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A Clinical Trial of BP1002 in Patients With Refractory/Relapsed Acute Myeloid Leukemia (AML)

Primary Purpose

Acute Myeloid Leukemia, in Relapse, Acute Myeloid Leukemia Refractory

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
BP1002; Liposomal Bcl-2 Antisense Oligodeoxynucleotide
Decitabine (in combination with BP1002)
Sponsored by
Bio-Path Holdings, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia, in Relapse

Eligibility Criteria

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

Inclusion Criteria:

  1. Adults ≥18 years of age, with histologic evidence of refractory/relapsed AML who have failed treatment with available therapies known to be active for refractory/relapsed AML
  2. Eastern Cooperative Oncology Group (ECOG) Performance Status Score of 0, 1 or 2
  3. For the dose expansion phase, participants with documented diagnosis of AML who are eligible for decitabine therapy
  4. Participants must have adequate hepatic and renal functions as defined by:

    1. Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 times the upper limit of normal (ULN); and
    2. Usually total bilirubin ≤ 1.5 ULN. In specific cases the PI may request a waiver of this requirement with medical justification and agreement with the medical monitor and Bio-Path Holdings. And;
    3. Estimated creatinine clearance of at least 60 mL/min. These estimations are calculated using the Cockcroft-Gault equation.
  5. Female participants of childbearing potential must agree to use an acceptable method of birth control (i.e. a hormonal contraceptive, intrauterine device, diaphragm with spermicide, condom with spermicide or abstinence) for the duration of the study and for at least 6 months after the last dose of study drug or decitabine
  6. Male participants must agree to use an acceptable method of contraception for the duration of the study
  7. Recovered from the effects of any prior surgery, radiotherapy, or antineoplastic treatment (with the exception of alopecia), based on Investigator assessment
  8. Participants must be willing and able to provide written informed consent

Exclusion Criteria:

  1. Active non-hematologic or lymphoid malignancy other than AML treated with immunotherapy, targeted therapy or chemotherapy within the previous 12 months
  2. Known, active leptomeningeal leukemia requiring intrathecal therapy. NOTE: Participants 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. Isolated potentially treatable extramedullary leukemia without also meeting bone marrow criteria for acute leukemia (for AML usually ≥ 5% blasts in BMA or biopsy). Participants may have leukemia with lower blast counts (Döhner 2017). Bio-Path Holdings and Investigator concurrence required.
  4. Acute promyelocytic leukemia (APL) with t(15;17)(q22;q12) PML-RARA
  5. Chronic myeloid leukemia in any phase
  6. Receipt of any anti-cancer therapy within 14 days prior to C1D1, with the exception of hydroxyurea or leukapheresis
  7. Participants may not be receiving any other investigational agents
  8. Female participants who are pregnant or breast-feeding
  9. Substance abuse, medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results
  10. Participants with human immunodeficiency virus (HIV) infection who have CD4+ T-cell counts < 350 cells/mcL or with clinically active hepatitis B or C infection
  11. History of any hypersensitivity to hypomethylating agents, unless reaction is deemed irrelevant to the study by the Investigator and Medical Monitor
  12. Unresolved toxicity higher than CTCAE Grade 1 attributed to any prior therapy or procedure, excluding alopecia
  13. Presence of concurrent conditions that, in the opinion of the Investigator and/or Medical Monitor, may compromise the participant's ability to tolerate study treatment 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 ECG abnormality (e.g., QTcF >470 msec)
  14. 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
  15. Uncontrolled seizure disorder (i.e., seizures within the past 2 months)
  16. Unable or unwilling to communicate or cooperate with the Investigator or follow the protocol for any reason

Sites / Locations

  • Scripps Green HospitalRecruiting
  • UCLA Medical CenterRecruiting
  • Weill Cornell Medical College - NewYork-Presbyterian HospitalRecruiting
  • MD Anderson Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Relapsed/Refractory AML - BP1002 monotherapy

Relapsed/Refractory AML - BP1002 in combination with decitabine

Arm Description

BP1002 monotherapy dose escalation

BP1002 single dose in combination with decitabine

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
Identify and grade treatment-emergent laboratory abnormalities of escalating doses of BP1002 using non-hematologic and hematologic measure per NCI CTCAE criteria
Recommended Phase 2 (RP2D) of BP1002
Determine RP2D by evaluating Maximally Tolerated Dose (MTD) data
Determine plasma pharmacokinetics (PK) of BP1002 using maximum plasma drug concentration
Evaluate plasma 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 using volume of distribution (Vd)
Determine plasma pharmacokinetics (PK) of BP1002 using elimination rate constant
Evaluate in vivo PK of BP1002 using elimination rate constant
Determine half-life plasma pharmacokinetics (PK) of BP1002
Evaluate in vivo PK of BP1002 half-life (t1/2)
Identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in ECG intervals) of escalating doses of BP1002
Collection of 12-lead ECGs at defined intervals to identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in ECG intervals)
Determine pharmacodynamics (PD) of BP1002
Flow cytometry will be performed using peripheral blood to evaluate Bcl-2 target inhibition by BP1002 on pre and post treatment samples
Determine anti-drug antibody (ADA) levels of BP1002
Evaluate ADA via peripheral blood

Secondary Outcome Measures

Determine evidence of response by bone marrow aspirate
Assess complete remission (CR), CR with incomplete hematologic recovery (CRi), and CR with partial hematologic recovery (CRh) per Döhner 2017
Determine evidence of response by complete blood counts using peripheral blood
Assess complete remission (CR), CR with incomplete hematologic recovery (CRi), and CR with partial hematologic recovery (CRh) per Döhner 2017
Assessment of morphologic leukemia free state (MLFS) and partial remissions by bone marrow aspirate and complete blood counts
To assess percentage of participants with MLFS and partial remissions per Döhner 2017
Assessment of morphologic leukemia free state (MLFS) and partial remissions by bone marrow aspirate
To assess percentage of participants with MLFS and partial remissions per Döhner 2017
Assessment of blast count reductions by complete blood counts using peripheral blood
To assess blast count reductions per Williams 2016
To determine progression-free survival (PFS), overall survival (OS), and duration of response
To assess progression-free survival (PFS), overall survival (OS), and duration of response from date of study entry to study closure or death

Full Information

First Posted
December 8, 2021
Last Updated
August 18, 2023
Sponsor
Bio-Path Holdings, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05190471
Brief Title
A Clinical Trial of BP1002 in Patients With Refractory/Relapsed Acute Myeloid Leukemia (AML)
Official Title
A Phase I/Ib Study of BP1002 (a Liposomal Bcl-2 Antisense Oligodeoxynucleotide) in Patients With Refractory/Relapsed Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 16, 2022 (Actual)
Primary Completion Date
March 2024 (Anticipated)
Study Completion Date
September 2024 (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 and tolerability of escalating doses of BP1002 (Liposomal Bcl-2 Antisense Oligodeoxynucleotide) in patients with refractory/relapsed AML. The study is designed to assess the safety profile, identify DLTs, biologically effective doses, PK, PD and potential anti-leukemic effects of BP1002 as single agent (dose escalation phase) followed by assessing BP1002 in combination with decitabine (dose expansion phase).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Relapsed/Refractory AML - BP1002 monotherapy
Arm Type
Experimental
Arm Description
BP1002 monotherapy dose escalation
Arm Title
Relapsed/Refractory AML - BP1002 in combination with decitabine
Arm Type
Experimental
Arm Description
BP1002 single dose in combination with decitabine
Intervention Type
Drug
Intervention Name(s)
BP1002; Liposomal Bcl-2 Antisense Oligodeoxynucleotide
Other Intervention Name(s)
Liposomal Bcl-2; L-Bcl-2
Intervention Description
Dose escalation of BP1002 monotherapy
Intervention Type
Drug
Intervention Name(s)
Decitabine (in combination with BP1002)
Other Intervention Name(s)
Decitabine
Intervention Description
Dose expansion of BP1002 in combination with decitabine
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
Description
Identify and grade treatment-emergent laboratory abnormalities of escalating doses of BP1002 using non-hematologic and hematologic measure per NCI CTCAE criteria
Time Frame
30 days
Title
Recommended Phase 2 (RP2D) of BP1002
Description
Determine RP2D by evaluating Maximally Tolerated Dose (MTD) data
Time Frame
210 days
Title
Determine plasma pharmacokinetics (PK) of BP1002 using maximum plasma drug concentration
Description
Evaluate plasma 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 using 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 using 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
Identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in ECG intervals) of escalating doses of BP1002
Description
Collection of 12-lead ECGs at defined intervals to identify conduction and rhythm changes (treatment emergent QTc elevations or other treatment emergent changes in ECG intervals)
Time Frame
30 days
Title
Determine pharmacodynamics (PD) of BP1002
Description
Flow cytometry will be performed using peripheral blood to evaluate Bcl-2 target inhibition by BP1002 on pre and post treatment samples
Time Frame
30 days
Title
Determine anti-drug antibody (ADA) levels of BP1002
Description
Evaluate ADA via peripheral blood
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Determine evidence of response by bone marrow aspirate
Description
Assess complete remission (CR), CR with incomplete hematologic recovery (CRi), and CR with partial hematologic recovery (CRh) per Döhner 2017
Time Frame
180 days
Title
Determine evidence of response by complete blood counts using peripheral blood
Description
Assess complete remission (CR), CR with incomplete hematologic recovery (CRi), and CR with partial hematologic recovery (CRh) per Döhner 2017
Time Frame
180 days
Title
Assessment of morphologic leukemia free state (MLFS) and partial remissions by bone marrow aspirate and complete blood counts
Description
To assess percentage of participants with MLFS and partial remissions per Döhner 2017
Time Frame
180 days
Title
Assessment of morphologic leukemia free state (MLFS) and partial remissions by bone marrow aspirate
Description
To assess percentage of participants with MLFS and partial remissions per Döhner 2017
Time Frame
180 days
Title
Assessment of blast count reductions by complete blood counts using peripheral blood
Description
To assess blast count reductions per Williams 2016
Time Frame
180 days
Title
To determine progression-free survival (PFS), overall survival (OS), and duration of response
Description
To assess progression-free survival (PFS), overall survival (OS), and duration of response from date of study entry to study closure or death
Time Frame
180 days
Other Pre-specified Outcome Measures:
Title
Exploratory objective to correlate treatment response with cytogenetic characteristics
Description
Flow cytometry 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 cytometry 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, with histologic evidence of refractory/relapsed AML who have failed treatment with available therapies known to be active for refractory/relapsed AML Eastern Cooperative Oncology Group (ECOG) Performance Status Score of 0, 1 or 2 For the dose expansion phase, participants with documented diagnosis of AML who are eligible for decitabine therapy Participants must have 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 Usually total bilirubin ≤ 1.5 ULN. In specific cases the PI may request a waiver of this requirement with medical justification and agreement with the medical monitor and Bio-Path Holdings. And; Estimated creatinine clearance of at least 60 mL/min. These estimations are calculated using the Cockcroft-Gault equation. Female participants of childbearing potential must agree to use an acceptable method of birth control (i.e. a hormonal contraceptive, intrauterine device, diaphragm with spermicide, condom with spermicide or abstinence) for the duration of the study and for at least 6 months after the last dose of study drug or decitabine Male participants must agree to use an acceptable method of contraception for the duration of the study Recovered from the effects of any prior surgery, radiotherapy, or antineoplastic treatment (with the exception of alopecia), based on Investigator assessment Participants must be willing and able to provide written informed consent Exclusion Criteria: Active non-hematologic or lymphoid malignancy other than AML treated with immunotherapy, targeted therapy or chemotherapy within the previous 12 months Known, active leptomeningeal leukemia requiring intrathecal therapy. NOTE: Participants 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 Isolated potentially treatable extramedullary leukemia without also meeting bone marrow criteria for acute leukemia (for AML usually ≥ 5% blasts in BMA or biopsy). Participants may have leukemia with lower blast counts (Döhner 2017). Bio-Path Holdings and Investigator concurrence required. Acute promyelocytic leukemia (APL) with t(15;17)(q22;q12) PML-RARA Chronic myeloid leukemia in any phase Receipt of any anti-cancer therapy within 14 days prior to C1D1, with the exception of hydroxyurea or leukapheresis Participants may not be receiving any other investigational agents Female participants who are pregnant or breast-feeding Substance abuse, medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results Participants with human immunodeficiency virus (HIV) infection who have CD4+ T-cell counts < 350 cells/mcL or with clinically active hepatitis B or C infection History of any hypersensitivity to hypomethylating agents, unless reaction is deemed irrelevant to the study by the Investigator and Medical Monitor Unresolved toxicity higher than CTCAE Grade 1 attributed to any prior therapy or procedure, excluding alopecia Presence of concurrent conditions that, in the opinion of the Investigator and/or Medical Monitor, may compromise the participant's ability to tolerate study treatment 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 ECG 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 (i.e., seizures within the past 2 months) 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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gail J Roboz, MD
Organizational Affiliation
Weill Cornell Medical College - New York-Presbyterian Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Scripps Green Hospital
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kiley Borchard
Phone
858-554-9253
Email
borchard.kiley@scrippshealth.org
First Name & Middle Initial & Last Name & Degree
David Hermel, MD
Facility Name
UCLA Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90024
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gary Schiller, MD
First Name & Middle Initial & Last Name & Degree
Gary Schiller, MD
Facility Name
Weill Cornell Medical College - NewYork-Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dunay Bach
Phone
212-746-4447
Email
dub4001@med.cornell.edu
First Name & Middle Initial & Last Name & Degree
Gail Roboz, MD
Phone
646-962-2700
Email
gar2001@med.cornell.edu
First Name & Middle Initial & Last Name & Degree
Gail J Roboz, 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
Miranda Lim, BSN, RN
Phone
713-794-1722
Email
MGLim@mdanderson.org
First Name & Middle Initial & Last Name & Degree
Maro Ohanian, D.O.
Phone
713-792-2631
Email
mohanian@mdanderson.org
First Name & Middle Initial & Last Name & Degree
Maro Ohanian, D.O.

12. IPD Sharing Statement

Learn more about this trial

A Clinical Trial of BP1002 in Patients With Refractory/Relapsed Acute Myeloid Leukemia (AML)

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