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Phase I Clinical Study of CWP232291 in Acute Myeloid Leukemia Patients

Primary Purpose

Acute Myeloid Leukemia, Chronic Myelomonocytic Leukemia, Myelodysplastic Syndrome

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
CWP232291
Sponsored by
JW Pharmaceutical
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

Inclusion Criteria:

  • Able to understand and willing to sign an informed consent form (ICF) prior to initiation of any study-specific procedure and treatment
  • 18 years of age
  • 3. A pathologically confirmed diagnosis of AML or CMML-2 by World Health Organization (WHO) classification that is relapsed or refractory or for which no current therapies are anticipated to result in a durable remission, or MDS by WHO classification are RAEB-1 or RAEB-2 and that have failed at least three cycles of hypomethylating therapy, or primary (PMF), post-polycythemia vera (PPMF) or post-essential thrombocythemia (PTMF) MF by WHO classification, are high-risk category by the Dynamic International Prognostic Scoring System (DIPSS Plus), have ≥1% circulating blasts, and have failed treatment with ruxolitinib
  • Eastern Cooperative Oncology Group (ECOG) performance score 0-2
  • In the absence of rapidly progressing disease, the interval from prior treatment to time of study drug administration should be at least 2 weeks for cytotoxic agents or at least 5 half-lives for noncytotoxic agents. If a patient is on hydroxyurea to control peripheral blood leukemic cell counts, the patient must have discontinued hydroxyurea for at least 24 hours before initiation of treatment with study drug. Persistent clinically significant toxicities from prior chemotherapy must not be greater than grade 1
  • Adequate renal function:

    • Serum creatinine =/< 2.0mg/dL
  • Adequate hepatic function:

    • Total bilirubin <1.5 x upper limit of normal (ULN), unless considered due to Gilbert's syndrome
    • Alkaline phosphatase (AP) =/< 2.5 x ULN
    • Aspartate transaminase (AST) or alanine transaminase (ALT) ≤3 x ULN, unless considered due to organ leukemic involvement
  • Women of child-bearing potential (i.e., women who are pre menopausal or not surgically sterile) must use acceptable contraceptive methods (abstinence, intrauterine device [IUD], oral contraceptive, or double barrier device), and must have a negative serum or urine pregnancy test within 2 weeks prior to beginning treatment on this trial. Sexually active men must also use acceptable contraceptive methods for the duration of time on study
  • Able to adhere to the study visit schedule and other protocol requirements

Exclusion Criteria:

  • Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure (CHF), cardiac arrhythmia, or psychiatric illness/social situation that would limit compliance with study requirements
  • Active heart disease including myocardial infarction (MI) within previous 3 months, symptomatic coronary artery disease (CAD), arrhythmias not controlled by medication, or uncontrolled CHF
  • Active central nervous system (CNS) disease
  • Therapy with any other standard or investigational treatment for hematologic malignancy (except hydroxyurea, as mentioned in the inclusion criteria)
  • Therapy with anticoagulant or antithrombotic agents (including aspirin) within 7 days prior to study drug administration
  • History of gastrointestinal (GI) hemorrhage
  • Known positive status for human immunodeficiency virus (HIV) and/or active hepatitis B or C
  • Pregnant or nursing women. Pregnant and nursing patients are excluded because the effects of CWP232291 on a fetus or nursing child are unknown.
  • Patients eligible for bone marrow transplant, regardless of age
  • Patients with FLT3 ITD positive AML or AML patients with other cytogenetic abnormalities who are eligible for trials of other targeted investigational agents from which the investigator feels there is greater benefit.

Sites / Locations

  • The University of Texas MD Anderson Cancer Center
  • Fred Hutchinson Cancer Research Center
  • Asan Medical Center
  • Samsung Medical Center
  • Seoul National University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CWP232291

Arm Description

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose
If myelosuppression is DLT (Dose-Limiting Toxicity), it will be monitored up to 42 days after start of injection.

Secondary Outcome Measures

Cmax as a pharmacokinetic parameter of 'CWP232291'
Peak Plasma Concentration (Cmax) of 'CWP232291'
AUC as a pharmacokinetic parameter of 'CWP232291'
Area under the plasma concentration versus time curve (AUC) of 'CWP232291'
Cmax as a pharmacokinetic parameter of metabolites of 'CWP232291'
Peak Plasma Concentration (Cmax) of metabolites of 'CWP232291'
AUC as a pharmacokinetic parameter of metabolites of 'CWP232291'
Area under the plasma concentration versus time curve (AUC) of metabolites of 'CWP232291'

Full Information

First Posted
July 17, 2011
Last Updated
March 7, 2016
Sponsor
JW Pharmaceutical
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1. Study Identification

Unique Protocol Identification Number
NCT01398462
Brief Title
Phase I Clinical Study of CWP232291 in Acute Myeloid Leukemia Patients
Official Title
A Phase I Clinical Study of CWP232291 in Patients With Relapsed or Refractory Acute Myeloid Leukemia or Chronic Myelomonocytic Leukemia-2, Myelodysplastic Syndrome Having Failed Hypomethylating Treatment, and High-Risk Myelofibrosis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2016
Overall Recruitment Status
Completed
Study Start Date
July 2011 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
JW Pharmaceutical

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
CWP232291 blocks proliferation of cancer cells via activation of caspases. Active caspase have been shown to target beta-catenin, the hallmark of canonical Wnt signaling, for degradation through caspase-directed cleavage. CWP232291 targets beta-catenin for degradation and thereby inhibits the expression of cell cycle and anti-apoptotic genes such as cyclin D1 and survivin.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia, Chronic Myelomonocytic Leukemia, Myelodysplastic Syndrome, Myelofibrosis

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CWP232291
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
CWP232291
Intervention Description
IV Infusion
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose
Description
If myelosuppression is DLT (Dose-Limiting Toxicity), it will be monitored up to 42 days after start of injection.
Time Frame
Up to 3 weeks after start of injection
Secondary Outcome Measure Information:
Title
Cmax as a pharmacokinetic parameter of 'CWP232291'
Description
Peak Plasma Concentration (Cmax) of 'CWP232291'
Time Frame
0, 0.25, 0.5, 1, 1.5, 2, 4, 8, 24 hours post-dose
Title
AUC as a pharmacokinetic parameter of 'CWP232291'
Description
Area under the plasma concentration versus time curve (AUC) of 'CWP232291'
Time Frame
0, 0.25, 0.5, 1, 1.5, 2, 4, 8, 24 hours post-dose
Title
Cmax as a pharmacokinetic parameter of metabolites of 'CWP232291'
Description
Peak Plasma Concentration (Cmax) of metabolites of 'CWP232291'
Time Frame
0, 0.25, 0.5, 1, 1.5, 2, 4, 8, 24 hours post-dose
Title
AUC as a pharmacokinetic parameter of metabolites of 'CWP232291'
Description
Area under the plasma concentration versus time curve (AUC) of metabolites of 'CWP232291'
Time Frame
0, 0.25, 0.5, 1, 1.5, 2, 4, 8, 24 hours post-dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able to understand and willing to sign an informed consent form (ICF) prior to initiation of any study-specific procedure and treatment 18 years of age 3. A pathologically confirmed diagnosis of AML or CMML-2 by World Health Organization (WHO) classification that is relapsed or refractory or for which no current therapies are anticipated to result in a durable remission, or MDS by WHO classification are RAEB-1 or RAEB-2 and that have failed at least three cycles of hypomethylating therapy, or primary (PMF), post-polycythemia vera (PPMF) or post-essential thrombocythemia (PTMF) MF by WHO classification, are high-risk category by the Dynamic International Prognostic Scoring System (DIPSS Plus), have ≥1% circulating blasts, and have failed treatment with ruxolitinib Eastern Cooperative Oncology Group (ECOG) performance score 0-2 In the absence of rapidly progressing disease, the interval from prior treatment to time of study drug administration should be at least 2 weeks for cytotoxic agents or at least 5 half-lives for noncytotoxic agents. If a patient is on hydroxyurea to control peripheral blood leukemic cell counts, the patient must have discontinued hydroxyurea for at least 24 hours before initiation of treatment with study drug. Persistent clinically significant toxicities from prior chemotherapy must not be greater than grade 1 Adequate renal function: Serum creatinine =/< 2.0mg/dL Adequate hepatic function: Total bilirubin <1.5 x upper limit of normal (ULN), unless considered due to Gilbert's syndrome Alkaline phosphatase (AP) =/< 2.5 x ULN Aspartate transaminase (AST) or alanine transaminase (ALT) ≤3 x ULN, unless considered due to organ leukemic involvement Women of child-bearing potential (i.e., women who are pre menopausal or not surgically sterile) must use acceptable contraceptive methods (abstinence, intrauterine device [IUD], oral contraceptive, or double barrier device), and must have a negative serum or urine pregnancy test within 2 weeks prior to beginning treatment on this trial. Sexually active men must also use acceptable contraceptive methods for the duration of time on study Able to adhere to the study visit schedule and other protocol requirements Exclusion Criteria: Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure (CHF), cardiac arrhythmia, or psychiatric illness/social situation that would limit compliance with study requirements Active heart disease including myocardial infarction (MI) within previous 3 months, symptomatic coronary artery disease (CAD), arrhythmias not controlled by medication, or uncontrolled CHF Active central nervous system (CNS) disease Therapy with any other standard or investigational treatment for hematologic malignancy (except hydroxyurea, as mentioned in the inclusion criteria) Therapy with anticoagulant or antithrombotic agents (including aspirin) within 7 days prior to study drug administration History of gastrointestinal (GI) hemorrhage Known positive status for human immunodeficiency virus (HIV) and/or active hepatitis B or C Pregnant or nursing women. Pregnant and nursing patients are excluded because the effects of CWP232291 on a fetus or nursing child are unknown. Patients eligible for bone marrow transplant, regardless of age Patients with FLT3 ITD positive AML or AML patients with other cytogenetic abnormalities who are eligible for trials of other targeted investigational agents from which the investigator feels there is greater benefit.
Facility Information:
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Fred Hutchinson Cancer Research Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States
Facility Name
Asan Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Samsung Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul National University Hospital
City
Seoul
Country
Korea, Republic of

12. IPD Sharing Statement

Citations:
PubMed Identifier
32396615
Citation
Lee JH, Faderl S, Pagel JM, Jung CW, Yoon SS, Pardanani AD, Becker PS, Lee H, Choi J, Lee K, Kim M, Cortes JE. Phase 1 study of CWP232291 in patients with relapsed or refractory acute myeloid leukemia and myelodysplastic syndrome. Blood Adv. 2020 May 12;4(9):2032-2043. doi: 10.1182/bloodadvances.2019000757.
Results Reference
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Phase I Clinical Study of CWP232291 in Acute Myeloid Leukemia Patients

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