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A Safety, Tolerability and Efficacy Study of NC525 in Subjects With Advanced Myeloid Neoplasms

Primary Purpose

Relapsed or Refractory Acute Myeloid Leukemia, Relapsed or Refractory Chronic Myelomonocytic Leukemia, Relapsed or Refractory Myelodysplastic Syndrome

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
NC525
Sponsored by
NextCure, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory Acute Myeloid Leukemia focused on measuring Advanced Leukemia, Leukemia, NC525, PK, AML, MDS, CMML

Eligibility Criteria

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

Inclusion Criteria: The subject is willing to provide written informed consent for the trial. Be ≥ 18 years of age on the day of signing informed consent. Subject has one of the following Myeloid Neoplasms determined by pathology review at the treating institution: Relapsed or Refractory AML, Note: Active, relapsed, or refractory AML is defined as any one of the following: Primary induction failure, or (PIF) after 2 or more cycles of therapy, First early relapse after a remission duration of fewer than 6 months, Relapse refractory to salvage combination chemotherapy second or subsequent relapse, or Relapsed or refractory AML with at least 5% blasts by bone marrow biopsy or aspirate, or at least 1% blasts in peripheral blood. Relapsed or Refractory Myelodysplastic syndrome (MDS) after prior hypomethylating agents. Relapsed or Refractory Chronic myelomonocytic leukemia (CMML) with progressive disease or lack of response to hypomethylating agents A male subject must agree to use approved contraception (based on institutional guidelines) and refrain from sperm donation or expecting to father a child, from Screening through the treatment period and for at least 90 days after the last dose of study treatment. A female subject is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: Not a woman of childbearing potential (WOCBP); A WOCBP agrees to follow approved contraceptive guidance (based on institutional guidelines) from Screening through the treatment period and for at least 90 days after the last dose of study treatment. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2. Life expectancy greater than or equal to 12 weeks as judged by the Investigator. Have adequate organ function as defined in the protocol. Exclusion Criteria: Has a diagnosis of therapy-related AML, acute promyelocytic leukemia (M3, APL), accelerated phase or blast crisis of chronic myeloid leukemia. History or presence of clinically relevant CNS pathology such as epilepsy, childhood or adult seizure, paresis, aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis. Patients with active Central Nervous System (CNS) involvement (such as leukemic infiltration, blast in the spinal fluid, or subjects with extramedullary disease). A WOCBP who has a positive pregnancy test (within 72 hours) prior to treatment. History or evidence of any other clinically significant disorder, condition or disease (e.g., symptomatic congestive heart failure, unstable angina pectoris, symptomatic myocardial infection, uncontrolled cardiac arrhythmia, pericardial disease or heart failure New York Heart Association Class III or IV), or severe debilitating pulmonary disease, that would potentially increase patients' risk for toxicity and in the opinion of the Investigator, would pose a risk to patient safety or interfere with the study evaluation, procedures or completion. Chronic respiratory disease or any other medical condition that requires continuous oxygen that in the opinion of the Investigator, would adversely affect his/her participation in this study. Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks or 5 half-lives (whichever is longer) prior to the first dose of study treatment. Has not recovered to ≤ Grade 1 from toxic effects of prior therapy (including prior chemotherapy, immunotherapy and radiation therapy) and/or complications from interventions before starting therapy. Has previously had an allogeneic solid organ transplant. Autologous HSCT within 6 weeks before the start of study treatment. Allogeneic HSCT within 6 months before the start of study treatment. Any active acute or chronic graft-versus-host disease (GvHD), grade 2-4, or active chronic GvHD requiring systemic treatment. Any systemic therapy (e.g. calcineurin inhibitors (CNI), steroids, etc.) against GvHD within 4 weeks before the start of study treatment. Any Grade ≥ 2 persistent non-hematological toxicity related to allogeneic transplant, such as those requiring systemic immunosuppressive therapy. Previous CAR-T therapy. Known concurrent malignancy that is progressing or requires active treatment, or history of other malignancy within 2 years of study entry after treatment with curative intent. Has severe hypersensitivity (≥ Grade 3), known allergy or reaction to Immunoglobulins or NC525, and/or any of their excipients. Uncontrolled systemic fungal, bacterial, viral, or other infection despite appropriate anti-infection treatment at the time of eligibility confirmation. Has a known history of HIV infection. Has a known active chronic hepatitis B infection or chronic hepatitis C infection with the exception of those with an undetectable viral load within 3 months. (Hepatitis B or C testing is not required). Has a history or current evidence of any condition, therapy, or laboratory abnormality, or other circumstance that might confound the results of the study or interfere with the subject's participation for the full duration of the study, such that it is not in the best interest of the subject to participate, in the opinion of the treating investigator. Has a known psychiatric or substance abuse disorder that would interfere with the subject's ability to cooperate with the requirements of the study.

Sites / Locations

  • City of HopeRecruiting
  • Massachusetts General HospitalRecruiting
  • Roswell Park Cancer InstituteRecruiting
  • University Hospitals Cleveland Medical CenterRecruiting
  • Oregon Health & Science UniversityRecruiting
  • MD Anderson Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

NC525

Arm Description

Escalating dose levels will be explored.

Outcomes

Primary Outcome Measures

To evaluate the frequency, duration, and severity of treatment-emergent adverse events [Safety and Tolerability].
Toxicity grading per NCI CTCAE v5.0.
To evaluate dose-limiting toxicities (DLTs) of NC525.
Toxicity grading per NCI CTCAE v5.0.
Define a recommended Phase 2 dose (RP2D) of NC525
A Bayesian Optimal Interval (BOIN) design will be utilized to determine a recommended Phase 2 dose (RP2D) for NC525.
Define a minimally active dose (MAD) of NC525
A BOIN design will be utilized to determine a MAD
Define a pharmacologically active dose (PAD) of NC525
A BOIN design will be utilized to determine a PAD
Define a maximum tolerated dose (MTD) of NC525
A BOIN design will be utilized to determine a MTD

Secondary Outcome Measures

To evaluate the clinical benefit of NC525 by assessing Objective Response (OR).
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
To evaluate the clinical benefit of NC525 by assessing Event-free survival (EFS).
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
To evaluate the clinical benefit of NC525 by assessing Overall survival (OS).
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
Assessment of time to achieve response, defined as CR, CRi, or CRh
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
Maximum Observed Serum Concentration (Cmax) of NC525
Terminal Half-life (t1/2) of NC525
Area under the serum concentration versus time curve (AUC) of NC525

Full Information

First Posted
February 8, 2023
Last Updated
September 20, 2023
Sponsor
NextCure, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05787496
Brief Title
A Safety, Tolerability and Efficacy Study of NC525 in Subjects With Advanced Myeloid Neoplasms
Official Title
A Phase 1, Open-Label, Safety, Tolerability, And Efficacy Study of NC525 in Subjects With Advanced Myeloid Neoplasms
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 28, 2023 (Actual)
Primary Completion Date
May 2025 (Anticipated)
Study Completion Date
May 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NextCure, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open-label, non-randomized, Phase 1 study to determine the safety and tolerability of NC525. This study will also assess the clinical benefit in subjects with advanced myeloid neoplasms.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory Acute Myeloid Leukemia, Relapsed or Refractory Chronic Myelomonocytic Leukemia, Relapsed or Refractory Myelodysplastic Syndrome
Keywords
Advanced Leukemia, Leukemia, NC525, PK, AML, MDS, CMML

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
NC525
Arm Type
Experimental
Arm Description
Escalating dose levels will be explored.
Intervention Type
Drug
Intervention Name(s)
NC525
Intervention Description
Monoclonal antibody specific for LAIR-1
Primary Outcome Measure Information:
Title
To evaluate the frequency, duration, and severity of treatment-emergent adverse events [Safety and Tolerability].
Description
Toxicity grading per NCI CTCAE v5.0.
Time Frame
Up to 24 months
Title
To evaluate dose-limiting toxicities (DLTs) of NC525.
Description
Toxicity grading per NCI CTCAE v5.0.
Time Frame
Up to 56 days
Title
Define a recommended Phase 2 dose (RP2D) of NC525
Description
A Bayesian Optimal Interval (BOIN) design will be utilized to determine a recommended Phase 2 dose (RP2D) for NC525.
Time Frame
Up to 24 months
Title
Define a minimally active dose (MAD) of NC525
Description
A BOIN design will be utilized to determine a MAD
Time Frame
Up to 24 months
Title
Define a pharmacologically active dose (PAD) of NC525
Description
A BOIN design will be utilized to determine a PAD
Time Frame
Up to 24 months
Title
Define a maximum tolerated dose (MTD) of NC525
Description
A BOIN design will be utilized to determine a MTD
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
To evaluate the clinical benefit of NC525 by assessing Objective Response (OR).
Description
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
Time Frame
Until disease progression, up to 24 months
Title
To evaluate the clinical benefit of NC525 by assessing Event-free survival (EFS).
Description
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
Time Frame
Until disease progression, up to 24 months
Title
To evaluate the clinical benefit of NC525 by assessing Overall survival (OS).
Description
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
Time Frame
Until disease progression, up to 24 months
Title
Assessment of time to achieve response, defined as CR, CRi, or CRh
Description
Disease Assessments will be performed using the European Leukemia Net (ELN) Guidelines for the ELN Outcome Measures.
Time Frame
Cycle 1 Day 1 to day remission is achieved, up to 24 months (each cycle is 28 days)
Title
Maximum Observed Serum Concentration (Cmax) of NC525
Time Frame
During Cycles 1, 2, 3, 5, 7, and 11 (each cycle is 28 days)
Title
Terminal Half-life (t1/2) of NC525
Time Frame
During Cycles 1, 2, 3, 5, 7, and 11 (each cycle is 28 days)
Title
Area under the serum concentration versus time curve (AUC) of NC525
Time Frame
During Cycles 1, 2, 3, 5, 7, and 11 (each cycle is 28 days)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject is willing to provide written informed consent for the trial. Be ≥ 18 years of age on the day of signing informed consent. Subject has one of the following Myeloid Neoplasms determined by pathology review at the treating institution: Relapsed or Refractory AML, Note: Active, relapsed, or refractory AML is defined as any one of the following: Primary induction failure, or (PIF) after 2 or more cycles of therapy, First early relapse after a remission duration of fewer than 6 months, Relapse refractory to salvage combination chemotherapy second or subsequent relapse, or Relapsed or refractory AML with at least 5% blasts by bone marrow biopsy or aspirate, or at least 1% blasts in peripheral blood. Relapsed or Refractory Myelodysplastic syndrome (MDS) after prior hypomethylating agents. Relapsed or Refractory Chronic myelomonocytic leukemia (CMML) with progressive disease or lack of response to hypomethylating agents A male subject must agree to use approved contraception (based on institutional guidelines) and refrain from sperm donation or expecting to father a child, from Screening through the treatment period and for at least 90 days after the last dose of study treatment. A female subject is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: Not a woman of childbearing potential (WOCBP); A WOCBP agrees to follow approved contraceptive guidance (based on institutional guidelines) from Screening through the treatment period and for at least 90 days after the last dose of study treatment. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2. Life expectancy greater than or equal to 12 weeks as judged by the Investigator. Have adequate organ function as defined in the protocol. Exclusion Criteria: Has a diagnosis of therapy-related AML, acute promyelocytic leukemia (M3, APL), accelerated phase or blast crisis of chronic myeloid leukemia. History or presence of clinically relevant CNS pathology such as epilepsy, childhood or adult seizure, paresis, aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis. Patients with active Central Nervous System (CNS) involvement (such as leukemic infiltration, blast in the spinal fluid, or subjects with extramedullary disease). A WOCBP who has a positive pregnancy test (within 72 hours) prior to treatment. History or evidence of any other clinically significant disorder, condition or disease (e.g., symptomatic congestive heart failure, unstable angina pectoris, symptomatic myocardial infection, uncontrolled cardiac arrhythmia, pericardial disease or heart failure New York Heart Association Class III or IV), or severe debilitating pulmonary disease, that would potentially increase patients' risk for toxicity and in the opinion of the Investigator, would pose a risk to patient safety or interfere with the study evaluation, procedures or completion. Chronic respiratory disease or any other medical condition that requires continuous oxygen that in the opinion of the Investigator, would adversely affect his/her participation in this study. Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks or 5 half-lives (whichever is longer) prior to the first dose of study treatment. Has not recovered to ≤ Grade 1 from toxic effects of prior therapy (including prior chemotherapy, immunotherapy and radiation therapy) and/or complications from interventions before starting therapy. Has previously had an allogeneic solid organ transplant. Autologous HSCT within 6 weeks before the start of study treatment. Allogeneic HSCT within 6 months before the start of study treatment. Any active acute or chronic graft-versus-host disease (GvHD), grade 2-4, or active chronic GvHD requiring systemic treatment. Any systemic therapy (e.g. calcineurin inhibitors (CNI), steroids, etc.) against GvHD within 4 weeks before the start of study treatment. Any Grade ≥ 2 persistent non-hematological toxicity related to allogeneic transplant, such as those requiring systemic immunosuppressive therapy. Previous CAR-T therapy. Known concurrent malignancy that is progressing or requires active treatment, or history of other malignancy within 2 years of study entry after treatment with curative intent. Has severe hypersensitivity (≥ Grade 3), known allergy or reaction to Immunoglobulins or NC525, and/or any of their excipients. Uncontrolled systemic fungal, bacterial, viral, or other infection despite appropriate anti-infection treatment at the time of eligibility confirmation. Has a known history of HIV infection. Has a known active chronic hepatitis B infection or chronic hepatitis C infection with the exception of those with an undetectable viral load within 3 months. (Hepatitis B or C testing is not required). Has a history or current evidence of any condition, therapy, or laboratory abnormality, or other circumstance that might confound the results of the study or interfere with the subject's participation for the full duration of the study, such that it is not in the best interest of the subject to participate, in the opinion of the treating investigator. Has a known psychiatric or substance abuse disorder that would interfere with the subject's ability to cooperate with the requirements of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Associate Director Clinical Operations at NextCure, Inc.
Phone
502-320-2240
Email
NCCLin@nextcure.com
First Name & Middle Initial & Last Name or Official Title & Degree
Director of Clinical Research
Phone
(240) 399-4900
Email
NelsonM@NextCure.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Han Myint, MD
Organizational Affiliation
NextCure, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Samantha Humpal
Phone
626-218-9401
Email
shumpal@coh.org
First Name & Middle Initial & Last Name & Degree
Anthony Stein, MD
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Julie Supanekar
Phone
617-724-5253
Email
jsupanekar@mgh.harvard.edu
First Name & Middle Initial & Last Name & Degree
Amir Fathi, MD
Facility Name
Roswell Park Cancer Institute
City
Buffalo
State/Province
New York
ZIP/Postal Code
14263
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Layla Ortiz
Phone
716-845-7559
Email
Layla.Ortiz@RoswellPark.org
First Name & Middle Initial & Last Name & Degree
Elizabeth Griffiths, MD
Facility Name
University Hospitals Cleveland Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sarah Gollwitzer
Email
sarah.gollwitzer@uhhospitals.org
First Name & Middle Initial & Last Name & Degree
Benjamin Tomlinson, MD
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lara Fournier
Email
trials@ohsu.edu
First Name & Middle Initial & Last Name & Degree
Ronan Swords, MD
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Danielle Nguyen
Phone
713-792-4133
Email
dtnguyen7@mdanderson.org
First Name & Middle Initial & Last Name & Degree
Nicholas Short, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Safety, Tolerability and Efficacy Study of NC525 in Subjects With Advanced Myeloid Neoplasms

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