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A Study of AC220 Given After Transplant in Subjects With Acute Myeloid Leukemia (AML)

Primary Purpose

Leukemia, Myeloid, Acute

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AC220
Sponsored by
Daiichi Sankyo, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Myeloid, Acute focused on measuring AC220, Acute Myeloid Leukemia (AML), Transplantation, Stem Cell Transplantation, Allogeneic Transplantation, FMS-like tyrosine kinase (FLT3), FMS-like tyrosine kinase (FLT3) Inhibitor, Kinase, Kinase Inhibitor, Pharmacokinetics, ASP2689, quizartinib

Eligibility Criteria

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

Inclusion Criteria:

  • Subject has a diagnosis of acute myeloid leukemia (AML) according to WHO classification (2008) and has received a high dose or a reduced intensity conditioning allogeneic Hematopoietic Stem Cell Transplant (HSCT) during first or second remission and within 30 to 60 days prior to first dose of AC220. Donors may be human leukocyte antigen (HLA)-matched for HLA-A, B, C, DRB1, and DQB1 by high resolution typing, related or unrelated (only a single allele disparity will be allowed for HLA-A, B, or C as defined by high resolution typing) Note: more than one HSCT is allowed
  • Subject must be in morphologic remission (< 5% marrow blasts) and without active central nervous system (CNS) AML within 14 days prior to first dose of AC220
  • Subject must have CD3 donor chimerism > 50 % at Screening
  • Subject has a Karnofsky Performance Status (KPS) of ≥ 60
  • Subject must have absolute neutrophil count (ANC) > 1000/mm3 and platelet count > 50,000/mm3 without platelet transfusion support within 2 weeks prior to first dose
  • Subject must have adequate renal, hepatic, and coagulation parameters
  • Female subjects must not be lactating and must not be breastfeeding at Screening or during the study period and for 28 days [or five half lives of the study drug whichever is longer] after final study drug administration.
  • Subject is able to comply with study procedures and follow-up examinations

Exclusion Criteria:

  • Subject received AC220 and relapsed during treatment with AC220
  • Subject has active ≥ Grade 2 graft versus host disease (GVHD)
  • Subject has received concurrent chemotherapy, immunotherapy, or radio-therapy within 21 days prior to the first dose of AC220, or any antineoplastic therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation) within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug
  • Subject requires treatment with concomitant drugs that prolong QT/QTc interval or strong cytochrome P-3A4 (CYP3A4) inhibitors or inducers with the exception of immunosuppressants, antibiotics, antifungals, and antivirals that are used as standard of care post-transplant or to prevent or treat infections and other such drugs that are considered absolutely essential for the care of the subject
  • Subject requires treatment with anticoagulant therapy
  • Subject has a known positive test for human immunodeficiency virus, hepatitis C, or hepatitis B surface antigen
  • Subject had major surgery within 4 weeks prior to first dose of AC220
  • Subject has uncontrolled or significant cardiovascular disease
  • Subject has an active acute fungal, bacterial, or other infection that is unresponsive to therapy
  • Subject has participated in any interventional clinical study or has been treated with any investigational drugs within 30 days or 5 half lives whichever is longer, prior to the initiation of Screening.
  • Subject has any medical, psychiatric, addictive or other kind of disorder which compromises the ability of the subject to give written informed consent and/or to comply with procedures

Sites / Locations

  • City of Hope
  • Northwestern University
  • University of Minnesota
  • M.D. Anderson Cancer Center
  • Seattle Cancer Care Alliance

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AC220

Arm Description

Outcomes

Primary Outcome Measures

Incidence of dose limiting toxicity (DLT)
From first dose through last dose of Cycle 2
Safety assessed by recording adverse events, physical examinations, vital signs, electrocardiograms (ECGs) and laboratory assessments

Secondary Outcome Measures

Duration of confirmed complete remission (CR)
Time from first dose until date of relapse
Duration of overall complete remission
Complete remission (CR) + CR with incomplete platelet recovery (CRp) + CR with incomplete hematologic recovery (CRi) + complete molecular remission (CRm)
Disease-free survival
Time from first dose until date of relapse or death
Overall survival
Time from first dose until date of death from any cause
Percentage of transplant rejections
Through End of Treatment
Percentage of Subjects with Graft-versus-Host Disease (GVHD)
Percentage of Donor Chimerism
Treatment-related mortality (TRM)
Death in CR (CR, CRm, CRp and CRi)
Composite of pharmacokinetics: AUC24 , Cmax, Ctrough and Tmax

Full Information

First Posted
November 7, 2011
Last Updated
February 8, 2019
Sponsor
Daiichi Sankyo, Inc.
Collaborators
Ambit Biosciences Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01468467
Brief Title
A Study of AC220 Given After Transplant in Subjects With Acute Myeloid Leukemia (AML)
Official Title
A Phase 1 Study of AC220 (ASP2689) as Maintenance Therapy in Subjects With Acute Myeloid Leukemia Who Have Been Treated With an Allogeneic Hematopoietic Stem Cell Transplant
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Completed
Study Start Date
April 2012 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Daiichi Sankyo, Inc.
Collaborators
Ambit Biosciences Corporation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to define a safe dose of AC220 when given as maintenance therapy after treatment with an allogeneic stem cell transplant.
Detailed Description
This is a two-part, sequential group dose escalation study. In Part 1, subjects will be enrolled into successive cohorts to determine the maximum tolerated dose (MTD). Dose escalation decision will be made based on dose limiting toxicities (DLTs) that occur in subjects treated to date at a given dose level. In Part 2, a confirmation cohort will be opened to confirm the safety at the MTD. Subjects who have had an allogeneic Hematopoietic Stem Cell Transplant (HSCT) will enter treatment with AC220 between 30 to 60 days after receiving allogeneic HSCT. AC220 will be administered every day, with 28 consecutive days defined as a treatment cycle. Subjects may receive up to 24 continuous treatment cycles. Subjects will have study visits each week for the first 2 cycles, and then on Day 1 of each cycle after that.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Myeloid, Acute
Keywords
AC220, Acute Myeloid Leukemia (AML), Transplantation, Stem Cell Transplantation, Allogeneic Transplantation, FMS-like tyrosine kinase (FLT3), FMS-like tyrosine kinase (FLT3) Inhibitor, Kinase, Kinase Inhibitor, Pharmacokinetics, ASP2689, quizartinib

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
AC220
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
AC220
Other Intervention Name(s)
quizartinib, ASP2689
Intervention Description
Oral Liquid
Primary Outcome Measure Information:
Title
Incidence of dose limiting toxicity (DLT)
Description
From first dose through last dose of Cycle 2
Time Frame
up to Day 56
Title
Safety assessed by recording adverse events, physical examinations, vital signs, electrocardiograms (ECGs) and laboratory assessments
Time Frame
30 days after last subject discontinues treatment (maximum of 24 months)
Secondary Outcome Measure Information:
Title
Duration of confirmed complete remission (CR)
Description
Time from first dose until date of relapse
Time Frame
24 months
Title
Duration of overall complete remission
Description
Complete remission (CR) + CR with incomplete platelet recovery (CRp) + CR with incomplete hematologic recovery (CRi) + complete molecular remission (CRm)
Time Frame
24 months
Title
Disease-free survival
Description
Time from first dose until date of relapse or death
Time Frame
30 days after last subject discontinues treatment (maximum of 24 months)
Title
Overall survival
Description
Time from first dose until date of death from any cause
Time Frame
30 days after last subject discontinues treatment (maximum of 24 months)
Title
Percentage of transplant rejections
Description
Through End of Treatment
Time Frame
30 days after last subject discontinues treatment (maximum of 24 months)
Title
Percentage of Subjects with Graft-versus-Host Disease (GVHD)
Time Frame
Up through 24 months of treatment
Title
Percentage of Donor Chimerism
Time Frame
Up through 24 months of treatment
Title
Treatment-related mortality (TRM)
Description
Death in CR (CR, CRm, CRp and CRi)
Time Frame
Up through 24 months of treatment
Title
Composite of pharmacokinetics: AUC24 , Cmax, Ctrough and Tmax
Time Frame
Up through 24 months of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has a diagnosis of acute myeloid leukemia (AML) according to WHO classification (2008) and has received a high dose or a reduced intensity conditioning allogeneic Hematopoietic Stem Cell Transplant (HSCT) during first or second remission and within 30 to 60 days prior to first dose of AC220. Donors may be human leukocyte antigen (HLA)-matched for HLA-A, B, C, DRB1, and DQB1 by high resolution typing, related or unrelated (only a single allele disparity will be allowed for HLA-A, B, or C as defined by high resolution typing) Note: more than one HSCT is allowed Subject must be in morphologic remission (< 5% marrow blasts) and without active central nervous system (CNS) AML within 14 days prior to first dose of AC220 Subject must have CD3 donor chimerism > 50 % at Screening Subject has a Karnofsky Performance Status (KPS) of ≥ 60 Subject must have absolute neutrophil count (ANC) > 1000/mm3 and platelet count > 50,000/mm3 without platelet transfusion support within 2 weeks prior to first dose Subject must have adequate renal, hepatic, and coagulation parameters Female subjects must not be lactating and must not be breastfeeding at Screening or during the study period and for 28 days [or five half lives of the study drug whichever is longer] after final study drug administration. Subject is able to comply with study procedures and follow-up examinations Exclusion Criteria: Subject received AC220 and relapsed during treatment with AC220 Subject has active ≥ Grade 2 graft versus host disease (GVHD) Subject has received concurrent chemotherapy, immunotherapy, or radio-therapy within 21 days prior to the first dose of AC220, or any antineoplastic therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation) within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug Subject requires treatment with concomitant drugs that prolong QT/QTc interval or strong cytochrome P-3A4 (CYP3A4) inhibitors or inducers with the exception of immunosuppressants, antibiotics, antifungals, and antivirals that are used as standard of care post-transplant or to prevent or treat infections and other such drugs that are considered absolutely essential for the care of the subject Subject requires treatment with anticoagulant therapy Subject has a known positive test for human immunodeficiency virus, hepatitis C, or hepatitis B surface antigen Subject had major surgery within 4 weeks prior to first dose of AC220 Subject has uncontrolled or significant cardiovascular disease Subject has an active acute fungal, bacterial, or other infection that is unresponsive to therapy Subject has participated in any interventional clinical study or has been treated with any investigational drugs within 30 days or 5 half lives whichever is longer, prior to the initiation of Screening. Subject has any medical, psychiatric, addictive or other kind of disorder which compromises the ability of the subject to give written informed consent and/or to comply with procedures
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Guy Gammon, MB, BS, MRCP
Organizational Affiliation
Medical Monitor, Ambit Biosciences Corporation
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
M.D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Seattle Cancer Care Alliance
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual participant data (IPD) and applicable supporting clinical trial documents may be available upon request at https://vivli.org/. In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address: https://vivli.org/ourmember/daiichi-sankyo/
IPD Sharing Time Frame
Studies for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
IPD Sharing Access Criteria
Formal request from qualified scientific and medical researchers on IPD and clinical study documents from clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.
IPD Sharing URL
https://vivli.org/ourmember/daiichi-sankyo/

Learn more about this trial

A Study of AC220 Given After Transplant in Subjects With Acute Myeloid Leukemia (AML)

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