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A Phase I Open-Label Dose Escalation Study of Intravenous INKmune In Patients With MDS or AML (LAUREL)

Primary Purpose

Cancer, MDS-EB, Myelodysplastic Syndromes

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
INKmune
Sponsored by
Inmune Bio, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cancer focused on measuring MDS, AML, NK Cell Based Therapy, Immune Based Therapy

Eligibility Criteria

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

Inclusion Criteria: Subject is ≥ 18 years old. Subjects with: MDS-EB-1/2, MDS-CMML 1-2 who have completed treatment with Azacytidine (AZA), and not achieved complete remission (CR) who are not thought to be fit for intensive chemotherapy. Subjects with AML in complete remission (or complete remission with incomplete count recovery) unsuitable for intensive chemotherapy or allogeneic stem cell transplantation. Subjects with relapsed MDS or AML post-allogeneic stem cell transplant, with slowly progressive disease unsuitable for intensive chemotherapy. Subject has adequate organ and marrow function (as defined below): Serum creatinine ≤ 1.5 X ULN, or measured creatinine clearance ≥ 60 ml/min/1.73m2. Aspartate aminotransferase (AST) and ALT levels ≤ 3 X ULN. Total bilirubin < 1.5 X ULN, unless known diagnosis of Gilbert's syndrome. Absolute neutrophil (ANC) ≥ 500/mm3; 0.5 x 109/L Platelet count ≥ 50,000/mm3; 50 x 109/L Haemoglobin ≥ 100mg/L (transfusion to obtain haemoglobin ≥ 100mg/L within 24 hours prior to dosing is allowed). Subject must be at least 21 days from previous anticancer therapy (eg, chemotherapy, radiation therapy, immunotherapy and monoclonal antibodies, or investigational therapeutic agents) at the time of study screening and meet criteria in "3" above. Subject must have an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. a. Sexually active female subjects of childbearing potential must agree to use a highly effective method of contraception for the duration of study therapy and for 3 months after the last dose of INKmune. Acceptable forms of contraception methods are as follows: Non-hormonal methods (i.e. intrauterine device, IUD) have vasectomised partner (the vasectomised partner must be the sole partner of the trial participant and have received medical assessment of its surgical success) True sexual abstinence Women of childbearing potential must discontinue any hormonal forms of birth control at least 4 weeks prior to first study dosing and commence using a highly effective, non- hormonal method as described above. Any pregnancy that occurs for study participants should be monitored for potential side effects. b. Male subjects with partners who are of childbearing potential must agree a double barrier method of contraception i.e. condom with either cap or diaphragm for the duration of study therapy and for 3 months after the last dose of INKmune. Male subjects with partners who are pregnant must use a condom for the same duration to avoid INKmune exposure to developing foetus. Note: Subjects who are abstinent (defined as refraining from heterosexual intercourse during the entire period of risk associated with study treatments), must agree to remain abstinent for the study duration and for 3 months after the last study dose of INKmune. The reliability of sexual abstinence will be evaluated in relation to the preferred and usual lifestyle of the subject. Subject, must be able to understand and voluntarily sign a written informed consent, and are willing and able to comply with the protocol requirements. Subject must have a life expectancy greater than 3 months in the opinion of the PI. Exclusion Criteria: Subject diagnosed with any other sub-classification of MDS. Subject is currently receiving cancer-specific treatment with the exceptions of supportive treatments such as bisphosphonate or steroid treatments for symptomatic control. Subject has had prior NK cell targeting therapy. Subject has a current requirement for steroids > 10 mg daily; prednisolone or equivalent. Subject has impaired cardiac function or clinically significant cardiac disease including the following: New York Heart Association grade III or IV congestive heart failure. Myocardial infarction within the last 6 months prior to dosing with INKmune Impaired left ventricular ejection fraction (LVEF < 40%) as assessed according to institutional standards. Subject has shown lack of recovery of prior AEs to Grade ≤1 severity (NCI CTCAE v5.0) (except alopecia) due to therapy administered prior to the initiation of study drug dosing. Stable persistent grade 2 peripheral neuropathy may be allowed as determined on a case-by-case basis at the discretion of the PI and Medical Monitor. Subject has known allergy to any of the formulation components of INKmune. Subjects has active, severe infection requiring systemic treatment. Subjects may become eligible once infection has resolved and they are at least seven days from completion of antibiotics. Subject concomitant use of complementary or alternative medication or other agents (investigational therapeutic agents) will not be allowed without approval of a PI or sub- investigator (SI). Every effort will be made to maximize subject safety and minimize changes in chronic medications. Subject is pregnant or is currently breastfeeding. Subject has uncontrolled seizures as determined by the PI. Subject has any other condition or finding that in the opinion of the PI or Sponsor Medical Monitor may render the subject at excessive risk for treatment complications or may not be able provide evaluable outcome information.

Sites / Locations

  • Attikon University General HospitalRecruiting
  • University Hospital Southampton NHS Foundation TrustRecruiting
  • Sheffield Teaching Hospitals NHS FT - Royal Hallamshire HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Schedule of Assessments

Arm Description

INKmune therapy will be administered by a slow intravenous injection via conventional blood giving set. Patients will receive 3 weekly IV doses of INKmune on Day 1, 8, and 15. In Cohort 1, the initial planned dose is 1 x 10^8 INKmune; In Cohort 2, the weekly dose will increase to 3 x 10^8 INKmune; In Cohort 3, the weekly dose will increase to 5 x 10^8 INKmune.

Outcomes

Primary Outcome Measures

Primary Objective 1
Identify the incidence and seriousness of AEs and their relationship (causality) to INKmune as graded by NCI CTCAE criteria v.5.0.
Primary Objective 2
Identify a RP2D of INKmune. The RP2D is defined as the maximum tolerated dose (MTD) of the agent which will be defined as the dose at which the complication rate is less than 33%.

Secondary Outcome Measures

Secondary Objective 1
To assess the overall response rate by measuring changes in percentage blasts in PB at days 29, 43, 73, 119 and BM at day 29.
Secondary Objective 2
To assess the overall response rate, partial response rate or complete response rate in subjects administered INKmune using the WHO criteria by measuring changes in vital signs, electrocardiogram (ECG), and safety laboratory parameters throughout the study.
Secondary Objective 3
To assess the progression-free survival (PFS) time defined as time to increase in transfusion dependence and or increase in percentage blasts in Peripheral Blood (PB) and/or Bone Marrow (BM).

Full Information

First Posted
June 2, 2023
Last Updated
July 3, 2023
Sponsor
Inmune Bio, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05933070
Brief Title
A Phase I Open-Label Dose Escalation Study of Intravenous INKmune In Patients With MDS or AML
Acronym
LAUREL
Official Title
A Phase I Open-Label Dose Escalation Study Of Intravenous INKmune In Patients With Myelodysplastic Syndrome With Excess Blasts (MDS-EB-1/2 - MDS-CMML 1/2) Or Acute Myeloid Leukaemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 15, 2020 (Actual)
Primary Completion Date
July 14, 2024 (Anticipated)
Study Completion Date
January 8, 2025 (Anticipated)

3. Sponsor/Collaborators

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

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
INMB-INB16-002 is a Phase I open-label, dose escalation study of INKmune therapy in subjects with myelodysplastic syndrome (MDS) with excess blasts without Auer rods (EB-1 or 2, or CMML 1 or 2) or subjects with acute myeloid leukaemia (AML) in complete remission.
Detailed Description
INMB-INB16-002 is a Phase 1 open-label, dose escalation study of INKmune therapy in subjects with MDS with excess blasts without Auer rods (EB-1 or 2, or CMML 1 or 2) who have completed treatment with Azacytidine (AZA) and not achieved complete remission (CR) and who are not thought to be fit for intensive chemotherapy, or subjects with AML in complete remission (or complete remission with incomplete count recovery) unsuitable for intensive chemotherapy or allogeneic stem cell transplantation or subjects with relapsed MDS or AML post-allogeneic stem cell transplant with slowly progressive disease unsuitable for intensive chemotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer, MDS-EB, Myelodysplastic Syndromes, Acute Myeloid Leukemia, AML
Keywords
MDS, AML, NK Cell Based Therapy, Immune Based Therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Participants will receive 3 weekly IV doses of INKmune on Day 1, 8, and 15 in addition to supportive care. Three cohorts, comprised of at least 3 participants, are planned. Each participant will be screened up to 28 days prior to treatment. After participants have received all doses, they will be reviewed at Day 29 and Day 43 and then followed up with monthly clinic appointments for the following 3 months (Days 73 and 119) for clinical assessment and blood tests. Once Day 119 visit is completed this classifies end of study for the participant. The trial will end after data collection has been completed for each trial participant.
Masking
None (Open Label)
Masking Description
Open-Label
Allocation
N/A
Enrollment
9 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Schedule of Assessments
Arm Type
Experimental
Arm Description
INKmune therapy will be administered by a slow intravenous injection via conventional blood giving set. Patients will receive 3 weekly IV doses of INKmune on Day 1, 8, and 15. In Cohort 1, the initial planned dose is 1 x 10^8 INKmune; In Cohort 2, the weekly dose will increase to 3 x 10^8 INKmune; In Cohort 3, the weekly dose will increase to 5 x 10^8 INKmune.
Intervention Type
Biological
Intervention Name(s)
INKmune
Intervention Description
INKmune is a patented biologic delivery system and method for cancer treatment using in vivo priming and activation of natural killer (NK) cells in order to achieve tumor cell lysis. INKmune is a suspension of INB16 cells which have been rendered replication incompetent. INKumne is a replication-incompetent tumor cell line that does not require donor matching.
Primary Outcome Measure Information:
Title
Primary Objective 1
Description
Identify the incidence and seriousness of AEs and their relationship (causality) to INKmune as graded by NCI CTCAE criteria v.5.0.
Time Frame
2-3 years
Title
Primary Objective 2
Description
Identify a RP2D of INKmune. The RP2D is defined as the maximum tolerated dose (MTD) of the agent which will be defined as the dose at which the complication rate is less than 33%.
Time Frame
2-3 years
Secondary Outcome Measure Information:
Title
Secondary Objective 1
Description
To assess the overall response rate by measuring changes in percentage blasts in PB at days 29, 43, 73, 119 and BM at day 29.
Time Frame
1-2 years
Title
Secondary Objective 2
Description
To assess the overall response rate, partial response rate or complete response rate in subjects administered INKmune using the WHO criteria by measuring changes in vital signs, electrocardiogram (ECG), and safety laboratory parameters throughout the study.
Time Frame
3-4 years
Title
Secondary Objective 3
Description
To assess the progression-free survival (PFS) time defined as time to increase in transfusion dependence and or increase in percentage blasts in Peripheral Blood (PB) and/or Bone Marrow (BM).
Time Frame
2-3 years
Other Pre-specified Outcome Measures:
Title
Exploratory Objective 1
Description
Assess the pharmacodynamics (PD) (proof of biology) of INKmune by analyzing NK cells obtained from peripheral blood, and bone marrow as available and to measure primed NK cells and cell kill ability using the tumour killing assay.
Time Frame
2-3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is ≥ 18 years old. Subjects with: MDS-EB-1/2, MDS-CMML 1-2 who have completed treatment with Azacytidine (AZA), and not achieved complete remission (CR) who are not thought to be fit for intensive chemotherapy. Subjects with AML in complete remission (or complete remission with incomplete count recovery) unsuitable for intensive chemotherapy or allogeneic stem cell transplantation. Subjects with relapsed MDS or AML post-allogeneic stem cell transplant, with slowly progressive disease unsuitable for intensive chemotherapy. Subject has adequate organ and marrow function (as defined below): Serum creatinine ≤ 1.5 X ULN, or measured creatinine clearance ≥ 60 ml/min/1.73m2. Aspartate aminotransferase (AST) and ALT levels ≤ 3 X ULN. Total bilirubin < 1.5 X ULN, unless known diagnosis of Gilbert's syndrome. Absolute neutrophil (ANC) ≥ 500/mm3; 0.5 x 109/L Platelet count ≥ 50,000/mm3; 50 x 109/L Haemoglobin ≥ 100mg/L (transfusion to obtain haemoglobin ≥ 100mg/L within 24 hours prior to dosing is allowed). Subject must be at least 21 days from previous anticancer therapy (eg, chemotherapy, radiation therapy, immunotherapy and monoclonal antibodies, or investigational therapeutic agents) at the time of study screening and meet criteria in "3" above. Subject must have an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. a. Sexually active female subjects of childbearing potential must agree to use a highly effective method of contraception for the duration of study therapy and for 3 months after the last dose of INKmune. Acceptable forms of contraception methods are as follows: Non-hormonal methods (i.e. intrauterine device, IUD) have vasectomised partner (the vasectomised partner must be the sole partner of the trial participant and have received medical assessment of its surgical success) True sexual abstinence Women of childbearing potential must discontinue any hormonal forms of birth control at least 4 weeks prior to first study dosing and commence using a highly effective, non- hormonal method as described above. Any pregnancy that occurs for study participants should be monitored for potential side effects. b. Male subjects with partners who are of childbearing potential must agree a double barrier method of contraception i.e. condom with either cap or diaphragm for the duration of study therapy and for 3 months after the last dose of INKmune. Male subjects with partners who are pregnant must use a condom for the same duration to avoid INKmune exposure to developing foetus. Note: Subjects who are abstinent (defined as refraining from heterosexual intercourse during the entire period of risk associated with study treatments), must agree to remain abstinent for the study duration and for 3 months after the last study dose of INKmune. The reliability of sexual abstinence will be evaluated in relation to the preferred and usual lifestyle of the subject. Subject, must be able to understand and voluntarily sign a written informed consent, and are willing and able to comply with the protocol requirements. Subject must have a life expectancy greater than 3 months in the opinion of the PI. Exclusion Criteria: Subject diagnosed with any other sub-classification of MDS. Subject is currently receiving cancer-specific treatment with the exceptions of supportive treatments such as bisphosphonate or steroid treatments for symptomatic control. Subject has had prior NK cell targeting therapy. Subject has a current requirement for steroids > 10 mg daily; prednisolone or equivalent. Subject has impaired cardiac function or clinically significant cardiac disease including the following: New York Heart Association grade III or IV congestive heart failure. Myocardial infarction within the last 6 months prior to dosing with INKmune Impaired left ventricular ejection fraction (LVEF < 40%) as assessed according to institutional standards. Subject has shown lack of recovery of prior AEs to Grade ≤1 severity (NCI CTCAE v5.0) (except alopecia) due to therapy administered prior to the initiation of study drug dosing. Stable persistent grade 2 peripheral neuropathy may be allowed as determined on a case-by-case basis at the discretion of the PI and Medical Monitor. Subject has known allergy to any of the formulation components of INKmune. Subjects has active, severe infection requiring systemic treatment. Subjects may become eligible once infection has resolved and they are at least seven days from completion of antibiotics. Subject concomitant use of complementary or alternative medication or other agents (investigational therapeutic agents) will not be allowed without approval of a PI or sub- investigator (SI). Every effort will be made to maximize subject safety and minimize changes in chronic medications. Subject is pregnant or is currently breastfeeding. Subject has uncontrolled seizures as determined by the PI. Subject has any other condition or finding that in the opinion of the PI or Sponsor Medical Monitor may render the subject at excessive risk for treatment complications or may not be able provide evaluable outcome information.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nicole Kay-Mindick
Phone
386-852-2361
Email
nmindick@inmunebio.com
First Name & Middle Initial & Last Name or Official Title & Degree
INmune Bio
Email
trials@inmunebio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nicole Kay-Mindick
Organizational Affiliation
INmune Bio
Official's Role
Study Director
Facility Information:
Facility Name
Attikon University General Hospital
City
Athens
State/Province
Attiki
ZIP/Postal Code
124 62
Country
Greece
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Panagiotis Tsirigotis
Phone
302105832317
Email
panagtsirigotis@gmail.com
Facility Name
University Hospital Southampton NHS Foundation Trust
City
Southampton
State/Province
Hampshire
ZIP/Postal Code
S016 6YD
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Charmaine Gilbert
Phone
023 8077 7222
Email
LymphomaResearchNurses@soton.ac.uk
First Name & Middle Initial & Last Name & Degree
Amy Johnson
Phone
023 8077 7222
Email
LymphomaResearchNurses@soton.ac.uk
Facility Name
Sheffield Teaching Hospitals NHS FT - Royal Hallamshire Hospital
City
Sheffield
ZIP/Postal Code
S10 2RX
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rachael Selby
Phone
0114 271 1900
Email
r.selby@nhs.net

12. IPD Sharing Statement

Plan to Share IPD
No
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Learn more about this trial

A Phase I Open-Label Dose Escalation Study of Intravenous INKmune In Patients With MDS or AML

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