A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)
Primary Purpose
Myelodysplastic Syndrome (MDS)
Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
BLEX 404 Oral Liquid
Sponsored by
About this trial
This is an interventional treatment trial for Myelodysplastic Syndrome (MDS)
Eligibility Criteria
Inclusion Criteria:
- Age 20 or older, able to sign informed consent, understand and comply with protocol requirements and instructions.
- Body weight between 30 to 120 kg
- International Prognostic Scoring System (IPSS) intermediate-1 (int-1), intermediate-2 (int-2) or high-risk myelodysplastic syndrome (MDS) by World Health Organization (WHO) or Chronic Myelomonocytic Leukemia (CMML) patients.
- Not previously treated with MDS and CMML therapy and require treatment with azacitidine* for the first time at 75 mg/m2 subcutaneously or intravenously, daily for 7 days (7 nonconsecutive day of 6-1-1 or 5-2-2 treatment schedule is acceptable in which the drug is administered Monday-Saturday and then Monday of the following week for a 6-1-1 schedule, and in which the drug is administered Monday-Friday and then Monday-Tuesday of the following week for 5-2-2 schedule) per cycle. Treatment of the study drug, BLEX 404 Oral Liquid will begin at the same time receiving the first dose of azacitidine in this study.
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-3.
- Adequate baseline organ function defined by the criteria below: total bilirubin ≤ 1.5x the upper limit of normal (ULN) except for Gilbert's syndrome or indirect hyperbilirubinemia due to hemolysis; ALT ≤ 2.5x ULN; AST ≤ 2.5x ULN; creatinine clearance ≥ 60 mL/min/1.73 m2.
- Women must be either of non-child bearing potential, or women with child-bearing potential and men with reproductive potential and a female partner of childbearing potential must either have had a prior vasectomy or agree to use effective contraception from time of Screening Visit until the Follow-Up Visit.
Exclusion Criteria:
- Historical allergic events caused by mushroom.
- Previous treatment with hypomethylating agent or known immediate or delayed hypersensitivity reaction to drugs chemically related to azacitidine that contraindicates the subjects' participation.
- Patients with active infections or require treatments with immunosuppressive drugs at screening visit. However, patients require ongoing treatments with corticosteroids may be recruited.
- Treatment with an investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of BLEX 404 Oral Liquid.
- Any serious and/or unstable pre-existing medical condition (including any advanced malignancy other than the disease under study), psychiatric disorder, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance with the study procedures.
- Any clinically significant pulmonary, cardiovascular, endocrine, neurologic, gastrointestinal or genitourinary disease unrelated to underlying hematologic disorder.
- Active and uncontrolled infections of the following: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection. However, HBV and HCV carriers with viral load test of "not detected" or "negative" results may be recruited in this study.
- Lactating female and women with a positive serum or urine pregnancy test at screening assessments.
- (For Part II Interventional Study subjects only) No indication, in the opinion of the treating physician, for antibiotic prophylaxis within 2 weeks prior to study treatment.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
BLEX 404 Oral Liquid
Arm Description
Part I: Part I-1: Low Dose BLEX 404 Oral Liquid (3 mg/kg, BID) is administered in combination with 2 cycles of azacitidine. Part I-2: High Dose BLEX 404 Oral Liquid (4.5 mg/kg, BID) is administered in combination with 2 cycles of azacitidine. Part II: Recommended Dose Level (RDL) of BLEX 404 Oral Liquid will be determined by results from Part I. BLEX 404 Oral Liquid at RDL is administered in combination with 6 cycles of azacitidine.
Outcomes
Primary Outcome Measures
Part I: Recommended dose level (RDL) of BLEX 404 Oral Liquid
RDL is defined by BLEX 404 Oral Liquid-related prohibited toxicity in subjects undergoing 2 cycles of azacitidine treatment. When one of the stopping criteria is met during the study treatment period, RDL will be set at the lower dose level.
Part II: Incidence of infections
Number of subjects experience infection events and inpatient hospitalization due to infections.
Secondary Outcome Measures
Part I: (A) Number of subjects experience infections events and inpatient hospitalization due to infections
Part I: (B) Treatments and duration of each infections
Part I: (C) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
Part I: (D) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
Part I: (E) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
Part I: (F) Disease Progression (defined by 2006 IWG Criteria)
Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
Part II: (A) Time-to-first infection
Part II: (B) Duration (days) of each infection event
Part II: (C) Number of infections requiring supportive care or antimicrobial agents
Part II: (D) Duration (days) of treatments for infections
Part II: (E) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
Part II: (F) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
Part II: (G) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
Part II: (H) Disease Progression (defined by 2006 IWG Criteria)
Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
Part II: (I) Six-month overall survival rate (defined by 2006 IWG Criteria)
defined as time from beginning of treatment till death from any cause occurs or last follow-up.
Part II: (J) Six-month progression-free survival (defined by 2006 IWG Criteria)
defined as time from beginning of treatment till disease progression, death from MDS or CMML, or last follow-up.
Part II: (K) Immune Response
Neutrophil and monocyte function by respiratory burst assay
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02944955
Brief Title
A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)
Official Title
A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 2024 (Anticipated)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
June 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioLite, 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 is a clinical trial to determine the safety, recommended dose level (RDL), and infection control of BLEX 404 Oral Liquid in combination with azacitidine in patients with International Prognostic Scoring System (IPSS) intermediate-1 (int-1), intermediate-2 (int-2) or high-risk myelodysplastic syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndrome (MDS)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
52 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
BLEX 404 Oral Liquid
Arm Type
Experimental
Arm Description
Part I:
Part I-1: Low Dose BLEX 404 Oral Liquid (3 mg/kg, BID) is administered in combination with 2 cycles of azacitidine.
Part I-2: High Dose BLEX 404 Oral Liquid (4.5 mg/kg, BID) is administered in combination with 2 cycles of azacitidine.
Part II:
Recommended Dose Level (RDL) of BLEX 404 Oral Liquid will be determined by results from Part I.
BLEX 404 Oral Liquid at RDL is administered in combination with 6 cycles of azacitidine.
Intervention Type
Drug
Intervention Name(s)
BLEX 404 Oral Liquid
Intervention Description
BLEX 404 Oral Liquid is orally administered twice daily in combination with azacitdine treatment cycles (2 cycles in Part I and 6 cycles in Part II).
Azacitidine treatment: SC or IV injections at 75 mg/m2, QD for 7 days each cycle. 28 days/cycle, and repeat cycles every 4 weeks.
Primary Outcome Measure Information:
Title
Part I: Recommended dose level (RDL) of BLEX 404 Oral Liquid
Description
RDL is defined by BLEX 404 Oral Liquid-related prohibited toxicity in subjects undergoing 2 cycles of azacitidine treatment. When one of the stopping criteria is met during the study treatment period, RDL will be set at the lower dose level.
Time Frame
8 weeks (2 cycles of azacitidine)
Title
Part II: Incidence of infections
Description
Number of subjects experience infection events and inpatient hospitalization due to infections.
Time Frame
24 weeks (6 cycles of azacitidine)
Secondary Outcome Measure Information:
Title
Part I: (A) Number of subjects experience infections events and inpatient hospitalization due to infections
Time Frame
8 weeks (2 cycles of azacitidine)
Title
Part I: (B) Treatments and duration of each infections
Time Frame
8 weeks (2 cycles of azacitidine)
Title
Part I: (C) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
Description
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
Time Frame
8 weeks (2 cycles of azacitidine)
Title
Part I: (D) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
Description
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
Time Frame
8 weeks (2 cycles of azacitidine)
Title
Part I: (E) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
Description
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 2 cycles of azacitidine.
Time Frame
8 weeks (2 cycles of azacitidine)
Title
Part I: (F) Disease Progression (defined by 2006 IWG Criteria)
Description
Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
Time Frame
8 weeks (2 cycles of azacitidine)
Title
Part II: (A) Time-to-first infection
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (B) Duration (days) of each infection event
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (C) Number of infections requiring supportive care or antimicrobial agents
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (D) Duration (days) of treatments for infections
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (E) Complete remission (CR) or partial remission (PR) of bone marrow, peripheral blood, cytogenetic response (defined by 2006 IWG Criteria)
Description
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (F) Hematological improvement of erythroid (hemoglobin and RBC-transfusion independence), neutrophil (Absolute Neutrophil Count), and platelet (platelet count) response (defined by 2006 IWG Criteria)
Description
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (G) Frequency and requirement of red blood cell transfusion (defined by 2006 IWG Criteria)
Description
Hematological Response in subjects undergone BLEX 404 Oral Liquid in combination with 6 cycles of azacitidine.
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (H) Disease Progression (defined by 2006 IWG Criteria)
Description
Disease progression of bone marrow, erythroid (hemoglobin and RBC-transfusion independence), and platelet (platelet count) in subjects undergone BLEX 404 Oral Liquid treatment in combination with 2 cycles of azacitidine.
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (I) Six-month overall survival rate (defined by 2006 IWG Criteria)
Description
defined as time from beginning of treatment till death from any cause occurs or last follow-up.
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (J) Six-month progression-free survival (defined by 2006 IWG Criteria)
Description
defined as time from beginning of treatment till disease progression, death from MDS or CMML, or last follow-up.
Time Frame
24 weeks (6 cycles of azacitidine)
Title
Part II: (K) Immune Response
Description
Neutrophil and monocyte function by respiratory burst assay
Time Frame
24 weeks (6 cycles of azacitidine)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age 20 or older, able to sign informed consent, understand and comply with protocol requirements and instructions.
Body weight between 30 to 120 kg
International Prognostic Scoring System (IPSS) intermediate-1 (int-1), intermediate-2 (int-2) or high-risk myelodysplastic syndrome (MDS) by World Health Organization (WHO) or Chronic Myelomonocytic Leukemia (CMML) patients.
Not previously treated with MDS and CMML therapy and require treatment with azacitidine* for the first time at 75 mg/m2 subcutaneously or intravenously, daily for 7 days (7 nonconsecutive day of 6-1-1 or 5-2-2 treatment schedule is acceptable in which the drug is administered Monday-Saturday and then Monday of the following week for a 6-1-1 schedule, and in which the drug is administered Monday-Friday and then Monday-Tuesday of the following week for 5-2-2 schedule) per cycle. Treatment of the study drug, BLEX 404 Oral Liquid will begin at the same time receiving the first dose of azacitidine in this study.
Eastern Cooperative Oncology Group (ECOG) Performance Status 0-3.
Adequate baseline organ function defined by the criteria below: total bilirubin ≤ 1.5x the upper limit of normal (ULN) except for Gilbert's syndrome or indirect hyperbilirubinemia due to hemolysis; ALT ≤ 2.5x ULN; AST ≤ 2.5x ULN; creatinine clearance ≥ 60 mL/min/1.73 m2.
Women must be either of non-child bearing potential, or women with child-bearing potential and men with reproductive potential and a female partner of childbearing potential must either have had a prior vasectomy or agree to use effective contraception from time of Screening Visit until the Follow-Up Visit.
Exclusion Criteria:
Historical allergic events caused by mushroom.
Previous treatment with hypomethylating agent or known immediate or delayed hypersensitivity reaction to drugs chemically related to azacitidine that contraindicates the subjects' participation.
Patients with active infections or require treatments with immunosuppressive drugs at screening visit. However, patients require ongoing treatments with corticosteroids may be recruited.
Treatment with an investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of BLEX 404 Oral Liquid.
Any serious and/or unstable pre-existing medical condition (including any advanced malignancy other than the disease under study), psychiatric disorder, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance with the study procedures.
Any clinically significant pulmonary, cardiovascular, endocrine, neurologic, gastrointestinal or genitourinary disease unrelated to underlying hematologic disorder.
Active and uncontrolled infections of the following: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection. However, HBV and HCV carriers with viral load test of "not detected" or "negative" results may be recruited in this study.
Lactating female and women with a positive serum or urine pregnancy test at screening assessments.
(For Part II Interventional Study subjects only) No indication, in the opinion of the treating physician, for antibiotic prophylaxis within 2 weeks prior to study treatment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hsien-Ming Wu, M.S.
Phone
+886-3-6685386
Email
sonnywu@bioliteinc.com
12. IPD Sharing Statement
Learn more about this trial
A Study of BLEX 404 Oral Liquid in Patients With International Prognostic Scoring System (IPSS) Intermediate-1, Intermediate-2 or High-Risk Myelodysplastic Syndrome (MDS) and Chronic Myelomonocytic Leukemia (CMML)
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