Phase I/II Trial of S65487 Plus Azacitidine in Acute Myeloid Leukemia
Primary Purpose
Acute Myeloid Leukemia
Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
S65487 and azacitidine
Sponsored by
About this trial
This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring Acute Myeloid Leukemia, Dose escalation, Phase I/II, Azacitidine, Combination, Oncology
Eligibility Criteria
Inclusion Criteria:
- Male or female participant aged ≥ 18 years old
Participants with cytologically confirmed and documented treatment naïve, de novo or secondary AML defined by WHO 2016 classification (Arber, 2016). Secondary AML includes:
- Previous myelodysplastic syndrome transformed
- AML due to exposure to potentially leukemogenic therapies or agents (e.g. radiation therapy, alkylating agents, topoisomerase II inhibitors) with the primary malignancy in remission for at least 3 years
Participants not eligible for standard induction chemotherapy
- Aged ≥ 75 years old
Or Age ≥18 years with at least one of the following comorbidities:
Clinically significant heart or lung comorbidities, as reflected by at least one of:
- Lung diffusing capacity for carbon monoxide (DLCO) ≤65% of expected
- Forced expiratory volume in 1 second (FEV1) ≤65% of expected
- Other contraindication(s) to anthracycline therapy (must be documented)
- Other comorbidity that the Investigator judges as incompatible with intensive remission induction chemotherapy, which must be documented
- ECOG (Eastern Cooperative Oncology Group) performance status should be (criterion should be rechecked at inclusion visit) ECOG ≤ 2.
- Written informed consent obtained prior any study-specific procedure as described in section 13.3 of the protocol.
- Adequate renal and hepatic function
- Circulating White Blood Cell Count (WBC count) < 25*109 G/L (with or without use of hydroxycarbamide/leukapheresis)
- Serum potassium, serum calcium, serum phosphates, serum magnesium within normal limits with or without supplementation.
Exclusion Criteria:
- Major surgery within 3 weeks prior to the first IMP administration, or participants who have not recovered from side effects of the surgery
- Any radiotherapy within 3 weeks before the first IMP administration,
- Allogenic stem cell transplant within 3 months before the first IMP administration and/or participants with active Graft-versus-host disease within 3 months before the first IMP administration and/or participants who still receive immunosuppressive treatment within 3 months before the first IMP administration and/or participant who receive donor lymphocyte infusion (DLI) within 3 months before the first IMP administration
- Acute promyelocytic leukemia (APL, French-American-British M3 classification)
- Favorable risk cytogenetics such as t(8;21), inv(16) or t(16;16) or t(15;17) as per the National Comprehensive Cancer Network (NCCN) Guidelines Version 2, 2016 for Acute Myeloid Leukemia
- Treatment with hypomethylating agents (decitabine/azacitidine) or Venetoclax for AHD (antecedent hematologic disorders) in the 3 months prior to the first IMP intake
Sites / Locations
- Institut Gustave RoussyRecruiting
- Semmelweis Egyetem Belgyógyászati és Onkológiai Klinika Klinikai Farmakológiai Részleg
- Seoul National University Hospital - Department of Hematology-Oncology
- Samsung Medical Center - Division of Hematology-OncologyRecruiting
- Narodowy Instytut Onkologii im. M. Sklodowskiej-Curie Klinika Transplantacji Szpiku i Onkohematologii pokoj 4.041 ul. Wybrzeze Armii Krajowej 15
- Hospital Universitario Vall d´hebron
- Hospital 12 de Octubre Servicio de HematologíaRecruiting
- C. Universidad de Navarra Servicio de HematologiaRecruiting
- H. Universitario La Fe Servicio de HematologiaRecruiting
- Western General HospitalRecruiting
- University College London - Hospitals NHS Foundation TrustRecruiting
- The Christie NHS foundation Trust
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
S65487 with azacitidine
Arm Description
Outcomes
Primary Outcome Measures
Dose Limiting Toxicity (DLT) (phase I part)
DLT assessment at the end of cycle 1
Adverse Event (phase I part)
AE recording throughout the study evaluated according to CTCAE v5.0, dose interruptions, reductions, and intensity
Complete Remission (CR) rate (phase II part)
CR rate is defined as the proportion of subjects who achieve complete response. Response is evaluated based on the "'Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel" (Döhner, 2017).
Secondary Outcome Measures
PharmacoKinetics - maximum Concentration at the End of the infusion (Cinf) (phase I and phase II parts)
PK parameters of S65487, azacitidine and potential metabolite(s)
PharmacoKinetics - Area Under the Curve (AUC) (phase I and phase II parts)
PK parameters of S65487, azacitidine and potential metabolite(s)
Assessment of anti-leukemic activity of S65487 combined to azacitidine (phase I and phase II parts)
Complete Remission rate
Assessment of anti-leukemic activity of S65487 combined to azacitidine (phase I and phase II parts)
Progression Free Survival
Full Information
NCT ID
NCT04742101
First Posted
December 14, 2020
Last Updated
July 24, 2023
Sponsor
Institut de Recherches Internationales Servier
Collaborators
ADIR, a Servier Group company
1. Study Identification
Unique Protocol Identification Number
NCT04742101
Brief Title
Phase I/II Trial of S65487 Plus Azacitidine in Acute Myeloid Leukemia
Official Title
Phase I / II, Open Label, Dose Escalation Part (Phase I) Followed by Non-comparative Expansion Part (Phase II), Multi-centre Study, Evaluating Safety, Pharmacokinetics and Efficacy of S65487, a Bcl2 Inhibitor Combined With Azacitidine in Adult Patients With Previously Untreated Acute Myeloid Leukemia Not Eligible for Intensive Treatment
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 10, 2021 (Actual)
Primary Completion Date
June 15, 2024 (Anticipated)
Study Completion Date
January 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut de Recherches Internationales Servier
Collaborators
ADIR, a Servier Group company
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
The purpose of this study is to assess the safety, tolerability and clinical activity of the combination S65487 with azacitidine in patients with acute myeloid leukaemia.
Detailed Description
The study is designed in two parts: A single arm dose escalation phase I part and dose expansion phase II part.
During dose escalation of S65487 in combination with azacitidine, only S65487 agent dose will escalate and a DDI (Drug-Drug interaction) assessment between S65487 and posaconazole (antifungal drug) will be performed.
For the expansion phase, Ramp up dose and full dose will be the RP2D (Recommended Phase 2 Dose) determined during phase I part
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
Acute Myeloid Leukemia, Dose escalation, Phase I/II, Azacitidine, Combination, Oncology
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
89 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
S65487 with azacitidine
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
S65487 and azacitidine
Intervention Description
Treatment cycle of combination of S65487 and azacitidine during 4 weeks preceded by ramp-up doses. Two administration schedules are set up. S65487 will be administered via intravenous (IV) infusion. Azacitidine will be administered via either subcutaneous (SC) or Intravenous (IV) infusion according to local practices.
Primary Outcome Measure Information:
Title
Dose Limiting Toxicity (DLT) (phase I part)
Description
DLT assessment at the end of cycle 1
Time Frame
From Ramp-up period (day 4 or day 3 before the first cycle) to the end of first cycle (each cycle is 28 days)
Title
Adverse Event (phase I part)
Description
AE recording throughout the study evaluated according to CTCAE v5.0, dose interruptions, reductions, and intensity
Time Frame
Through study completion, an average of 3 years ans 5 months
Title
Complete Remission (CR) rate (phase II part)
Description
CR rate is defined as the proportion of subjects who achieve complete response. Response is evaluated based on the "'Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel" (Döhner, 2017).
Time Frame
Through study completion, up to 3 years and 5 months
Secondary Outcome Measure Information:
Title
PharmacoKinetics - maximum Concentration at the End of the infusion (Cinf) (phase I and phase II parts)
Description
PK parameters of S65487, azacitidine and potential metabolite(s)
Time Frame
Ramp-up (day 4 or day 3 before the first cycle), Cycle 1 Day 1, Cycle 1 Day 3 (schedule 2), Cycle 1 Day 5 (schedule 2), Cycle 1 Day 8, Cycle 1 Day 9 (schedule 1), each Day 15 (schedule 1) or Day 8 (schedule 2) for following cycles (each cycle is 28 day)
Title
PharmacoKinetics - Area Under the Curve (AUC) (phase I and phase II parts)
Description
PK parameters of S65487, azacitidine and potential metabolite(s)
Time Frame
Ramp-up (day 4 or day 3 before the first cycle), Cycle 1 Day 1, Cycle 1 Day 3 (schedule 2), Cycle 1 Day 5 (schedule 2), Cycle 1 Day 8, Cycle 1 Day 9 (schedule 1), each Day 15 (schedule 1) or Day 8 (schedule 2) for following cycles (each cycle is 28 day)
Title
Assessment of anti-leukemic activity of S65487 combined to azacitidine (phase I and phase II parts)
Description
Complete Remission rate
Time Frame
Through study completion, an average of 3 years and 5 months
Title
Assessment of anti-leukemic activity of S65487 combined to azacitidine (phase I and phase II parts)
Description
Progression Free Survival
Time Frame
Through study completion, an average of 3 years and 5 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female participant aged ≥ 18 years old
Participants with cytologically confirmed and documented treatment naïve, de novo or secondary AML defined by WHO 2016 classification (Arber, 2016). Secondary AML includes:
Previous myelodysplastic syndrome transformed
AML due to exposure to potentially leukemogenic therapies or agents (e.g. radiation therapy, alkylating agents, topoisomerase II inhibitors) with the primary malignancy in remission for at least 3 years
Participants not eligible for standard induction chemotherapy
Aged ≥ 75 years old
Or Age ≥18 years with at least one of the following comorbidities:
Clinically significant heart or lung comorbidities, as reflected by at least one of:
Lung diffusing capacity for carbon monoxide (DLCO) ≤65% of expected
Forced expiratory volume in 1 second (FEV1) ≤65% of expected
Other contraindication(s) to anthracycline therapy (must be documented)
Other comorbidity that the Investigator judges as incompatible with intensive remission induction chemotherapy, which must be documented
ECOG (Eastern Cooperative Oncology Group) performance status should be (criterion should be rechecked at inclusion visit) ECOG ≤ 2.
Written informed consent obtained prior any study-specific procedure as described in section 13.3 of the protocol.
Adequate renal and hepatic function
Circulating White Blood Cell Count (WBC count) < 25*109 G/L (with or without use of hydroxycarbamide/leukapheresis)
Serum potassium, serum calcium, serum phosphates, serum magnesium within normal limits with or without supplementation.
Exclusion Criteria:
Major surgery within 3 weeks prior to the first IMP administration, or participants who have not recovered from side effects of the surgery
Any radiotherapy within 3 weeks before the first IMP administration,
Allogenic stem cell transplant within 3 months before the first IMP administration and/or participants with active Graft-versus-host disease within 3 months before the first IMP administration and/or participants who still receive immunosuppressive treatment within 3 months before the first IMP administration and/or participant who receive donor lymphocyte infusion (DLI) within 3 months before the first IMP administration
Acute promyelocytic leukemia (APL, French-American-British M3 classification)
Favorable risk cytogenetics such as t(8;21), inv(16) or t(16;16) or t(15;17) as per the National Comprehensive Cancer Network (NCCN) Guidelines Version 2, 2016 for Acute Myeloid Leukemia
Treatment with hypomethylating agents (decitabine/azacitidine) or Venetoclax for AHD (antecedent hematologic disorders) in the 3 months prior to the first IMP intake
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Institut de Recherches Internationales Servier, Clinical Studies Department
Phone
+33 1 55 72 43 66
Email
scientificinformation@servier.com
Facility Information:
Facility Name
Institut Gustave Roussy
City
Villejuif
ZIP/Postal Code
94805
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stephane DE BOTTON
Phone
+33 142114079
Email
stephane.debotton@gustaveroussy.fr
Facility Name
Semmelweis Egyetem Belgyógyászati és Onkológiai Klinika Klinikai Farmakológiai Részleg
City
Budapest
ZIP/Postal Code
H-1083
Country
Hungary
Individual Site Status
Not yet recruiting
Facility Name
Seoul National University Hospital - Department of Hematology-Oncology
City
Seoul
ZIP/Postal Code
03080
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Name
Samsung Medical Center - Division of Hematology-Oncology
City
Seoul
ZIP/Postal Code
06351
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jun Ho JANG
Phone
82 2 3410 0219
Email
smcjunhojang@gmail.com
Facility Name
Narodowy Instytut Onkologii im. M. Sklodowskiej-Curie Klinika Transplantacji Szpiku i Onkohematologii pokoj 4.041 ul. Wybrzeze Armii Krajowej 15
City
Gliwice
ZIP/Postal Code
44-102
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Hospital Universitario Vall d´hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Individual Site Status
Withdrawn
Facility Name
Hospital 12 de Octubre Servicio de Hematología
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
María CALBACHO ROBLES
Phone
0034 917 792 877
Email
hematx.hdoc@salud.madrid.org
Email
maria.calbacho@salud.madrid.org
Facility Name
C. Universidad de Navarra Servicio de Hematologia
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ana Alfonso
Phone
0034 948 255 400
Ext
5801
Email
aalfonso@unav.es
Facility Name
H. Universitario La Fe Servicio de Hematologia
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pau MONTESINOS
Phone
0034 961 244 864
Email
montesinos_pau@gva.es
Facility Name
Western General Hospital
City
Edinburgh
ZIP/Postal Code
EH4 2XU
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Victoria CAMPBELL
Phone
+44 (0)131 537 1000
Email
Victoria.L.Campbell@nhslothian.scot.nhs.uk
Facility Name
University College London - Hospitals NHS Foundation Trust
City
London
ZIP/Postal Code
NW1 2PG
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
The Christie NHS foundation Trust
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom
Individual Site Status
Not yet recruiting
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified scientific and medical researchers can request access to anonymized patient-level and study-level clinical trial data.
Access can be requested for all interventional clinical studies:
used for Marketing Authorization (MA) of medicines and new indications approved after 1 January 2014 in the European Economic Area (EEA) or the United States (US).
where Servier is the Marketing Authorization Holder (MAH). The date of the first MA of the new medicine (or the new indication) in one of the EEA Member States will be considered for this scope.
In addition, access can be requested for all interventional clinical studies in patients:
sponsored by Servier
with a first patient enrolled as of 1 January 2004 onwards
for New Chemical Entity or New Biological Entity (new pharmaceutical form excluded) for which development has been terminated before any Marketing authorization (MA) approval.
IPD Sharing Time Frame
After Marketing Authorisation in EEA or US if the study is used for the approval.
IPD Sharing Access Criteria
Researchers should register on Servier Data Portal and fill in the research proposal form. This form in four parts should be fully documented. The Research Proposal Form will not be reviewed until all mandatory fields are completed.
IPD Sharing URL
https://clinicaltrials.servier.com/
Links:
URL
https://clinicaltrials.servier.com/
Description
Find Results on Servier Clinical Trial Data website
Available IPD and Supporting Information:
Available IPD/Information Type
Individual Participant Data Set
Available IPD/Information URL
https://clinicaltrials.servier.com/
Available IPD/Information Type
Study Protocol
Available IPD/Information URL
https://clinicaltrials.servier.com/
Available IPD/Information Type
Statistical Analysis Plan
Available IPD/Information URL
https://clinicaltrials.servier.com/
Available IPD/Information Type
Informed Consent Form
Available IPD/Information URL
https://clinicaltrials.servier.com/
Available IPD/Information Type
Clinical Study Report
Available IPD/Information URL
https://clinicaltrials.servier.com/
Available IPD/Information Type
Study-level clinical trial data
Available IPD/Information URL
https://clinicaltrials.servier.com/
Learn more about this trial
Phase I/II Trial of S65487 Plus Azacitidine in Acute Myeloid Leukemia
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