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Dose Escalation, Safety and Pharmacokinetic Study of SAR103168 in Patients Refractory/ Relapsed Acute Leukemias or High-risk Myelodysplastic Syndromes

Primary Purpose

Acute Myelogenous Leukemia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SAR103168
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myelogenous Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with refractory/relapsed acute leukemias or high-risk myelodysplastic syndromes with no curative option available including any of the following:

    • Patients with de novo or secondary acute myelogenous leukemia (AML) (except acute promyelocytic leukemia), meeting one of the following conditions:
    • Refractory or relapsed AML; In case of first relapse the CR duration should be less than 12 months. If the relapse failed at least one prior salvage attempt, the CR duration may be more than 12 months.
    • Into the expanded cohort at the MTD, previously untreated AML patients over age 60 with poor- risk cytogenetics who are not eligible for or do not accept induction chemotherapy may also be included.
  • Patients with refractory/relapsed acute lymphoblastic leukemia (ALL)
  • Patients with high-risk myelodysplastic syndrome (MDS) as defined by the International Prognostic Scoring System
  • Patients with chronic myeloid leukemia in blast phase (CML-BP)

Exclusion Criteria:

  • performance status > 2
  • Active uncontrolled central nervous system leukemia
  • Cytotoxic therapy within 2 weeks prior to the first dose of SAR103168. For the non cytotoxic agents/investigational drugs this washout period should be at least 2 weeks or at least 5 half-lives whichever is longer. Hydroxyurea must be stopped at least 24 hours prior to the first dose of SAR103168
  • Lack of recovery from toxicities from prior therapies to grade < 1
  • White blood cells > 30 x 10^9/L prior to the first dose of SAR103168
  • Prior allogeneic stem cell transplantation or donor lymphocytes infusion within 3 months preceding the first dose of SAR103168
  • Any of the following within 6 months prior to the first dose of SAR103168:

    • Myocardial infarction, congestive heart failure, documented angina pectoris, arrhythmia requiring medication (in particular atrial fibrillation or flutter), severe conduction disorder (second or third atrio-ventricular block, pacemaker), coronary/peripheral artery bypass graft surgery
    • Arterial or venous thromboembolism, deep venous thrombosis
  • Left ventricular ejection fraction < 50% by echocardiography or multiple gated acquisition scan
  • Cardiac ischemia on 12-lead ECG
  • Baseline QTc-interval > 500 msec
  • Hypertension uncontrolled with appropriate therapy
  • Active infection (viral, bacterial or fungal) uncontrolled with appropriate therapy
  • Major surgery within 6 weeks prior to the first dose of SAR103168
  • Poor organ function defined by one of the following:

    • Total bilirubin > 1.5 x upper limit of normal (ULN) unless related to leukemia (i.e. hemolysis) or Gilbert's syndrome
    • Aspartate aminotransferase (AST), alanine aminotransferase (ALT) > 2.5 x ULN
    • Serum creatinine > 1.5 x ULN or calculated creatinine clearance < 50 mL/min
  • Patients under treatment with potent inhibitors of CYP3A4 unless these treatments may be stopped at least 3 days prior to the first dose of SAR103168
  • Patients under treatment with CYP3A4 or CYP2C9 inducers, unless these treatments may be stopped at least 3 days prior to the first dose of SAR103168
  • Pregnant or breast-feeding women or refusal to use adequate contraceptive method, when applicable.

Sites / Locations

  • Sanofi-Aventis Investigational Site Number 840003
  • Sanofi-Aventis Investigational Site Number 840002
  • Sanofi-Aventis Investigational Site Number 840001

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dose escalation

Arm Description

Cohorts of 3 to 6 patients will be included at each dose level. The starting dose is 1.2mg/m2/day. The dose will be increased in new cohorts of patients according to toxicities observed during the first 4-week treatment period. The escalation process will continue until the MTD is determined. Additional 15 patients will be included at the MTD.

Outcomes

Primary Outcome Measures

Incidence of DLTs during the initial 4-week period of treatment
Pharmacokinetic parameters of SAR103168

Secondary Outcome Measures

Global safety profile of SAR103168 based on treatment emergent adverse events (TEAEs), serious adverse events (SAEs), deaths, laboratory abnormalities
Preliminary evidence of anti-leukemia activity
Pharmacokinetic parameters of midazolam in the absence and the presence of SAR103168.

Full Information

First Posted
September 21, 2009
Last Updated
March 26, 2012
Sponsor
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT00981240
Brief Title
Dose Escalation, Safety and Pharmacokinetic Study of SAR103168 in Patients Refractory/ Relapsed Acute Leukemias or High-risk Myelodysplastic Syndromes
Official Title
A Dose Escalation Safety and Pharmacokinetic Study of SAR103168 Administered as a Single Agent by Intravenous Infusion, Once Daily for 5 Consecutive Days to Patients With Refractory/ Relapsed Acute Leukemias or High-risk Myelodysplastic Syndromes.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
September 2009 (undefined)
Primary Completion Date
January 2012 (Actual)
Study Completion Date
February 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Primary objectives: To determine the maximum tolerated dose (MTD) of SAR103168 and to characterize the dose limiting toxicities (DLTs) in the proposed dose regimen To evaluate the pharmacokinetic (PK) profile of SAR103168 Secondary objectives: To characterize the global safety profile of SAR103168 To evaluate preliminary anti-leukemia activity To investigate the potential induction effect on CYP3A4 and persistence of this effect by using oral midazolam as a probe substrate in patients enrolled into the expanded cohort at the MTD To determine the metabolic pathways of SAR103168 and identify the chemical structures of metabolites To determine the potential impact of SAR103168 on the QTc interval in patients enrolled at the MTD
Detailed Description
Patients will receive the study drug until unacceptable toxicity, clinically significant disease progression, withdrawal of consent or investigator's decision, and for a maximum of 1 year.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myelogenous Leukemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose escalation
Arm Type
Experimental
Arm Description
Cohorts of 3 to 6 patients will be included at each dose level. The starting dose is 1.2mg/m2/day. The dose will be increased in new cohorts of patients according to toxicities observed during the first 4-week treatment period. The escalation process will continue until the MTD is determined. Additional 15 patients will be included at the MTD.
Intervention Type
Drug
Intervention Name(s)
SAR103168
Intervention Description
Pharmaceutical form: Concentrate for solution for infusion Route of administration: Intravenous infusion
Primary Outcome Measure Information:
Title
Incidence of DLTs during the initial 4-week period of treatment
Time Frame
4 weeks
Title
Pharmacokinetic parameters of SAR103168
Time Frame
First course: Days 1, 2, 5, 6, and 8; Second and subsequent courses: Day 5 only
Secondary Outcome Measure Information:
Title
Global safety profile of SAR103168 based on treatment emergent adverse events (TEAEs), serious adverse events (SAEs), deaths, laboratory abnormalities
Time Frame
Treatment period up to 1 year
Title
Preliminary evidence of anti-leukemia activity
Time Frame
Treatment period up to 1 year
Title
Pharmacokinetic parameters of midazolam in the absence and the presence of SAR103168.
Time Frame
During second (Day-1 and Day 5) and forth course (Day 5)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with refractory/relapsed acute leukemias or high-risk myelodysplastic syndromes with no curative option available including any of the following: Patients with de novo or secondary acute myelogenous leukemia (AML) (except acute promyelocytic leukemia), meeting one of the following conditions: Refractory or relapsed AML; In case of first relapse the CR duration should be less than 12 months. If the relapse failed at least one prior salvage attempt, the CR duration may be more than 12 months. Into the expanded cohort at the MTD, previously untreated AML patients over age 60 with poor- risk cytogenetics who are not eligible for or do not accept induction chemotherapy may also be included. Patients with refractory/relapsed acute lymphoblastic leukemia (ALL) Patients with high-risk myelodysplastic syndrome (MDS) as defined by the International Prognostic Scoring System Patients with chronic myeloid leukemia in blast phase (CML-BP) Exclusion Criteria: performance status > 2 Active uncontrolled central nervous system leukemia Cytotoxic therapy within 2 weeks prior to the first dose of SAR103168. For the non cytotoxic agents/investigational drugs this washout period should be at least 2 weeks or at least 5 half-lives whichever is longer. Hydroxyurea must be stopped at least 24 hours prior to the first dose of SAR103168 Lack of recovery from toxicities from prior therapies to grade < 1 White blood cells > 30 x 10^9/L prior to the first dose of SAR103168 Prior allogeneic stem cell transplantation or donor lymphocytes infusion within 3 months preceding the first dose of SAR103168 Any of the following within 6 months prior to the first dose of SAR103168: Myocardial infarction, congestive heart failure, documented angina pectoris, arrhythmia requiring medication (in particular atrial fibrillation or flutter), severe conduction disorder (second or third atrio-ventricular block, pacemaker), coronary/peripheral artery bypass graft surgery Arterial or venous thromboembolism, deep venous thrombosis Left ventricular ejection fraction < 50% by echocardiography or multiple gated acquisition scan Cardiac ischemia on 12-lead ECG Baseline QTc-interval > 500 msec Hypertension uncontrolled with appropriate therapy Active infection (viral, bacterial or fungal) uncontrolled with appropriate therapy Major surgery within 6 weeks prior to the first dose of SAR103168 Poor organ function defined by one of the following: Total bilirubin > 1.5 x upper limit of normal (ULN) unless related to leukemia (i.e. hemolysis) or Gilbert's syndrome Aspartate aminotransferase (AST), alanine aminotransferase (ALT) > 2.5 x ULN Serum creatinine > 1.5 x ULN or calculated creatinine clearance < 50 mL/min Patients under treatment with potent inhibitors of CYP3A4 unless these treatments may be stopped at least 3 days prior to the first dose of SAR103168 Patients under treatment with CYP3A4 or CYP2C9 inducers, unless these treatments may be stopped at least 3 days prior to the first dose of SAR103168 Pregnant or breast-feeding women or refusal to use adequate contraceptive method, when applicable.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Farhad Ravandi-Kashani, MD
Organizational Affiliation
M.D. Anderson Cancer Center, Houston, Texas
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sanofi-Aventis Investigational Site Number 840003
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Sanofi-Aventis Investigational Site Number 840002
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Sanofi-Aventis Investigational Site Number 840001
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24794806
Citation
Roboz GJ, Khoury HJ, Jabbour E, Session W, Ritchie EK, Miao H, Faderl S, Zheng W, Feldman EJ, Arellano M, Morrison JG, Ravandi F. Phase I trial of SAR103168, a novel multi-kinase inhibitor, in patients with refractory/relapsed acute leukemia or high-risk myelodysplastic syndrome. Leuk Lymphoma. 2015 Feb;56(2):395-400. doi: 10.3109/10428194.2014.918970.
Results Reference
derived

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Dose Escalation, Safety and Pharmacokinetic Study of SAR103168 in Patients Refractory/ Relapsed Acute Leukemias or High-risk Myelodysplastic Syndromes

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