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CPX-351 in Combination With Gemtuzumab Ozogamicin in Newly Diagnosed AML

Primary Purpose

Acute Myeloid Leukemia

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Vyxeos
Gemtuzumab Ozogamicin
Sponsored by
H. Lee Moffitt Cancer Center and Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Provision of signed and dated informed consent form
  • Stated willingness to comply with all study procedures and availability for the duration of the study
  • Male or female, aged ≥18 and ≤70 years with newly diagnosed favorable or intermediate risk AML as defined by ELN 2017 criteria
  • For females of child-bearing potential: use of highly effective contraception upon enrollment and during study participation and for an additional 6 months after the end of CPX-351 and Gemtuzumab ozogamicin administration: A female of child-bearing potential is considered when a sexually mature female: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 12 consecutive months
  • The effects of CPX-351 and gemtuzumab ozogamicin on the developing human fetus are unknown. For this reason, women of child-bearing potential as defined above must have a negative serum or urine pregnancy test within 24 hours prior to beginning study treatment.
  • For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner
  • Myeloblasts expressing CD33 as determined by flow cytometry or immunohistochemistry
  • ECOG ≤ 2 and eligible to receive intensive chemotherapy as determined by the treating physician
  • Prior malignancy is allowed providing it does not require concurrent therapy. Exception: Active hormonal therapy is allowed.
  • Prior hypomethylating agents (HMA) therapy including azacitidine or decitabine when used for non-AML diagnoses is allowed. Most recent dose must have been ≥14 days prior to day 1 of study treatment.
  • Participants must have acceptable organ function
  • Adequate cardiac function defined as ejection fraction of ≥50% as determined by multigated acquisition scan (MUGA) or 2D echocardiogram.
  • Hydroxyurea is allowed for cytoreduction until day 1 of study treatment

Exclusion Criteria:

  • Prior treatment of AML except hydroxyurea and/or leukapheresis
  • Participants with adverse risk AML as defined by ELN 2017 criteria
  • Participants with acute promyelocytic leukemia (APL).
  • Known clinically active central nervous system (CNS) leukemia.
  • Severe liver disease (cirrhosis, non-alcoholic steatohepatitis, sclerosing cholangitis) or patients with known Wilson's disease.
  • Participants with known active infection with hepatitis B or hepatitis C virus
  • Known allergic reactions to components of the CPX-351 (cytarabine or daunorubicin) or Gemtuzumab ozogamicin.
  • Patients with any prior anthracycline exposure plus any planned on-study anthracycline exposure cannot not exceed 550 mg/m2 of daunorubicin (or equivalent). For participants who have received radiation therapy to the mediastinum, the total cumulative dose of anthracycline should not exceed 400 mg/m2 of daunorubicin(or equivalent).
  • Hemodynamically unstable (subjects requiring vasopressor support will not be eligible).
  • Treatment with another investigational drug within 14 days.
  • Uncontrolled cardiac disease including congestive heart failure class III or IV by the NYHA, unstable angina (angina symptoms at rest), new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months.
  • Any disorder that compromises the subject's ability to give written informed consent and/or to comply with study procedures.
  • Any substance abuse, severe and/or uncontrolled medical, social or psychiatric conditions that may prevent the subject from completing the study, interfere with the evaluation of safety and/or efficacy, or interfere with the interpretation of the study results.
  • Female subject who is pregnant or breastfeeding.
  • Any patient with a known FLT3 ITD or FLT3 TKD mutation

Sites / Locations

  • Moffitt Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dose Escalation

Arm Description

Dose escalation to determine the maximum tolerated dose (MTD) of CPX-351 in combination with Gemtuzumab Ozogamicin in participants with newly diagnosed acute myeloid leukemia. Participants will be treated in cohorts of size three to six and the dosage will be escalated if the clinical toxicity is acceptable. A total of 3 dose levels will be used.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD)
Dose escalation will determine the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of Vyxeos plus Gemtuzumab Ozogamicin. The MTD is the highest dose of the combination therapy that dose not cause unacceptable side effects.

Secondary Outcome Measures

Rate of Complete Remission
Rate of complete remission (CR) and complete remission with incomplete blood count recovery (CRi). The definition of CR and CRi is based on the European LeukemiaNet 2017 Response Criteria for AML.
Measurable Residual Disease
Rate of measurable residual disease via RT-PCR for core binding factor leukemia as well as NPM1 mutated AML
Overall Survival
Overall survival is defined as the duration of time from start of treatment to the time of death from any cause or date of last contact.
Relapse Free Survival (RFS)
RFS is defined as time interval between achievement of CR to time of relapse

Full Information

First Posted
September 22, 2022
Last Updated
October 9, 2023
Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
Jazz Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05558124
Brief Title
CPX-351 in Combination With Gemtuzumab Ozogamicin in Newly Diagnosed AML
Official Title
A Phase 1/1b Dose Escalation and Expansion of CPX-351 in Combination With Gemtuzumab Ozogamicin in Newly Diagnosed Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 22, 2022 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
Jazz Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the study is to determine the safety of combining the drugs gemtuzumab ozogamicin (GO) with CPX-351 in order to treat the disease, as well as to find the maximum tolerated dose level and recommended Phase 2 dose level of GO with a fixed dose of CPX-351.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation
Arm Type
Experimental
Arm Description
Dose escalation to determine the maximum tolerated dose (MTD) of CPX-351 in combination with Gemtuzumab Ozogamicin in participants with newly diagnosed acute myeloid leukemia. Participants will be treated in cohorts of size three to six and the dosage will be escalated if the clinical toxicity is acceptable. A total of 3 dose levels will be used.
Intervention Type
Drug
Intervention Name(s)
Vyxeos
Other Intervention Name(s)
daunorubicin-cytarabine, CPX-351
Intervention Description
Fixed dose of Vyxeos (44 mg/m2 daunorubicin and 100 mg/m2 cytarabine) (Day 1, 3, and 5) in combination with various dose schedules of Gemtuzumab Ozogamicin (GO)
Intervention Type
Drug
Intervention Name(s)
Gemtuzumab Ozogamicin
Other Intervention Name(s)
Mylotarg
Intervention Description
Participants will be treated at the following dose levels: Dose Level 1 - Gemtuzumab Ozogamicin will administered 3mg/m2 on Day 1 Dose Level 2 - Gemtuzumab Ozogamicin will administered 3mg/m2 on Day 1 and 4 Dose Level 3 - Gemtuzumab Ozogamicin will administered 3mg/m2 on Day 1, 4, 7
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Description
Dose escalation will determine the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of Vyxeos plus Gemtuzumab Ozogamicin. The MTD is the highest dose of the combination therapy that dose not cause unacceptable side effects.
Time Frame
Up to 18 Months
Secondary Outcome Measure Information:
Title
Rate of Complete Remission
Description
Rate of complete remission (CR) and complete remission with incomplete blood count recovery (CRi). The definition of CR and CRi is based on the European LeukemiaNet 2017 Response Criteria for AML.
Time Frame
Up to 18 Months
Title
Measurable Residual Disease
Description
Rate of measurable residual disease via RT-PCR for core binding factor leukemia as well as NPM1 mutated AML
Time Frame
Up to 18 Months
Title
Overall Survival
Description
Overall survival is defined as the duration of time from start of treatment to the time of death from any cause or date of last contact.
Time Frame
Up to 5 years
Title
Relapse Free Survival (RFS)
Description
RFS is defined as time interval between achievement of CR to time of relapse
Time Frame
Up to 18 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: Provision of signed and dated informed consent form Stated willingness to comply with all study procedures and availability for the duration of the study Male or female, aged ≥18 and ≤70 years with newly diagnosed any risk AML as defined by ELN 2017 criteria For females of child-bearing potential: use of highly effective contraception upon enrollment and during study participation and for an additional 6 months after the end of CPX-351 and Gemtuzumab ozogamicin administration: A female of child-bearing potential is considered when a sexually mature female: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 12 consecutive months The effects of CPX-351 and gemtuzumab ozogamicin on the developing human fetus are unknown. For this reason, women of child-bearing potential as defined above must have a negative serum or urine pregnancy test within 24 hours prior to beginning study treatment. For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner Myeloblasts expressing CD33 as determined by flow cytometry or immunohistochemistry ECOG ≤ 2 and eligible to receive intensive chemotherapy as determined by the treating physician Prior malignancy is allowed providing it does not require concurrent therapy. Exception: Active hormonal therapy is allowed. Prior hypomethylating agents (HMA) therapy including azacitidine or decitabine when used for non-AML diagnoses is allowed. Most recent dose must have been ≥14 days prior to day 1 of study treatment. Participants must have acceptable organ function Adequate cardiac function defined as ejection fraction of ≥50% as determined by multigated acquisition scan (MUGA) or 2D echocardiogram. Hydroxyurea is allowed for cytoreduction until day 1 of study treatment Exclusion Criteria: Prior treatment of AML except hydroxyurea and/or leukapheresis Participants with acute promyelocytic leukemia (APL). Known current and clinically active central nervous system (CNS) leukemia. Severe liver disease (cirrhosis, non-alcoholic steatohepatitis, sclerosing cholangitis) or patients with known Wilson's disease. Participants with known active infection with hepatitis B or hepatitis C virus Known allergic reactions to components of the CPX-351 (cytarabine or daunorubicin) or Gemtuzumab ozogamicin. Patients with any prior anthracycline exposure plus any planned on-study anthracycline exposure cannot not exceed 550 mg/m2 of daunorubicin (or equivalent). For participants who have received radiation therapy to the mediastinum, the total cumulative dose of anthracycline should not exceed 400 mg/m2 of daunorubicin(or equivalent). Hemodynamically unstable (subjects requiring vasopressor support will not be eligible). Treatment with another investigational drug within 14 days. Uncontrolled cardiac disease including congestive heart failure class III or IV by the NYHA, unstable angina (angina symptoms at rest), new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months. Any disorder that compromises the subject's ability to give written informed consent and/or to comply with study procedures. Any substance abuse, severe and/or uncontrolled medical, social or psychiatric conditions that may prevent the subject from completing the study, interfere with the evaluation of safety and/or efficacy, or interfere with the interpretation of the study results. Female subject who is pregnant or breastfeeding. Any patient with a known FLT3 ITD or FLT3 TKD mutation
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lisa Nardelli
Phone
1-813-745-4731
Email
Lisa.Nardelli@moffitt.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Onyee Chan, MD
Organizational Affiliation
Moffitt Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lisa Nardelli
Phone
813-745-4731
Email
lisa.nardelli@moffitt.org
First Name & Middle Initial & Last Name & Degree
Onyee Chan
Phone
1-813-745-2069
Email
Onyee.Chan@moffitt.org
First Name & Middle Initial & Last Name & Degree
Onyee Chan, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Links:
URL
https://moffitt.org/clinical-trials-research/clinical-trials/?gclid=EAIaIQobChMImIymzIa-9gIVAZ2GCh3uzAWJEAAYASAAEgI0ovD_BwE
Description
Moffitt Cancer Center Clinical Trial Search

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CPX-351 in Combination With Gemtuzumab Ozogamicin in Newly Diagnosed AML

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