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A Phase Ib Study of APG-115 Single Agent or in Combination With Azacitidine or Cytarabine in Patients With AML and MDS.

Primary Purpose

Acute Myeloid Leukemia (AML), Myelodysplastic Syndromes (MDS)

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
APG-115
Azacitidine
Cytarabine
Sponsored by
Ascentage Pharma Group Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia (AML) focused on measuring APG-115, AML, MDS

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients with a diagnosis of histologically confirmed relapsed or refractory (R/R) acute myeloid leukemia by WHO classification or relapsed/progressed high/very high risk MDS (score≥4.5) according to IPSS-R risk stratification
  2. Age >/= 18 years.
  3. Adequate organ function
  4. Subject must have a projected life expectancy of at least 12 weeks.
  5. ECOG performance status of 0-1.
  6. Patient must have the ability to understand the requirements of the study and signed informed consent. A signed informed consent by the patient or his legally authorized representative is required prior to their enrollment on the protocol.
  7. Subject has a white blood cell count< 50 × 109/L. Note: Hydroxyurea is permitted to meet this criterion.

Exclusion Criteria:

  1. Subject has acute promyelocytic leukemia.
  2. Patients must not have had leukemia biotherapy 4 weeks prior to starting investigational drug, or less than 5 half-lives small molecular targeted drug therapy, or 28 days any anti-cancer therapy (whichever is longer)
  3. Uncontrolled intercurrent illness including, but not limited to active uncontrolled infection, symptomatic congestive heart failure (NYHA Class III or IV), unstable angina pectoris, clinically significant cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  4. Active infection requiring systemic antibiotic/antifungal medication, known clinically active hepatitis B or C, or HIV infection.
  5. Participants who have received allogeneic HSCT, or autologous HSCT within 12 months.
  6. Patients with active, uncontrolled CNS leukemia will not be eligible.
  7. Any prior systemic MDM2-p53 inhibitor treatment
  8. Any other condition or circumstance that would, in the opinion of the investigator, make the patient unsuitable for participation in the study.
  9. Subject has a history of other malignancies within 2 years prior to study entry, with the exception of:

    • Adequately treated in situ carcinoma of the cervix uteri or carcinoma in situ of breast;
    • Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin;
    • Previous malignancy confined and surgically resected (or treated with other modalities) with curative intention: requires discussion with sponsor.

Sites / Locations

  • The First Hospital of Peking University
  • Guangzhou panyu central hospitalRecruiting
  • Nanfang Hospital of Southern Medical UniversityRecruiting
  • Henan Provincial Oncology HospitalRecruiting
  • Union Hospital medical college Huazhong University of Science and TechnologyRecruiting
  • Zhongnan Hospital of Wuhan UniversityRecruiting
  • Xiangya Hospital Central South UniversityRecruiting
  • The First Affilated Hospital of Ganzhou Medical University
  • The First affiliated hospital of Soochow UniversityRecruiting
  • The First Affiliated Hospital of Nanchang University
  • First Hospital of Jilin UniversityRecruiting
  • Shanghai Jiao Tong University school of medicine Ruijing HospitalRecruiting
  • Shanghai Sixth people's HospitalRecruiting
  • Blood Diseases Hospital Chinese Academy of Medical SciencesRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

APG-115/APG-115+Cytarabine in Relapse/Refractory AML

APG-115/APG-115+Aza in relapsed/progressed high risk MDS

Arm Description

Outcomes

Primary Outcome Measures

Dose Limiting Toxicities (DLT)
DLT will be graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE, version 5) by organ system. DLT will be defined as clinically significant drug-related adverse events during the Cycle one.

Secondary Outcome Measures

Overall Response Rate (ORR)
ORR is defined by CR + CRi+ PR (according to IWG AML(2003)and IWG MDS(2006)criteria)
Overall survival (OS)
From date of treatment start until the date of death due to any cause or date of termination of the study, whichever came first. Termination of the Study: The last subject has completed at least 6 cycle's treatment or the subject discontinues treatment for any reason.

Full Information

First Posted
February 5, 2020
Last Updated
August 28, 2023
Sponsor
Ascentage Pharma Group Inc.
Collaborators
Suzhou Yasheng Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04275518
Brief Title
A Phase Ib Study of APG-115 Single Agent or in Combination With Azacitidine or Cytarabine in Patients With AML and MDS.
Official Title
A Phase Ib Study to Investigate the Safety, Pharmacokinetics and Pharmacodynamics of APG-115 as a Single Agent or in Combination With Azacitidine or Cytarabine in Patients With Relapse/Refractory AML and Relapsed/Progressed High/Very High Risk MDS
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 6, 2020 (Actual)
Primary Completion Date
December 31, 2025 (Anticipated)
Study Completion Date
December 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ascentage Pharma Group Inc.
Collaborators
Suzhou Yasheng Pharmaceutical 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
No

5. Study Description

Brief Summary
Acute myeloid leukemia is a malignant disorder characterized by the rapid, uncontrolled proliferation of malignant clonal hematopoietic stem cells that accumulate as immature, undifferentiated cells (blasts) in the bone marrow and circulation. APG-115 is a potent and orally active small-molecule MDM2 inhibitor, it binds to MDM2 protein and shows potent cell growth inhibitory activity in vitro with low nanomolar potencies in a subset of human cancer cell lines. APG-115 has demonstrated its strong antitumor activities with either daily or less frequent dosing-schedules in the acute leukemia xenograft models. This is a phase 1b, open-label, three-stages study that will initially evaluate the safety and PK/PD profile of APG-115 as a single agent, followed by a combination of APG-115 + azacytidine or cytarabine in R/R AML or MDS subjects. Patients will continue treatment for maximally 6 cycles or until progression of disease or unacceptable toxicity is observed or administrative discontinuation whichever occurs first. Patients who continue to be benefit after 6 cycles' treatment will receive additional cycles of treatment until progression of disease, unacceptable toxicity is observed or administrative discontinuation. (As long as it is proven safe).
Detailed Description
Stage 1: This will be a 3+3 dose escalation to determine the DLTs and MTD/RP2D of APG-115 given according to the different dose levels once daily from Days 1 to 7 every 28 days. Stage 2: After stage 1 of APG-115 single agent dose escalation first cycle is completed, stage 2 can be initiated with the combination regimen. This will be a 3+3 dose escalation to determine the MTD/RP2D and DLTs of APG-115 + AZA(arm A)/Cytarabine (arm B)combination. Stage 3: dose expansion of the combination regimes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia (AML), Myelodysplastic Syndromes (MDS)
Keywords
APG-115, AML, MDS

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
102 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
APG-115/APG-115+Cytarabine in Relapse/Refractory AML
Arm Type
Experimental
Arm Title
APG-115/APG-115+Aza in relapsed/progressed high risk MDS
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
APG-115
Intervention Description
APG-115 orally once daily from Days 1 to 7 every 28 days.
Intervention Type
Drug
Intervention Name(s)
Azacitidine
Intervention Description
75 mg/m^2 SC QD on Days 1- 7 (28-day cycle)
Intervention Type
Drug
Intervention Name(s)
Cytarabine
Intervention Description
1g/m^2 IV QD on Days 3-7 (28-day cycle)
Primary Outcome Measure Information:
Title
Dose Limiting Toxicities (DLT)
Description
DLT will be graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE, version 5) by organ system. DLT will be defined as clinically significant drug-related adverse events during the Cycle one.
Time Frame
From day 1 to the end of cycle 1 (each cycle is 28 days).
Secondary Outcome Measure Information:
Title
Overall Response Rate (ORR)
Description
ORR is defined by CR + CRi+ PR (according to IWG AML(2003)and IWG MDS(2006)criteria)
Time Frame
Evaluated for response by the end of cycle 1 and cycle 2, and then 2 months thereafter till complete 6 cycles treatment or 1 month after last dose (each cycle is 28 days).
Title
Overall survival (OS)
Description
From date of treatment start until the date of death due to any cause or date of termination of the study, whichever came first. Termination of the Study: The last subject has completed at least 6 cycle's treatment or the subject discontinues treatment for any reason.
Time Frame
Measured up to 6 months after the last subject has received treatment.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with a diagnosis of histologically confirmed relapsed or refractory (R/R) acute myeloid leukemia by WHO classification or relapsed/progressed high/very high risk MDS (score≥4.5) according to IPSS-R risk stratification Age >/= 18 years. Adequate organ function Subject must have a projected life expectancy of at least 12 weeks. ECOG performance status of 0-1. Patient must have the ability to understand the requirements of the study and signed informed consent. A signed informed consent by the patient or his legally authorized representative is required prior to their enrollment on the protocol. Subject has a white blood cell count< 50 × 109/L. Note: Hydroxyurea is permitted to meet this criterion. Exclusion Criteria: Subject has acute promyelocytic leukemia. Patients must not have had leukemia biotherapy 4 weeks prior to starting investigational drug, or less than 5 half-lives small molecular targeted drug therapy, or 28 days any anti-cancer therapy (whichever is longer) Uncontrolled intercurrent illness including, but not limited to active uncontrolled infection, symptomatic congestive heart failure (NYHA Class III or IV), unstable angina pectoris, clinically significant cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Active infection requiring systemic antibiotic/antifungal medication, known clinically active hepatitis B or C, or HIV infection. Participants who have received allogeneic HSCT, or autologous HSCT within 12 months. Patients with active, uncontrolled CNS leukemia will not be eligible. Any prior systemic MDM2-p53 inhibitor treatment Any other condition or circumstance that would, in the opinion of the investigator, make the patient unsuitable for participation in the study. Subject has a history of other malignancies within 2 years prior to study entry, with the exception of: Adequately treated in situ carcinoma of the cervix uteri or carcinoma in situ of breast; Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin; Previous malignancy confined and surgically resected (or treated with other modalities) with curative intention: requires discussion with sponsor.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Junyuan Qi, M.D.
Phone
+86-18622662361
Email
qi_jy@yahoo.com
First Name & Middle Initial & Last Name or Official Title & Degree
Bo Jiang, M.D.
Phone
+86-22-23909067
Email
jianbo044@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jianxiang Wang, M.D.
Organizational Affiliation
Blood Diseases Hospital Chinese Academy of Medical Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Hospital of Peking University
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100034
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qian Jiang, Ph.D
First Name & Middle Initial & Last Name & Degree
Qian Jiang, Ph.D
Facility Name
Guangzhou panyu central hospital
City
Guangzhou
State/Province
Guangdong
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shuqin Cheng, Master
First Name & Middle Initial & Last Name & Degree
Hui Yang Professor
Facility Name
Nanfang Hospital of Southern Medical University
City
Guangzhou
State/Province
Guangdong
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yu Zhang, Master
First Name & Middle Initial & Last Name & Degree
Chongyuan Xu Professor
Phone
86-020-62786845
Email
nfyygcp@126.com
Facility Name
Henan Provincial Oncology Hospital
City
Zhengzhou
State/Province
Henan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xudong Wei, M.D.
Facility Name
Union Hospital medical college Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qiubo Li, Doctor
Facility Name
Zhongnan Hospital of Wuhan University
City
Wuhan
State/Province
Hubei
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fuling Zhou, M.D.
First Name & Middle Initial & Last Name & Degree
Jianying Huang Director
Facility Name
Xiangya Hospital Central South University
City
Changsha
State/Province
Hunan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qun He, Master
First Name & Middle Initial & Last Name & Degree
Qun Qin, M.D.
Facility Name
The First Affilated Hospital of Ganzhou Medical University
City
Suzhou
State/Province
Jiangsu
ZIP/Postal Code
215636
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liping Liu, Ph.D.
First Name & Middle Initial & Last Name & Degree
Liping Liu, Ph.D.
Facility Name
The First affiliated hospital of Soochow University
City
Suzhou
State/Province
Jiangsu
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaowen Tang, Doctor
Facility Name
The First Affiliated Hospital of Nanchang University
City
Nanchang
State/Province
Jiangxi
ZIP/Postal Code
330006
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fei Li, Ph.D.
First Name & Middle Initial & Last Name & Degree
Fei Li, Ph.D.
Facility Name
First Hospital of Jilin University
City
Changchun
State/Province
Jilin
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sujun Gao, M.D.
Facility Name
Shanghai Jiao Tong University school of medicine Ruijing Hospital
City
Shanghai
State/Province
Shanghai
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Junmin Li Professor
Facility Name
Shanghai Sixth people's Hospital
City
Shanghai
State/Province
Shanghai
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chunkang Chang Professor
Facility Name
Blood Diseases Hospital Chinese Academy of Medical Sciences
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianxiang Wang, MD
Phone
+86 22-23909120
Email
wangjx@ihcams.ac.cn
First Name & Middle Initial & Last Name & Degree
Junyuan Qi, MD
Phone
+86 18622662361
Email
qi_jy@yahoo.com

12. IPD Sharing Statement

Learn more about this trial

A Phase Ib Study of APG-115 Single Agent or in Combination With Azacitidine or Cytarabine in Patients With AML and MDS.

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