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Clinical Trial of BP1001 (L-Grb-2 Antisense Oligonucleotide) in CML, AML, ALL & MDS

Primary Purpose

Recurrent Adult Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Myelodysplastic Syndrome

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
BP1001
BP1001 in combination with LDAC
Sponsored by
Bio-Path Holdings, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Adult Acute Myeloid Leukemia focused on measuring Liposomal Grb-2 treatment of CML, AML, CLL, MDS, Liposomal Grb-2 with LDAC for AML

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Male or female patients 18 years of age or older
  2. A diagnosis of refractory or relapsed AML, or Ph+ CML (in chronic, accelerated or blast phase, or acute lymphoblastic leukemia, or myelodysplastic syndrome.

    One of the following parameters is required to meet criteria for accelerated phase CML:

    • Blasts in Peripheral Blood or Bone Marrow ≥15%
    • Promyelocytes and Blasts in Peripheral Blood or Bone Marrow ≥30%
    • PB or BM basophils ≥20%
    • Thrombocytopenia <100 x 103/ml, not resulting from therapy

    Blast phase is defined as ≥30% blasts in peripheral blood or bone marrow, or presence of extramedullary disease, except for liver or spleen.

  3. Patients with CML must have demonstrated resistance and/or intolerance to therapy with at least 2 tyrosine kinase inhibitors (TKI)
  4. Patients with AML and ALL should have received at least 1 prior treatment regimen and either failed to achieve response or relapsed on treatment
  5. Patients with MDS should have failed prior therapy with a hypomethylating agent or, if associated with a 5q- chromosomal abnormality, lenalidomide. NOTE: Patients with 5q- unable to receive or intolerant to lenalidomide are also eligible.
  6. Have clinically adequate hepatic and renal functions as defined by:

    • ALT<2x ULN
    • Serum creatinine concentration <2x ULN
    • Serum bilirubin <2x ULN
  7. Patients must sign an informed consent
  8. Women of childbearing age must have a negative serum or urine pregnancy test prior to the initiation of study drug.
  9. Barrier contraceptive precautions are to be used throughout the trial by all study participants of child bearing potential.
  10. Have not received anti-cancer therapy for at least 2 weeks prior to study entry, with the exception of low dose ara-C (LDAC) given as subcutaneous injections (no less than 15 days prior), hydroxyurea or anagrelide (no less than 24 hours prior), TKI (no less than 5 days prior), and interferon (no less than 2 weeks prior)
  11. Have an ECOG Performance of 0-2
  12. Have a life-expectancy ≥3 months

Exclusion Criteria

  1. Serious intercurrent medical illnesses which would interfere with the ability of the patient to carry out the treatment program
  2. Pregnant or breastfeeding women
  3. Patients who have uncontrolled active infection
  4. Patients who have received another investigational product within the longer of 14 days or 5 half-lives of the previous product
  5. Any history of adverse reaction or hypersensitivity to LDAC

Part B: BP1001 with Concurrent LDAC Dose-Expansion Cohorts

Enrollment in the dose-expansion cohorts (DEC) will be limited to only those patients with a diagnosis of refractory or relapsed AML(except acute promyelocytic leukemia) or those who are refractory to at least 1 prior therapy regimen and no more than 1 prior salvage regimen.

Sites / Locations

  • M. D. Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

BP1001

BP1001 in combination with LDAC

Arm Description

Subjects are treated with open-label study drug (BP1001) in a dose-escalation model.

AML subjects are treated with open-label escalating study drug (BP1001) in combination with low dose ara-C (LDAC)

Outcomes

Primary Outcome Measures

Safety of BP1001
Evaluate toxicity, tolerance, and MTD of escalating doses of BP1001
Safety of BP1001 in combination with LDAC
Evaluate safety and toxicity of the combination of BP1001 and concurrent LDAC using non-hematologic and hematologic measures per NCI CTCAE criteria.

Secondary Outcome Measures

Optimal biologically active dose
Determine the optimal biologically active dose of BP1001 defined as a 50% reduction in Grb-2 expression in circulating leukemia cells
In vivo pharmacokinetics
Evaluate the in vivo PK of BP1001 in all subjects using plasma and urine to compute half life and elimination
Correlate PK data with historical experience
Correlate the in vivo PK data with historical experience to demonstrate the liposomal delivery performs as expected for all subjects by comparing PK data (half life and elimination) obtained from each subject with historical experience

Full Information

First Posted
July 7, 2010
Last Updated
May 26, 2020
Sponsor
Bio-Path Holdings, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01159028
Brief Title
Clinical Trial of BP1001 (L-Grb-2 Antisense Oligonucleotide) in CML, AML, ALL & MDS
Official Title
A Phase I Clinical Trial to Study the Safety, Pharmacokinetics, and Efficacy of BP1001 (L-Grb-2 Antisense Oligonucleotide) in Patients With Refractory or Relapsed Acute Myeloid Leukemia, Philadelphia Chromosome Positive Chronic Myelogenous Leukemia, or Acute Lymphoblastic Leukemia, and Myelodysplastic Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Completed
Study Start Date
June 2010 (undefined)
Primary Completion Date
March 30, 2017 (Actual)
Study Completion Date
March 30, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bio-Path Holdings, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The first goal of this clinical research study is to find the highest safe dose of BP1001, a liposomal Growth Factor Receptor Bound Protein-2 antisense oligodeoxynucleotide (L-Grb2 AS), for patients with Philadelphia Chromosome positive CML, AML, ALL and MDS. The response of the leukemia to this treatment will also be studied. The second goal of this clinical research study is to evaluate the safety and toxicity of the combination of BP1001 and concurrent low-dose ara-C (LDAC) in patients with AML.
Detailed Description
The Philadelphia Chromosome is an unusual genetic trait found in 90-95% of patients with CML and approximately 20-25% of patients with ALL. The protein created by this unusual trait causes normal cells within the body to become cancer cells, and then causes these cells to grow and divide at a rapid rate. Researchers think that the protein "Growth Factor Receptor Bound Protein-2 (Grb-2)" plays an important role in the rapid growth of leukemic cells. The study drug (BP1001) may be able to inhibit the cells from making Grb-2. Researchers hope that without this protein, the leukemia cells will die. Up to 60 patients are expected to be enrolled on this study. Part A: Dose escalation: Each cohort will receive BP1001 at a dose higher than the previous group. Part B: Dose-expansion Cohorts: Subjects with relapsed or refractory AML will receive escalating doses of BP1001 concurrently with fixed low-dose ara-C (LDAC) The study drug is an antisense molecule complementary to the messenger RNA (mRNA) code for the cell's expression of the protein Grb-2. The study drug is incorporated into lipid (fat) particles known as liposomes. This incorporation process is part of the manufacturing process and is done before the study drug is administered. The liposomes (which carry the study drug) will be administered intravenously twice a week for 28 days. Subjects enrolled in Part B of the study will receive study drug twice a week for 28 days concurrently with low dose ara-C, self administered twice daily for 10 consecutive days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Adult Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Myelodysplastic Syndrome, Ph1 Positive CML
Keywords
Liposomal Grb-2 treatment of CML, AML, CLL, MDS, Liposomal Grb-2 with LDAC for AML

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
BP1001
Arm Type
Experimental
Arm Description
Subjects are treated with open-label study drug (BP1001) in a dose-escalation model.
Arm Title
BP1001 in combination with LDAC
Arm Type
Experimental
Arm Description
AML subjects are treated with open-label escalating study drug (BP1001) in combination with low dose ara-C (LDAC)
Intervention Type
Drug
Intervention Name(s)
BP1001
Other Intervention Name(s)
Liposomal Grb-2, L-Grb-2, BP-100-1.01
Intervention Description
Study drug (BP1001) is constituted in normal saline, administered by IV on twice weekly for 28 days.
Intervention Type
Drug
Intervention Name(s)
BP1001 in combination with LDAC
Other Intervention Name(s)
Liposomal Grb-2, L-Grb-2, BP-100-1.01, low dose ara-C
Intervention Description
Study drug (BP1001) is constituted in normal saline, administered by IV twice weekly for 28 days. Low dose ara-C (LDAC) is self administered twice daily for 10 consecutive days during the 28 day cycle.
Primary Outcome Measure Information:
Title
Safety of BP1001
Description
Evaluate toxicity, tolerance, and MTD of escalating doses of BP1001
Time Frame
30 days
Title
Safety of BP1001 in combination with LDAC
Description
Evaluate safety and toxicity of the combination of BP1001 and concurrent LDAC using non-hematologic and hematologic measures per NCI CTCAE criteria.
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Optimal biologically active dose
Description
Determine the optimal biologically active dose of BP1001 defined as a 50% reduction in Grb-2 expression in circulating leukemia cells
Time Frame
30 days
Title
In vivo pharmacokinetics
Description
Evaluate the in vivo PK of BP1001 in all subjects using plasma and urine to compute half life and elimination
Time Frame
30 days
Title
Correlate PK data with historical experience
Description
Correlate the in vivo PK data with historical experience to demonstrate the liposomal delivery performs as expected for all subjects by comparing PK data (half life and elimination) obtained from each subject with historical experience
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Male or female patients 18 years of age or older A diagnosis of refractory or relapsed AML, or Ph+ CML (in chronic, accelerated or blast phase, or acute lymphoblastic leukemia, or myelodysplastic syndrome. One of the following parameters is required to meet criteria for accelerated phase CML: Blasts in Peripheral Blood or Bone Marrow ≥15% Promyelocytes and Blasts in Peripheral Blood or Bone Marrow ≥30% PB or BM basophils ≥20% Thrombocytopenia <100 x 103/ml, not resulting from therapy Blast phase is defined as ≥30% blasts in peripheral blood or bone marrow, or presence of extramedullary disease, except for liver or spleen. Patients with CML must have demonstrated resistance and/or intolerance to therapy with at least 2 tyrosine kinase inhibitors (TKI) Patients with AML and ALL should have received at least 1 prior treatment regimen and either failed to achieve response or relapsed on treatment Patients with MDS should have failed prior therapy with a hypomethylating agent or, if associated with a 5q- chromosomal abnormality, lenalidomide. NOTE: Patients with 5q- unable to receive or intolerant to lenalidomide are also eligible. Have clinically adequate hepatic and renal functions as defined by: ALT<2x ULN Serum creatinine concentration <2x ULN Serum bilirubin <2x ULN Patients must sign an informed consent Women of childbearing age must have a negative serum or urine pregnancy test prior to the initiation of study drug. Barrier contraceptive precautions are to be used throughout the trial by all study participants of child bearing potential. Have not received anti-cancer therapy for at least 2 weeks prior to study entry, with the exception of low dose ara-C (LDAC) given as subcutaneous injections (no less than 15 days prior), hydroxyurea or anagrelide (no less than 24 hours prior), TKI (no less than 5 days prior), and interferon (no less than 2 weeks prior) Have an ECOG Performance of 0-2 Have a life-expectancy ≥3 months Exclusion Criteria Serious intercurrent medical illnesses which would interfere with the ability of the patient to carry out the treatment program Pregnant or breastfeeding women Patients who have uncontrolled active infection Patients who have received another investigational product within the longer of 14 days or 5 half-lives of the previous product Any history of adverse reaction or hypersensitivity to LDAC Part B: BP1001 with Concurrent LDAC Dose-Expansion Cohorts Enrollment in the dose-expansion cohorts (DEC) will be limited to only those patients with a diagnosis of refractory or relapsed AML(except acute promyelocytic leukemia) or those who are refractory to at least 1 prior therapy regimen and no more than 1 prior salvage regimen.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jorge Cortes, MD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Maro Ohanian, MD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
M. D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29550383
Citation
Ohanian M, Tari Ashizawa A, Garcia-Manero G, Pemmaraju N, Kadia T, Jabbour E, Ravandi F, Borthakur G, Andreeff M, Konopleva M, Lim M, Pierce S, O'Brien S, Alvarado Y, Verstovsek S, Wierda W, Kantarjian H, Cortes J. Liposomal Grb2 antisense oligodeoxynucleotide (BP1001) in patients with refractory or relapsed haematological malignancies: a single-centre, open-label, dose-escalation, phase 1/1b trial. Lancet Haematol. 2018 Apr;5(4):e136-e146. doi: 10.1016/S2352-3026(18)30021-8. Epub 2018 Mar 14.
Results Reference
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Clinical Trial of BP1001 (L-Grb-2 Antisense Oligonucleotide) in CML, AML, ALL & MDS

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