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A Clinical Trial of BP1002 in Patients With Advanced Lymphoid Malignancies

Primary Purpose

Mantle Cell Lymphoma, Peripheral T-cell Lymphoma (PTCL), Cutaneous T-cell Lymphoma (CTCL)

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
L-Bcl-2 antisense oligonucleotide
Sponsored by
Bio-Path Holdings, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mantle Cell Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Adults ≥18 years of age
  2. Patient has a life expectancy ≥ 3 month
  3. Patient has relapsed or refractory disease Relapsed lymphoma: Relapsed lymphoma is disease that has responded to treatment but then returns.

    Refractory lymphoma: Failure to achieve complete response at the end of therapy or progression within 6 months from completion of therapy

  4. Included Diseases

    • DLBCL, including transformed lymphoma
    • Mantle Cell Lymphoma
    • PTCL
    • CTCL
    • CLL/SLL
    • Follicular lymphoma
    • Marginal zone lymphoma
    • Hodgkin lymphoma (both classical and lymphocyte predominant)
    • Waldenströms Macroglobulinemia
  5. Must has failed or is not a candidate for available therapies with reasonable likelihood of clinical benefit, which includes FDA approved products and standard of care regimens
  6. Therapy means at least three front lines of therapy including Hematopoeitic Stem Cell Transplant (HSCT and/or Chimeric Antigen Receptor (CAR) T cells, when applicable
  7. Females must be of non-childbearing potential, surgically sterile, postmenopausal, or practice adequate methods of contraception during the study
  8. Males must agree to use an adequate method of contraception during the study
  9. Eastern Cooperative Oncology Group (ECOG) Performance score of 0, 1, or 2
  10. Adequate hepatic and renal functions as defined by:

    • Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 times the upper limit of normal (ULN); and
    • Total bilirubin ≤1.5 times ULN; and
    • Estimated glomerular filtration rate (eGFR) of at least 50ml/min. These estimations can be calculated using the following methods:

      • Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) equation
      • Cockcroft Gault equation
      • Modification of Diet in Renal Disease (MDRD study equation)
      • Creatinine clearance estimated by 24-hr urine collection for creatinine clearance
  11. Recovered from the effects of any prior surgery, radiotherapy, or antineoplastic treatment (with the exception of alopecia), based on Investigator assessment
  12. Willing and able to provide written informed consent

Exclusion Criteria:

  1. Active non-hematologic malignancy other than lymphoid malignancies treated with immuno- or chemotherapy within the previous 12 months except active non-melanoma, non-invasive skin cancer will be allowed
  2. Known, active Central Nervous System (CNS) involvement of disease requiring intrathecal therapy. Note: Patients with a history of CNS disease may be allowed to participate based on at least 1 documented, negative spinal fluid assessment within 28 days prior to Screening
  3. Patient eligible for high dose chemotherapy and autologous stem cell transplant
  4. Indolent non-Hodgkin lymphoma (iNHL)
  5. Patients at high risk of Tumor Lysis Syndrome (TLS)

    a. Bulky disease i. A unidimensional lesion greater than 10 cm and/or b. Lymphocyte count greater than 25,000 per µL

  6. Receipt of any anti-cancer therapy within 14 days prior to Cycle 1 Day 1 (C1D1)
  7. Uncontrolled active, untreated, or progressive infection
  8. Receipt of any investigational agent or on study treatment within 30 days prior to C1D1
  9. Females who are pregnant, test positive for pregnancy, or are breast-feeding during the Screening period, or intend to become pregnant or breast-feed during the course of the study or within 30 days after last dose of study drug
  10. Serious intercurrent medical or psychiatric illness which, in the opinion of the Investigator, would interfere with the ability of the participant to complete the study
  11. Active hepatitis B infection (based on positive surface antigen [HBsAg]), hepatitis C infection (based on Hepatitis C Virus (HCV) positive antibody [HCV Ab]), or human immunodeficiency virus (HIV-1 or HIV-2, based on positive antibody)
  12. Presence of concurrent conditions that, in the opinion of the Investigator and/or Medical Monitor, may compromise or interfere with any aspect of study conduct or interpretation of results. This includes, but is not limited to, unstable or uncontrolled angina, New York Heart Association (NYHA) class III or IV congestive heart failure, uncontrolled and sustained hypertension, clinically significant cardiac dysrhythmia or clinically significant baseline EKG abnormality (e.g., QTcF >470 msec)
  13. Within the past 6 months, has had any of the following: myocardial infarction, unstable angina pectoris, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack
  14. Uncontrolled seizure disorder
  15. Unable or unwilling to communicate or cooperate with the Investigator or follow the protocol for any reason.

Sites / Locations

  • Georgia Cancer CenterRecruiting
  • Sarah Cannon Research Institute/Tennesee Oncology
  • University of Texas Southwestern Medical CenterRecruiting
  • MD Anderson Cancer Research Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

BP1002 monotherapy

Arm Description

L-Bcl-2 Antisense oligonucleotide (BP1002) is given in a sequential, dose escalation design. Starting dose is 20mg/m^2.

Outcomes

Primary Outcome Measures

Identify Dose Limiting Toxicity (DLT) of BP1002
Identify DLT of BP1002 using non-hematologic and hematologic measures per NCI CTCAE criteria
Identify and grade treatment-emergent adverse events (TEAE) of escalating doses of BP1002
Identify TEAE of BP1002 using non-hematologic and hematologic measures per NCI CTCAE criteria
Identify and grade treatment-emergent laboratory abnormalities of escalating doses of BP1002 by identification and grading of
Identify and grade treatment-emergent laboratory abnormalities of BP1002 using non-hematologic and hematologic measures per NCI CTCAE criteria
Identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in EKG intervals) of escalating doses of BP1002
Collection of 12-lead EKGs at defined intervals to identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in EKG intervals)
Recommended Phase 2 dose (RP2D) of BP1002
Determine RP2D by evaluating Maximally Tolerated Dose (MTD) data: Any Dose Limiting Toxicity (DLT) observed will trigger an expansion of a cohort from 3 to 6 patients. A second DLT at any dose level will identify the Maximum Dose. The dose below that will be the MTD.
Determine plasma pharmacokinetics (PK) of BP1002 using maximum plasma drug concentration
Evaluate in vivo PK of BP1002 using maximum plasma drug concentration (Cmax)
Determine plasma pharmacokinetics (PK) of BP1002 using volume of distribution
Evaluate in vivo PK of BP1002 volume of distribution (Vd)
Determine plasma pharmacokinetics (PK) of BP1002 using elimination rate constant
Evaluate in vivo PK of BP1002 elimination rate constant
Determine half-life plasma pharmacokinetics (PK) of BP1002
Evaluate in vivo PK of BP1002 half-life (t1/2)
Determine pharmacokinetics (PK) of BP1002
12-lead EKG assessments will be collected and analyzed for conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in EKG intervals) from those the EKG obtained immediately before the first BP1002 dose, and after BP1002 dose, and will mirror the time points used to collect the plasma PK assessments

Secondary Outcome Measures

Determine evidence of tumor response by bone marrow aspirate
Assess tumor response by evaluating bone marrow aspirate to determine complete response (CR), partial response (PR), or minor response (MR) using appropriate uniform response criteria as published by Response Evaluation Criteria in Lymphoma (RECIL) 2017, CLL guidelines, and International Workshop on Waldenström's Macroglobulinemia (IWWM 6th)
Determine evidence of tumor response by Complete Blood Count (CBC)
Assess tumor response by evaluating CBC measurements to determine complete response (CR), partial response (PR), or minor response (MR) using appropriate uniform response criteria as published by Response Evaluation Criteria in Lymphoma (RECIL) 2017, CLL guidelines, and International Workshop on Waldenström's Macroglobulinemia (IWWM 6th)
Determine estimates for time to progression (TTP)
Measured from treatment start date to date of progression by CBC and/or bone marrow aspirate
Determine estimates for progression-free survival (PFS)
Measured from treatment start date to date of progression or death by CBC and/or bone marrow aspirate
Determine estimates for event-free survival (EFS)
Measured from treatment start date to date of progression, death, or change in therapy by CBC and/or bone marrow aspirate
Activity of BP1002 on Bcl-2 expression in tumor samples
Flow cytometric assays to determine the effects of BP1002 on Bcl-2 protein expression using patient blood samples

Full Information

First Posted
August 23, 2019
Last Updated
October 11, 2023
Sponsor
Bio-Path Holdings, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04072458
Brief Title
A Clinical Trial of BP1002 in Patients With Advanced Lymphoid Malignancies
Official Title
A Phase 1 Clinical Trial to Study the Safety, Pharmacokinetics, and Efficacy of BP1002 (L-Bcl-2) Antisense Oligonucleotide in Patients With Advanced Lymphoid Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 5, 2020 (Actual)
Primary Completion Date
September 2024 (Anticipated)
Study Completion Date
January 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bio-Path Holdings, Inc.

4. Oversight

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

5. Study Description

Brief Summary
This study evaluates the safety, pharmacokinetics, and efficacy of BP1002 (L-Bcl-2) antisense oligonucleotide in patients with advanced lymphoid malignancies. Up to 12 evaluable patients with a diagnosis of relapsed or refractory lymphoid malignancies are expected to participate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mantle Cell Lymphoma, Peripheral T-cell Lymphoma (PTCL), Cutaneous T-cell Lymphoma (CTCL), Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL), Follicular Lymphoma, Marginal Zone Lymphoma, Hodgkin Lymphoma, Waldenstrom Macroglobulinemia, DLBCL

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
BP1002 monotherapy
Arm Type
Experimental
Arm Description
L-Bcl-2 Antisense oligonucleotide (BP1002) is given in a sequential, dose escalation design. Starting dose is 20mg/m^2.
Intervention Type
Drug
Intervention Name(s)
L-Bcl-2 antisense oligonucleotide
Other Intervention Name(s)
BP1002
Intervention Description
There will be 2 planned dose levels, 20, and 40 mg/m^2. Successive cohorts of eligible patients with will be treated with BP1002. BP1002 is given as an intravenous infusion, twice weekly, as 8 doses per 28-day cycle. Cycles may be repeated every 4 weeks.
Primary Outcome Measure Information:
Title
Identify Dose Limiting Toxicity (DLT) of BP1002
Description
Identify DLT of BP1002 using non-hematologic and hematologic measures per NCI CTCAE criteria
Time Frame
30 days
Title
Identify and grade treatment-emergent adverse events (TEAE) of escalating doses of BP1002
Description
Identify TEAE of BP1002 using non-hematologic and hematologic measures per NCI CTCAE criteria
Time Frame
30 days
Title
Identify and grade treatment-emergent laboratory abnormalities of escalating doses of BP1002 by identification and grading of
Description
Identify and grade treatment-emergent laboratory abnormalities of BP1002 using non-hematologic and hematologic measures per NCI CTCAE criteria
Time Frame
30 days
Title
Identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in EKG intervals) of escalating doses of BP1002
Description
Collection of 12-lead EKGs at defined intervals to identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in EKG intervals)
Time Frame
30 days
Title
Recommended Phase 2 dose (RP2D) of BP1002
Description
Determine RP2D by evaluating Maximally Tolerated Dose (MTD) data: Any Dose Limiting Toxicity (DLT) observed will trigger an expansion of a cohort from 3 to 6 patients. A second DLT at any dose level will identify the Maximum Dose. The dose below that will be the MTD.
Time Frame
210 days
Title
Determine plasma pharmacokinetics (PK) of BP1002 using maximum plasma drug concentration
Description
Evaluate in vivo PK of BP1002 using maximum plasma drug concentration (Cmax)
Time Frame
30 days
Title
Determine plasma pharmacokinetics (PK) of BP1002 using volume of distribution
Description
Evaluate in vivo PK of BP1002 volume of distribution (Vd)
Time Frame
30 days
Title
Determine plasma pharmacokinetics (PK) of BP1002 using elimination rate constant
Description
Evaluate in vivo PK of BP1002 elimination rate constant
Time Frame
30 days
Title
Determine half-life plasma pharmacokinetics (PK) of BP1002
Description
Evaluate in vivo PK of BP1002 half-life (t1/2)
Time Frame
30 days
Title
Determine pharmacokinetics (PK) of BP1002
Description
12-lead EKG assessments will be collected and analyzed for conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in EKG intervals) from those the EKG obtained immediately before the first BP1002 dose, and after BP1002 dose, and will mirror the time points used to collect the plasma PK assessments
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Determine evidence of tumor response by bone marrow aspirate
Description
Assess tumor response by evaluating bone marrow aspirate to determine complete response (CR), partial response (PR), or minor response (MR) using appropriate uniform response criteria as published by Response Evaluation Criteria in Lymphoma (RECIL) 2017, CLL guidelines, and International Workshop on Waldenström's Macroglobulinemia (IWWM 6th)
Time Frame
30 days
Title
Determine evidence of tumor response by Complete Blood Count (CBC)
Description
Assess tumor response by evaluating CBC measurements to determine complete response (CR), partial response (PR), or minor response (MR) using appropriate uniform response criteria as published by Response Evaluation Criteria in Lymphoma (RECIL) 2017, CLL guidelines, and International Workshop on Waldenström's Macroglobulinemia (IWWM 6th)
Time Frame
30 days
Title
Determine estimates for time to progression (TTP)
Description
Measured from treatment start date to date of progression by CBC and/or bone marrow aspirate
Time Frame
30 days
Title
Determine estimates for progression-free survival (PFS)
Description
Measured from treatment start date to date of progression or death by CBC and/or bone marrow aspirate
Time Frame
30 days
Title
Determine estimates for event-free survival (EFS)
Description
Measured from treatment start date to date of progression, death, or change in therapy by CBC and/or bone marrow aspirate
Time Frame
30 days
Title
Activity of BP1002 on Bcl-2 expression in tumor samples
Description
Flow cytometric assays to determine the effects of BP1002 on Bcl-2 protein expression using patient blood samples
Time Frame
30 days
Other Pre-specified Outcome Measures:
Title
Exploratory objective to correlate treatment response with cytogenetic characteristics
Description
Flow cytometric assays to determine the effects of BP1002 on Bcl-2 protein expression
Time Frame
30 days
Title
Exploratory objective to correlate treatment response with molecular characteristics
Description
Flow cytometric assays to determine the effects of BP1002 on Bcl-2 protein expression
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adults ≥18 years of age Patient has a life expectancy ≥ 3 month Patient has relapsed or refractory disease Relapsed lymphoma: Relapsed lymphoma is disease that has responded to treatment but then returns. Refractory lymphoma: Failure to achieve complete response at the end of therapy or progression within 6 months from completion of therapy Included Diseases DLBCL, including transformed lymphoma Mantle Cell Lymphoma PTCL CTCL CLL/SLL Follicular lymphoma Marginal zone lymphoma Hodgkin lymphoma (both classical and lymphocyte predominant) Waldenströms Macroglobulinemia Must has failed or is not a candidate for available therapies with reasonable likelihood of clinical benefit, which includes FDA approved products and standard of care regimens Therapy means at least three front lines of therapy including Hematopoeitic Stem Cell Transplant (HSCT and/or Chimeric Antigen Receptor (CAR) T cells, when applicable Females must be of non-childbearing potential, surgically sterile, postmenopausal, or practice adequate methods of contraception during the study Males must agree to use an adequate method of contraception during the study Eastern Cooperative Oncology Group (ECOG) Performance score of 0, 1, or 2 Adequate hepatic and renal functions as defined by: Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 times the upper limit of normal (ULN); and Total bilirubin ≤1.5 times ULN; and Estimated glomerular filtration rate (eGFR) of at least 50ml/min. These estimations can be calculated using the following methods: Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) equation Cockcroft Gault equation Modification of Diet in Renal Disease (MDRD study equation) Creatinine clearance estimated by 24-hr urine collection for creatinine clearance Recovered from the effects of any prior surgery, radiotherapy, or antineoplastic treatment (with the exception of alopecia), based on Investigator assessment Willing and able to provide written informed consent Exclusion Criteria: Active non-hematologic malignancy other than lymphoid malignancies treated with immuno- or chemotherapy within the previous 12 months except active non-melanoma, non-invasive skin cancer will be allowed Known, active Central Nervous System (CNS) involvement of disease requiring intrathecal therapy. Note: Patients with a history of CNS disease may be allowed to participate based on at least 1 documented, negative spinal fluid assessment within 28 days prior to Screening Patient eligible for high dose chemotherapy and autologous stem cell transplant Indolent non-Hodgkin lymphoma (iNHL) Patients at high risk of Tumor Lysis Syndrome (TLS) a. Bulky disease i. A unidimensional lesion greater than 10 cm and/or b. Lymphocyte count greater than 25,000 per µL Receipt of any anti-cancer therapy within 14 days prior to Cycle 1 Day 1 (C1D1) Uncontrolled active, untreated, or progressive infection Receipt of any investigational agent or on study treatment within 30 days prior to C1D1 Females who are pregnant, test positive for pregnancy, or are breast-feeding during the Screening period, or intend to become pregnant or breast-feed during the course of the study or within 30 days after last dose of study drug Serious intercurrent medical or psychiatric illness which, in the opinion of the Investigator, would interfere with the ability of the participant to complete the study Active hepatitis B infection (based on positive surface antigen [HBsAg]), hepatitis C infection (based on Hepatitis C Virus (HCV) positive antibody [HCV Ab]), or human immunodeficiency virus (HIV-1 or HIV-2, based on positive antibody) Presence of concurrent conditions that, in the opinion of the Investigator and/or Medical Monitor, may compromise or interfere with any aspect of study conduct or interpretation of results. This includes, but is not limited to, unstable or uncontrolled angina, New York Heart Association (NYHA) class III or IV congestive heart failure, uncontrolled and sustained hypertension, clinically significant cardiac dysrhythmia or clinically significant baseline EKG abnormality (e.g., QTcF >470 msec) Within the past 6 months, has had any of the following: myocardial infarction, unstable angina pectoris, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack Uncontrolled seizure disorder Unable or unwilling to communicate or cooperate with the Investigator or follow the protocol for any reason.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Michael Hickey
Phone
832-742-1361
Email
mhickey@biopathholdings.com
Facility Information:
Facility Name
Georgia Cancer Center
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30912
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Julie Stiefel
Phone
706-721-0734
Email
jstiefel@augusta.edu
First Name & Middle Initial & Last Name & Degree
Locke J Bryan, MD
Facility Name
Sarah Cannon Research Institute/Tennesee Oncology
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Individual Site Status
Terminated
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ryan Sabu
Phone
214-645-9883
Email
Ryan.Sabu@utsouthwestern.edu
First Name & Middle Initial & Last Name & Degree
Praveen Ramakrishnan, MD
Facility Name
MD Anderson Cancer Research Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Terminated

12. IPD Sharing Statement

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A Clinical Trial of BP1002 in Patients With Advanced Lymphoid Malignancies

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