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Dose Escalation Study to Investigate the Safety, Tolerability and Pharmacokinetics of ASP2215 in Japanese Patients With Relapsed or Refractory Acute Myeloid Leukemia

Primary Purpose

Acute Myeloid Leukemia (AML)

Status
Completed
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
Gilteritinib
Sponsored by
Astellas Pharma Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia (AML) focused on measuring AML, Acute myeloid leukemia, Gilteritinib, ASP2215

Eligibility Criteria

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

Inclusion Criteria:

  • Subject is defined as morphologically documented primary or secondary acute myeloid leukemia (AML) according to the World Health Organization (WHO) criteria (2008) and fulfills one of the following:

    • Refractory to prior induction chemotherapy
    • Relapsed after achieving remission with prior therapy
  • Subject has an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
  • Subject's interval from prior treatment to the time of study drug administration is at least 14 days for antineoplastic agents other than ASP2215 (except for hydroxyurea, which is given to control blast cells).
  • Subject's interval from prior treatment to the time of study drug (ASP2215) administration is at least 5 half-lives (if the half-life is unknown, 14 days) for other investigational products or drugs used for immunosuppressive therapy posthematopoietic stem cell transplantation (HSCT).

Exclusion Criteria:

  • Subject was diagnosed with acute promyelocytic leukemia (APL).
  • Subject has breakpoint cluster region-abelson (BCR-ABL)-positive leukemia (chronic myelogenous leukemia in blast crisis)
  • Subject has active malignant tumors other than AML or myelodysplastic syndrome (MDS)
  • Subject has persistent non-hematological toxicities of ≥ Grade 2 (CTCAE v4), with symptoms and objective findings, due to prior AML treatment (including chemotherapy, kinase inhibitors, immunotherapy, investigational products, radiation therapy, and surgery)
  • Subject has received hematopoietic stem cell transplant (HSCT) and falls under either of the following:

    • Is within 2 months of transplant
    • Has persistent and clinically significant graft-versus-host disease requiring treatment
    • Has persistent non-hematological toxicities of ≥ Grade 2 related to the transplant
  • Subject has clinically active central nervous system leukemia
  • Subject has disseminated intravascular coagulation (DIC)
  • Subject has had major surgery within 28 days prior to the first study drug administration
  • Subject has had radiation therapy within 28 days prior to the first study drug administration
  • Subject has congestive heart failure of NYHA class 3 or 4, or subject with a past history of congestive heart failure of NYHA class 3 or 4 and in whom echocardiogram or Multiple Gate Acquisition (MUGA) scan performed within 3 months prior to screening or at screening showed a left ventricular ejection fraction (LVEF) of < 45%.
  • Subject requires treatment with concomitant drugs that are strong inhibitors or inducers of CYP3A4 or of P-gp with such exceptions of antibiotics, antifungals, and antivirals that are considered absolutely essential for prevention or treatment of infections and for which the physician judged that there are no interchangeable drugs.
  • Subject requires treatment with concomitant drugs that target serotonin 5HT1R or 5HT2BR receptors or sigma nonspecific receptors, with the exception of drugs that are considered absolutely essential for treatment of the subject.
  • Subject has an active uncontrollable infection
  • Subject is known to have human immunodeficiency virus (HIV) infection
  • Subject has active hepatitis B or C or other active hepatic disorders

Sites / Locations

  • Site JP00002
  • Site JP00003
  • Site JP00001
  • Site JP00004
  • Site JP00005

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dose Escalation Cohort

Arm Description

ASP2215

Outcomes

Primary Outcome Measures

Safety and Tolerability assessed through adverse events to determine maximum tolerated dose

Secondary Outcome Measures

Response Rate
Response Rate includes following parameters; CR rate, composite CR [CR + CRp + CRi] rate, overall response rate [CRc + PR], duration of response
Pharmacokinetics of ASP2215 in plasma: AUCinf
Area under the concentration-time curve from the time of dosing extrapolated to time infinity
Pharmacokinetics of ASP2215 in plasma: AUClast
Area under the concentration-time curve from the time of dosing to the last measurable concentration
Pharmacokinetics of ASP2215 in plasma: AUC24
Area under the plasma concentration time curve from time 0 to 24 hours
Pharmacokinetics of ASP2215 in plasma: AUC48
Area under the plasma concentration time curve from time 0 to 48 hours
Pharmacokinetics of ASP2215 in plasma: Cmax
Maximum concentration
Pharmacokinetics of ASP2215 in plasma: C24
Concentration at 24 hours
Pharmacokinetics of ASP2215 in plasma: CLF
Oral clearance
Pharmacokinetics of ASP2215 in plasma: Lambda z
Terminal first order elimination rate constant
Pharmacokinetics of ASP2215: tmax
Time to attain Cmax
Pharmacokinetics of ASP2215 in plasma: t1/2
Apparent terminal elimination half-life
Pharmacokinetics of ASP2215 in plasma: Vz/F
Apparent volume of distribution during the terminal elimination phase after oral dosing
Pharmacokinetics of ASP2215 in plasma: AUCtau
Area under the plasma concentration time curve during a dosing interval
Pharmacokinetics of ASP2215 in plasma: PTR
Peak-trough ratio
Pharmacokinetics of ASP2215 in plasma: Rac(AUC)
Accumulation ratio calculated using the area under the concentration-time curve
Pharmacokinetics of ASP2215 in plasma: Rac(Cmax)
Accumulation ratio calculated using the maximum concentration
Pharmacokinetics of ASP2215 in plasma: Rac derived t1/2
t1/2 derived from accumulation index
Pharmacokinetics of ASP2215 in plasma: Ctrough
Plasma trough concentration
Pharmacokinetics of ASP2215 in urine: Ae24
Amount of drug excreted in urine from time 0 to 24 hours
Pharmacokinetics of ASP2215 in urine: Ae48
Amount of drug excreted in urine from time 0 to 48 hours
Pharmacokinetics of ASP2215 in urine: Ae24%
Fraction of drug excreted into urine from time 0 to 24 hours as % of dose
Pharmacokinetics of ASP2215 in urine: Ae48%
Fraction of drug excreted into urine from time 0 to 48 hours as % of dose
Pharmacokinetics of ASP2215 in urine: CLR
Renal clearance
Pharmacokinetics of ASP2215 in urine: Aetau
Amount of drug excreted in urine during a dosing interval
Pharmacokinetics of ASP2215 in urine: Aetau %
Fraction of drug excreted in urine during a dosing interval

Full Information

First Posted
July 2, 2014
Last Updated
December 20, 2018
Sponsor
Astellas Pharma Inc
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1. Study Identification

Unique Protocol Identification Number
NCT02181660
Brief Title
Dose Escalation Study to Investigate the Safety, Tolerability and Pharmacokinetics of ASP2215 in Japanese Patients With Relapsed or Refractory Acute Myeloid Leukemia
Official Title
A Phase 1 Open-label, Dose-escalation Study Investigating the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ASP2215 in Japanese Patients With Relapsed or Refractory Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Completed
Study Start Date
June 16, 2014 (Actual)
Primary Completion Date
June 27, 2016 (Actual)
Study Completion Date
June 27, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Astellas Pharma Inc

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objectives of this study are to determine the safety and tolerability of ASP2215 as well as the maximum tolerated dose (MTD) based on the onset of dose limiting toxicity (DLT) and/or determine the recommended dose (RD) of ASP2215 for the next phase in subjects with relapsed or treatment-refractory acute myeloid leukemia (AML).
Detailed Description
This study will be conducted to determine the safety, tolerability, PK, PD, and efficacy of single and repeated oral dosing of ASP2215 once daily in patients with relapsed or refractory AML. After the determination of the MTD and/or RD, an expansion cohort might be set to further investigate the safety and efficacy of ASP2215. This study will consist of a single-dose period (Cycle 0, 2 days) and a repeated-dose period (Cycle 1 and subsequent cycles, each cycle consisting of 28 days). The enrolled subjects will orally receive their assigned single dose in Cycle 0 (Day -2), followed by a 2-day observation period (dosing day inclusive). In Cycle 1 and subsequent cycles (one cycle is defined as 28 days), the subjects will receive oral ASP2215 once daily repeatedly until one of the discontinuation criteria is met. Another dosing regimen may be considered such as dosing twice daily based on the safety and PK data that will become available. In this study, the Bayesian-Continual Reassessment Method (hereinafter, Bayesian-CRM) will be used as a reference for dose-escalation procedures, and based on the onset of DLTs, the RD level of the subsequent cohort will be set higher or lower. DLTs will be assessed during Cycle 0 and Cycle 1 (30 days). ASP2215 may be escalated by one dose level if the subject meets the criteria at the end of each cycle after Cycle 1 and the investigator/sub-investigator judges escalation of ASP2215 is of clinical benefit. Dose reduction of ASP2215 will be considered if study drug-related toxicities are observed in a subject.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia (AML)
Keywords
AML, Acute myeloid leukemia, Gilteritinib, ASP2215

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation Cohort
Arm Type
Experimental
Arm Description
ASP2215
Intervention Type
Drug
Intervention Name(s)
Gilteritinib
Other Intervention Name(s)
ASP2215
Intervention Description
oral
Primary Outcome Measure Information:
Title
Safety and Tolerability assessed through adverse events to determine maximum tolerated dose
Time Frame
Up to 17 months
Secondary Outcome Measure Information:
Title
Response Rate
Description
Response Rate includes following parameters; CR rate, composite CR [CR + CRp + CRi] rate, overall response rate [CRc + PR], duration of response
Time Frame
Up to 16 months
Title
Pharmacokinetics of ASP2215 in plasma: AUCinf
Description
Area under the concentration-time curve from the time of dosing extrapolated to time infinity
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in plasma: AUClast
Description
Area under the concentration-time curve from the time of dosing to the last measurable concentration
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in plasma: AUC24
Description
Area under the plasma concentration time curve from time 0 to 24 hours
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in plasma: AUC48
Description
Area under the plasma concentration time curve from time 0 to 48 hours
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in plasma: Cmax
Description
Maximum concentration
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1 and Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: C24
Description
Concentration at 24 hours
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1 and Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: CLF
Description
Oral clearance
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1 and Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: Lambda z
Description
Terminal first order elimination rate constant
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215: tmax
Description
Time to attain Cmax
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1 and Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: t1/2
Description
Apparent terminal elimination half-life
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in plasma: Vz/F
Description
Apparent volume of distribution during the terminal elimination phase after oral dosing
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in plasma: AUCtau
Description
Area under the plasma concentration time curve during a dosing interval
Time Frame
Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: PTR
Description
Peak-trough ratio
Time Frame
Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: Rac(AUC)
Description
Accumulation ratio calculated using the area under the concentration-time curve
Time Frame
Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: Rac(Cmax)
Description
Accumulation ratio calculated using the maximum concentration
Time Frame
Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: Rac derived t1/2
Description
t1/2 derived from accumulation index
Time Frame
Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in plasma: Ctrough
Description
Plasma trough concentration
Time Frame
Cycle 1 Day 8, Day 15, Day 22, Day 28 and Day 29
Title
Pharmacokinetics of ASP2215 in urine: Ae24
Description
Amount of drug excreted in urine from time 0 to 24 hours
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in urine: Ae48
Description
Amount of drug excreted in urine from time 0 to 48 hours
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in urine: Ae24%
Description
Fraction of drug excreted into urine from time 0 to 24 hours as % of dose
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in urine: Ae48%
Description
Fraction of drug excreted into urine from time 0 to 48 hours as % of dose
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1
Title
Pharmacokinetics of ASP2215 in urine: CLR
Description
Renal clearance
Time Frame
Cycle 0 Day -2 through Cycle 1 Day 1 and Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in urine: Aetau
Description
Amount of drug excreted in urine during a dosing interval
Time Frame
Cycle 1 Day 28
Title
Pharmacokinetics of ASP2215 in urine: Aetau %
Description
Fraction of drug excreted in urine during a dosing interval
Time Frame
Cycle 1 Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is defined as morphologically documented primary or secondary acute myeloid leukemia (AML) according to the World Health Organization (WHO) criteria (2008) and fulfills one of the following: Refractory to prior induction chemotherapy Relapsed after achieving remission with prior therapy Subject has an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2 Subject's interval from prior treatment to the time of study drug administration is at least 14 days for antineoplastic agents other than ASP2215 (except for hydroxyurea, which is given to control blast cells). Subject's interval from prior treatment to the time of study drug (ASP2215) administration is at least 5 half-lives (if the half-life is unknown, 14 days) for other investigational products or drugs used for immunosuppressive therapy posthematopoietic stem cell transplantation (HSCT). Exclusion Criteria: Subject was diagnosed with acute promyelocytic leukemia (APL). Subject has breakpoint cluster region-abelson (BCR-ABL)-positive leukemia (chronic myelogenous leukemia in blast crisis) Subject has active malignant tumors other than AML or myelodysplastic syndrome (MDS) Subject has persistent non-hematological toxicities of ≥ Grade 2 (CTCAE v4), with symptoms and objective findings, due to prior AML treatment (including chemotherapy, kinase inhibitors, immunotherapy, investigational products, radiation therapy, and surgery) Subject has received hematopoietic stem cell transplant (HSCT) and falls under either of the following: Is within 2 months of transplant Has persistent and clinically significant graft-versus-host disease requiring treatment Has persistent non-hematological toxicities of ≥ Grade 2 related to the transplant Subject has clinically active central nervous system leukemia Subject has disseminated intravascular coagulation (DIC) Subject has had major surgery within 28 days prior to the first study drug administration Subject has had radiation therapy within 28 days prior to the first study drug administration Subject has congestive heart failure of NYHA class 3 or 4, or subject with a past history of congestive heart failure of NYHA class 3 or 4 and in whom echocardiogram or Multiple Gate Acquisition (MUGA) scan performed within 3 months prior to screening or at screening showed a left ventricular ejection fraction (LVEF) of < 45%. Subject requires treatment with concomitant drugs that are strong inhibitors or inducers of CYP3A4 or of P-gp with such exceptions of antibiotics, antifungals, and antivirals that are considered absolutely essential for prevention or treatment of infections and for which the physician judged that there are no interchangeable drugs. Subject requires treatment with concomitant drugs that target serotonin 5HT1R or 5HT2BR receptors or sigma nonspecific receptors, with the exception of drugs that are considered absolutely essential for treatment of the subject. Subject has an active uncontrollable infection Subject is known to have human immunodeficiency virus (HIV) infection Subject has active hepatitis B or C or other active hepatic disorders
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Astellas Pharma Inc
Official's Role
Study Director
Facility Information:
Facility Name
Site JP00002
City
Aichi
Country
Japan
Facility Name
Site JP00003
City
Fukuoka
Country
Japan
Facility Name
Site JP00001
City
Gunma
Country
Japan
Facility Name
Site JP00004
City
Tokyo
Country
Japan
Facility Name
Site JP00005
City
Tokyo
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Access to anonymized individual participant level data will not be provided for this trial as it meets one or more of the exceptions described on www.clinicalstudydatarequest.com under "Sponsor Specific Details for Astellas."
Links:
URL
https://astellasclinicalstudyresults.com/study.aspx?ID=283
Description
Link to results on the Astellas Clinical Study Results website

Learn more about this trial

Dose Escalation Study to Investigate the Safety, Tolerability and Pharmacokinetics of ASP2215 in Japanese Patients With Relapsed or Refractory Acute Myeloid Leukemia

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