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A Pivotal Study of HQP1351 in Patients With Chronic Myeloid Leukemia in Chronic Phase

Primary Purpose

Chronic Myeloid Leukemia, Chronic Phase

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
HQP1351
Hydroxyurea or Interferon-based therapy
Homoharringtonine
Imatinib, Dasatinib or Nilotinib
Sponsored by
Ascentage Pharma Group Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Myeloid Leukemia, Chronic Phase focused on measuring Chronic Myeloid Leukemia, HQP1351, CML, CML-CP, Olverembatinib Tablets

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or non-pregnant, non-lactating female patients who are 18 years of age or older.
  2. CML-CP patients with positive Ph chromosome or BCR-ABL fusion genes.
  3. Resistance and intolerance of first- and second-generation TKIs: defined as resistance or intolerance to imatinib, nilotinib, and dasatinib.
  4. Ability to understand and willingness to sign a written informed consent form. The consent form must be signed by the patient prior to any study specific procedures.
  5. Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2.
  6. Predicted life expectancy of ≥3 months.
  7. Organ function as indicated by the following laboratory indicators must be met (Hematological indicators require that no blood transfusion or any blood products or cytokines be used within 14 days prior to testing):

    • Hemoglobin ≥8.0g/dL.
    • White blood cell count ≥ 3.0×10^9/L.
    • Platelet count ≥ 75×10^9/L.
    • Serum creatinine ≤ 1.5×upper limit of normal (ULN) or 24 hours calculated creatinine clearance ≥ 50mL/min when serum creatinine >1.5×ULN.
    • Serum albumin ≥ 3.0 g/dL.
    • Total bilirubin ≤ 1.5 x ULN.
    • Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 x ULN.
    • Amylase≤1.5×ULN. Lipase≤1.5×ULN.
    • PT/APTT/INR≤1.5×ULN.
  8. Cardiac function index: ejection fraction (EF) > 50%, pulmonary arterial systolic pressure (PASP) ≤50 mmHg.
  9. QT interval corrected on electrocardiogram (ECG) evaluation: QTc≤450ms in males or ≤470ms in females.
  10. Males and females of childbearing potential and their partners voluntarily take contraceptive measures that the researchers believe are effective within 120 days from the signing of the informed consent to the last use of the research drug, or confirm that sterilization has been performed (at least one month before screening).
  11. Willingness and ability to comply with study procedures and follow-up examination.

Exclusion Criteria:

  1. Received cytotoxic chemotherapy or radiotherapy within 28 days prior to the first administration, interferon or cytarabine or antitumor effect Chinese herbal medicine or Chinese patent medicine within 14 days prior to the first administration, or targeted BCR-ABL1 TKI within 7 days prior to the first administration, or hydroxyurea or anagrelide within 24 hours after the first administration, or adverse events (except alopecia) caused by previous treatment and have not recovered.
  2. The patients who received any other investigating drugs within 14 days prior to first administration.
  3. For patients with CML-CP, if they have progressed to AP or BP, they cannot be enrolled after treatment with CML-CP.
  4. Patients who are currently receiving treatment with a medication that has the potential to interact with research drug.
  5. Have previously been treated with ponatinib or HQP1351 (or drugs of similar composition).
  6. Absorption disorder syndrome or other diseases affecting oral drug absorption.
  7. Have any history of heart or vascular disease, such as hypertension (systolic blood pressure (HBP) > 140mmHg and/or diastolic blood pressure > 90mmHg), or take medications that are known to cause QT interval prolongation. The patients with well controlled HBP can be included.
  8. Pulmonary systolic pressure (PSP) of echocardiography is more than 50 mmHg, or there is clinical symptom related to pulmonary hypertension.
  9. Have a history of serious cardiovascular diseases during the previous treatment of chronic myeloid leukemia with TKI, including myocardial infarction, unstable angina pectoris, severe arrhythmia and congestive heart failure.
  10. Underwent autologous or allogeneic stem cell transplant.
  11. CML-CP patient currently diagnosed as Complete cytogenetic response (CCyR).
  12. Have diseases with abnormal bleeding and coagulation function, or have a bleeding disorder unrelated to CML within 3 months before first dose of study drug.
  13. Underwent major surgery (except minor surgical procedures, such as placement or bone marrow biopsy) with 14 days prior to the first dose of study drug.
  14. Require concurrent treatment with immunosuppressive agents, other than corticosteroids prescribed for a short course of therapy (It is defined as a daily dose of corticosteroids less than 30 mg prednisone or the same amount of other corticosteroids within 7 days).
  15. Have active nervous system (CNS) disease as evidence by cytology or pathology. In the absence of clinical CNS disease, lumbar puncture is not required.
  16. History of another primary malignancies.
  17. Active symptomatic infection.
  18. Known to be allergic to study drug ingredients or their analogues.
  19. Female patients with blood β-Human chorionic gonadotropin positive, pregnant or lactating or expecting pregnancy during the study program.
  20. Suffer from any condition or illness that, in the opinion of the Investigator or the medical monitor, would compromise patient safety or interfere with the evaluation of the safety of the research drug.

Sites / Locations

  • Peking University People's Hospital
  • Sun Yat-sen University Cancer Center
  • Nanfang hospital of southern medical university
  • Shenzhen Second People's Hospital
  • The First affiliated hospital of Guangxi Medical University
  • Henan Provincial Oncology Hospital
  • Henan Provincial people's Hospital
  • Tongji Hospital medical college Huazhong University of Science and Technology
  • Union Hospital medical college Huazhong University of Science and Technology
  • Zhongnan Hospital of Wuhan University
  • Xiangya Hospital Central South University
  • Jiangsu Province Hospital
  • The First Affiliated Hospital of Soochow University
  • The First affiliated hospital of Nanchang University
  • First Hospital of Jilin University
  • The Affiliated hospital of Qingdao University
  • Qilu hospital of Shandong University
  • Ruijing Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
  • West China Hospital of Sichuan University
  • Blood Diseases Hospital Chinese Academy of Medical Sciences
  • The First Affiliated Hospital, Zhejiang University School of Medicine(hematology dept)
  • The First Affiliated Hospital, Zhejiang University School of Medicine(HSCTdept)

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

HQP1351 therapy cohort

Best Available Therapy (BAT) cohort

Arm Description

HQP1351 40 mg, taken orally once every other day of a 28-day cycle

Best available therapy (BAT) will be selected by the investigator for each participant.

Outcomes

Primary Outcome Measures

Event free survival (EFS)
EFS is defined as any "event" occurred since randomization, such as disease progression.

Secondary Outcome Measures

Complete hematologic response (CHR)
CHR is the proportion of patients achieving CHR after being treated. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Major cytogenetic response (MCyR)
MCyR is the proportion of patients achieving Complete cytogenetic response (CCyR: defined as 0% Philadelphia chromosome-positive [Ph+] metaphases by cytogenetic analysis of bone marrow) or Partial Cytogenetic Response (PCyR: defined as >0% to 35% Ph+ metaphases by cytogenetic analysis of bone marrow). It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Complete cytogenetic response (CCyR)
CCyR is the proportion of patients achieving CCyR after being treated. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Major molecular response (MMR)
MMR is the proportion of patients achieving a ratio of ≤0.1% breakpoint cluster region (BCR) abelson leukemia (ABL) to ABL transcripts on the international scale (≤0.1% BCR-ABL/ABL[IS]) after being treated with HQP1351. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Progression free survival (PFS)
PFS is defined as the interval between the first dose date and the first date at which the criteria for progression are met, or death. The subject who isn't progression or death will be censored at the last response assessment.
Overall survive (OS)
OS is defined as the interval between the first dose date and date of death, censored at the last contact date to be alive.
Incidence and severity of adverse events
Adverse events (AEs), and serious AEs (SAEs): Patients treatment related AE, SAE will be assessed according NCI CTCAE Version 5.0.

Full Information

First Posted
October 11, 2019
Last Updated
April 2, 2023
Sponsor
Ascentage Pharma Group Inc.
Collaborators
HealthQuest Pharma Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04126681
Brief Title
A Pivotal Study of HQP1351 in Patients With Chronic Myeloid Leukemia in Chronic Phase
Official Title
A Phase 2, Randomized, Open Label, Pivotal Study to Evaluate the Efficacy and Safety of HQP1351 in CML CP Patients Who Are Resistant and/or Intolerant to First- and Second-Generation Tyrosine Kinase Inhibitors
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 21, 2019 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ascentage Pharma Group Inc.
Collaborators
HealthQuest Pharma Inc.

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy of HQP1351 in patients with chronic myeloid leukemia in chronic phase (CML-CP) who are resistant and/or intolerant to first- and second-generation tyrosine kinase inhibitors. The efficacy of HQP1351 is determined by evaluating the subjects' event free survival (EFS).
Detailed Description
This is a phase 2, randomized, open label, pivotal study to evaluate the efficacy and safety of HQP1351 in CML CP patients who are resistant and/or intolerant to first- and second-generation TKIs in China. A total of 141 CML CP patients will be included in this study. After screening, eligible subjects will be randomized by 2:1 ratio to enter HQP1351 therapy cohort and best available therapy (BAT) cohort. When the subjects in the two cohorts reach EFS assessment, they can crossover to contralateral cohort if the investigator and Sponsor think they could be clinically benefited. During treatment, each subject will be assessed regularly for hematological, cytogenetic and molecular responses. At the same time, safety information also will be evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Myeloid Leukemia, Chronic Phase
Keywords
Chronic Myeloid Leukemia, HQP1351, CML, CML-CP, Olverembatinib Tablets

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
144 (Actual)

8. Arms, Groups, and Interventions

Arm Title
HQP1351 therapy cohort
Arm Type
Experimental
Arm Description
HQP1351 40 mg, taken orally once every other day of a 28-day cycle
Arm Title
Best Available Therapy (BAT) cohort
Arm Type
Active Comparator
Arm Description
Best available therapy (BAT) will be selected by the investigator for each participant.
Intervention Type
Drug
Intervention Name(s)
HQP1351
Intervention Description
HQP1351 is a new, bioavailable inhibitor against BCRABLWT and a broad spectrum of BCR-ABL mutants including BCR-ABLT315I
Intervention Type
Drug
Intervention Name(s)
Hydroxyurea or Interferon-based therapy
Intervention Description
Patients will receive BAT based on the Investigator's opinion, taking into account the manufacturer's instructions, labeling, subject's medical condition, and institutional guidelines.
Intervention Type
Drug
Intervention Name(s)
Homoharringtonine
Intervention Description
Patients will receive BAT based on the Investigator's opinion, taking into account the manufacturer's instructions, labeling, subject's medical condition, and institutional guidelines.
Intervention Type
Drug
Intervention Name(s)
Imatinib, Dasatinib or Nilotinib
Intervention Description
Patients will receive BAT based on the Investigator's opinion, taking into account the manufacturer's instructions, labeling, subject's medical condition, and institutional guidelines.
Primary Outcome Measure Information:
Title
Event free survival (EFS)
Description
EFS is defined as any "event" occurred since randomization, such as disease progression.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)
Secondary Outcome Measure Information:
Title
Complete hematologic response (CHR)
Description
CHR is the proportion of patients achieving CHR after being treated. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)
Title
Major cytogenetic response (MCyR)
Description
MCyR is the proportion of patients achieving Complete cytogenetic response (CCyR: defined as 0% Philadelphia chromosome-positive [Ph+] metaphases by cytogenetic analysis of bone marrow) or Partial Cytogenetic Response (PCyR: defined as >0% to 35% Ph+ metaphases by cytogenetic analysis of bone marrow). It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)
Title
Complete cytogenetic response (CCyR)
Description
CCyR is the proportion of patients achieving CCyR after being treated. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)
Title
Major molecular response (MMR)
Description
MMR is the proportion of patients achieving a ratio of ≤0.1% breakpoint cluster region (BCR) abelson leukemia (ABL) to ABL transcripts on the international scale (≤0.1% BCR-ABL/ABL[IS]) after being treated with HQP1351. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)
Title
Progression free survival (PFS)
Description
PFS is defined as the interval between the first dose date and the first date at which the criteria for progression are met, or death. The subject who isn't progression or death will be censored at the last response assessment.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)
Title
Overall survive (OS)
Description
OS is defined as the interval between the first dose date and date of death, censored at the last contact date to be alive.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)
Title
Incidence and severity of adverse events
Description
Adverse events (AEs), and serious AEs (SAEs): Patients treatment related AE, SAE will be assessed according NCI CTCAE Version 5.0.
Time Frame
By the end of Cycle 24 (each cycle is 28 days)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant, non-lactating female patients who are 18 years of age or older. CML-CP patients with positive Ph chromosome or BCR-ABL fusion genes. Resistance and intolerance of first- and second-generation TKIs: defined as resistance or intolerance to imatinib, nilotinib, and dasatinib. Ability to understand and willingness to sign a written informed consent form. The consent form must be signed by the patient prior to any study specific procedures. Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2. Predicted life expectancy of ≥3 months. Organ function as indicated by the following laboratory indicators must be met (Hematological indicators require that no blood transfusion or any blood products or cytokines be used within 14 days prior to testing): Hemoglobin ≥8.0g/dL. White blood cell count ≥ 3.0×10^9/L. Platelet count ≥ 75×10^9/L. Serum creatinine ≤ 1.5×upper limit of normal (ULN) or 24 hours calculated creatinine clearance ≥ 50mL/min when serum creatinine >1.5×ULN. Serum albumin ≥ 3.0 g/dL. Total bilirubin ≤ 1.5 x ULN. Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 x ULN. Amylase≤1.5×ULN. Lipase≤1.5×ULN. PT/APTT/INR≤1.5×ULN. Cardiac function index: ejection fraction (EF) > 50%, pulmonary arterial systolic pressure (PASP) ≤50 mmHg. QT interval corrected on electrocardiogram (ECG) evaluation: QTc≤450ms in males or ≤470ms in females. Males and females of childbearing potential and their partners voluntarily take contraceptive measures that the researchers believe are effective within 120 days from the signing of the informed consent to the last use of the research drug, or confirm that sterilization has been performed (at least one month before screening). Willingness and ability to comply with study procedures and follow-up examination. Exclusion Criteria: Received cytotoxic chemotherapy or radiotherapy within 28 days prior to the first administration, interferon or cytarabine or antitumor effect Chinese herbal medicine or Chinese patent medicine within 14 days prior to the first administration, or targeted BCR-ABL1 TKI within 7 days prior to the first administration, or hydroxyurea or anagrelide within 24 hours after the first administration, or adverse events (except alopecia) caused by previous treatment and have not recovered. The patients who received any other investigating drugs within 14 days prior to first administration. For patients with CML-CP, if they have progressed to AP or BP, they cannot be enrolled after treatment with CML-CP. Patients who are currently receiving treatment with a medication that has the potential to interact with research drug. Have previously been treated with ponatinib or HQP1351 (or drugs of similar composition). Absorption disorder syndrome or other diseases affecting oral drug absorption. Have any history of heart or vascular disease, such as hypertension (systolic blood pressure (HBP) > 140mmHg and/or diastolic blood pressure > 90mmHg), or take medications that are known to cause QT interval prolongation. The patients with well controlled HBP can be included. Pulmonary systolic pressure (PSP) of echocardiography is more than 50 mmHg, or there is clinical symptom related to pulmonary hypertension. Have a history of serious cardiovascular diseases during the previous treatment of chronic myeloid leukemia with TKI, including myocardial infarction, unstable angina pectoris, severe arrhythmia and congestive heart failure. Underwent autologous or allogeneic stem cell transplant. CML-CP patient currently diagnosed as Complete cytogenetic response (CCyR). Have diseases with abnormal bleeding and coagulation function, or have a bleeding disorder unrelated to CML within 3 months before first dose of study drug. Underwent major surgery (except minor surgical procedures, such as placement or bone marrow biopsy) with 14 days prior to the first dose of study drug. Require concurrent treatment with immunosuppressive agents, other than corticosteroids prescribed for a short course of therapy (It is defined as a daily dose of corticosteroids less than 30 mg prednisone or the same amount of other corticosteroids within 7 days). Have active nervous system (CNS) disease as evidence by cytology or pathology. In the absence of clinical CNS disease, lumbar puncture is not required. History of another primary malignancies. Active symptomatic infection. Known to be allergic to study drug ingredients or their analogues. Female patients with blood β-Human chorionic gonadotropin positive, pregnant or lactating or expecting pregnancy during the study program. Suffer from any condition or illness that, in the opinion of the Investigator or the medical monitor, would compromise patient safety or interfere with the evaluation of the safety of the research drug.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xiaojun Huang, Professor
Organizational Affiliation
Peking University People's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking University People's Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100044
Country
China
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Gongdong
Country
China
Facility Name
Nanfang hospital of southern medical university
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510515
Country
China
Facility Name
Shenzhen Second People's Hospital
City
Shenzhen
State/Province
Guangdong
Country
China
Facility Name
The First affiliated hospital of Guangxi Medical University
City
Nanning
State/Province
Guangxi
Country
China
Facility Name
Henan Provincial Oncology Hospital
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450003
Country
China
Facility Name
Henan Provincial people's Hospital
City
Zhengzhou
State/Province
Henan
Country
China
Facility Name
Tongji Hospital medical college Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Facility Name
Union Hospital medical college Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Facility Name
Zhongnan Hospital of Wuhan University
City
Wuhan
State/Province
Hubei
Country
China
Facility Name
Xiangya Hospital Central South University
City
Changsha
State/Province
Hunan
Country
China
Facility Name
Jiangsu Province Hospital
City
Nanjing
State/Province
Jiangsu
Country
China
Facility Name
The First Affiliated Hospital of Soochow University
City
Suzhou
State/Province
Jiangsu
Country
China
Facility Name
The First affiliated hospital of Nanchang University
City
Nanchang
State/Province
Jiangxi
Country
China
Facility Name
First Hospital of Jilin University
City
Changchun
State/Province
Jilin
Country
China
Facility Name
The Affiliated hospital of Qingdao University
City
Qingdao
State/Province
Shandong
Country
China
Facility Name
Qilu hospital of Shandong University
City
Jinan
State/Province
Shangdong
Country
China
Facility Name
Ruijing Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Facility Name
West China Hospital of Sichuan University
City
Chengdu
State/Province
Sichuan
Country
China
Facility Name
Blood Diseases Hospital Chinese Academy of Medical Sciences
City
Tianjin
State/Province
Tianjin
Country
China
Facility Name
The First Affiliated Hospital, Zhejiang University School of Medicine(hematology dept)
City
Hangzhou
State/Province
Zhejiang
Country
China
Facility Name
The First Affiliated Hospital, Zhejiang University School of Medicine(HSCTdept)
City
Hangzhou
State/Province
Zhejiang
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
35982483
Citation
Jiang Q, Li Z, Qin Y, Li W, Xu N, Liu B, Zhang Y, Meng L, Zhu H, Du X, Chen S, Liang Y, Hu Y, Liu X, Song Y, Men L, Chen Z, Niu Q, Wang H, Lu M, Yang D, Zhai Y, Huang X. Olverembatinib (HQP1351), a well-tolerated and effective tyrosine kinase inhibitor for patients with T315I-mutated chronic myeloid leukemia: results of an open-label, multicenter phase 1/2 trial. J Hematol Oncol. 2022 Aug 18;15(1):113. doi: 10.1186/s13045-022-01334-z. Erratum In: J Hematol Oncol. 2022 Oct 31;15(1):159. J Hematol Oncol. 2023 Feb 20;16(1):13.
Results Reference
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A Pivotal Study of HQP1351 in Patients With Chronic Myeloid Leukemia in Chronic Phase

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