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Dose-escalating Phase I Trial With GEM333 in Patients With Acute Myeloid Leukemia

Primary Purpose

Acute Myeloid Leukemia, Relapsed AML, Refractory AML

Status
Terminated
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
GEM333
Sponsored by
AvenCell Europe GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patients, ≥ 18 years of age
  2. Documented definitive diagnosis of CD33 positive AML (according to standard of care testing) in

    • 2a. Patients having received standard induction chemotherapy: either refractory to standard induction treatment, or is relapsed within 6 months after achieving 1st CR, or relapsed later than 6 months after 1st CR and refractory to standard salvage regimen, or relapse after ≥ 2nd CR and not eligible for curative treatment (i.e. allogeneic stem cell transplantation)
    • 2b. Patients not eligible for standard induction chemotherapy: either refractory or progressive after at least 1 cycle of demethylating agents
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1
  4. Life expectancy of at least 2 months
  5. Adequate renal and hepatic laboratory assessments:
  6. Adequate cardiac function, i.e. left ventricular ejection fraction (LVEF) of ≥ 45% as assessed by transthoracal two-dimensional echocardiography
  7. A female of childbearing potential may be enrolled providing she has a negative pregnancy test at screening visit and is routinely using a highly effective method of birth control (pearl index of ≤ 1 required) resulting in a low failure rate (e.g. hormonal contraception, intrauterine device, total sexual abstinence or sterilization) until 3 months from the last study drug administration. Male patients must also practice a highly effective method of birth control.
  8. Able to give written informed consent
  9. Weight ≥ 45 kg

Exclusion Criteria:

  1. Acute promyelocytic leukemia (t15;17)
  2. Manifestation of AML in central nervous system
  3. Leukocytosis > 10 Gpt/L
  4. Cardiac disease: i.e. heart failure NYHA III or IV; unstable coronary artery disease (Myocardial Infarction more than 6 months prior to study entry is permitted); serious cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
  5. Patients undergoing renal dialysis
  6. Pulmonary disease with clinical relevant hypoxia (need for continuous oxygen inhalation)
  7. Active central nervous diseases (e.g. parkinson, multiple sclerosis, epilepsy) and stroke within last 6 months
  8. Active infectious disease considered by investigator to be incompatible with protocol
  9. Allogeneic stem cell transplantation within last three months or GvHD requiring immune-suppressive therapy
  10. Major surgery within 28 days prior to start of study medication
  11. Other malignancy requiring active therapy but adjuvant endocrine therapy is allowed
  12. Checkpoint inhibitors und CD33 targeting agents within 8 weeks prior to start of trial medication
  13. Autoimmune diseases requiring systemic steroids or other systemic immunosuppressants
  14. Treatment with any investigational drug substance or experimental therapy within 4 weeks prior to start of trial medication or 5 half lives of the substance prior to start of trial medication
  15. Pregnant or breastfeeding women
  16. Psychologic disorders, drug and/or significant active alcohol abuse
  17. Known history of human immunodeficiency virus (HIV) or active/chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV)
  18. Known hypersensitivity to GEM333 excipients
  19. Evidence suggesting that the patient is not likely to follow the study protocol (e.g. lacking compliance)
  20. Incapability of understanding purpose and possible consequences of the trial
  21. Patients who should not be included according to the opinion of the investigator

Sites / Locations

  • Universitätsmedizin Mannheim
  • Klinikum rechts der Isar
  • Universitätsklinikum Würzburg
  • Universitätsklinikum Frankfurt
  • Universitätsklinikum Marburg
  • Universitätsklinikum Dresden
  • Charité Universitätsmedizin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GEM333

Arm Description

application of GEM333, a CD33 targeted bispecific antibody engaging T-cells

Outcomes

Primary Outcome Measures

Maximum tolerated dose (MTD)
MTD is the previous dose level of the cohort where a DLT is observed in at least wo subjects.
Incidence of dose limiting toxicity (DLT)
Dose Limiting Toxicity is defined as any event at least possibly related to IMP (complete definition provided protocol)
Incidence and intensity of adverse events graded according to CTCAE V4.03

Secondary Outcome Measures

Recommended phase 2 dose
The RP2D will be determined based on MTD, all available efficacy data, and all available safety data, including information derived from additional treatment cycles.
Complete remission (CR)
bone marrow blasts < 5%, absence of extramedullary disease, absolute neutrophil count > 1 Gpt/L and platelet count > 100 Gpt/L
Composite complete remission (CRc) rate
Rate at any time point, defined as the proportion of patients having either CR or CRi
Partial Remission (PR)
All hematological criteria for CR with bone marrow blasts 5-25% and decrease of pre-treatment bone marrow blast percentage by at least 50 %.
Disease stabilization (DS)
Reduction of blast percentage by 25% compared to baseline without normalization of peripheral blood counts to levels not qualifying for PR or CR
Best response rate
Defined as the best observed response at any time point during observational period.
Duration of CRc
Defined as the number of days between the date of CR/CRi achievement and the date of the last assessment confirming CR/CRi
Duration of PR
Defined as the number of days between the date of PR achievement and the date of the last assessment confirming PR.
Progression free survival (PFS)
Is defined as the time from first treatment with GEM333 until disease progression or death from any cause
Overall survival
Defined as the number of days between the first study drug administration and death from any cause

Full Information

First Posted
April 6, 2018
Last Updated
September 28, 2022
Sponsor
AvenCell Europe GmbH
Collaborators
GCP-Service International Ltd. & Co. KG
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1. Study Identification

Unique Protocol Identification Number
NCT03516760
Brief Title
Dose-escalating Phase I Trial With GEM333 in Patients With Acute Myeloid Leukemia
Official Title
A Multicenter, Open-label, Dose-escalating, Phase I Trial With GEM333, a CD33 Targeted Bispecific Antibody Engaging T-cells, in Relapsed or Refractory Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Terminated
Why Stopped
The actions and measures to be taken to restart the trial could not be implemented which made the premature termination inevitability.
Study Start Date
April 11, 2018 (Actual)
Primary Completion Date
June 14, 2022 (Actual)
Study Completion Date
June 14, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AvenCell Europe GmbH
Collaborators
GCP-Service International Ltd. & Co. KG

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 dose-escalating phase I trial assesses for the first time the safety, the side effects and the harmlessness, as well as the therapeutical benefit of the new study drug GEM333 in patients with acute myeloid leukemia (AML). This AML was relapsed after previous therapy or was refractory to the standard therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia, Relapsed AML, Refractory AML

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Dose escalation scheme; Single patient cohorts on the first three dose levels, 3+3 afterwards.
Masking
None (Open Label)
Allocation
N/A
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GEM333
Arm Type
Experimental
Arm Description
application of GEM333, a CD33 targeted bispecific antibody engaging T-cells
Intervention Type
Drug
Intervention Name(s)
GEM333
Intervention Description
infusion of GEM333; administered intravenously and continuously over 10 days
Primary Outcome Measure Information:
Title
Maximum tolerated dose (MTD)
Description
MTD is the previous dose level of the cohort where a DLT is observed in at least wo subjects.
Time Frame
End of Treatment (EOT) +8 days resp. +28 days (DLT period)
Title
Incidence of dose limiting toxicity (DLT)
Description
Dose Limiting Toxicity is defined as any event at least possibly related to IMP (complete definition provided protocol)
Time Frame
End of Treatment (EOT) +8 days resp. +28 days
Title
Incidence and intensity of adverse events graded according to CTCAE V4.03
Time Frame
End of Treatment (EOT) +8 days resp. +28 days
Secondary Outcome Measure Information:
Title
Recommended phase 2 dose
Description
The RP2D will be determined based on MTD, all available efficacy data, and all available safety data, including information derived from additional treatment cycles.
Time Frame
From start of treatment until up to +28 days after last treatment cycle (1 initial cycle + max. 2 additional cycles per patient). Each cycle consists of 10 days treatment plus DLT evaluation period (8 resp. 28 days, depending on blast clearance).
Title
Complete remission (CR)
Description
bone marrow blasts < 5%, absence of extramedullary disease, absolute neutrophil count > 1 Gpt/L and platelet count > 100 Gpt/L
Time Frame
until two years after start of study medication
Title
Composite complete remission (CRc) rate
Description
Rate at any time point, defined as the proportion of patients having either CR or CRi
Time Frame
until two years after start of study medication
Title
Partial Remission (PR)
Description
All hematological criteria for CR with bone marrow blasts 5-25% and decrease of pre-treatment bone marrow blast percentage by at least 50 %.
Time Frame
until two years after start of study medication
Title
Disease stabilization (DS)
Description
Reduction of blast percentage by 25% compared to baseline without normalization of peripheral blood counts to levels not qualifying for PR or CR
Time Frame
until two years after start of study medication
Title
Best response rate
Description
Defined as the best observed response at any time point during observational period.
Time Frame
until two years after start of study medication
Title
Duration of CRc
Description
Defined as the number of days between the date of CR/CRi achievement and the date of the last assessment confirming CR/CRi
Time Frame
until two years after start of study medication
Title
Duration of PR
Description
Defined as the number of days between the date of PR achievement and the date of the last assessment confirming PR.
Time Frame
until two years after start of study medication
Title
Progression free survival (PFS)
Description
Is defined as the time from first treatment with GEM333 until disease progression or death from any cause
Time Frame
until two years after start of study medication
Title
Overall survival
Description
Defined as the number of days between the first study drug administration and death from any cause
Time Frame
until two years after start of study medication

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients, ≥ 18 years of age Documented definitive diagnosis of CD33 positive AML (according to standard of care testing) in 2a. Patients having received standard induction chemotherapy: either refractory to standard induction treatment, or is relapsed within 6 months after achieving 1st CR, or relapsed later than 6 months after 1st CR and refractory to standard salvage regimen, or relapse after ≥ 2nd CR and not eligible for curative treatment (i.e. allogeneic stem cell transplantation) 2b. Patients not eligible for standard induction chemotherapy: either refractory or progressive after at least 1 cycle of demethylating agents Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 Life expectancy of at least 2 months Adequate renal and hepatic laboratory assessments: Adequate cardiac function, i.e. left ventricular ejection fraction (LVEF) of ≥ 45% as assessed by transthoracal two-dimensional echocardiography A female of childbearing potential may be enrolled providing she has a negative pregnancy test at screening visit and is routinely using a highly effective method of birth control (pearl index of ≤ 1 required) resulting in a low failure rate (e.g. hormonal contraception, intrauterine device, total sexual abstinence or sterilization) until 3 months from the last study drug administration. Male patients must also practice a highly effective method of birth control. Able to give written informed consent Weight ≥ 45 kg Exclusion Criteria: Acute promyelocytic leukemia (t15;17) Manifestation of AML in central nervous system Leukocytosis > 10 Gpt/L Cardiac disease: i.e. heart failure NYHA III or IV; unstable coronary artery disease (Myocardial Infarction more than 6 months prior to study entry is permitted); serious cardiac ventricular arrhythmias requiring anti-arrhythmic therapy Patients undergoing renal dialysis Pulmonary disease with clinical relevant hypoxia (need for continuous oxygen inhalation) Active central nervous diseases (e.g. parkinson, multiple sclerosis, epilepsy) and stroke within last 6 months Active infectious disease considered by investigator to be incompatible with protocol Allogeneic stem cell transplantation within last three months or GvHD requiring immune-suppressive therapy Major surgery within 28 days prior to start of study medication Other malignancy requiring active therapy but adjuvant endocrine therapy is allowed Checkpoint inhibitors und CD33 targeting agents within 8 weeks prior to start of trial medication Autoimmune diseases requiring systemic steroids or other systemic immunosuppressants Treatment with any investigational drug substance or experimental therapy within 4 weeks prior to start of trial medication or 5 half lives of the substance prior to start of trial medication Pregnant or breastfeeding women Psychologic disorders, drug and/or significant active alcohol abuse Known history of human immunodeficiency virus (HIV) or active/chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV) Known hypersensitivity to GEM333 excipients Evidence suggesting that the patient is not likely to follow the study protocol (e.g. lacking compliance) Incapability of understanding purpose and possible consequences of the trial Patients who should not be included according to the opinion of the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin Wermke, MD
Organizational Affiliation
Universitätsklinikum Carl Gustav Carus Dresden
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsmedizin Mannheim
City
Mannheim
State/Province
Baden-Württemberg
ZIP/Postal Code
68167
Country
Germany
Facility Name
Klinikum rechts der Isar
City
München
State/Province
Bayern
ZIP/Postal Code
81675
Country
Germany
Facility Name
Universitätsklinikum Würzburg
City
Würzburg
State/Province
Bayern
ZIP/Postal Code
97080
Country
Germany
Facility Name
Universitätsklinikum Frankfurt
City
Frankfurt am Main
State/Province
Hessen
ZIP/Postal Code
60590
Country
Germany
Facility Name
Universitätsklinikum Marburg
City
Marburg
State/Province
Hessen
ZIP/Postal Code
35039
Country
Germany
Facility Name
Universitätsklinikum Dresden
City
Dresden
State/Province
Sachsen
ZIP/Postal Code
01307
Country
Germany
Facility Name
Charité Universitätsmedizin
City
Berlin
ZIP/Postal Code
13353
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

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Dose-escalating Phase I Trial With GEM333 in Patients With Acute Myeloid Leukemia

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