search
Back to results

A Study to Evaluate the Tolerance and Efficacy of Mitoxantrone Hydrochloride Liposome Injection Combined With Cytarabine in Patients With Acute Myeloid Leukemia (AML)

Primary Purpose

Treatment-naive or Relapsed or Refractory Acute Myeloid Leukemia (AML)

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Mitoxantrone Hydrochloride liposome injection
Cytarabine (LoDAC)
Sponsored by
CSPC ZhongQi Pharmaceutical Technology Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Treatment-naive or Relapsed or Refractory Acute Myeloid Leukemia (AML)

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients volunteer to participate in this study and sign the informed consent form.
  2. Age≥18 years old, no gender limitation.
  3. Patient has a diagnosis of newly diagnosed or relapsed or refractory(R/R) AML as determined by pathological and morphological results, according to World Health Organization (WHO) 2016 classification.
  4. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
  5. Patient must meet the following criteria as indicated on the clinical laboratory tests:a. Serum aspartate aminotransferase and alanine aminotransferase ≤ 3.0 x upper limit of normal (ULN);b. Serum total bilirubin ≤ 1.5 x ULN;c. Serum creatinine ≤ 1.5 x ULN.
  6. Patient and their partner agree to take effective contraception from the date of signing an informed consent to 180 days after the last dose; female patients must have negative urine or blood HCG (except for menopause and hysterectomy).

Exclusion Criteria:

  1. Any of the following cases:(1) diagnosed as acute promyelocytic leukemia (APL);(2) chronic myelogenous leukemia in blast crisis;(3) AML with central nervous system leukemia.
  2. Patient has been previously diagnosed with another malignancy in last 5 years (except for cured basal cell carcinoma of skin or cervical carcinoma in situ).
  3. Patient is receiving continuous treatment for graft-versus-host disease (GVHD), or has received autologous or allogeneic stem cell transplantation more than once.
  4. Allergic history of mitoxantrone hydrochloride injection, cytarabine or liposome.
  5. Previously received doxorubicin or other anthracyclines, and the cumulative dose of doxorubicin exceeds 400 mg/m^2 (calculation of equivalent dose of anthracyclines: 1 mg doxorubicin = 2 mg epirubicin = 2 mg daunorubicin = 0.5 mg noroxydaunorubicin = 0.45 mg mitoxantrone; except doxorubicin liposomes).
  6. Patient has received any anti-tumor treatment within 2 weeks before the first dose (or within 5 half-lives of the drug), including chemotherapy, immunotherapy, targeted therapy, endocrine therapy and radiation therapy (local radiation therapy interval < 2 weeks). Leukopenia treatment (hydroxyurea, leukocyte separation, etc.) and preventive intrathecal injection exceeds 24 hours are the exception.
  7. The non-hematological toxicity of previous anti-tumor treatment does not return to grade≤1 (except for alopecia, skin pigmentation or tolerable events judged by the investigator).
  8. Patient is receiving systemic anti-infection treatment but has poor response (there are signs of infection progression within 1 week prior to the first dose or determined by the investigator).
  9. The estimated survival time is less than 3 months.
  10. Any of the following conditions occurs in cardiac function:(1) Long QTc syndrome or QTc interval > 480 ms;(2) Complete left bundle branch block or severe atrioventricular block disease (except for patients who use the pacemaker);(3) Serious and uncontrolled arrhythmias and unstable angina pectoris requiring drug treatment;(4) History of chronic congestive heart failure, New York Heart Association (NYHA)≥grade 3;(5) The cardiac ejection fraction is less than 50% or lower than the lower limit of the laboratory test value range of the research center;(6)Uncontrollable hypertension (defined as multiple measurements of systolic blood pressure > 150 mmHg or diastolic blood pressure > 90 mmHg under drug control);(7) History of myocardial infarction, unstable angina pectoris, viral myocarditis or severe pericardial disease, ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before screening.
  11. Patients have thromboembolic events in the past 6 months, such as cerebrovascular accidents (including transient ischemic attack) and pulmonary embolism.
  12. HBsAg/HBcAb positive with HBV-DNA ≥2000 IU/mL, hepatitis C antibody-positive with HCV-RNA higher than the lower limit of the detection value of the research center, or HIV antibody positive in the preliminary screening.
  13. Patients who have undergone major surgery (except intravenous infusion port implantation) within 3 months before the first study dose, or plan to perform major surgery during the study period.
  14. Patient is suffering from any serious and /or non-controllable disease, or the investigator determines that the disease might affect the participants in the study, including (but not limited to, uncontrolled diabetes, dialysis related kidney diseases, severe liver diseases, life-threatening autoimmune diseases and hemorrhagic diseases, drug abuse, neurological diseases, etc.).
  15. Pregnant or lactating female.
  16. Patients are not suitable for the study in the investigator's opinion.

Sites / Locations

  • The Affiliated Hospital of Guizhou Medical University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Mitoxantrone Hydrochloride liposome and cytarabine

Arm Description

Chemotherapy will be given in 28-day cycles, and total treatment period is 2 cycles. Dose escalation phase: Patients will receive 24 mg/m^2, 30 mg/m^2 or 36mg/m^2 of mitoxantrone hydrochloride liposome daily by intravenous (IV) injections on the first day and 1.5 g/m^2 of cytarabine twice daily by IV for 3 days (day 1, day3 and day5). Dose expansion phase: Patients with newly diagnosed AML will receive mitoxantrone hydrochloride liposome daily by IV on the first day, 100~200 mg/m^2 of cytarabine by IV for 7 days (day 1~7). Patients with R/R AML will receive mitoxantrone hydrochloride liposome daily by IV on the first day, 1.5 g/m^2 of cytarabine twice daily by IV for 3 days (day 1, day3 and day5). The dose size of mitoxantrone hydrochloride liposome will be determined by the investigator and the sponsor based on the results of the previous study.

Outcomes

Primary Outcome Measures

Occurrence of dose-limiting toxicity (DLT)in dose escalation phase
Adverse events during treatment in dose expansion phase

Secondary Outcome Measures

Adverse events during treatment in dose escalation phase
Composite CR rate (CRc: CR+CRi) in dose escalation phase
Objective response rate (ORR) in dose escalation phase
Overall survival (OS) in dose escalation phase
Explore maximum tolerated dose (MTD) in dose escalation phase
Composite CR rate (CRc: CR+CRi) in dose expansion phase
Objective response rate (ORR) in dose expansion phase
Overall survival (OS) in dose expansion phase
Explore RP2D in dose expansion phase

Full Information

First Posted
October 19, 2021
Last Updated
October 19, 2021
Sponsor
CSPC ZhongQi Pharmaceutical Technology Co., Ltd.
search

1. Study Identification

Unique Protocol Identification Number
NCT05100303
Brief Title
A Study to Evaluate the Tolerance and Efficacy of Mitoxantrone Hydrochloride Liposome Injection Combined With Cytarabine in Patients With Acute Myeloid Leukemia (AML)
Official Title
An Open-label, Multi-center Phase Ib/II Study to Evaluate the Tolerance and Efficacy of Mitoxantrone Hydrochloride Liposome Injection Combined With Cytarabine in Patients With Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Unknown status
Study Start Date
December 2021 (Anticipated)
Primary Completion Date
November 2022 (Anticipated)
Study Completion Date
June 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CSPC ZhongQi Pharmaceutical Technology 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
This is an open-label, multi-cohort, multi-center Phase Ib/II clinical study to evaluate the tolerance and efficacy of Mitoxantrone Hydrochloride liposome injection combined with cytarabine in patients with Acute Myeloid Leukemia (AML). The study will be divided into two phases, the dose escalation phase and the dose expansion phase. Patients with relapsed or refractory(R/R) AML will be included in the dose-escalation phase, and patients with treatment-naïve or R/R AML will be included in the dose-expansion phase.
Detailed Description
Dose escalation phase: Eligible patients will enter the screening period up to 14 days before the start of treatment. Patients will receive mitoxantrone liposomes combined with cytarabine, with a fixed dose of cytarabine and mitoxantrone liposomes in 3 dose groups: 24 mg/m^2, 30 mg/m^2 and 36 mg/m^2. The starting dose will be 24 mg/m^2, and the "3+3" principle is adopted for the escalation. If the maximum tolerated dose is not explored at the preset maximum dose (36 mg/m^2), the investigator and the sponsor will determine whether to continue the dose escalation, and it is necessary to ensure that 6 patients complete the dose-limiting toxicity (DLT) observation under this dose group. The treatment period includes 2 cycles with each cycle lasting 28 days. Cycle 1 is the DLT observation period and Cycle 2 is the extended dosing period. Mitoxantrone hydrochloride liposome injection will be given on the first day of each cycle, and cytarabine will be given every 12 hours on Day 1, 3, and 5 of each cycle. Patients who do not experience a DLT in the first cycle and achieve is at least PR, may enter the extended dosing period and be treated with the original regimen in Cycle 2. Patients who have completed 2 cycles and have a DLT in the first cycle or have not achieved PR will be withdrawn from treatment. Dose expansion phase: Newly treated AML or R/R AML patients will be included and divided into two cohorts. Eligible patients will enter the screening period up to 14 days before receiving treatments. The treatment period is 2 cycles, and each cycle is 28 days. Mitoxantrone hydrochloride liposome injection will be given on the first day of each cycle, whose dose size will be determined by the investigator and the sponsor based on the results of the previous study. Cytarabine will be given on Day 1-7 of each cycle for the treatment-naïve group, and on Day 1, 3 and 5 of each cycle for the R/R group. Patients will take 1 cycle of therapy and will be assessed for response at the end of the 1st cycle. After the efficacy evaluation, the patient may receive a second cycle of chemotherapy at the investigator's discretion. And patients whose curative effect do not reach PR will be withdrawn from treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Treatment-naive or Relapsed or Refractory Acute Myeloid Leukemia (AML)

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
58 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Mitoxantrone Hydrochloride liposome and cytarabine
Arm Type
Experimental
Arm Description
Chemotherapy will be given in 28-day cycles, and total treatment period is 2 cycles. Dose escalation phase: Patients will receive 24 mg/m^2, 30 mg/m^2 or 36mg/m^2 of mitoxantrone hydrochloride liposome daily by intravenous (IV) injections on the first day and 1.5 g/m^2 of cytarabine twice daily by IV for 3 days (day 1, day3 and day5). Dose expansion phase: Patients with newly diagnosed AML will receive mitoxantrone hydrochloride liposome daily by IV on the first day, 100~200 mg/m^2 of cytarabine by IV for 7 days (day 1~7). Patients with R/R AML will receive mitoxantrone hydrochloride liposome daily by IV on the first day, 1.5 g/m^2 of cytarabine twice daily by IV for 3 days (day 1, day3 and day5). The dose size of mitoxantrone hydrochloride liposome will be determined by the investigator and the sponsor based on the results of the previous study.
Intervention Type
Drug
Intervention Name(s)
Mitoxantrone Hydrochloride liposome injection
Intervention Description
Mitoxantrone hydrochloride liposome will be administered by intravenous (IV) injections.
Intervention Type
Drug
Intervention Name(s)
Cytarabine (LoDAC)
Intervention Description
Low-dose or high-dose cytarabine (LoDAC) will be administered by intravenous (IV) injections.
Primary Outcome Measure Information:
Title
Occurrence of dose-limiting toxicity (DLT)in dose escalation phase
Time Frame
The first cycle (28 days)
Title
Adverse events during treatment in dose expansion phase
Time Frame
up to 3 years
Secondary Outcome Measure Information:
Title
Adverse events during treatment in dose escalation phase
Time Frame
up to 3 years
Title
Composite CR rate (CRc: CR+CRi) in dose escalation phase
Time Frame
up to 3 years
Title
Objective response rate (ORR) in dose escalation phase
Time Frame
up to 3 years
Title
Overall survival (OS) in dose escalation phase
Time Frame
up to 3 years
Title
Explore maximum tolerated dose (MTD) in dose escalation phase
Time Frame
up to 3 years
Title
Composite CR rate (CRc: CR+CRi) in dose expansion phase
Time Frame
up to 3 years
Title
Objective response rate (ORR) in dose expansion phase
Time Frame
up to 3 years
Title
Overall survival (OS) in dose expansion phase
Time Frame
up to 3 years
Title
Explore RP2D in dose expansion phase
Time Frame
up to 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients volunteer to participate in this study and sign the informed consent form. Age≥18 years old, no gender limitation. Patient has a diagnosis of newly diagnosed or relapsed or refractory(R/R) AML as determined by pathological and morphological results, according to World Health Organization (WHO) 2016 classification. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. Patient must meet the following criteria as indicated on the clinical laboratory tests:a. Serum aspartate aminotransferase and alanine aminotransferase ≤ 3.0 x upper limit of normal (ULN);b. Serum total bilirubin ≤ 1.5 x ULN;c. Serum creatinine ≤ 1.5 x ULN. Patient and their partner agree to take effective contraception from the date of signing an informed consent to 180 days after the last dose; female patients must have negative urine or blood HCG (except for menopause and hysterectomy). Exclusion Criteria: Any of the following cases:(1) diagnosed as acute promyelocytic leukemia (APL);(2) chronic myelogenous leukemia in blast crisis;(3) AML with central nervous system leukemia. Patient has been previously diagnosed with another malignancy in last 5 years (except for cured basal cell carcinoma of skin or cervical carcinoma in situ). Patient is receiving continuous treatment for graft-versus-host disease (GVHD), or has received autologous or allogeneic stem cell transplantation more than once. Allergic history of mitoxantrone hydrochloride injection, cytarabine or liposome. Previously received doxorubicin or other anthracyclines, and the cumulative dose of doxorubicin exceeds 400 mg/m^2 (calculation of equivalent dose of anthracyclines: 1 mg doxorubicin = 2 mg epirubicin = 2 mg daunorubicin = 0.5 mg noroxydaunorubicin = 0.45 mg mitoxantrone; except doxorubicin liposomes). Patient has received any anti-tumor treatment within 2 weeks before the first dose (or within 5 half-lives of the drug), including chemotherapy, immunotherapy, targeted therapy, endocrine therapy and radiation therapy (local radiation therapy interval < 2 weeks). Leukopenia treatment (hydroxyurea, leukocyte separation, etc.) and preventive intrathecal injection exceeds 24 hours are the exception. The non-hematological toxicity of previous anti-tumor treatment does not return to grade≤1 (except for alopecia, skin pigmentation or tolerable events judged by the investigator). Patient is receiving systemic anti-infection treatment but has poor response (there are signs of infection progression within 1 week prior to the first dose or determined by the investigator). The estimated survival time is less than 3 months. Any of the following conditions occurs in cardiac function:(1) Long QTc syndrome or QTc interval > 480 ms;(2) Complete left bundle branch block or severe atrioventricular block disease (except for patients who use the pacemaker);(3) Serious and uncontrolled arrhythmias and unstable angina pectoris requiring drug treatment;(4) History of chronic congestive heart failure, New York Heart Association (NYHA)≥grade 3;(5) The cardiac ejection fraction is less than 50% or lower than the lower limit of the laboratory test value range of the research center;(6)Uncontrollable hypertension (defined as multiple measurements of systolic blood pressure > 150 mmHg or diastolic blood pressure > 90 mmHg under drug control);(7) History of myocardial infarction, unstable angina pectoris, viral myocarditis or severe pericardial disease, ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before screening. Patients have thromboembolic events in the past 6 months, such as cerebrovascular accidents (including transient ischemic attack) and pulmonary embolism. HBsAg/HBcAb positive with HBV-DNA ≥2000 IU/mL, hepatitis C antibody-positive with HCV-RNA higher than the lower limit of the detection value of the research center, or HIV antibody positive in the preliminary screening. Patients who have undergone major surgery (except intravenous infusion port implantation) within 3 months before the first study dose, or plan to perform major surgery during the study period. Patient is suffering from any serious and /or non-controllable disease, or the investigator determines that the disease might affect the participants in the study, including (but not limited to, uncontrolled diabetes, dialysis related kidney diseases, severe liver diseases, life-threatening autoimmune diseases and hemorrhagic diseases, drug abuse, neurological diseases, etc.). Pregnant or lactating female. Patients are not suitable for the study in the investigator's opinion.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jishi Wang, Chief doctor
Phone
+86-13639089646
Email
Wangjishi9646@163.com
Facility Information:
Facility Name
The Affiliated Hospital of Guizhou Medical University
City
Guiyang
State/Province
Guizhou
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jishi Wang, Chief doctor
Phone
+86-13639089646
Email
Wangjishi9646@163.com

12. IPD Sharing Statement

Learn more about this trial

A Study to Evaluate the Tolerance and Efficacy of Mitoxantrone Hydrochloride Liposome Injection Combined With Cytarabine in Patients With Acute Myeloid Leukemia (AML)

We'll reach out to this number within 24 hrs