Clinical Trials /

A Dose-finding Study of the Bromodomain (Brd) Inhibitor OTX015/MK-8628 in Hematologic Malignancies (MK-8628-001)

NCT01713582

Description:

The primary purpose of this study was to determine the recommended dose (RD) of MK-8628 /OTX015 for further phase II studies, in participants with acute leukemia (AL) including acute myeloid leukemia (AML; de novo and secondary to a myelodysplastic syndrome) and acute lymphoblastic leukemia (ALL) or other hematologic malignancies (OHM) including diffuse large B cell lymphoma (DLBCL) and multiple myeloma (MM). The first phase of the study will be a dose escalation phase to determine the Phase II RD using dose-limiting toxicities (DLTs). Once the RD is determined, participants will be enrolled in an expansion phase at the RD to determine preliminary efficacy in AL and OHM cohorts. Participants received therapy in 21-day cycles until disease progression, intolerable toxicity, or treatment interruption for >2 weeks due to toxicity.

Related Conditions:
  • Acute Myeloid Leukemia
  • Diffuse Large B-Cell Lymphoma
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Dose-finding Study of the Bromodomain (Brd) Inhibitor OTX015/MK-8628 in Hematologic Malignancies (MK-8628-001)
  • Official Title: A Phase I, Dose-finding Study of the Bromodomain (Brd) Inhibitor OTX015/MK-8628 in Haematological Malignancies

Clinical Trial IDs

  • ORG STUDY ID: 8628-001
  • SECONDARY ID: OTX015_104
  • SECONDARY ID: 2012-003380-22
  • SECONDARY ID: MK-8628-001
  • NCT ID: NCT01713582
  • NCT ALIAS: NCT02542358

Conditions

  • Acute Myeloid Leukemia
  • Diffuse Large B-cell Lymphoma
  • Acute Lymphoblastic Leukemia
  • Multiple Myeloma

Interventions

DrugSynonymsArms
OTX015/MK-8628AL 10 mg QD 14-21

Purpose

The primary purpose of this study was to determine the recommended dose (RD) of MK-8628 /OTX015 for further phase II studies, in participants with acute leukemia (AL) including acute myeloid leukemia (AML; de novo and secondary to a myelodysplastic syndrome) and acute lymphoblastic leukemia (ALL) or other hematologic malignancies (OHM) including diffuse large B cell lymphoma (DLBCL) and multiple myeloma (MM). The first phase of the study will be a dose escalation phase to determine the Phase II RD using dose-limiting toxicities (DLTs). Once the RD is determined, participants will be enrolled in an expansion phase at the RD to determine preliminary efficacy in AL and OHM cohorts. Participants received therapy in 21-day cycles until disease progression, intolerable toxicity, or treatment interruption for >2 weeks due to toxicity.

Trial Arms

NameTypeDescriptionInterventions
AL 10 mg QD 14-21ExperimentalParticipants received 10 mg MK-8628/OTX015 administered orally (PO), once daily (QD), in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AL 20 mg QD 14-21ExperimentalParticipants received 20 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AL 40 mg QD 14-21ExperimentalParticipants received 40 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AL 20 mg BID 21-21ExperimentalParticipants received 20 mg MK-8628/OTX015 administered PO, twice a day (BID), with the first daily dose in a fasted state, on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
AL 80 mg QD 14-21ExperimentalParticipants received 80 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AL 40 mg BID 14-21ExperimentalParticipants received 40 mg MK-8628/OTX015 administered PO, twice a day (BID), with the first daily dose in a fasted state, on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AL 120 mg QD 14-21ExperimentalParticipants received 120 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AL 120 mg QD 21-21ExperimentalParticipants received 120 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
AL 160 mg QD 14-21ExperimentalParticipants received 160 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AML de novo 80 mg QD 14-21ExperimentalParticipants received 80 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
AML/MDS 80 mg QD 14-21ExperimentalParticipants received 80 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
OHM 10 mg QD 21-21ExperimentalParticipants received 10 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
OHM 20 mg QD 21-21ExperimentalParticipants received 20 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
OHM 40 mg QD 21-21ExperimentalParticipants received 40 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
OHM 80 mg QD 21-21ExperimentalParticipants received 80 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
OHM 40 mg BID 21-21ExperimentalParticipants received 40 mg MK-8628/OTX015 administered PO, BID, with the first daily dose in a fasted state, on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
OHM 120 mg QD 21-21ExperimentalParticipants received 120 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 21 of a 21-day cycle.
  • OTX015/MK-8628
OHM 120 mg QD 14-21ExperimentalParticipants received 120 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628
OHM 120 mg QD 5-7ExperimentalParticipants received 120 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 5 of a 7-day cycle.
  • OTX015/MK-8628
OHM 120 mg QD 7-21ExperimentalParticipants received 120 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 7 of a 21-day cycle
  • OTX015/MK-8628
OHM/DLBCL 80 mg QD 14-21ExperimentalParticipants received 80 mg MK-8628/OTX015 administered PO, QD, in a fasted state on Days 1 to 14 of a 21-day cycle.
  • OTX015/MK-8628

Eligibility Criteria

        Inclusion Criteria:

          -  Histologically or cytologically proven acute leukemias (AML or ALL) or hematologic
             malignancies (DLBCL or MM) using standard diagnosis criteria. Acute leukemia includes
             de novo and secondary to a pre-existing myelodysplastic syndrome, according to the
             World Health Organization 2008 classification. For DLBCL, an archived
             formaldehyde-fixed paraffin-embedded block must be available.

          -  Has failed all standard therapies or for whom standard treatments are
             contra-indicated:

               -  Acute leukemia participants: <60 years old in second relapse or relapsing after
                  allogeneic stem cell transplantation (aSCT) regardless of number of relapses; >60
                  years old in first relapse with a disease-free interval (DFI) <12 months or
                  further relapse; irrespective of age, in participants relapsing after aSCT, the
                  time elapsed since aSCT should be >90 days; participants with B-cell ALL:
                  Philadelphia chromosome positive (Ph+) must have received ≥2 lines of therapy,
                  including 2 bcr-abl tyrosine-kinase (TK) inhibitors (among imatinib, nilotinib
                  and dasatinib), or only 1 line including 1 TK inhibitor, if the
                  relapse/refractoriness is associated with the detection of a resistance mutation
                  to these inhibitors

               -  DLBCL participants: Failed 2 standard lines of therapy (≥1 containing an
                  anti-CD20 monoclonal antibody), or for whom such treatment is contra-indicated

               -  MM participants: Adequately exposed to at least one alkylating agent, one
                  corticosteroid, one immunomodulatory drug (IMiD) and bortezomib, or for whom such
                  treatments are contra-indicated.

          -  For participants with evaluable disease:

               -  Advanced leukemia participants must have >5% bone marrow blasts at study entry,
                  without alternative causality (e.g. bone marrow regeneration)

               -  DLBCL participants must have ≥1 non-irradiated tumor mass ≥15 mm (long axis of
                  lymph node) or ≥10 mm (short axis of lymph node or extranodal lesions) on spiral
                  computed tomography (CT)-scan.

               -  MM participants must have ≥1 of the following: serum monoclonal component >1 g/dL
                  (IgG), or >0.5 g/dL (IgA), or Bence-Jones (BJ) proteinuria >200 mg/24h, or
                  measurable plasmacytoma (not previously irradiated).

          -  Life expectancy ≥3 months.

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.

          -  Off previous therapy ≥3 weeks prior to first study drug administration with full
             recovery from any previous toxicities, except 1) hydroxyurea single agent of in
             combination (e.g. + 6-Mercaptopurine [6MP]) to control hyperleukocytosis, which should
             be stopped for ≥48 hours, and 2) rituximab, which should be stopped for ≥3 weeks.

          -  Recovery from the non-hematologic toxic effects of prior treatment to grade ≤1,
             according to National Cancer Institute Common Toxicity Criteria (NCI-CTC)
             classification, except alopecia.

          -  Adequate bone marrow function.

          -  Adequate calculated creatinine clearance.

          -  Adequate liver function tests.

          -  Complete baseline disease assessment workup prior to first study drug administration.

        Exclusion Criteria:

          -  History of prior malignancy other than those previously treated with a curative intent
             >3 years ago and without relapse (any tumor) or basal cell skin cancer, in situ
             cervical cancer, superficial bladder cancer, or high grade intestinal polyps treated
             adequately, regardless of the DFI.

          -  Pregnant or lactating women or women of childbearing potential not using adequate
             contraception. Male participants not using adequate contraception.

          -  Peripheral cytopenias (i.e. auto-immune hemolytic anemia or thrombocytopenia).

          -  Acute promyelocytic leukemia or with clinically uncontrolled (i.e. with bleeding)
             disseminated intravascular coagulation (DIC).

          -  Chronic graft versus host disease (GVHD) or on immunosuppressive therapy for the
             control of GVHD.

          -  Uncontrolled leptomeningeal disease.

          -  Other tumor location necessitating an urgent therapeutic intervention (palliative
             care, surgery or radiation therapy), such as spinal cord compression, other
             compressive mass, uncontrolled painful lesion, bone fracture, etc.

          -  Unable to swallow oral medications, or has gastrointestinal condition (e.g.
             malabsorption, resection) deemed to jeopardize intestinal absorption.

          -  Other serious illness or medical conditions, which, in the investigator's opinion
             could hamper understanding of the study by the participants, participant's compliance
             to study treatment, participant's safety or interpretation of study results. These
             conditions include (but are not restricted to):

               1. Congestive heart failure or angina pectoris except if medically controlled.
                  Previous history of myocardial infarction within 1 year of study entry,
                  uncontrolled hypertension or arrhythmias.

               2. Existence of significant neurologic or psychiatric disorders impairing the
                  ability to obtain consent.

               3. Uncontrolled infection.

               4. Known human immunodeficiency virus (HIV) positivity

          -  Concurrent treatment with other experimental therapies or participation in another
             clinical trial within 30 days prior to first study drug administration.

          -  Concurrent treatment or treatment within 30 days prior to first study drug
             administration with any other anticancer therapy, except hydroxyurea (+/- 6MP) to
             control hyperleukocytosis.

          -  Concomitant treatment with corticosteroids except if chronic treatment with ≤30 mg of
             methylprednisolone daily or equivalent dose of other corticosteroids.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of Participants With Dose Limiting Toxicities (DLTs)
Time Frame:Cycle 1 (Up to 21 days)
Safety Issue:
Description:A DLT was graded using the National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE) version 4.02 and defined as any of the following: grade 3 or 4 non-hematologic adverse events unless they were not optimally treated with supportive care; grade 3 or 4 asymptomatic laboratory abnormal values lasting >7 days; prolonged grade 2 toxicity (lasting more than 2 weeks) leading to treatment interruption and/or dose reduction; pancytopenia with a hypocellular bone marrow and no marrow blasts lasting ≥6 weeks (AL participants); grade 3 neutropenia with fever or infection (OHM participants); grade 3 thrombocytopenia with bleeding (OHM participants); or grade 4 neutropenia or thrombocytopenia, regardless of symptoms and lasting ≥3 days (OHM participants).

Secondary Outcome Measures

Measure:Number of Participants Who Experienced at Least One Adverse Event (AE)
Time Frame:Up to 40 days after last dose of study therapy (Up to 28 months)
Safety Issue:
Description:AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have to have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product/protocol specified procedure, whether or not considered related to the medicinal product/protocol specified procedure. Any worsening of a preexisting condition temporally associated with the use of the product was also an AE. AEs were collected during the entire time frame of treatment plus up to 40 days of follow-up.
Measure:Number of Participants Who Discontinued Study Therapy Due to AEs
Time Frame:From time of first dose of study therapy until the end of treatment (up to 26 months)
Safety Issue:
Description:All participants who discontinued study therapy due to an AE at any time during treatment.
Measure:Number of Participants Whose Best Response Was Partial Response (PR) or Complete Response (CR)
Time Frame:From time of first dose of study therapy until the end of treatment (up to 26 months)
Safety Issue:
Description:Best response was determined from the start of treatment until disease progression, recurrence, or completion of 26 months of treatment. Partial and complete response was assessed by bone marrow aspiration (AL participants); or computed tomography scan, magnetic resonance imaging, positron emission tomography, or X-ray (OHM participants) using standard criteria. Acute leukemia participants were assessed based on the recommendations from the European LeukemiaNet Döhner 2010); lymphoma participants according to Cheson 2007; and MM participants according to Durie 2006.
Measure:Maximum Concentration (Cmax) of MK-8628/OTX015
Time Frame:Cycle 1: Pre-infusion and 20 minutes; 1, 2.25, 3.25, 4, 6, 8, 9, 12, and 24 hours plus one sampling at either 10 hour or 16 hour post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion dependent on dose regimen and enrollment position
Safety Issue:
Description:Data were collected in Cycle 1 according to dosing regimen and enrollment position at the following sampling schedules: 1) Complete QD for the first 3 participants per dose level: Pre-infusion and 1, 4, 8, 12, and 24 hours (h) + 1 sampling at either 10h or 16h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 2) Limited QD for participants 4 and higher: Pre-infusion and 1, 4, 6, and 8h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 3) BID: Pre-infusion and at 20 minutes and 1, 2.25, 3.25. 9, 12, and 24h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level. Blood samples for Cmax were measured using liquid chromatography-tandem mass spectrometry and analyzed using a nonlinear mixed-effects modelling software program Monolix version 4.3.2. Results for each dose level and method of administration included participants from both AL and OHM cohorts and different regimen frequencies.
Measure:Time to Maximum Concentration (Tmax) of MK-8628/OTX015
Time Frame:Cycle 1: Pre-infusion and 20 minutes; 1, 2.25, 3.25, 4, 6, 8, 9, 12, and 24 hours plus one sampling at either 10 hour or 16 hour post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion dependent on dose regimen and enrollment position
Safety Issue:
Description:Data were collected in Cycle 1 according to dosing regimen and enrollment position at the following sampling schedules: 1) Complete QD for the first 3 participants per dose level: Pre-infusion and 1, 4, 8, 12, and 24h + 1 sampling at either 10h or 16h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 2) Limited QD for participants 4 and higher: Pre-infusion and 1, 4, 6, and 8h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 3) BID: Pre-infusion and at 20 minutes and 1, 2.25, 3.25. 9, 12, and 24h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level. Blood samples for Tmax were measured using liquid chromatography-tandem mass spectrometry and analyzed using a nonlinear mixed-effects modelling software program Monolix version 4.3.2. Results for each dose level and method of administration included participants from both AL and OHM cohorts and different regimen frequencies.
Measure:Apparent Terminal Half-Life (t1/2) of MK-8628/OTX015
Time Frame:Cycle 1: Pre-infusion and 20 minutes; 1, 2.25, 3.25, 4, 6, 8, 9, 12, and 24 hours plus one sampling at either 10 hour or 16 hour post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion dependent on dose regimen and enrollment position
Safety Issue:
Description:Data were collected in Cycle 1 according to dosing regimen and enrollment position at the following sampling schedules: 1) Complete QD for the first 3 participants per dose level: Pre-infusion and 1, 4, 8, 12, and 24h + 1 sampling at either 10h or 16h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 2) Limited QD for participants 4 and higher: Pre-infusion and 1, 4, 6, and 8h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 3) BID: Pre-infusion and at 20 minutes and 1, 2.25, 3.25. 9, 12, and 24h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level. Blood samples for t1/2 were measured using liquid chromatography-tandem mass spectrometry and analyzed using a nonlinear mixed-effects modelling software program Monolix version 4.3.2. Results for each dose level and method of administration included participants from both AL and OHM cohorts and different regimen frequencies.
Measure:Area Under the Concentration Time Curve of MK-8628/OTX015 From Time 0 to Infinity (AUC 0-inf)
Time Frame:Cycle 1: Pre-infusion and 20 minutes; 1, 2.25, 3.25, 4, 6, 8, 9, 12, and 24 hours plus one sampling at either 10 hour or 16 hour post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion dependent on dose regimen and enrollment position
Safety Issue:
Description:Data were collected in Cycle 1 according to dosing regimen and enrollment position at the following sampling schedules: 1) Complete QD for the first 3 participants per dose level: Pre-infusion and 1, 4, 8, 12, and 24h + 1 sampling at either 10h or 16h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 2) Limited QD for participants 4 and higher: Pre-infusion and 1, 4, 6, and 8h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 3) BID: Pre-infusion and at 20 minutes and 1, 2.25, 3.25. 9, 12, and 24h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level. Blood samples for AUC 0-first were measured using liquid chromatography-tandem mass spectrometry and analyzed using a nonlinear mixed-effects modelling software program Monolix version 4.3.2. Results for each dose level and method of administration included participants from both AL and OHM cohorts and different regimen frequencies.
Measure:Apparent Total Body Clearance (CL/F) of MK-8628/OTX015
Time Frame:cycle 1: Pre-infusion and 20 minutes; 1, 2.25, 3.25, 4, 6, 8, 9, 12, and 24 hours plus one sampling at either 10 hour or 16 hour post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion dependent on dose regimen and enrollment position
Safety Issue:
Description:Data were collected in Cycle 1 according to dosing regimen and enrollment position at the following sampling schedules: 1) Complete QD for the first 3 participants per dose level: Pre-infusion and 1, 4, 8, 12, and 24h + 1 sampling at either 10h or 16h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 2) Limited QD for participants 4 and higher: Pre-infusion and 1, 4, 6, and 8h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 3) BID: Pre-infusion and at 20 minutes and 1, 2.25, 3.25. 9, 12, and 24h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level. Blood samples for CL/F were measured using liquid chromatography-tandem mass spectrometry and analyzed using a nonlinear mixed-effects modelling software program Monolix version 4.3.2. Results for each dose level and method of administration included participants from both AL and OHM cohorts and different regimen frequencies.
Measure:Volume of Distribution at Steady State (Vz/F) of MK-8628/OTX015
Time Frame:Cycle 1: Pre-infusion and 20 minutes; 1, 2.25, 3.25, 4, 6, 8, 9, 12, and 24 hours plus one sampling at either 10 hour or 16 hour post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion dependent on dose regimen and enrollment position
Safety Issue:
Description:Data were collected in Cycle 1 according to dosing regimen and enrollment position at the following sampling schedules: 1) Complete QD for the first 3 participants per dose level: Pre-infusion and 1, 4, 8, 12, and 24h + 1 sampling at either 10h or 16h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 2) Limited QD for participants 4 and higher: Pre-infusion and 1, 4, 6, and 8h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level; 3) BID: Pre-infusion and at 20 minutes and 1, 2.25, 3.25. 9, 12, and 24h post-infusion on Days 1 and 2 and on Days 8, 15, and 22 pre-infusion per dose level. Blood samples for Vz/F were measured using liquid chromatography-tandem mass spectrometry and analyzed using a nonlinear mixed-effects modelling software program Monolix version 4.3.2. Results for each dose level and method of administration included participants from both AL and OHM cohorts and different regimen frequencies.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:Oncoethix GmbH

Last Updated