Safety and Tolerability of Ziftomenib Combinations in Patients With Relapsed/Refractory Acute Myeloid Leukemia
AML, AML With Mutated NPM1, Hematologic Malignancy
About this trial
This is an interventional treatment trial for AML
Eligibility Criteria
Key Inclusion Criteria: Has been diagnosed with relapsed/refractory AML. Has a documented NPM1 mutation or KMT2A rearrangement. Has a documented FLT3 mutation (cohort A-3 only). Has an Eastern Cooperative Oncology Group (ECOG) Performance status ≤ 2. Has adequate hepatic and renal function as defined per protocol. Has an ejection fraction above a protocol defined limit. Participant, or legally authorized representative, must be able to understand and provide written informed consent prior to the first screening procedure. Has agreed to use contraception as defined per protocol. Key Exclusion Criteria: Has a diagnosis of acute promyelocytic leukemia or blast chronic myeloid leukemia. Has clinically active central nervous system leukemia. Has an active and uncontrolled infection. Has a mean corrected QT interval (QTcF) > 480ms. Has uncontrolled intercurrent illness, including, but not limited to protocol defined cardiac disease. Has received radiation, chemotherapy, immunotherapy, or any other anticancer therapy including investigational therapy <14 days or within 5 drug half-lives prior to the first dose of study intervention. Has had major surgery within 4 weeks prior to the first dose of study intervention. Has received a hematopoietic stem cell transplant (HSCT) and has not previously had adequate recovery per protocol defined criteria. Has active graft-versus-host disease (GvHD) and or on immunosuppressive drugs for the treatment of GvHD. Participant is pregnant or lactating.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Phase 1a
Phase 1b
Oral ziftomenib; sequential cohorts of escalating dose levels of ziftomenib to identify the safety and tolerability of the combination regimens. Participants will be enrolled in 1 of 5 dose escalation cohorts: A-1: Participants with a NPM1 mutation: ziftomenib plus FLAG-IDA A-2: Participants with a NPM1 mutation: ziftomenib plus low-dose cytarabine (LDAC) A-3: Participants with a NPM1 mutation: ziftomenib plus gilteritinib B-1: Participants with a KMT2A rearrangement: ziftomenib plus FLAG-IDA B-2: Participants with a KMT2A rearrangement: ziftomenib plus low-dose cytarabine (LDAC)
Oral ziftomenib; Following the determination of the maximum tolerated dose in Phase 1a, participants will be enrolled in 1 of 5 dose validation/expansion cohorts: A-1: Participants with a NPM1 mutation: ziftomenib plus FLAG-IDA A-2: Participants with a NPM1 mutation: ziftomenib plus low-dose cytarabine (LDAC) A-3: Participants with a NPM1 mutation: ziftomenib plus gilteritinib B-1: Participants with a KMT2A rearrangement: ziftomenib plus FLAG-IDA B-2: Participants with a KMT2A rearrangement: ziftomenib plus low-dose cytarabine (LDAC)