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Safety and Tolerability of CHR-2845 to Treat Haematological Diseases or Lymphoid Malignancies (CHR-2845-001)

Primary Purpose

Hematological Disease, Lymphoid Malignancies

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
CHR-2845
Sponsored by
Chroma Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hematological Disease focused on measuring Haematological disease, Lymphoid malignancy, Histone deacetylase inhibitor, dose escalation

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed, informed consent
  2. Confirmed malignant haematological disease or lymphoid malignancy refractory to standard therapy or for which no standard therapy exists, including acute leukemias, MDS, CML, CLL, CMML, multiple myeloma and Non-Hodgkin's Lymphomas/Hodgkin's disease
  3. Patients shall have recovered from all acute adverse effects of prior therapies, with the exception of alopecia and grade 1 neuropathy where recovery is not required
  4. Adequate bone marrow, hepatic and renal function including the following:

    1. Patients with high blast counts can be included if they can be controlled by the use of hydroxyurea (500 mg -3,000 mg daily).
    2. Total bilirubin ≤ 1.5 x upper normal limit, excluding cases where elevated bilirubin can be attributed to Gilbert's Syndrome
    3. AST (SGOT), ALT (SGPT) ≤ 2.5 x upper normal limit
    4. Creatinine ≤ 1.5 x upper normal limit
  5. Age ≥ 18 years
  6. Performance status (PS) ≤ 2 - Eastern Cooperative Oncology Group (ECOG) scale
  7. Estimated life expectancy greater than 3 months
  8. Female patients with reproductive potential must have a negative serum pregnancy test within 7 days prior to start of trial. Both women and men must agree to use a medically acceptable method of contraception throughout the treatment period and for 3 months after discontinuation of treatment.

Exclusion Criteria:

  1. Patients receiving anti-cancer therapy or use of other investigational agents within 21 days prior to trial entry (or a longer period depending on the defined characteristics of the agents used. Bisphosphonates for bone disease and corticosteroids are permitted provided the dose does not change during the trial. Patients must have recovered from all transient toxicity induced by prior therapy
  2. Patients with co-existing active infection, graft versus host disease or serious concurrent illness
  3. Patients who have failed to recover from or after a bone marrow transplantation or haematopoietic stem cell transplantation
  4. The following diseases are excluded: Burkitt's lymphoma, primary effusion lymphoma, precursor B-cell lymphoblastic lymphoma, symptomatic central nervous system (CNS) lymphoma, CML blast crisis
  5. Patients with significant cardiovascular disease as defined by:

    1. history of congestive heart failure requiring therapy
    2. history of angina pectoris requiring treatment or myocardial infarction within 6 months prior to trial entry
    3. presence of severe valvular heart disease
    4. presence of an atrial or ventricular arrhythmia requiring treatment
    5. Left Ventricular Ejection Fraction (LVEF) below the normal range at the study centre
    6. Uncontrolled hypertension
    7. A history of abnormal QTc intervals or an average QTc interval at screening ≥450 msec
  6. Any medical or other condition that in the investigator's opinion renders the patient unsuitable for this study due to unacceptable risk
  7. Psychiatric disorders or altered mental status precluding understanding of the informed consent process and/or completion of the necessary studies
  8. Gastrointestinal disorders that may interfere with absorption of the study drug
  9. Patients with known brain tumours or metastases
  10. More than 6 prior chemotherapy regimens
  11. Patients requiring growth factor support (erythropoietin, Granulocyte/monocyte Colony Stimulating Factor (GM/CSF), etc)
  12. Patients requiring palliative radiotherapy within the last 4 weeks prior to study entry
  13. Uncontrolled hypercalcaemia (CTCAE v3 grade 2 or higher)
  14. Abnormal plasma potassium or magnesium levels (Common Terminology Criteria for Adverse Events (CTCAE) v3 grade 3 or greater) despite therapy
  15. Pregnant or breast-feeding women

Sites / Locations

  • ZNA Stuivenberg
  • Institut Paoli-Calmettes
  • VU University Medical Center
  • Erasmus University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1

Arm Description

Oral, once daily administration of CHR-2845 to determine safety and tolerability

Outcomes

Primary Outcome Measures

To determine the safety, tolerability, dose-limiting toxicities (DLT), maximum acceptable dose (MAD) and maximum tolerated dose (MTD)

Secondary Outcome Measures

To determine pharmacokinetic parameters of CHR-2845 and the active metabolite CHR-2847

Full Information

First Posted
January 9, 2009
Last Updated
November 25, 2011
Sponsor
Chroma Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT00820508
Brief Title
Safety and Tolerability of CHR-2845 to Treat Haematological Diseases or Lymphoid Malignancies
Acronym
CHR-2845-001
Official Title
A Phase I Study to Evaluate the Safety and Tolerability of the Histone Deacetylase Inhibitor, CHR-2845, in Patients With Advanced or Treatment Refractory Haematological Diseases or Lymphoid Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
November 2011
Overall Recruitment Status
Completed
Study Start Date
December 2008 (undefined)
Primary Completion Date
July 2011 (Actual)
Study Completion Date
July 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chroma Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether the histone deacetylase inhibitor CHR-2845 is tolerated in patients with haematological diseases and lymphoid malignancies.
Detailed Description
CHR-2845 is a novel type of histone deacetylase inhibitor (HDACi) for use in cancer that, in addition to having broad ranging anti-proliferative activity against transformed cells, is designed to have an increased therapeutic window against diseases which involve cells of the monocyte-macrophage lineage. There are several HDACi's in clinical development and one, SAHA (Vorinostat, Zolinza®), has recently been approved for use in the treatment of cutaneous T-cell lymphoma. CHR-2845 is a cell-permeant ester that is metabolised to give an active acid, CHR-2847, which selectively accumulates in monocytes and macrophages. This results in a 20-100 fold increase in anti-proliferative potency of CHR-2845 for monocytic over non-monocytic tumour cells. This selectivity should lead to an increased therapeutic window in haematological malignancies involving cells of the monocyte lineage (AML M4, AML M5 and CMML). In addition, there is increasing evidence that monocytes and macrophages associated with some haematological tumours (tumour-associated macrophages (TAMs)) are involved in supporting the growth and spread of the tumour. This clinical trial will focus on haematological and lymphoid malignancies with the intention of evaluating the safety and tolerability of CHR-2845. Additionally it will compare response in patients where monocytes/macrophages are important disease drivers, with the response in other patients. This will allow an early determination of the potential improvement in therapeutic window afforded by the monocyte/macrophage directed HDACi activity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hematological Disease, Lymphoid Malignancies
Keywords
Haematological disease, Lymphoid malignancy, Histone deacetylase inhibitor, dose escalation

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Oral, once daily administration of CHR-2845 to determine safety and tolerability
Intervention Type
Drug
Intervention Name(s)
CHR-2845
Intervention Description
Once daily oral ingestion of capsules (10, 40 or 80mg), dose depending on cohort, treatment cycle of 28 days
Primary Outcome Measure Information:
Title
To determine the safety, tolerability, dose-limiting toxicities (DLT), maximum acceptable dose (MAD) and maximum tolerated dose (MTD)
Time Frame
28 days
Secondary Outcome Measure Information:
Title
To determine pharmacokinetic parameters of CHR-2845 and the active metabolite CHR-2847
Time Frame
days 1 and 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed, informed consent Confirmed malignant haematological disease or lymphoid malignancy refractory to standard therapy or for which no standard therapy exists, including acute leukemias, MDS, CML, CLL, CMML, multiple myeloma and Non-Hodgkin's Lymphomas/Hodgkin's disease Patients shall have recovered from all acute adverse effects of prior therapies, with the exception of alopecia and grade 1 neuropathy where recovery is not required Adequate bone marrow, hepatic and renal function including the following: Patients with high blast counts can be included if they can be controlled by the use of hydroxyurea (500 mg -3,000 mg daily). Total bilirubin ≤ 1.5 x upper normal limit, excluding cases where elevated bilirubin can be attributed to Gilbert's Syndrome AST (SGOT), ALT (SGPT) ≤ 2.5 x upper normal limit Creatinine ≤ 1.5 x upper normal limit Age ≥ 18 years Performance status (PS) ≤ 2 - Eastern Cooperative Oncology Group (ECOG) scale Estimated life expectancy greater than 3 months Female patients with reproductive potential must have a negative serum pregnancy test within 7 days prior to start of trial. Both women and men must agree to use a medically acceptable method of contraception throughout the treatment period and for 3 months after discontinuation of treatment. Exclusion Criteria: Patients receiving anti-cancer therapy or use of other investigational agents within 21 days prior to trial entry (or a longer period depending on the defined characteristics of the agents used. Bisphosphonates for bone disease and corticosteroids are permitted provided the dose does not change during the trial. Patients must have recovered from all transient toxicity induced by prior therapy Patients with co-existing active infection, graft versus host disease or serious concurrent illness Patients who have failed to recover from or after a bone marrow transplantation or haematopoietic stem cell transplantation The following diseases are excluded: Burkitt's lymphoma, primary effusion lymphoma, precursor B-cell lymphoblastic lymphoma, symptomatic central nervous system (CNS) lymphoma, CML blast crisis Patients with significant cardiovascular disease as defined by: history of congestive heart failure requiring therapy history of angina pectoris requiring treatment or myocardial infarction within 6 months prior to trial entry presence of severe valvular heart disease presence of an atrial or ventricular arrhythmia requiring treatment Left Ventricular Ejection Fraction (LVEF) below the normal range at the study centre Uncontrolled hypertension A history of abnormal QTc intervals or an average QTc interval at screening ≥450 msec Any medical or other condition that in the investigator's opinion renders the patient unsuitable for this study due to unacceptable risk Psychiatric disorders or altered mental status precluding understanding of the informed consent process and/or completion of the necessary studies Gastrointestinal disorders that may interfere with absorption of the study drug Patients with known brain tumours or metastases More than 6 prior chemotherapy regimens Patients requiring growth factor support (erythropoietin, Granulocyte/monocyte Colony Stimulating Factor (GM/CSF), etc) Patients requiring palliative radiotherapy within the last 4 weeks prior to study entry Uncontrolled hypercalcaemia (CTCAE v3 grade 2 or higher) Abnormal plasma potassium or magnesium levels (Common Terminology Criteria for Adverse Events (CTCAE) v3 grade 3 or greater) despite therapy Pregnant or breast-feeding women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bob Löwenberg, M.D
Organizational Affiliation
Erasmus Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Gert Ossenkoppele, M.D
Organizational Affiliation
Amsterdam UMC, location VUmc
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Pierre Zachee, MD
Organizational Affiliation
ZNA Stuivenberg
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Norbert Vey, MD
Organizational Affiliation
Institut Paoli-Calmettes
Official's Role
Principal Investigator
Facility Information:
Facility Name
ZNA Stuivenberg
City
Antwerp
ZIP/Postal Code
2060
Country
Belgium
Facility Name
Institut Paoli-Calmettes
City
Marseille
Country
France
Facility Name
VU University Medical Center
City
Amsterdam
ZIP/Postal Code
1007 MB
Country
Netherlands
Facility Name
Erasmus University Medical Center
City
Rotterdam
ZIP/Postal Code
3015 CE
Country
Netherlands

12. IPD Sharing Statement

Citations:
PubMed Identifier
23647373
Citation
Ossenkoppele GJ, Lowenberg B, Zachee P, Vey N, Breems D, Van de Loosdrecht AA, Davidson AH, Wells G, Needham L, Bawden L, Toal M, Hooftman L, Debnam PM. A phase I first-in-human study with tefinostat - a monocyte/macrophage targeted histone deacetylase inhibitor - in patients with advanced haematological malignancies. Br J Haematol. 2013 Jul;162(2):191-201. doi: 10.1111/bjh.12359. Epub 2013 May 7.
Results Reference
derived

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Safety and Tolerability of CHR-2845 to Treat Haematological Diseases or Lymphoid Malignancies

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