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A Study to Investigate the Safety and Tolerability of Ziftomenib in Combination With Venetoclax/Azacitidine, Venetoclax, or 7+3 in Patients With AML

Primary Purpose

Acute Myeloid Leukemia, Mixed Lineage Acute Leukemia, Mixed Lineage Leukemia Gene Mutation

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ziftomenib
Venetoclax
Azacitidine
Daunorubicin
Cytarabine
Sponsored by
Kura Oncology, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia

Eligibility Criteria

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

Key Inclusion Criteria: Patients must have a documented NPM1 mutation or KMT2A rearrangement and have either newly diagnosed or relapsed/refractory AML Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 Adequate liver, renal, and cardiac function according to protocol defined criteria A female of childbearing potential must agree to use adequate contraception from the time of screening through 180 days following the last dose of study intervention. A male of childbearing potential must agree to use abstinence or adequate contraception from the time of screening through 90 days following the last dose of study intervention Key Exclusion Criteria: Diagnosis of either acute promyelocytic leukemia or blast chronic myelomonocytic leukemia Known history of BCR-ABL alteration Advanced malignant hepatic tumor [for patients receiving ven/aza combination] Administration of live attenuated vaccines within 14 days prior to, during, or after treatment until B-cell recovery Active central nervous system (CNS) involvement by AML. Clinical signs/symptoms of leukostasis or WBC > 25,000 / microliter. Hydroxyurea and/or leukapheresis are permitted to meet this criterion Not recovered to Grade ≤1 (NCI-CTCAE v5.0) from all nonhematological toxicities except for alopecia Known clinically active human immunodeficiency virus, active hepatitis B or active hepatitis C infection For newly diagnosed cohorts: received prior chemotherapy for leukemia, except hydroxyurea and/or leukapheresis to control leukocytosis, prior treatment with all-transretinoic acid for initially suspected acute promyelocytic leukemia, or non-HMA therapy for prior myelodysplastic syndrome For relapsed/refractory cohorts: received chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational < 14 days prior to the first dose of ziftomenib or within 5 drug half-lives prior to the first dose of study drug Uncontrolled intercurrent illness including, but not limited to, cardiac illness as defined in the protocol Mean corrected QT interval corrected for heart rate by Fredericia's formula (QTcF) >480 ms on triplicate ECGs Uncontrolled infection Women who are pregnant or lactating An active malignancy and currently receiving chemotherapy for that malignancy or disease that is uncontrolled/progressing

Sites / Locations

  • USC University of Southern California / Norris Comprehensive Cancer CenterRecruiting
  • Colorado Blood Cancer InstituteRecruiting
  • Yale Cancer Center and Smilow Cancer HospitalRecruiting
  • The University of Kansas Cancer CenterRecruiting
  • Massachusetts General HospitalRecruiting
  • Karmanos Cancer InstituteRecruiting
  • TriStar Bone Marrow TransplantRecruiting
  • MD Anderson Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose Escalation: Ziftomenib/Venetoclax/Azacitidine in R/R NPM1-m (A-1)

Dose Escalation: Ziftomenib/7+3 in 1L NPM1-m (A-2)

Dose Escalation: Ziftomenib/Venetoclax/Azacitidine in R/R KMT2A-r (B-1)

Dose Escalation: Ziftomenib/7+3 in 1L KMT2A-r (B-2)

Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in R/R NPM1-m (A-1)

Dose Validation/Expansion: Ziftomenib/7+3 in 1L NPM1-m (A-2)

Dose Validation/Expansion: Ziftomenib/Venetoclax in R/R NPM1-m (A-3)

Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in 1L NPM1-m (A-4)

Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in R/R KMT2A-r (B-1)

Dose Validation/Expansion: Ziftomenib/7+3 in 1L KMT2A-r (B-2)

Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in 1L KMT2A-r (B-3)

Arm Description

Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy

Ziftomenib/7+3 in newly diagnosed NPM1-m AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease

Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory KMT2A-r AML patients who have failed at least one prior line of therapy

Ziftomenib/7+3 in newly diagnosed KMT2A-r AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease

Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy

Ziftomenib/7+3 in newly diagnosed NPM1-m AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease

Ziftomenib/Venetoclax in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy

Ziftomenib/Venetoclax/Azacitidine in newly diagnosed NPM1-m AML patients

Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory KMT2A-r AML patients who have failed at least one prior line of therapy

Ziftomenib/7+3 in newly diagnosed KMT2A-r AML patients who are candidates for intensive chemotherapy

Ziftomenib/Venetoclax/Azacitidine in newly diagnosed KMT2A-r AML patients

Outcomes

Primary Outcome Measures

Rate of dose limiting toxicities (DLTs) per dose level
Assessed by the NCI-CTCAE v5.0
Descriptive statistics of adverse events
Assessed by the NCI-CTCAE v5.0
Complete remission (CR) rate
Assessed by the ELN 2022 criteria

Secondary Outcome Measures

Composite Complete Remission (CRc) or MLFS rate
Assessed by the ELN 2022 criteria
Measurable residual disease (MRD)
Assessed by multiparameter flow cytometry (MFC) and molecular analysis
Median OS
To assess overall survival of ziftomenib
Proportion of patients alive
To assess proportion of patients alive at 1 year following treatment with ziftomenib
Median EFS
To assess median event free survival
EFS
To assess event free survival
Median DOR
To assess median duration of remission
Proportion of patients who undergo HSCT
To assess proportion of patients who undergo hematopoietic stem cell transplant
TI
To assess rate of transfusion independence
Cmax
Maximum plasma concentration (Cmax) of ziftomenib and metabolites
Tmax
Time to maximum plasma concentration (Tmax) of ziftomenib and metabolites
AUC0-last
Area under the concentration-time curve from time zero to the time of the last quantifiable concentration after dosing (AUC0-last) of ziftomenib and metabolites
AUCtau
Area under the concentration-time curve over a dosing interval (AUCtau) of ziftomenib
Accumulation ratio of ziftomenib and metabolites
To assess accumulation ratio of ziftomenib and metabolites
Cmax of venetoclax
Maximum plasma concentration (Cmax) of venetoclax
Tmax of venetoclax
Time to maximum plasma concentration (Tmax) of venetoclax
AUC0-last of venetoclax
Area under the concentration-time curve from time zero to the time of the last quantifiable concentration after dosing (AUC0-last) of venetoclax
AUCtau of venetoclax
Area under the concentration-time curve over a dosing interval (AUCtau) of venetoclax

Full Information

First Posted
February 9, 2023
Last Updated
September 27, 2023
Sponsor
Kura Oncology, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05735184
Brief Title
A Study to Investigate the Safety and Tolerability of Ziftomenib in Combination With Venetoclax/Azacitidine, Venetoclax, or 7+3 in Patients With AML
Official Title
Phase 1 Study of Venetoclax/Azacitidine or Venetoclax in Combination With Ziftomenib or Standard Induction Cytarabine/Daunorubicin (7+3) Chemotherapy in Combination With Ziftomenib for the Treatment of Patients With Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 18, 2023 (Actual)
Primary Completion Date
May 2026 (Anticipated)
Study Completion Date
May 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kura Oncology, Inc.

4. Oversight

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

5. Study Description

Brief Summary
This Phase 1 study will assess the safety, tolerability, and preliminary antileukemic activity of ziftomenib in combination with venetoclax and azacitidine (ven/aza), ven, and 7+3 for two different molecularly-defined arms, NPM1-m and KMT2A-r.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia, Mixed Lineage Acute Leukemia, Mixed Lineage Leukemia Gene Mutation, Mixed Phenotype Acute Leukemia, Refractory AML, AML With Mutated NPM1, Acute Myeloid Leukemia Recurrent, Acute Myeloid Leukemia, in Relapse, NPM1 Mutation, KMT2Ar, Myeloid Sarcoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation: Ziftomenib/Venetoclax/Azacitidine in R/R NPM1-m (A-1)
Arm Type
Experimental
Arm Description
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy
Arm Title
Dose Escalation: Ziftomenib/7+3 in 1L NPM1-m (A-2)
Arm Type
Experimental
Arm Description
Ziftomenib/7+3 in newly diagnosed NPM1-m AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease
Arm Title
Dose Escalation: Ziftomenib/Venetoclax/Azacitidine in R/R KMT2A-r (B-1)
Arm Type
Experimental
Arm Description
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory KMT2A-r AML patients who have failed at least one prior line of therapy
Arm Title
Dose Escalation: Ziftomenib/7+3 in 1L KMT2A-r (B-2)
Arm Type
Experimental
Arm Description
Ziftomenib/7+3 in newly diagnosed KMT2A-r AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease
Arm Title
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in R/R NPM1-m (A-1)
Arm Type
Experimental
Arm Description
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy
Arm Title
Dose Validation/Expansion: Ziftomenib/7+3 in 1L NPM1-m (A-2)
Arm Type
Experimental
Arm Description
Ziftomenib/7+3 in newly diagnosed NPM1-m AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease
Arm Title
Dose Validation/Expansion: Ziftomenib/Venetoclax in R/R NPM1-m (A-3)
Arm Type
Experimental
Arm Description
Ziftomenib/Venetoclax in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy
Arm Title
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in 1L NPM1-m (A-4)
Arm Type
Experimental
Arm Description
Ziftomenib/Venetoclax/Azacitidine in newly diagnosed NPM1-m AML patients
Arm Title
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in R/R KMT2A-r (B-1)
Arm Type
Experimental
Arm Description
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory KMT2A-r AML patients who have failed at least one prior line of therapy
Arm Title
Dose Validation/Expansion: Ziftomenib/7+3 in 1L KMT2A-r (B-2)
Arm Type
Experimental
Arm Description
Ziftomenib/7+3 in newly diagnosed KMT2A-r AML patients who are candidates for intensive chemotherapy
Arm Title
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in 1L KMT2A-r (B-3)
Arm Type
Experimental
Arm Description
Ziftomenib/Venetoclax/Azacitidine in newly diagnosed KMT2A-r AML patients
Intervention Type
Drug
Intervention Name(s)
Ziftomenib
Intervention Description
Oral Administration
Intervention Type
Drug
Intervention Name(s)
Venetoclax
Intervention Description
Oral Administration
Intervention Type
Drug
Intervention Name(s)
Azacitidine
Intervention Description
Subcutaneous or Intravenous Administration
Intervention Type
Drug
Intervention Name(s)
Daunorubicin
Intervention Description
Intravenous Administration
Intervention Type
Drug
Intervention Name(s)
Cytarabine
Intervention Description
Intravenous Administration
Primary Outcome Measure Information:
Title
Rate of dose limiting toxicities (DLTs) per dose level
Description
Assessed by the NCI-CTCAE v5.0
Time Frame
During the first 28 days of ziftomenib in combination with SOC backbone treatment (1 cycle)
Title
Descriptive statistics of adverse events
Description
Assessed by the NCI-CTCAE v5.0
Time Frame
First dose of ziftomenib up to and including 28 days after last dose of ziftomenib, or if the patient is lost to follow-up, whichever comes first
Title
Complete remission (CR) rate
Description
Assessed by the ELN 2022 criteria
Time Frame
Up to 1 year following end of treatment with ziftomenib
Secondary Outcome Measure Information:
Title
Composite Complete Remission (CRc) or MLFS rate
Description
Assessed by the ELN 2022 criteria
Time Frame
Up to 1 year following end of treatment with ziftomenib
Title
Measurable residual disease (MRD)
Description
Assessed by multiparameter flow cytometry (MFC) and molecular analysis
Time Frame
Up to 1 year following end of treatment with ziftomenib
Title
Median OS
Description
To assess overall survival of ziftomenib
Time Frame
Up to 1 year following end of treatment with ziftomenib
Title
Proportion of patients alive
Description
To assess proportion of patients alive at 1 year following treatment with ziftomenib
Time Frame
1 year following end of treatment with ziftomenib
Title
Median EFS
Description
To assess median event free survival
Time Frame
Up to 1 year following end of treatment with ziftomenib
Title
EFS
Description
To assess event free survival
Time Frame
1 year following end of treatment with ziftomenib
Title
Median DOR
Description
To assess median duration of remission
Time Frame
Up to 1 year following end of treatment with ziftomenib
Title
Proportion of patients who undergo HSCT
Description
To assess proportion of patients who undergo hematopoietic stem cell transplant
Time Frame
Up to 1 year following end of treatment with ziftomenib
Title
TI
Description
To assess rate of transfusion independence
Time Frame
Up to 1 year following end of treatment with ziftomenib
Title
Cmax
Description
Maximum plasma concentration (Cmax) of ziftomenib and metabolites
Time Frame
Cycle 1. Each cycle is 28 days.
Title
Tmax
Description
Time to maximum plasma concentration (Tmax) of ziftomenib and metabolites
Time Frame
Cycle 1. Each cycle is 28 days.
Title
AUC0-last
Description
Area under the concentration-time curve from time zero to the time of the last quantifiable concentration after dosing (AUC0-last) of ziftomenib and metabolites
Time Frame
Cycle 1. Each cycle is 28 days.
Title
AUCtau
Description
Area under the concentration-time curve over a dosing interval (AUCtau) of ziftomenib
Time Frame
Cycle 1. Each cycle is 28 days.
Title
Accumulation ratio of ziftomenib and metabolites
Description
To assess accumulation ratio of ziftomenib and metabolites
Time Frame
Cycle 1. Each cycle is 28 days.
Title
Cmax of venetoclax
Description
Maximum plasma concentration (Cmax) of venetoclax
Time Frame
Cycle 1. Each cycle is 28 days.
Title
Tmax of venetoclax
Description
Time to maximum plasma concentration (Tmax) of venetoclax
Time Frame
Cycle 1. Each cycle is 28 days.
Title
AUC0-last of venetoclax
Description
Area under the concentration-time curve from time zero to the time of the last quantifiable concentration after dosing (AUC0-last) of venetoclax
Time Frame
Cycle 1. Each cycle is 28 days.
Title
AUCtau of venetoclax
Description
Area under the concentration-time curve over a dosing interval (AUCtau) of venetoclax
Time Frame
Cycle 1. Each cycle is 28 days.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Patients must have a documented NPM1 mutation or KMT2A rearrangement and have either newly diagnosed or relapsed/refractory AML Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 Adequate liver, renal, and cardiac function according to protocol defined criteria A female of childbearing potential must agree to use adequate contraception from the time of screening through 180 days following the last dose of study intervention. A male of childbearing potential must agree to use abstinence or adequate contraception from the time of screening through 90 days following the last dose of study intervention Key Exclusion Criteria: Diagnosis of either acute promyelocytic leukemia or blast chronic myelomonocytic leukemia Known history of BCR-ABL alteration Advanced malignant hepatic tumor [for patients receiving ven/aza combination] Administration of live attenuated vaccines within 14 days prior to, during, or after treatment until B-cell recovery Active central nervous system (CNS) involvement by AML. Clinical signs/symptoms of leukostasis or WBC > 25,000 / microliter. Hydroxyurea and/or leukapheresis are permitted to meet this criterion Not recovered to Grade ≤1 (NCI-CTCAE v5.0) from all nonhematological toxicities except for alopecia Known clinically active human immunodeficiency virus, active hepatitis B or active hepatitis C infection For newly diagnosed cohorts: received prior chemotherapy for leukemia, except hydroxyurea and/or leukapheresis to control leukocytosis, prior treatment with all-transretinoic acid for initially suspected acute promyelocytic leukemia, or non-HMA therapy for prior myelodysplastic syndrome For relapsed/refractory cohorts: received chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational < 14 days prior to the first dose of ziftomenib or within 5 drug half-lives prior to the first dose of study drug Uncontrolled intercurrent illness including, but not limited to, cardiac illness as defined in the protocol Mean corrected QT interval corrected for heart rate by Fredericia's formula (QTcF) >480 ms on triplicate ECGs Uncontrolled infection Women who are pregnant or lactating An active malignancy and currently receiving chemotherapy for that malignancy or disease that is uncontrolled/progressing
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Clinical Operations
Phone
617 588 3755
Email
KO-MEN-007@kuraoncology.com
Facility Information:
Facility Name
USC University of Southern California / Norris Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christine Duran
Phone
323-865-0371
Email
duran_c@med.usc.edu
Facility Name
Colorado Blood Cancer Institute
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marcello Rotta, MD
Phone
720-754-4800
Email
pslmdlcbcinewpatient@hcahealthcare.com
Facility Name
Yale Cancer Center and Smilow Cancer Hospital
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christina Wiess
Phone
203-737-3472
Email
christina.wiess@yale.edu
Facility Name
The University of Kansas Cancer Center
City
Fairway
State/Province
Kansas
ZIP/Postal Code
66205
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Thania Medrano
Email
tmedrano@kumc.edu
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Amir Fathi, MD
Phone
617-724-1124
Facility Name
Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Karmanos Cancer Institute
Phone
800-527-6266
Facility Name
TriStar Bone Marrow Transplant
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ask Sarah
Phone
844-482-4812
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
Ramya Ganesh
Phone
713-792-5640
Email
rganesh@mdanderson.org
First Name & Middle Initial & Last Name & Degree
Ghayas Issa, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

A Study to Investigate the Safety and Tolerability of Ziftomenib in Combination With Venetoclax/Azacitidine, Venetoclax, or 7+3 in Patients With AML

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