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Study of Quizartinib in Combination With Standard Therapies in Chinese Participants With Newly Diagnosed Acute Myeloid Leukemia (AML)

Primary Purpose

Acute Myeloid Leukemia (AML)

Status
Completed
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Quizartinib
Sponsored by
Daiichi Sankyo Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia (AML)

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  • Has provided written informed consent for participation in the study
  • Is aged 18 to 70 years at the time of enrollment into the study
  • Has newly diagnosed, morphologically documented primary AML or AML secondary to myelodysplastic syndrome or a myeloproliferative neoplasm based on the World Health Organization (WHO) 2008 classification (at Screening)
  • Has Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 at enrollment
  • Has all of the required laboratory test results performed within 14 days prior to enrollment in the study.
  • Is capable of orally taking quizartinib
  • Is capable of being admitted to the hospital during the dose limiting toxicity (DLT) evaluation period
  • If a woman of childbearing potential, has a negative serum pregnancy test upon entry into this study and is willing to use highly effective birth control upon enrollment, during the treatment period and for 6 months following the last dose of investigational drug or cytarabine, whichever is later. A woman is considered of childbearing potential following menarche and until becoming postmenopausal (no menstrual period for a minimum of 12 months) unless permanently sterile (having undergone a hysterectomy, bilateral salpingectomy or bilateral oophorectomy).
  • If male, is surgically sterile or willing to use highly effective birth control upon enrollment, during the treatment period, and for 6 months following the last dose of investigational drug or cytarabine, whichever is later.

Exclusion criteria:

  • Has diagnosis of acute promyelocytic leukemia (APL), French-American-British classification M3 or WHO classification of APL with translocation, t(15;17)(q22;q12), or BCR-ABL positive leukemia (ie, chronic myelogenous leukemia in blast crisis). Subjects who undergo diagnostic workup for APL and treatment with all-trans retinoic acid (ATRA), but who are found not to have APL, are eligible (treatment with ATRA must be discontinued before starting induction chemotherapy).
  • Has a diagnosis of AML secondary to prior chemotherapy or radiotherapy for other neoplasms
  • Had prior treatment for AML, except for the following allowances:

    1. Leukapheresis
    2. Treatment for hyperleukocytosis with hydroxyurea
    3. Cranial radiotherapy for central nervous system (CNS) leukostasis
    4. Prophylactic intrathecal chemotherapy
    5. Growth factor or cytokine support
  • Has received prior treatment with any investigational product or device within 30 days prior to enrollment in the study or is currently participating in other investigational procedures
  • Has a history of other malignancies excluding the following:

    1. Adequately treated non-melanoma skin cancer
    2. Curatively treated in situ disease, or other solid tumors curatively treated with no evidence of disease for at least two years
  • Has a past or current history of the following cardiovascular diseases:

    1. Heart rate of < 50 beats/min performed with 12-lead ECG within 14 days prior to enrollment in the study (excluding patients using a heart pacemaker)
    2. QT interval corrected by Fridericia (QTcF) of ≥ 450 msec performed with 12-lead ECG within 14 days prior to enrollment in the study
    3. Congenital long QT syndrome diagnosed or suspected (including family history of long QT syndrome)
    4. Systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg measured within 7 days prior to enrollment in the study
    5. History of clinically significant ventricular arrhythmias [such as ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes (TdP)]
    6. History of second (Mobitz II) or third-degree heart block (patients with pacemakers are eligible if they have no history of fainting or clinically relevant arrhythmias while using the pacemaker)
    7. History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to enrollment in the study
    8. History of heart failure according to New York Heart Association (NYHA) Functional Classification: Class 3 or 4 heart failure
    9. Left ventricular ejection fraction (LVEF) of ≤ 45% or lower than the institutional lower limit of normal value per multi-gated acquisition scan (MUGA) or echocardiogram done within 30 days prior to enrollment
    10. Complete left bundle branch block
  • Has active acute or chronic systemic fungal, bacterial, or viral infection not well controlled by antifungal, antibacterial, or antiviral therapy
  • Has active clinically relevant liver disease (such as active hepatitis B or active hepatitis C).
  • Has a history of human immunodeficiency virus (HIV). Patients will be tested for HIV prior to enrollment in the study, if required by local regulations or the Ethics Committee.
  • Has a history of hypersensitivity to any excipients in the quizartinib tablets
  • Is a female who is pregnant or breastfeeding
  • Is considered inappropriate for the study by the investigator

Sites / Locations

  • Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Quizartinib 20 mg

Quizartinib 40 mg

Arm Description

Participants receive 20 mg quizartinib in combination with standard induction therapy and consolidation therapy once daily in the fasted state in the morning (at least 1 hour before or two hours after a meal)

Participants receive 40 mg quizartinib in combination with standard induction therapy and consolidation therapy once daily in the fasted state in the morning (at least 1 hour before or two hours after a meal)

Outcomes

Primary Outcome Measures

Number of Participants with Dose-Limiting Toxicities
Number of Participants with Adverse Events During the Trial
Maximum Concentration (Cmax)
Categories: quizartinib, active metabolite
Time to Cmax (Tmax)
Categories: quizartinib, active metabolite
Area under the Plasma Concentration-Time Curve (AUC)
Categories: quizartinib, active metabolite

Secondary Outcome Measures

Number of Participants with Response
Categories: Complete remission (CR), CR with incomplete platelet or hematological recovery (CRi), partial remission (PR), no response (NR)
Response Rates
Categories: response rate (CRc + PR), composite CR (CRc: CR + CRi) rate

Full Information

First Posted
October 18, 2018
Last Updated
July 27, 2022
Sponsor
Daiichi Sankyo Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03723681
Brief Title
Study of Quizartinib in Combination With Standard Therapies in Chinese Participants With Newly Diagnosed Acute Myeloid Leukemia (AML)
Official Title
A Study to Evaluate the Safety and Pharmacokinetics of Quizartinib in Combination With Standard Induction Therapy and Consolidation Therapy in Chinese Patients With Newly Diagnosed Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
November 5, 2018 (Actual)
Primary Completion Date
March 3, 2022 (Actual)
Study Completion Date
March 3, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Daiichi Sankyo Co., Ltd.

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
20 mg or 40 mg of quizartinib will be given to Chinese patients who were just diagnosed with AML. The study drug will be given to them along with standard therapies. The purpose is to find out the highest dose they can stand.
Detailed Description
This is a Phase 1, multicenter, open-label study to evaluate the safety and pharmacokinetics (PK) of quizartinib in combination with standard induction therapy and consolidation therapy in Chinese patients with newly diagnosed AML. The quizartinib doses will be Level 1: 20 mg and Level 2: 40 mg. No increase in the quizartinib dose will be made in the same subject. Dose-limiting toxicity associated with quizartinib occurring at each level will be assessed, and the maximum tolerated dose (MTD) will be decided using a 3 + 3 design.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Quizartinib 20 mg
Arm Type
Experimental
Arm Description
Participants receive 20 mg quizartinib in combination with standard induction therapy and consolidation therapy once daily in the fasted state in the morning (at least 1 hour before or two hours after a meal)
Arm Title
Quizartinib 40 mg
Arm Type
Experimental
Arm Description
Participants receive 40 mg quizartinib in combination with standard induction therapy and consolidation therapy once daily in the fasted state in the morning (at least 1 hour before or two hours after a meal)
Intervention Type
Drug
Intervention Name(s)
Quizartinib
Other Intervention Name(s)
Experimental product, AC220
Intervention Description
Quizartinib is provided as 20 mg tablets for oral administration
Primary Outcome Measure Information:
Title
Number of Participants with Dose-Limiting Toxicities
Time Frame
At the end of induction phase at approximately 56 days
Title
Number of Participants with Adverse Events During the Trial
Time Frame
within approximately 19 months
Title
Maximum Concentration (Cmax)
Description
Categories: quizartinib, active metabolite
Time Frame
within 56 days
Title
Time to Cmax (Tmax)
Description
Categories: quizartinib, active metabolite
Time Frame
within 56 days
Title
Area under the Plasma Concentration-Time Curve (AUC)
Description
Categories: quizartinib, active metabolite
Time Frame
within 56 days
Secondary Outcome Measure Information:
Title
Number of Participants with Response
Description
Categories: Complete remission (CR), CR with incomplete platelet or hematological recovery (CRi), partial remission (PR), no response (NR)
Time Frame
within approximately 19 months
Title
Response Rates
Description
Categories: response rate (CRc + PR), composite CR (CRc: CR + CRi) rate
Time Frame
within approximately 19 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Has provided written informed consent for participation in the study Is aged 18 to 70 years at the time of enrollment into the study Has newly diagnosed, morphologically documented primary AML or AML secondary to myelodysplastic syndrome or a myeloproliferative neoplasm based on the World Health Organization (WHO) 2008 classification (at Screening) Has Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 at enrollment Has all of the required laboratory test results performed within 14 days prior to enrollment in the study. Is capable of orally taking quizartinib Is capable of being admitted to the hospital during the dose limiting toxicity (DLT) evaluation period If a woman of childbearing potential, has a negative serum pregnancy test upon entry into this study and is willing to use highly effective birth control upon enrollment, during the treatment period and for 6 months following the last dose of investigational drug or cytarabine, whichever is later. A woman is considered of childbearing potential following menarche and until becoming postmenopausal (no menstrual period for a minimum of 12 months) unless permanently sterile (having undergone a hysterectomy, bilateral salpingectomy or bilateral oophorectomy). If male, is surgically sterile or willing to use highly effective birth control upon enrollment, during the treatment period, and for 6 months following the last dose of investigational drug or cytarabine, whichever is later. Exclusion criteria: Has diagnosis of acute promyelocytic leukemia (APL), French-American-British classification M3 or WHO classification of APL with translocation, t(15;17)(q22;q12), or BCR-ABL positive leukemia (ie, chronic myelogenous leukemia in blast crisis). Subjects who undergo diagnostic workup for APL and treatment with all-trans retinoic acid (ATRA), but who are found not to have APL, are eligible (treatment with ATRA must be discontinued before starting induction chemotherapy). Has a diagnosis of AML secondary to prior chemotherapy or radiotherapy for other neoplasms Had prior treatment for AML, except for the following allowances: Leukapheresis Treatment for hyperleukocytosis with hydroxyurea Cranial radiotherapy for central nervous system (CNS) leukostasis Prophylactic intrathecal chemotherapy Growth factor or cytokine support Has received prior treatment with any investigational product or device within 30 days prior to enrollment in the study or is currently participating in other investigational procedures Has a history of other malignancies excluding the following: Adequately treated non-melanoma skin cancer Curatively treated in situ disease, or other solid tumors curatively treated with no evidence of disease for at least two years Has a past or current history of the following cardiovascular diseases: Heart rate of < 50 beats/min performed with 12-lead ECG within 14 days prior to enrollment in the study (excluding patients using a heart pacemaker) QT interval corrected by Fridericia (QTcF) of ≥ 450 msec performed with 12-lead ECG within 14 days prior to enrollment in the study Congenital long QT syndrome diagnosed or suspected (including family history of long QT syndrome) Systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg measured within 7 days prior to enrollment in the study History of clinically significant ventricular arrhythmias [such as ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes (TdP)] History of second (Mobitz II) or third-degree heart block (patients with pacemakers are eligible if they have no history of fainting or clinically relevant arrhythmias while using the pacemaker) History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to enrollment in the study History of heart failure according to New York Heart Association (NYHA) Functional Classification: Class 3 or 4 heart failure Left ventricular ejection fraction (LVEF) of ≤ 45% or lower than the institutional lower limit of normal value per multi-gated acquisition scan (MUGA) or echocardiogram done within 30 days prior to enrollment Complete left bundle branch block Has active acute or chronic systemic fungal, bacterial, or viral infection not well controlled by antifungal, antibacterial, or antiviral therapy Has active clinically relevant liver disease (such as active hepatitis B or active hepatitis C). Has a history of human immunodeficiency virus (HIV). Patients will be tested for HIV prior to enrollment in the study, if required by local regulations or the Ethics Committee. Has a history of hypersensitivity to any excipients in the quizartinib tablets Is a female who is pregnant or breastfeeding Is considered inappropriate for the study by the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Global Clinical Leader
Organizational Affiliation
Daiichi Sankyo, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences
City
Tianjin
ZIP/Postal Code
300020
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual participant data (IPD) and applicable supporting clinical trial documents may be available upon request at https://vivli.org/. In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address: https://vivli.org/ourmember/daiichi-sankyo/
IPD Sharing Time Frame
Studies for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
IPD Sharing Access Criteria
Formal request from qualified scientific and medical researchers on IPD and clinical study documents from clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.
IPD Sharing URL
https://vivli.org/ourmember/daiichi-sankyo/

Learn more about this trial

Study of Quizartinib in Combination With Standard Therapies in Chinese Participants With Newly Diagnosed Acute Myeloid Leukemia (AML)

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