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Study of AMV564 in Patients With AML

Primary Purpose

Acute Myeloid Leukemia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AMV564
AMV564 in combination with pembrolizumab
Sponsored by
Amphivena Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring AML, treatment, relapsed, refractory, phase 1

Eligibility Criteria

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

Inclusion Criteria:

  • ≥ 18 years of age at the time of signing informed consent
  • Diagnosis of AML according to the World Health Organization (WHO) 2008 criteria
  • Relapsed or refractory disease meeting the following criteria:

    1. Primary refractory, ie, refractory to induction with a standard intensive anthracycline/cytarabine-based regimen or a non-intensive regimen (e.g., decitabine, azacytidine, low-dose cytarabine) for patients ineligible for an intensive anthracycline/cytarabine-based therapy
    2. First untreated relapse after a first CR lasting less than 12 months or first relapse refractory to salvage therapy regardless of length of first CR; or
    3. Second or later relapse. Relapse is defined as the reappearance of leukemic blasts in the peripheral blood or ≥ 5% leukemic blasts in the bone marrow after prior achievement of a CR or CRi.

OR Patients with newly diagnosed therapy-related AML, AML progressed from antecedent MDS or CMML treated with hypomethylating agents, or de novo AML with MDS-related cytogenetic abnormalities (per 2008 WHO criteria) and who are not candidates for (or decline) intensive remission induction therapy

  • No more than 3 prior induction/salvage regimens to treat active disease, and no more than 1 prior stem cell transplant. Any number of continuous cycles of therapy with an individual hypomethylating agent count as one induction or salvage regimen.
  • Blasts at least 5% in bone marrow
  • Peripheral white blood cell (WBC) count: no upper limit at Screening, but must be < 10 x 109/L on Day 1 prior to treatment; patients with excessive blasts may be treated with hydroxyurea to bring counts down.
  • Chemistry laboratory parameters within the following range:

    1. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2x the upper limit of normal (ULN)
    2. Total bilirubin ≤ 1.5x the ULN; patients with Gilbert's syndrome can enroll if conjugated bilirubin is within normal limits.
    3. Creatinine clearance > 50 mL/min (measured or calculated by Cockcroft-Gault method)
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Patients with ECOG score of 2 may be included, after discussion with the Sponsor Medical Monitor, if score is influenced by symptoms attributable to underlying AML disease.
  • Willing to complete all scheduled visits and assessments at the institution administering therapy
  • Able to read, understand and provide written informed consent

Exclusion Criteria:

Patients who meet any of the following criteria will be excluded from the study.

  • History of, or known, central nervous system (CNS) disease involvement, or prior history of National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE) Grade ≥ 3 drug-related CNS toxicity
  • Prior allogeneic transplant (dose escalation only)
  • Prior solid organ transplantation
  • Treatment with anti-thymocyte globulin (ATG) within 14 days prior to start date
  • Treatment with any local or systemic antineoplastic therapy or radiation within 14 days prior to the initiation of AMV564 administration (hydroxyurea is exempted if used to reduce total WBC counts)
  • Clinically significant cardiac disease,
  • Pulmonary, renal, hepatic, gastrointestinal, neurological or psychiatric disease that would limit compliance with study requirements
  • Evidence of active, uncontrolled, viral, bacterial, or systemic fungal infection. Prophylactic therapy according to institutional protocols is acceptable.
  • Known positive test result for human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS)
  • Active hepatitis C virus (HCV) or hepatitis B virus (HBV). Patients who are positive for hepatitis B core antibody, hepatitis B surface antigen, or hepatitis C antibody must have a negative polymerase chain reaction (PCR) result before enrollment. Those who are PCR positive will be excluded.
  • Second primary malignancy that has not been in remission for greater than 3 years. Exceptions that do not require a 3-year remission include: non-melanoma skin cancer; cervical carcinoma in situ on biopsy or squamous intraepithelial lesion on Papanicolaou (PAP) smear; localized prostate cancer (Gleason score < 6); or resected melanoma in situ.
  • Major trauma or major surgery within 28 days prior to the initiation of AMV564 treatment
  • Any serious underlying medical or psychiatric condition (e.g. alcohol or drug abuse), dementia or altered mental status or any issue that would impair the ability of the patient to understand informed consent or that in the opinion of the investigator would contraindicate the patient's participation in the study or confound the results of the study.
  • Ability to become pregnant. However, female patients who have a negative serum or urine pregnancy test before enrollment and agree to use two highly effective forms of contraception (oral, injected or implanted hormonal contraception and condom; intrauterine device and condom; diaphragm with spermicidal gel and condom) during the trial and for 90 days afterward (90 days after the end of AMV564 treatment) are considered eligible.
  • Male patients with partners of childbearing potential.
  • Pregnant or breastfeeding women
  • Is a participant or plans to participate in another interventional clinical study, while taking part in this protocol. Participation in an observational study is acceptable.

Sites / Locations

  • University of California, San Francisco
  • Northwestern
  • Johns Hopkins University
  • Washington University School of Medicine
  • New York Medical College
  • Weill Cornell Medical College, The New York Presbyterian Hospital
  • The Ohio State University Comprehensive Cancer Center
  • University of Pennsylvania
  • MD Anderson Cancer Center, The University of Texas
  • Fred Hutchinson Cancer Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

AMV564

Combination AMV564

Arm Description

Continuous infusion or subcutaneous dosing of AMV564 at increasing dose levels

Continuous infusion or subcutaneous dosing of AMV564 at increasing dose levels in combination with pembrolizumab

Outcomes

Primary Outcome Measures

Dose escalation + expansion stage: incidence of all adverse events and serious adverse events (safety and tolerability)
Number of participants with adverse events as a measure of safety and tolerability.
Expansion stage: Efficacy - Remission Rate
Proportion of participants who achieve complete remission, complete remission with incomplete recovery or partial remission

Secondary Outcome Measures

Full Information

First Posted
April 25, 2017
Last Updated
October 11, 2021
Sponsor
Amphivena Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03144245
Brief Title
Study of AMV564 in Patients With AML
Official Title
A Phase 1, First in Human, Open Label, Dose Escalation Study of AMV564, a CD33 x CD3 Tandem Diabody in Patients With Relapsed or Refractory Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
March 20, 2017 (Actual)
Primary Completion Date
July 21, 2020 (Actual)
Study Completion Date
November 5, 2020 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
This is a first in human, non randomized, open-label, dose escalation study to investigate the safety, tolerability and preliminary efficacy of AMV564.
Detailed Description
This study is a first in human, Phase 1, open label, multicenter, dose escalation study with expansion at the RP2D to evaluate the safety, tolerability and preliminary antileukemic activity of AMV564 in patients with relapsed or refractory acute myeloid leukemia (AML). AMV564 will be given on Days 1-14 of a 4-week cycle, or Days 1-28 of a 6-week cycle,via CIV or subcutaneous administration for 1 or more treatment cycles as monotherapy or in combination with pembrolizumab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
AML, treatment, relapsed, refractory, phase 1

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
AMV564
Arm Type
Experimental
Arm Description
Continuous infusion or subcutaneous dosing of AMV564 at increasing dose levels
Arm Title
Combination AMV564
Arm Type
Experimental
Arm Description
Continuous infusion or subcutaneous dosing of AMV564 at increasing dose levels in combination with pembrolizumab
Intervention Type
Biological
Intervention Name(s)
AMV564
Intervention Description
AMV564 for administration via continuous intravenous daily infusion or subcutaneous dosing
Intervention Type
Combination Product
Intervention Name(s)
AMV564 in combination with pembrolizumab
Intervention Description
AMV564 for administration via continuous intravenous daily infusion or subcutaneous dosing.in combination with pembrolizumab given IV every 21 days
Primary Outcome Measure Information:
Title
Dose escalation + expansion stage: incidence of all adverse events and serious adverse events (safety and tolerability)
Description
Number of participants with adverse events as a measure of safety and tolerability.
Time Frame
42 months
Title
Expansion stage: Efficacy - Remission Rate
Description
Proportion of participants who achieve complete remission, complete remission with incomplete recovery or partial remission
Time Frame
42 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ≥ 18 years of age at the time of signing informed consent Diagnosis of AML according to the World Health Organization (WHO) 2008 criteria Relapsed or refractory disease meeting the following criteria: Primary refractory, ie, refractory to induction with a standard intensive anthracycline/cytarabine-based regimen or a non-intensive regimen (e.g., decitabine, azacytidine, low-dose cytarabine) for patients ineligible for an intensive anthracycline/cytarabine-based therapy First untreated relapse after a first CR lasting less than 12 months or first relapse refractory to salvage therapy regardless of length of first CR; or Second or later relapse. Relapse is defined as the reappearance of leukemic blasts in the peripheral blood or ≥ 5% leukemic blasts in the bone marrow after prior achievement of a CR or CRi. OR Patients with newly diagnosed therapy-related AML, AML progressed from antecedent MDS or CMML treated with hypomethylating agents, or de novo AML with MDS-related cytogenetic abnormalities (per 2008 WHO criteria) and who are not candidates for (or decline) intensive remission induction therapy No more than 3 prior induction/salvage regimens to treat active disease, and no more than 1 prior stem cell transplant. Any number of continuous cycles of therapy with an individual hypomethylating agent count as one induction or salvage regimen. Blasts at least 5% in bone marrow Peripheral white blood cell (WBC) count: no upper limit at Screening, but must be < 10 x 109/L on Day 1 prior to treatment; patients with excessive blasts may be treated with hydroxyurea to bring counts down. Chemistry laboratory parameters within the following range: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2x the upper limit of normal (ULN) Total bilirubin ≤ 1.5x the ULN; patients with Gilbert's syndrome can enroll if conjugated bilirubin is within normal limits. Creatinine clearance > 50 mL/min (measured or calculated by Cockcroft-Gault method) Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Patients with ECOG score of 2 may be included, after discussion with the Sponsor Medical Monitor, if score is influenced by symptoms attributable to underlying AML disease. Willing to complete all scheduled visits and assessments at the institution administering therapy Able to read, understand and provide written informed consent Exclusion Criteria: Patients who meet any of the following criteria will be excluded from the study. History of, or known, central nervous system (CNS) disease involvement, or prior history of National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE) Grade ≥ 3 drug-related CNS toxicity Prior allogeneic transplant (dose escalation only) Prior solid organ transplantation Treatment with anti-thymocyte globulin (ATG) within 14 days prior to start date Treatment with any local or systemic antineoplastic therapy or radiation within 14 days prior to the initiation of AMV564 administration (hydroxyurea is exempted if used to reduce total WBC counts) Clinically significant cardiac disease, Pulmonary, renal, hepatic, gastrointestinal, neurological or psychiatric disease that would limit compliance with study requirements Evidence of active, uncontrolled, viral, bacterial, or systemic fungal infection. Prophylactic therapy according to institutional protocols is acceptable. Known positive test result for human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) Active hepatitis C virus (HCV) or hepatitis B virus (HBV). Patients who are positive for hepatitis B core antibody, hepatitis B surface antigen, or hepatitis C antibody must have a negative polymerase chain reaction (PCR) result before enrollment. Those who are PCR positive will be excluded. Second primary malignancy that has not been in remission for greater than 3 years. Exceptions that do not require a 3-year remission include: non-melanoma skin cancer; cervical carcinoma in situ on biopsy or squamous intraepithelial lesion on Papanicolaou (PAP) smear; localized prostate cancer (Gleason score < 6); or resected melanoma in situ. Major trauma or major surgery within 28 days prior to the initiation of AMV564 treatment Any serious underlying medical or psychiatric condition (e.g. alcohol or drug abuse), dementia or altered mental status or any issue that would impair the ability of the patient to understand informed consent or that in the opinion of the investigator would contraindicate the patient's participation in the study or confound the results of the study. Ability to become pregnant. However, female patients who have a negative serum or urine pregnancy test before enrollment and agree to use two highly effective forms of contraception (oral, injected or implanted hormonal contraception and condom; intrauterine device and condom; diaphragm with spermicidal gel and condom) during the trial and for 90 days afterward (90 days after the end of AMV564 treatment) are considered eligible. Male patients with partners of childbearing potential. Pregnant or breastfeeding women Is a participant or plans to participate in another interventional clinical study, while taking part in this protocol. Participation in an observational study is acceptable.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Chun, MD
Organizational Affiliation
Amphivena Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Northwestern
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
New York Medical College
City
Hawthorne
State/Province
New York
ZIP/Postal Code
10532
Country
United States
Facility Name
Weill Cornell Medical College, The New York Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
The Ohio State University Comprehensive Cancer Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
MD Anderson Cancer Center, The University of Texas
City
Houston
State/Province
Texas
ZIP/Postal Code
70030-4009
Country
United States
Facility Name
Fred Hutchinson Cancer Research
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109-1024
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Study of AMV564 in Patients With AML

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