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SNS-301 Monotherapy in High Risk MDS and CMML

Primary Purpose

Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia (CMML)

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
SNS-301
Sponsored by
Sensei Biotherapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndromes

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed informed consent.
  2. Be 18 years of age or older.
  3. Confirmed diagnosis of MDS or CMML.
  4. Assessment of high-risk-MDS/CMML status defined as follows:

    1. MDS: IPSS-R criteria for categorization ≥ Intermediate Risk-3
    2. CMML: WHO criteria for CMML-2 (peripheral blasts of 5% to 19%, and 10% to 19% bone marrow blasts and/or presence of Auer rods).
  5. Be willing to provide a fresh bone marrow aspirate sample at pre-treatment and demonstrate ASPH expression by flow cytometry.
  6. Patient who has relapsed or is refractory / intolerant of hypomethylating agents (HMAs) or not responding to 4 treatment cycles of decitabine or 6 treatment cycles of azacytidine or progressing at any point after initiation of an HMA.
  7. Patient refuses or is not considered a candidate for intensive induction chemotherapy using consensus criteria for defining such patients.
  8. Patients with CMML must have been treated with at least 1 prior therapy (hydroxyurea or an HMA).
  9. Eastern Cooperative Oncology Group (ECOG) Performance Scale 0-1.
  10. Demonstrate adequate organ function: renal, hepatic, coagulation parameters.
  11. For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use two highly effective contraceptive methods during the treatment period and for at least 180 days after the last dose of study treatment. For male patients: Agree that during the period specified above, men will not father a child. Male patients must remain abstinent, must be surgically sterile during the treatment period and for at least 180 days after the last dose of study treatment.

Exclusion Criteria:

  1. Any approved anti-cancer therapy including chemotherapy, targeted small molecule therapy or radiation therapy within 2 weeks prior to trial Day 0.
  2. Participated on a clinical trial of an investigational agent and/or investigational device within 28 days prior to Day 0.
  3. Malignancies other than indications open for enrollment within 3 years prior to Day 0.
  4. Diagnosis of a core binding factor leukemia (t(8;21), t(16;16); or inv(16)) or diagnosis of acute promyelocytic leukemia (t(15;17)).
  5. Active or history of autoimmune disease or immune deficiency.
  6. History of HIV. HIV antibody testing recommended per investigator's clinical suspicion.
  7. Active hepatitis B (hepatitis B surface antigen reactive) or active hepatitis C (HCV qualitative RNA detected); testing recommended per investigator's clinical suspicion.
  8. Severe infections within 4 weeks prior to enrollment.
  9. Received therapeutic oral or IV antibiotics within 2 weeks prior to Day 0.
  10. History or current evidence of any condition, therapy or laboratory abnormality that in the opinion of the treating investigator might confound the results of the trial.
  11. Known previous or ongoing, active psychiatric or substance abuse disorders that would interfere with the requirements of the trial.
  12. Treatment with systemic immunomodulating agents (including but not limited to IFNs, IL-2) within 6 weeks or five half-lives of the drug, whichever is shorter, prior to first dose.
  13. Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during the course of the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    SNS-301

    Arm Description

    SNS-301

    Outcomes

    Primary Outcome Measures

    Adverse events of SNS-301
    Number of adverse events including adverse events of special interest as assessed by CTCAE v5.0
    Objective response rate by International Working Group (IWG) 2006 criteria
    Best objective response during the study
    Minimal residual disease by IWG 2006 criteria
    Minimal residual disease by peripheral and bone marrow blast count during the study
    Duration of Response by IWG 2006 criteria
    Duration of response calculated from date of first response to date of progression
    Disease control rate (DCR) by IWG 2006 criteria
    Disease control rate calculated as the proportion of patients with stable disease or better
    Progression Free Survival (PFS) as assessed by IWG 2006 criteria
    Progression free survival calculated from the date of start of treatment to date of progression
    Overall Survival
    Overall survival calculated from date of treatment to date of death

    Secondary Outcome Measures

    Measurement of ASPH specific responses
    Evaluate blood and tissue ASPH-specific responses at pretreatment, changes during treatment and at progression or end of study in all study participants where sample is available for analysis
    Measurement of T cell immune response
    Characterize blood and bone marrow T cell types and numbers at pretreatment, changes during treatment and at progression or end of study in all study participants where sample is available for analysis
    Measurement B cell immune responses
    Characterize blood and bone marrow B cell numbers at pretreatment, changes during treatment and at progression or end of study in all study participants where sample is available for analyses
    Evaluation of immune gene transcript profiles
    Determine changes in commercially available gene signature panels in blood and bone marrow pretreatment, during treatment and at progression in all study participants where sample is available for analysis
    Measurement of pro-inflammatory and/or immunosuppressive molecules
    The immunological response of pro-inflammatory/immunosuppressive molecules will be observed before, during and after treatment using commercially available assays. Analyses will be performed both on blood and bone marrow samples in all study participants where sample is available for analysis
    Measurement of oncoprotein expression
    Changes in oncoprotein levels will be evaluated before, during and after treatment using methods such as flow cytometry. Analyses will be performed both on blood and bone marrow samples in all study participants where sample is available for analysis

    Full Information

    First Posted
    October 31, 2019
    Last Updated
    August 9, 2021
    Sponsor
    Sensei Biotherapeutics, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04217720
    Brief Title
    SNS-301 Monotherapy in High Risk MDS and CMML
    Official Title
    An Open-Label, Multi-Center Phase 2 Clinical Trial Evaluating SNS-301 in Patients With ASPH+ High Risk Myelodysplastic Syndrome and Chronic Myelomonocytic Leukemia
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Sponsor decision
    Study Start Date
    April 1, 2020 (Anticipated)
    Primary Completion Date
    January 1, 2022 (Anticipated)
    Study Completion Date
    January 1, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Sensei Biotherapeutics, Inc.

    4. Oversight

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

    5. Study Description

    Brief Summary
    To evaluate safety, immunogenicity and anti-tumor responses of intradermally delivered SNS-301 in patients with ASPH+ high risk MDS and CMML.
    Detailed Description
    This phase 2, open-label, multi-center trial to evaluate the safety, immunogenicity and preliminary clinical efficacy of intradermally-delivered SNS-301 delivered using the 3M® hollow microstructured transdermal system (hMTS) device in patients with ASPH+ high risk myelodysplastic syndrome (MDS) and chronic myelomonocytic leukemia (CMML). The trial population consists of high risk ≥ Intermediate Risk-3 (IR-3) MDS and CMML-2.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia (CMML)

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    SNS-301
    Arm Type
    Experimental
    Arm Description
    SNS-301
    Intervention Type
    Drug
    Intervention Name(s)
    SNS-301
    Intervention Description
    SNS-301 (1x 1011 dose/1ml) ID injection every 3 weeks for 4 doses then every 6 weeks for 6 additional doses, and thereafter every 12 weeks up to 24 months.
    Primary Outcome Measure Information:
    Title
    Adverse events of SNS-301
    Description
    Number of adverse events including adverse events of special interest as assessed by CTCAE v5.0
    Time Frame
    12 weeks
    Title
    Objective response rate by International Working Group (IWG) 2006 criteria
    Description
    Best objective response during the study
    Time Frame
    12 weeks
    Title
    Minimal residual disease by IWG 2006 criteria
    Description
    Minimal residual disease by peripheral and bone marrow blast count during the study
    Time Frame
    12 weeks
    Title
    Duration of Response by IWG 2006 criteria
    Description
    Duration of response calculated from date of first response to date of progression
    Time Frame
    12 weeks
    Title
    Disease control rate (DCR) by IWG 2006 criteria
    Description
    Disease control rate calculated as the proportion of patients with stable disease or better
    Time Frame
    12 weeks
    Title
    Progression Free Survival (PFS) as assessed by IWG 2006 criteria
    Description
    Progression free survival calculated from the date of start of treatment to date of progression
    Time Frame
    12 weeks
    Title
    Overall Survival
    Description
    Overall survival calculated from date of treatment to date of death
    Time Frame
    36 months
    Secondary Outcome Measure Information:
    Title
    Measurement of ASPH specific responses
    Description
    Evaluate blood and tissue ASPH-specific responses at pretreatment, changes during treatment and at progression or end of study in all study participants where sample is available for analysis
    Time Frame
    up to 12 weeks
    Title
    Measurement of T cell immune response
    Description
    Characterize blood and bone marrow T cell types and numbers at pretreatment, changes during treatment and at progression or end of study in all study participants where sample is available for analysis
    Time Frame
    up 12 weeks
    Title
    Measurement B cell immune responses
    Description
    Characterize blood and bone marrow B cell numbers at pretreatment, changes during treatment and at progression or end of study in all study participants where sample is available for analyses
    Time Frame
    up to 12 weeks
    Title
    Evaluation of immune gene transcript profiles
    Description
    Determine changes in commercially available gene signature panels in blood and bone marrow pretreatment, during treatment and at progression in all study participants where sample is available for analysis
    Time Frame
    up to12 weeks
    Title
    Measurement of pro-inflammatory and/or immunosuppressive molecules
    Description
    The immunological response of pro-inflammatory/immunosuppressive molecules will be observed before, during and after treatment using commercially available assays. Analyses will be performed both on blood and bone marrow samples in all study participants where sample is available for analysis
    Time Frame
    up to 12 weeks
    Title
    Measurement of oncoprotein expression
    Description
    Changes in oncoprotein levels will be evaluated before, during and after treatment using methods such as flow cytometry. Analyses will be performed both on blood and bone marrow samples in all study participants where sample is available for analysis
    Time Frame
    up to 12 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Signed informed consent. Be 18 years of age or older. Confirmed diagnosis of MDS or CMML. Assessment of high-risk-MDS/CMML status defined as follows: MDS: IPSS-R criteria for categorization ≥ Intermediate Risk-3 CMML: WHO criteria for CMML-2 (peripheral blasts of 5% to 19%, and 10% to 19% bone marrow blasts and/or presence of Auer rods). Be willing to provide a fresh bone marrow aspirate sample at pre-treatment and demonstrate ASPH expression by flow cytometry. Patient who has relapsed or is refractory / intolerant of hypomethylating agents (HMAs) or not responding to 4 treatment cycles of decitabine or 6 treatment cycles of azacytidine or progressing at any point after initiation of an HMA. Patient refuses or is not considered a candidate for intensive induction chemotherapy using consensus criteria for defining such patients. Patients with CMML must have been treated with at least 1 prior therapy (hydroxyurea or an HMA). Eastern Cooperative Oncology Group (ECOG) Performance Scale 0-1. Demonstrate adequate organ function: renal, hepatic, coagulation parameters. For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use two highly effective contraceptive methods during the treatment period and for at least 180 days after the last dose of study treatment. For male patients: Agree that during the period specified above, men will not father a child. Male patients must remain abstinent, must be surgically sterile during the treatment period and for at least 180 days after the last dose of study treatment. Exclusion Criteria: Any approved anti-cancer therapy including chemotherapy, targeted small molecule therapy or radiation therapy within 2 weeks prior to trial Day 0. Participated on a clinical trial of an investigational agent and/or investigational device within 28 days prior to Day 0. Malignancies other than indications open for enrollment within 3 years prior to Day 0. Diagnosis of a core binding factor leukemia (t(8;21), t(16;16); or inv(16)) or diagnosis of acute promyelocytic leukemia (t(15;17)). Active or history of autoimmune disease or immune deficiency. History of HIV. HIV antibody testing recommended per investigator's clinical suspicion. Active hepatitis B (hepatitis B surface antigen reactive) or active hepatitis C (HCV qualitative RNA detected); testing recommended per investigator's clinical suspicion. Severe infections within 4 weeks prior to enrollment. Received therapeutic oral or IV antibiotics within 2 weeks prior to Day 0. History or current evidence of any condition, therapy or laboratory abnormality that in the opinion of the treating investigator might confound the results of the trial. Known previous or ongoing, active psychiatric or substance abuse disorders that would interfere with the requirements of the trial. Treatment with systemic immunomodulating agents (including but not limited to IFNs, IL-2) within 6 weeks or five half-lives of the drug, whichever is shorter, prior to first dose. Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during the course of the study.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Ildiko Csiki, MD, PhD
    Organizational Affiliation
    Sensei Biotherapeutics
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Individual participant data that underline the results reported in the article, after deidentification (text, tables, figures and appendices) will be shared to researchers who have provide a methodologically sound proposal and sign a data access agreement.
    IPD Sharing Time Frame
    Beginning 9 months and ending 36 months following article publication.
    IPD Sharing Access Criteria
    Access will be considered to researchers who provide a methodologically sound proposal. Analysis must achieve the aims outlined in the approved proposal Proposals should be directed to info@senseibio.com. To gain access, data requestors will need to sign a data access agreement. Data are available for 36 months following article publication.

    Learn more about this trial

    SNS-301 Monotherapy in High Risk MDS and CMML

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