active HBV, HCV, or Hepatitis A infection
- No consent for registration, storage and processing of the individual disease-characteristics and course as well as information of the family physician and/or other physicians involved in the treatment about study participation
- No consent for biobanking
- Presence of any medical/psychiatric condition or laboratory abnormalities which may limit full compliance with the study, increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study
- Prior history of malignancies, other than AML/MDS, unless the subject has been free of the disease for ≥ 2 years. Exceptions include the following: Basal cell carcinoma of the skin, carcinoma in situ of the cervix, carcinoma in situ of the breast, histological finding of prostate cancer of TNM stage T1
- Patients receiving any medication listed in the Appendix IV "Prohibited Medications" (within 14 days prior to the first dose of study drug)
- Uncontrolled infection, e.g. infection progressing under adequate antimicrobial/antifungal/antiviral treatment
- Patients under ongoing treatment with another investigational medication or having been treated with an investigational medication within 14 days of screening
- Current treatment with immunosuppressive agents
- Systemic diseases (cardiovascular, renal, hepatic, etc.) that would prevent study treatment (e.g., creatinine >1.5x upper normal serum level; bilirubin, AST or AP >2.5x upper normal serum level; heart failure NYHA III/IV; severe obstructive or restrictive ventilation disorder)
Sites / Locations
- University Hospital Tuebingen
- University Hospital Ulm
- Hannover Medical School
- University Hospital of Heidelberg
- University of Leipzig Medical Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Experimental: FLYSYN
Arm Description
IV infusion over a 3-hr duration
Outcomes
Primary Outcome Measures
Incidence and severity of adverse events (AE) (CTCAE V 4.03)
Secondary Outcome Measures
Incidence and severity of adverse events (AE) (CTCAE V 4.03)
Pharmacokinetics and pharmacodynamics
Immunogenicity of FLYSYN based on both absolute (number and percentage of subjects who develop HAMA/HAHA) and semi-quantitative (HAMA/HAHA titer determination of confirmed positive samples) assessments
Absolute and percent change from baseline in measurements of B, T, and NK cell populations and activation
For evaluation of the status of the immune system, B, T, and NK cells will be measured frequently throughout the study (immune status). The percentage and absolute numbers as well as the absolute and percent changes from baseline of NK cells will be evaluated (determination of absolute NK cell numbers). If feasible, CD16 and CD69 expression on NK cells will be evaluated at baseline and after antibody exposition (NK cell activation). Pending sample availability, endogenous antibody titers (e.g., tetanus titers) will be measured from remaining PK back-up samples in order to gain information about the influence of FLYSYN treatment on normal plasma cells and immunity.
Change in cytokines from baseline
Overall response rate, defined as MRD negativity or reduction of at least one log step,
Duration of response, time to MRD progression (log step), time to relapse
Absolute change from baseline in overall quality of life scores (EORTC QLQ C-30)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02789254
Brief Title
FLYSYN in MRD Positive AML
Acronym
FLYSYN-101
Official Title
First in Man Study to Evaluate the Safety, Tolerability and Preliminary Efficacy of the Fc-optimized FLT3 Antibody FLYSYN for the Treatment of Acute Myeloid Leukemia Patients With Minimal Residual Disease
Study Type
Interventional
2. Study Status
Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
February 7, 2017 (Actual)
Primary Completion Date
September 27, 2021 (Actual)
Study Completion Date
September 27, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Synimmune GmbH
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a first in human, prospective, multicentric, nonrandomized, open-label study to investigate the safety, tolerability, preliminary efficacy, pharmacokinetics, pharmacodynamics and immunogenicity of the Fc-optimized antibody FLYSYN as monotherapy in adult subjects.
Detailed Description
Cohort 1:
Patient 1-3: FLYSYN 0.5 mg/m² body surface area (BSA) day 1
Cohort 2:
Patient 4-6: FLYSYN 0.5 mg/m² body surface area (BSA) day 1 FLYSYN 1.0 mg/m² BSA day 2
Cohort 3:
Patient 7-9: FLYSYN 0.5 mg/m² body surface area (BSA) day 1, FLYSYN 4.5 mg/m² BSA day 2
Cohort 4:
Patient 10-12 and 13-18: FLYSYN 0.5 mg/m² body surface area (BSA) day 1, FLYSYN 14.5 mg/m² BSA day 2
Cohort 5:
Patient 19-21: FLYSYN 0.5 mg/m² body surface area (BSA) day 1, FLYSYN 44.5 mg/m² BSA day 2
Cohort 6:
Patient 22-24 and 25 -31: FLYSYN 0.5 mg/m² body surface area (BSA) day 1, FLYSYN 14.5 mg/m² BSA day 2, FLYSYN 15 mg/m² BSA day 15, FLYSYN 15 mg/m² BSA day 29
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
acute myeloid leukemia, Fms-like receptor tyrosine kinase (FLT3), stem cell transplantation, complete remission, CD135, antibodies, Leukemia, AML, Fc-optimized
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
31 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Experimental: FLYSYN
Arm Type
Experimental
Arm Description
IV infusion over a 3-hr duration
Intervention Type
Biological
Intervention Name(s)
FLYSYN
Intervention Description
Cohort 1:
Patient 1-3: FLYSYN 0.5 mg/m² BSA* day 1
Cohort 2:
Patient 4-6: FLYSYN 0.5 mg/m² BSA day 1 FLYSYN 1.0 mg/m² BSA day 2
Cohort 3:
Patient 7-9: FLYSYN 0.5 mg/m² BSA day 1, FLYSYN 4.5 mg/m² BSA day 2
Cohort 4:
Patient 10-12 and 13-18: FLYSYN 0.5 mg/m² BSA day 1, FLYSYN 14.5 mg/m² BSA day 2
Cohort 5:
Patient 19-21: FLYSYN 0.5 mg/m² BSA day 1, FLYSYN 44.5 mg/m² BSA day 2
Cohort 6:
Patient 22-24 and 25-31: FLYSYN 0.5 mg/m² BSA day 1, FLYSYN 14.5 mg/m² BSA day 2, FLYSYN 15 mg/m² BSA day 15, FLYSYN 15 mg/m² BSA day 29
* The maximum upper limit for calculation of antibody dose is fixed at a body surface of 2.0 m², even if the calculated body surface exceeds this. In this study DLT are defined as the following treatment-related adverse events or laboratory abnormalities, graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03.
Primary Outcome Measure Information:
Title
Incidence and severity of adverse events (AE) (CTCAE V 4.03)
Time Frame
until 28 days (i.e. Visit7, day 29) after last dosing
Secondary Outcome Measure Information:
Title
Incidence and severity of adverse events (AE) (CTCAE V 4.03)
Time Frame
until 180 days (i.e.Visit 11, day 180) after last dosing
Title
Pharmacokinetics and pharmacodynamics
Time Frame
Visit 1 to 13
Title
Immunogenicity of FLYSYN based on both absolute (number and percentage of subjects who develop HAMA/HAHA) and semi-quantitative (HAMA/HAHA titer determination of confirmed positive samples) assessments
Time Frame
BSL; Visits 5-7;9-13
Title
Absolute and percent change from baseline in measurements of B, T, and NK cell populations and activation
Description
For evaluation of the status of the immune system, B, T, and NK cells will be measured frequently throughout the study (immune status). The percentage and absolute numbers as well as the absolute and percent changes from baseline of NK cells will be evaluated (determination of absolute NK cell numbers). If feasible, CD16 and CD69 expression on NK cells will be evaluated at baseline and after antibody exposition (NK cell activation). Pending sample availability, endogenous antibody titers (e.g., tetanus titers) will be measured from remaining PK back-up samples in order to gain information about the influence of FLYSYN treatment on normal plasma cells and immunity.
Time Frame
Visits 1;3;4;5;9
Title
Change in cytokines from baseline
Time Frame
Visits 1-3;5 +6
Title
Overall response rate, defined as MRD negativity or reduction of at least one log step,
Time Frame
BSL; Visits1;4-13
Title
Duration of response, time to MRD progression (log step), time to relapse
Time Frame
BSL; Visits1;4-13
Title
Absolute change from baseline in overall quality of life scores (EORTC QLQ C-30)
Time Frame
Visit 1, Visit 6,Visit 9,Visit 10, Visit 11, Visit 12, Visit 13
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥18 years at the time of voluntarily signing an IEC-approved informed consent, there is no upper age limit
Diagnosis of AML according to WHO criteria
Confirmed FLT3 expression on leukemic cells
Known mutational status of FLT3 (FLT3-ITD, FLT3-TKD, FLT3 wild type)
Hematological CR (ANC count >1.000/μL, Thrombocytes > 100.000/μL), but MRD positivity (determined by NGS and NPM1 RT-PCR, where applicable) after any therapy except allogeneic stem cell transplantation
Life expectancy of > 3 months
ECOG performance status ≤ 2
Subject must be willing to receive transfusion of blood products
Be willing and able to comply with the study protocol for the duration of the study
Females of childbearing potential (FCBP) must undergo repetitive pregnancy testing (serum or urine) and results must be negative
Reliable contraception should be maintained throughout the study and for 6 months after study treatment
Unless practicing complete abstinence from heterosexual intercourse, sexually active FCBP must agree to use adequate contraceptive methods
Males (including those who have had a vasectomy) must use an effective barrier method of contraception throughout the study and for 6 months after study treatment if sexually active with a female of childbearing potential
All subjects must:
understand that the investigational product could have a potential teratogenic risk.
be counseled about pregnancy precautions and risks of fetal exposure.
be able to comply with all study-related procedures, medication use, and evaluations.
Exclusion Criteria:
The presence of ANY of the following criteria will exclude a patient from study enrollment:
Patients proceeding to hematopoietic stem cell transplantation (suitable candidate and donor available, informed consent of patient)
Pregnant or breast feeding females
>5% blasts in bone marrow or extramedullary disease
Treatment with monoclonal antibody within 3 months before treatment with FLYSYN or known immunoglobulin intolerance
Known positivity for HIV, active HBV, HCV, or Hepatitis A infection
No consent for registration, storage and processing of the individual disease-characteristics and course as well as information of the family physician and/or other physicians involved in the treatment about study participation
No consent for biobanking
Presence of any medical/psychiatric condition or laboratory abnormalities which may limit full compliance with the study, increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study
Prior history of malignancies, other than AML/MDS, unless the subject has been free of the disease for ≥ 2 years. Exceptions include the following: Basal cell carcinoma of the skin, carcinoma in situ of the cervix, carcinoma in situ of the breast, histological finding of prostate cancer of TNM stage T1
Patients receiving any medication listed in the Appendix IV "Prohibited Medications" (within 14 days prior to the first dose of study drug)
Uncontrolled infection, e.g. infection progressing under adequate antimicrobial/antifungal/antiviral treatment
Patients under ongoing treatment with another investigational medication or having been treated with an investigational medication within 14 days of screening
Current treatment with immunosuppressive agents
Systemic diseases (cardiovascular, renal, hepatic, etc.) that would prevent study treatment (e.g., creatinine >1.5x upper normal serum level; bilirubin, AST or AP >2.5x upper normal serum level; heart failure NYHA III/IV; severe obstructive or restrictive ventilation disorder)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Helmut Salih, Prof. Dr.
Organizational Affiliation
Department of Internal Medicine, Internal Medicine II; Oncology, haematology, clinical immunology, rheumatology and pneumology University Hospital Tuebingen
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Tuebingen
City
Tuebingen
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
72076
Country
Germany
Facility Name
University Hospital Ulm
City
Ulm
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
89081
Country
Germany
Facility Name
Hannover Medical School
City
Hannover
State/Province
Niedersachsen
ZIP/Postal Code
30625
Country
Germany
Facility Name
University Hospital of Heidelberg
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
University of Leipzig Medical Center
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
12. IPD Sharing Statement
Plan to Share IPD
Undecided
IPD Sharing Plan Description
publication
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FLYSYN in MRD Positive AML
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