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A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)

Primary Purpose

Myelodysplastic Syndrome (MDS)

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
BLEX 404 Oral Liquid
Sponsored by
BioLite, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndrome (MDS)

Eligibility Criteria

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

Inclusion Criteria:

  • Age 20 or older, able to sign informed consent, understand and comply with protocol requirements and instructions.
  • Body weight between 30 to 120 kg
  • International Prognostic Scoring System (IPSS) intermediate-1 (int-1), intermediate-2 (int-2) or high-risk myelodysplastic syndrome (MDS) by World Health Organization (WHO) or Chronic Myelomonocytic Leukemia (CMML) patients.
  • Not previously treated with MDS and CMML therapy and require treatment with azacitidine* for the first time at 75 mg/m2 subcutaneously or intravenously, daily for 7 days (7 nonconsecutive day of 6-1-1 or 5-2-2 treatment schedule is acceptable in which the drug is administered Monday-Saturday and then Monday of the following week for a 6-1-1 schedule, and in which the drug is administered Monday-Friday and then Monday-Tuesday of the following week for 5-2-2 schedule) per cycle. Treatment of the study drug, BLEX 404 Oral Liquid will begin at the same time receiving the first dose of azacitidine in this study.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0-3.
  • Adequate baseline organ function defined by the criteria below: total bilirubin ≤ 1.5x the upper limit of normal (ULN) except for Gilbert's syndrome or indirect hyperbilirubinemia due to hemolysis; ALT ≤ 2.5x ULN; AST ≤ 2.5x ULN; creatinine clearance ≥ 60 mL/min/1.73 m2.
  • Women must be either of non-child bearing potential, or women with child-bearing potential and men with reproductive potential and a female partner of childbearing potential must either have had a prior vasectomy or agree to use effective contraception from time of Screening Visit until the Follow-Up Visit.

Exclusion Criteria:

  • Historical allergic events caused by mushroom.
  • Previous treatment with hypomethylating agent or known immediate or delayed hypersensitivity reaction to drugs chemically related to azacitidine that contraindicates the subjects' participation.
  • Patients with active infections or require treatments with immunosuppressive drugs at screening visit. However, patients require ongoing treatments with corticosteroids may be recruited.
  • Treatment with an investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of BLEX 404 Oral Liquid.
  • Any serious and/or unstable pre-existing medical condition (including any advanced malignancy other than the disease under study), psychiatric disorder, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance with the study procedures.
  • Any clinically significant pulmonary, cardiovascular, endocrine, neurologic, gastrointestinal or genitourinary disease unrelated to underlying hematologic disorder.
  • Active and uncontrolled infections of the following: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection. However, HBV and HCV carriers with viral load test of "not detected" or "negative" results may be recruited in this study.
  • Lactating female and women with a positive serum or urine pregnancy test at screening assessments.
  • (For Part II Interventional Study subjects only) No indication, in the opinion of the treating physician, for antibiotic prophylaxis within 2 weeks prior to study treatment.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    BLEX 404 Oral Liquid

    Arm Description

    Part I: Part I-1: Low Dose BLEX 404 Oral Liquid (3 mg/kg, BID) is administered in combination with 2 cycles of azacitidine. Part I-2: High Dose BLEX 404 Oral Liquid (4.5 mg/kg, BID) is administered in combination with 2 cycles of azacitidine. Part II: Recommended Dose Level (RDL) of BLEX 404 Oral Liquid will be determined by results from Part I. BLEX 404 Oral Liquid at RDL is administered in combination with 6 cycles of azacitidine.

    Outcomes

    Primary Outcome Measures

    Part I: Recommended dose level (RDL) of BLEX 404 Oral Liquid
    RDL is defined by BLEX 404 Oral Liquid-related prohibited toxicity in subjects undergoing 2 cycles of azacitidine treatment. When one of the stopping criteria is met during the study treatment period, RDL will be set at the lower dose level.
    Part II: Incidence of infections
    Number of subjects experience infection events and inpatient hospitalization due to infections.

    Secondary Outcome Measures

    Part I: (A) Number of subjects experience infections events and inpatient hospitalization due to infections
    Part I: (B) Treatments and duration of each infections
    Part I: (C) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
    Part I: (D) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
    Part I: (E) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
    Part I: (F) Disease Progression (defined by 2006 IWG Criteria)
    Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
    Part II: (A) Time-to-first infection
    Part II: (B) Duration (days) of each infection event
    Part II: (C) Number of infections requiring supportive care or antimicrobial agents
    Part II: (D) Duration (days) of treatments for infections
    Part II: (E) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
    Part II: (F) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
    Part II: (G) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
    Part II: (H) Disease Progression (defined by 2006 IWG Criteria)
    Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
    Part II: (I) Six-month overall survival rate (defined by 2006 IWG Criteria)
    defined as time from beginning of treatment till death from any cause occurs or last follow-up.
    Part II: (J) Six-month progression-free survival (defined by 2006 IWG Criteria)
    defined as time from beginning of treatment till disease progression, death from MDS or CMML, or last follow-up.
    Part II: (K) Immune Response
    Neutrophil and monocyte function by respiratory burst assay

    Full Information

    First Posted
    October 4, 2016
    Last Updated
    July 4, 2023
    Sponsor
    BioLite, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02944955
    Brief Title
    A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)
    Official Title
    A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    January 2024 (Anticipated)
    Primary Completion Date
    December 2024 (Anticipated)
    Study Completion Date
    June 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    BioLite, Inc.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is a clinical trial to determine the safety, recommended dose level (RDL), and infection control of BLEX 404 Oral Liquid in combination with azacitidine in patients with International Prognostic Scoring System (IPSS) intermediate-1 (int-1), intermediate-2 (int-2) or high-risk myelodysplastic syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Myelodysplastic Syndrome (MDS)

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    52 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    BLEX 404 Oral Liquid
    Arm Type
    Experimental
    Arm Description
    Part I: Part I-1: Low Dose BLEX 404 Oral Liquid (3 mg/kg, BID) is administered in combination with 2 cycles of azacitidine. Part I-2: High Dose BLEX 404 Oral Liquid (4.5 mg/kg, BID) is administered in combination with 2 cycles of azacitidine. Part II: Recommended Dose Level (RDL) of BLEX 404 Oral Liquid will be determined by results from Part I. BLEX 404 Oral Liquid at RDL is administered in combination with 6 cycles of azacitidine.
    Intervention Type
    Drug
    Intervention Name(s)
    BLEX 404 Oral Liquid
    Intervention Description
    BLEX 404 Oral Liquid is orally administered twice daily in combination with azacitdine treatment cycles (2 cycles in Part I and 6 cycles in Part II). Azacitidine treatment: SC or IV injections at 75 mg/m2, QD for 7 days each cycle. 28 days/cycle, and repeat cycles every 4 weeks.
    Primary Outcome Measure Information:
    Title
    Part I: Recommended dose level (RDL) of BLEX 404 Oral Liquid
    Description
    RDL is defined by BLEX 404 Oral Liquid-related prohibited toxicity in subjects undergoing 2 cycles of azacitidine treatment. When one of the stopping criteria is met during the study treatment period, RDL will be set at the lower dose level.
    Time Frame
    8 weeks (2 cycles of azacitidine)
    Title
    Part II: Incidence of infections
    Description
    Number of subjects experience infection events and inpatient hospitalization due to infections.
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Secondary Outcome Measure Information:
    Title
    Part I: (A) Number of subjects experience infections events and inpatient hospitalization due to infections
    Time Frame
    8 weeks (2 cycles of azacitidine)
    Title
    Part I: (B) Treatments and duration of each infections
    Time Frame
    8 weeks (2 cycles of azacitidine)
    Title
    Part I: (C) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
    Description
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
    Time Frame
    8 weeks (2 cycles of azacitidine)
    Title
    Part I: (D) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
    Description
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
    Time Frame
    8 weeks (2 cycles of azacitidine)
    Title
    Part I: (E) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
    Description
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
    Time Frame
    8 weeks (2 cycles of azacitidine)
    Title
    Part I: (F) Disease Progression (defined by 2006 IWG Criteria)
    Description
    Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
    Time Frame
    8 weeks (2 cycles of azacitidine)
    Title
    Part II: (A) Time-to-first infection
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (B) Duration (days) of each infection event
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (C) Number of infections requiring supportive care or antimicrobial agents
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (D) Duration (days) of treatments for infections
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (E) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
    Description
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (F) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
    Description
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (G) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
    Description
    Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (H) Disease Progression (defined by 2006 IWG Criteria)
    Description
    Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (I) Six-month overall survival rate (defined by 2006 IWG Criteria)
    Description
    defined as time from beginning of treatment till death from any cause occurs or last follow-up.
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (J) Six-month progression-free survival (defined by 2006 IWG Criteria)
    Description
    defined as time from beginning of treatment till disease progression, death from MDS or CMML, or last follow-up.
    Time Frame
    24 weeks (6 cycles of azacitidine)
    Title
    Part II: (K) Immune Response
    Description
    Neutrophil and monocyte function by respiratory burst assay
    Time Frame
    24 weeks (6 cycles of azacitidine)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    20 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age 20 or older, able to sign informed consent, understand and comply with protocol requirements and instructions. Body weight between 30 to 120 kg International Prognostic Scoring System (IPSS) intermediate-1 (int-1), intermediate-2 (int-2) or high-risk myelodysplastic syndrome (MDS) by World Health Organization (WHO) or Chronic Myelomonocytic Leukemia (CMML) patients. Not previously treated with MDS and CMML therapy and require treatment with azacitidine* for the first time at 75 mg/m2 subcutaneously or intravenously, daily for 7 days (7 nonconsecutive day of 6-1-1 or 5-2-2 treatment schedule is acceptable in which the drug is administered Monday-Saturday and then Monday of the following week for a 6-1-1 schedule, and in which the drug is administered Monday-Friday and then Monday-Tuesday of the following week for 5-2-2 schedule) per cycle. Treatment of the study drug, BLEX 404 Oral Liquid will begin at the same time receiving the first dose of azacitidine in this study. Eastern Cooperative Oncology Group (ECOG) Performance Status 0-3. Adequate baseline organ function defined by the criteria below: total bilirubin ≤ 1.5x the upper limit of normal (ULN) except for Gilbert's syndrome or indirect hyperbilirubinemia due to hemolysis; ALT ≤ 2.5x ULN; AST ≤ 2.5x ULN; creatinine clearance ≥ 60 mL/min/1.73 m2. Women must be either of non-child bearing potential, or women with child-bearing potential and men with reproductive potential and a female partner of childbearing potential must either have had a prior vasectomy or agree to use effective contraception from time of Screening Visit until the Follow-Up Visit. Exclusion Criteria: Historical allergic events caused by mushroom. Previous treatment with hypomethylating agent or known immediate or delayed hypersensitivity reaction to drugs chemically related to azacitidine that contraindicates the subjects' participation. Patients with active infections or require treatments with immunosuppressive drugs at screening visit. However, patients require ongoing treatments with corticosteroids may be recruited. Treatment with an investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of BLEX 404 Oral Liquid. Any serious and/or unstable pre-existing medical condition (including any advanced malignancy other than the disease under study), psychiatric disorder, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance with the study procedures. Any clinically significant pulmonary, cardiovascular, endocrine, neurologic, gastrointestinal or genitourinary disease unrelated to underlying hematologic disorder. Active and uncontrolled infections of the following: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection. However, HBV and HCV carriers with viral load test of "not detected" or "negative" results may be recruited in this study. Lactating female and women with a positive serum or urine pregnancy test at screening assessments. (For Part II Interventional Study subjects only) No indication, in the opinion of the treating physician, for antibiotic prophylaxis within 2 weeks prior to study treatment.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Hsien-Ming Wu, M.S.
    Phone
    +886-3-6685386
    Email
    sonnywu@bioliteinc.com

    12. IPD Sharing Statement

    Learn more about this trial

    A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)

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