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MAX-40279 in Subjects With Acute Myelogenous Leukemia (AML)

Primary Purpose

Acute Myelogenous Leukemia (AML)

Status
Recruiting
Phase
Phase 1
Locations
Australia
Study Type
Interventional
Intervention
MAX-40279
Sponsored by
Maxinovel Pty., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myelogenous Leukemia (AML)

Eligibility Criteria

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

Inclusion Criteria:

  1. Males and/or females over age 18
  2. Ability to understand the purposes and risks of the trial and signed informed consent forms approved by the investigator's Institutional Review Board (IRB)/Independent Ethics Committee (IEC) of the trial site was obtained before the entering the trial
  3. Subject has morphologically documented primary AML or AML secondary to myelodysplastic syndrome (MDS) as defined by the World Health Organization (WHO) criteria for which no established standard therapy is available
  4. ECOG performance status of 0 to 2
  5. Persistent chronic clinically significant nonhematological toxicities from prior treatment (including chemotherapy, kinase inhibitors, immunotherapy, experimental agents, radiation, HSCT, or surgery) must be Grade ≤ 1
  6. In the absence of rapidly progressing disease clearly documented by the investigator, the interval from prior treatment to time of MAX-40279 administration will be at least 2 weeks (14 days) for prior cytotoxic agents or at least 5 half-lives for prior noncytotoxic agents, including immunosuppressive therapy post HSCT
  7. Acceptable liver function defined below:

    • Total bilirubin ≤ 1.5 times upper limit of normal range (ULN)
    • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 times ULN;
  8. Acceptable renal function defined below:

    • Serum creatinine ≤ 1.5 times ULN or calculated creatinine clearance (by the Cockcroft-Gault formula) ≥ 60 mL/min

  9. Acceptable coagulation status defined below:

    • Prothrombin time < 1.3 times ULN
    • Partial thrombin time < 1.3 times ULN
  10. No clinically significant abnormalities in urinalysis
  11. Female participants of child bearing potential agree not to be pregnant or lactating during the study and for three months following the last dose of study drug. Both men and women of reproductive potential must agree to use a highly effective method of birth control during the study and for three months following the last dose of study drug. A highly effective method of contraception is defined as one that results in a low failure rate, i.e., less than 1% per year, when used consistently and correctly

Exclusion Criteria:

  1. Disease diagnosis of acute promyelocytic leukemia
  2. Previously treated malignancies other than the current disease, except for adequately treated non-melanoma skin cancer, in situ cancer, or other cancer from which the subject has been disease-free for at least 5 years at the trial entry
  3. Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy
  4. Major surgery, other than diagnostic surgery, within 4 weeks prior to the trial entry, without complete recovery
  5. Percutaneous coronary intervention conducted within 6 months prior to the trial entry for cardiac infarction or angina pectoris
  6. Seizure disorders requiring anticonvulsant therapy
  7. Taking a medication that prolongs QT interval and has a risk of Torsades de Pointes,or a history of long QT syndrome
  8. Medical history of difficulty swallowing, malabsorption or other chronic gastrointestinal disease, or conditions that may hamper compliance and/or absorption of the tested product
  9. Participation in an investigational drug or device trial within 4 weeks prior to the trial entry
  10. Known infection with human immunodeficiency virus (HIV), hepatitis B, or hepatitis C
  11. Recent venous thrombosis (including deep vein thrombosis or pulmonary embolism within 1 year of study)
  12. History of upper gastrointestinal hemorrhage, peptic ulcer disease, or bleeding diathesis
  13. Subject is pregnant (positive serum beta human chorionic gonadotropin [β-HCG] test at screening) or is currently breast-feeding, their partner anticipates becoming pregnant/impregnating during the trial or within 6 months after receiving the last dose of trial treatment
  14. Concomitant disease or condition that could interfere with the conduct of the trial, or that would, in the opinion of the Investigator, pose an unacceptable risk to the subject in this trial
  15. Unwillingness or inability to comply with the trial protocol for any reason
  16. Legal incapacity or limited legal capacity
  17. Cardiac disease with New York Heart Association (NYHA) Class III or IV, including congestive heart failure, myocardial infarction within 6 months prior to the trial entry, unstable arrhythmia, or symptomatic peripheral arterial vascular

Sites / Locations

  • St Vincent's Hospital Sydney LimitedRecruiting
  • Western NSW Local Health DistrictRecruiting
  • Monash HealthRecruiting
  • Austin HealthRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MAX-40279

Arm Description

MAX-40279 is provided as a capsule for oral use at 5mg, 25mg. In the dose-escalation phase, patients will be enrolled sequentially into the 5 dose levels of MAX-40279 designated in this study: 20, 40, 70, 100 and 120 mg/day (3-6 patients per cohort),bid.For each dose level, a single dose of MAX-40279 will be first administered orally followed by 1 day observation, then continuous treatment will start 4 weeks treatment (per cycle). After completion of the dose escalation, additional patients will be enrolled into dose expansion at the Maximum tolerated dose(MTD), up to 12 patients will be enrolled into expansion cohorts.

Outcomes

Primary Outcome Measures

Adverse events (AEs)
Incidence of treatment-related AEs
Maximum tolerated dose (MTD)
MTD will be defined as the maximum dose level at which no more than 1 of 3 participants experience a dose-limiting toxicity (DLT) within the first 4 weeks of multiple dosing.

Secondary Outcome Measures

Tmax
Time to maximum plasma concentration
Cmax
Maximum plasma drug concentration
AUC
Area under the time-concentration curve
t1/2
Observed terminal half-life
p-FLT3 Y591
To examine the phosphorylation (activation) of either wild-type or mutated Fms-like Tyrosine Kinase-3(FLT3)
FGFR aberration
To detect Fibroblast growth factor receptor(FGFR) mutation

Full Information

First Posted
January 8, 2018
Last Updated
January 18, 2022
Sponsor
Maxinovel Pty., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03412292
Brief Title
MAX-40279 in Subjects With Acute Myelogenous Leukemia (AML)
Official Title
A Phase I Trial of MAX-40279 Given Orally to Subjects With Acute Myelogenous Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2018 (Actual)
Primary Completion Date
November 1, 2022 (Anticipated)
Study Completion Date
December 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Maxinovel Pty., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a dose-escalation phase I trial to evaluate the safety and tolerability of MAX-40279 in subjects with acute myelogenous leukemia(AML).
Detailed Description
The class III receptor tyrosine kinase FMS-related tyrosine kinase 3 (FLT3), is mutated and activated in about 30% of adult patients with AML. The mutations involve either an internal tandem duplication (ITD) (in about 25% of AML patients) or a point mutation in the tyrosine kinase domain (TKD) (in about 7% of patients). Patients with mutations in FLT3, particularly those with ITD mutations, have a worse prognosis, with lower rate of complete remission, and lower overall survival . Thus, inhibition of activated FLT3 kinase by a pharmacologic agent is an attractive therapeutic strategy in AML. The aberrant of fibroblast growth factor receptor (FGFR) might be a major reason fot resistance to targeted therapies, and FGFR inhibitors significantly suppress leukemia development in vivo. MAX-40279 is a dual inhibitor of FLT3 and FGFR. Our goal is to develpe this uqiue dual inhibitor to be a more effective and wider use for AML treatment than the current known FLT3 inhibitors.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
MAX-40279
Arm Type
Experimental
Arm Description
MAX-40279 is provided as a capsule for oral use at 5mg, 25mg. In the dose-escalation phase, patients will be enrolled sequentially into the 5 dose levels of MAX-40279 designated in this study: 20, 40, 70, 100 and 120 mg/day (3-6 patients per cohort),bid.For each dose level, a single dose of MAX-40279 will be first administered orally followed by 1 day observation, then continuous treatment will start 4 weeks treatment (per cycle). After completion of the dose escalation, additional patients will be enrolled into dose expansion at the Maximum tolerated dose(MTD), up to 12 patients will be enrolled into expansion cohorts.
Intervention Type
Drug
Intervention Name(s)
MAX-40279
Other Intervention Name(s)
MAX-40279-001
Intervention Description
MAX-40279, is a multi-targeted kinase inhibitor inhibitor mainly target FLT3 and FGFR. It has a molecular weight of 496.56 Daltons, which has a formula of C24H25FN6O3S. MAX-40279 is yellow powder. It is insoluble in water, methanol, ethanol, 0.1 mol/L hydrochloride solution or 0.1% saline; very slightly soluble in methylene dichloride and sparingly soluble in dimethylformamide. It is stable under strong acid, strong alkali, high temperatures and exposure to light. MAX-40279 for clinical use is presented as a sterile yellow powder packaged in capsules at 5 mg, or 25 mg doses.
Primary Outcome Measure Information:
Title
Adverse events (AEs)
Description
Incidence of treatment-related AEs
Time Frame
8 weeks
Title
Maximum tolerated dose (MTD)
Description
MTD will be defined as the maximum dose level at which no more than 1 of 3 participants experience a dose-limiting toxicity (DLT) within the first 4 weeks of multiple dosing.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Tmax
Description
Time to maximum plasma concentration
Time Frame
First single dose(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 1 (the second dose)(pre-dose),Cycle 1 Day 15(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 28(pre-dose), Cycle 2 Day 28(pre-dose).
Title
Cmax
Description
Maximum plasma drug concentration
Time Frame
First single dose(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 1 (the second dose)(pre-dose),Cycle 1 Day 15(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 28(pre-dose), Cycle 2 Day 28(pre-dose).
Title
AUC
Description
Area under the time-concentration curve
Time Frame
First single dose(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 1 (the second dose)(pre-dose),Cycle 1 Day 15(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 28(pre-dose), Cycle 2 Day 28(pre-dose).
Title
t1/2
Description
Observed terminal half-life
Time Frame
First single dose(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 1 (the second dose)(pre-dose),Cycle 1 Day 15(pre-dose and 0.5, 1, 1.5, 2, 4, 6, 8, 10, 24h post-dose), Cycle 1 Day 28(pre-dose), Cycle 2 Day 28(pre-dose).
Title
p-FLT3 Y591
Description
To examine the phosphorylation (activation) of either wild-type or mutated Fms-like Tyrosine Kinase-3(FLT3)
Time Frame
First single dose(pre-dose), Cycle 1 Day 15(pre-dose), Cycle 1 Day 28(pre-dose), Cycle 2 Day 28(pre-dose).
Title
FGFR aberration
Description
To detect Fibroblast growth factor receptor(FGFR) mutation
Time Frame
First single dose(pre-dose), Cycle 1 Day 15(pre-dose), Cycle 1 Day 28(pre-dose), Cycle 2 Day 28(pre-dose).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and/or females over age 18 Ability to understand the purposes and risks of the trial and signed informed consent forms approved by the investigator's Institutional Review Board (IRB)/Independent Ethics Committee (IEC) of the trial site was obtained before the entering the trial Subject has morphologically documented primary AML or AML secondary to myelodysplastic syndrome (MDS) as defined by the World Health Organization (WHO) criteria for which no established standard therapy is available ECOG performance status of 0 to 2 Persistent chronic clinically significant nonhematological toxicities from prior treatment (including chemotherapy, kinase inhibitors, immunotherapy, experimental agents, radiation, HSCT, or surgery) must be Grade ≤ 1 In the absence of rapidly progressing disease clearly documented by the investigator, the interval from prior treatment to time of MAX-40279 administration will be at least 2 weeks (14 days) for prior cytotoxic agents or at least 5 half-lives for prior noncytotoxic agents, including immunosuppressive therapy post HSCT Acceptable liver function defined below: Total bilirubin ≤ 1.5 times upper limit of normal range (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 times ULN; Acceptable renal function defined below: • Serum creatinine ≤ 1.5 times ULN or calculated creatinine clearance (by the Cockcroft-Gault formula) ≥ 60 mL/min Acceptable coagulation status defined below: Prothrombin time < 1.3 times ULN Partial thrombin time < 1.3 times ULN No clinically significant abnormalities in urinalysis Female participants of child bearing potential agree not to be pregnant or lactating during the study and for three months following the last dose of study drug. Both men and women of reproductive potential must agree to use a highly effective method of birth control during the study and for three months following the last dose of study drug. A highly effective method of contraception is defined as one that results in a low failure rate, i.e., less than 1% per year, when used consistently and correctly Exclusion Criteria: Disease diagnosis of acute promyelocytic leukemia Previously treated malignancies other than the current disease, except for adequately treated non-melanoma skin cancer, in situ cancer, or other cancer from which the subject has been disease-free for at least 5 years at the trial entry Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy Major surgery, other than diagnostic surgery, within 4 weeks prior to the trial entry, without complete recovery Percutaneous coronary intervention conducted within 6 months prior to the trial entry for cardiac infarction or angina pectoris Seizure disorders requiring anticonvulsant therapy Taking a medication that prolongs QT interval and has a risk of Torsades de Pointes,or a history of long QT syndrome Medical history of difficulty swallowing, malabsorption or other chronic gastrointestinal disease, or conditions that may hamper compliance and/or absorption of the tested product Participation in an investigational drug or device trial within 4 weeks prior to the trial entry Known infection with human immunodeficiency virus (HIV), hepatitis B, or hepatitis C Recent venous thrombosis (including deep vein thrombosis or pulmonary embolism within 1 year of study) History of upper gastrointestinal hemorrhage, peptic ulcer disease, or bleeding diathesis Subject is pregnant (positive serum beta human chorionic gonadotropin [β-HCG] test at screening) or is currently breast-feeding, their partner anticipates becoming pregnant/impregnating during the trial or within 6 months after receiving the last dose of trial treatment Concomitant disease or condition that could interfere with the conduct of the trial, or that would, in the opinion of the Investigator, pose an unacceptable risk to the subject in this trial Unwillingness or inability to comply with the trial protocol for any reason Legal incapacity or limited legal capacity Cardiac disease with New York Heart Association (NYHA) Class III or IV, including congestive heart failure, myocardial infarction within 6 months prior to the trial entry, unstable arrhythmia, or symptomatic peripheral arterial vascular
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Chun Fong, MD
Phone
+61394965000
Email
chun.fong@austin.org.au
First Name & Middle Initial & Last Name or Official Title & Degree
Hanying Bao, MD,Ph.D
Phone
+86-021-51370693
Email
hybao@maxinovel.com
Facility Information:
Facility Name
St Vincent's Hospital Sydney Limited
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kent Robert
Facility Name
Western NSW Local Health District
City
Dubbo
State/Province
New South Wales
ZIP/Postal Code
2830
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Millard Stephen
First Name & Middle Initial & Last Name & Degree
Douglas Lenton, DM
Facility Name
Monash Health
City
Clayton
State/Province
Victoria
ZIP/Postal Code
3168
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Uhe Micheleine
Phone
+6139594 4044
First Name & Middle Initial & Last Name & Degree
Jake Shortt
Facility Name
Austin Health
City
Heidelberg
State/Province
Victoria
ZIP/Postal Code
3084
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chun Fong

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

MAX-40279 in Subjects With Acute Myelogenous Leukemia (AML)

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