Clinical Trials /

Flotetuzumab in Primary Induction Failure (PIF) or Early Relapse (ER) Acute Myeloid Leukemia (AML)

NCT02152956

Description:

The primary objective of this study now is to assess the anti-neoplastic activity of flotetuzumab in patients with PIF/ER AML, as determined by the proportion of patients who achieve complete remission (CR) or complete remission with partial hematologic recovery (CRh).

Related Conditions:
  • Acute Myeloid Leukemia
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Flotetuzumab in Primary Induction Failure (PIF) or Early Relapse (ER) Acute Myeloid Leukemia (AML)
  • Official Title: A Phase 1/2, First in Human, Dose Escalation Study of MGD006, a CD123 x CD3 DART® Bi-Specific Antibody Based Molecule, in Patients With Relapsed or Refractory AML or Intermediate-2/High Risk Myelodysplastic Syndrome (MDS)

Clinical Trial IDs

  • ORG STUDY ID: CP-MGD006-01
  • NCT ID: NCT02152956

Conditions

  • AML

Interventions

DrugSynonymsArms
FlotetuzumabMGD006Flotetuzumab

Purpose

The primary objective of this study now is to assess the anti-neoplastic activity of flotetuzumab in patients with PIF/ER AML, as determined by the proportion of patients who achieve complete remission (CR) or complete remission with partial hematologic recovery (CRh).

Detailed Description

      Open-label, multi-dose, single-arm, multi-center, Phase 1/2 study conducted in three
      segments: the Single Patient Dose Escalation Segment (complete), followed by the
      Multi-Patient Dose Escalation Segment (complete) and the Maximum Tolerated Dose and Schedule
      (MTDS) Expansion Cohort Segment (ongoing). Having characterized safety and determined the
      maximum tolerated dose and schedule, the primary objective of this study now is to assess the
      anti-neoplastic activity of flotetuzumab in patients with PIF/ER AML, as determined by the
      proportion of patients who achieve CR or CRh. Starting with Cycle 2, patients who are
      benefiting from flotetuzumab may receive up to a maximum of 8 cycles of treatment.
    

Trial Arms

NameTypeDescriptionInterventions
FlotetuzumabExperimentalCD123 x CD3 bispecific DART® antibody
  • Flotetuzumab

Eligibility Criteria

        Inclusion Criteria:

          -  Confirmed diagnosis of primary or secondary AML [any subtype except acute
             promyelocytic leukemia (APL)] according to World Health Organization (WHO)
             classification

          -  Patients with AML must meet one of the following criteria, a or b:

             a. Primary Induction Failure (PIF) AML, defined as disease refractory to one of the
             following, i or ii: i. An intensive induction attempt, per institution. Induction
             attempts include high-dose and/or standard-dose cytarabine

             ± an anthracyclines/anthracenedione ± an anti-metabolite, with or without growth
             factor or targeted therapy containing regimens.

        Examples include but are not limited to:

          1. One cycle of high dose cytarabine (HiDAC) containing regimen

          2. One cycle of liposomal cytarabine and daunorubicin

          3. Two cycles of standard dose cytarabine containing regimen ii. For adults who are age
             75 years or older, or who have comorbidities that preclude use of intensive induction
             chemotherapy; PIF is defined as AML refractory to one of the following less intensive
             regimens, 1 or 2:

        1. ≥ 2 but ≤ 4 cycles of Bcl-2 inhibitors in combination with azacitidine, decitabine, or
        low dose cytarabine 2. ≥ 2 but ≤ 4 cycles of gemtuzumab ozogamicin monotherapy b. Early
        relapse (ER) AML, defined as AML in first relapse with initial CR1 duration < 6 months 3.
        Limit of 3 prior lines of therapy: up to 2 induction (induction, re-induction) or 1
        induction plus/minus 1 consolidation attempt, followed by a maximum of 1
        salvage/re-induction attempt.

          -  Eastern Cooperative Oncology Group (ECOG) performance status ≤2

          -  Life expectancy of at least 4 weeks

          -  Peripheral blast count </= 20,000/mm3 at the time of first dose

          -  Acceptable laboratory parameters and adequate organ reserve

        Exclusion Criteria:

          -  History of allogeneic stem cell transplantation

          -  Prior treatment with an anti-CD123-directed agent

          -  Need for concurrent other cytoreductive chemotherapy

          -  Any active untreated autoimmune disorders (with the exception of vitiligo, resolved
             childhood atopic dermatitis, prior Grave's disease now euthyroid clinically and with
             stable supplementation)

          -  Second primary malignancy that requires active therapy. Adjuvant hormonal therapy is
             allowed.

          -  Antitumor therapy or investigational agent within 14 days or 5 half-lives of Cycle 1
             Day 1.

          -  Requirement, at the time of study entry, for concurrent steroids > 10 mg/day of oral
             prednisone or the equivalent, except steroid inhaler, otic preparations, nasal spray
             or ophthalmic solution

          -  Use of immunosuppressant medications in the 2 weeks of Cycle 1 Day 1

          -  Use of granulocyte colony stimulating or granulocyte-macrophage colony stimulating
             factor in the 2 weeks of Cycle 1 Day 1

          -  Known central nervous system (CNS) leukemia

          -  Active uncontrolled infection (including, but not limited to viral, bacterial, fungal,
             or mycobacterial infection),

          -  Known human immunodeficiency virus infection, unless all of the following criteria are
             met:

             i. CD4+ count ≥ 350 cells/μL, ii. undetectable viral load, and iii. receiving highly
             active antiretroviral therapy.

          -  Known, active, history of or current acute or chronic hepatitis B or C virus (HBV)
             infection (as evidenced by detectable HBV surface antigen and HBV DNA ≥ 500 IU/mL),

          -  History of hepatitis C virus (HCV) infection, unless the infection has been treated
             and cured,

          -  Active SARS-CoV-2 infection. While SARS-CoV-2 testing is not mandatory for study
             entry, testing for ongoing infection should follow local clinical practice
             guidelines/standards. Participants with a positive test result for ongoing SARS-CoV-2
             infection, known asymptomatic infection, or suspected infection are excluded unless or
             until asymptomatic and with subsequent negative SARS-CoV-2 laboratory test.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Efficacy based on CR/CRh rate
Time Frame:14 months
Safety Issue:
Description:Proportion of patients achieving a best response of CR (morphologic CR [mCR], cytogenetic CR [CRc], molecular CR [CRm], or CRh per Interworking Group AML response criteria.

Secondary Outcome Measures

Measure:Overall complete response rate
Time Frame:14 months
Safety Issue:
Description:Rate of CR + CRh + CRi (CR with incomplete blood cell recovery [CR with incomplete neutrophil or platelet recovery]) + MLFS (morphologic leukemia-free state)
Measure:CR rate
Time Frame:14 months
Safety Issue:
Description:Proportion of patients achieving a best response of CR (morphologic CR [mCR], cytogenetic CR [CRc], or molecular CR [CRm] per Interworking Group AML response criteria.
Measure:CRh rate
Time Frame:14 months
Safety Issue:
Description:Proportion of patients achieving a best response of CRh per Interworking Group AML response criteria.
Measure:Duration of response
Time Frame:Up to 2 years
Safety Issue:
Description:Time of initial documentation of response to the time of disease relapse or death due to any cause, whichever occurs first.
Measure:Transfusion independence rate
Time Frame:56 days
Safety Issue:
Description:The rate of conversion from transfusion dependence to transfusion independence will be calculated. The rate of patients who are transfusion independent at baseline and remain independent during any 56-day post-baseline period will also be calculated.
Measure:Overall survival
Time Frame:Up to 2 years
Safety Issue:
Description:Time from first dose to death from any cause
Measure:HSCT rate
Time Frame:8 months
Safety Issue:
Description:Rate of successful hematopoietic stem cell transplantation (HSCT) through flotetuzumab treatment but before subsequent therapy.
Measure:Incidence rate of hospitalization
Time Frame:8 months
Safety Issue:
Description:Incidence rate of hospitalization will be calculated
Measure:Duration of hospitalization
Time Frame:8 months
Safety Issue:
Description:Duration of hospitalization will be characterized
Measure:Event-free survival
Time Frame:Up to 2 years
Safety Issue:
Description:Time from the first dose of study drug until date of evidence of progression, relapse, or death from any cause, whichever occurs first.
Measure:Time to response
Time Frame:14 months
Safety Issue:
Description:Time from first dose of study drug to first CR, CRh, CR with incomplete blood cell recovery (CRi), CR with incomplete neutrophil recovery (CRn), CR with incomplete platelet recover (CRp), or morphologic leukemia-free state (MLFS)
Measure:Mortality rate
Time Frame:Up to 180 days
Safety Issue:
Description:rate of death from any cause within 30, 60, 90, or 180 days of first dose of study drug
Measure:6-month survival rate
Time Frame:6 months
Safety Issue:
Description:Probability of survival at 6 months from first dose of study drug
Measure:One-year survival rate
Time Frame:1 year
Safety Issue:
Description:Probability of survival at 1 year from first dose of study drug
Measure:Infusion related reaction (IRR)/cytokine release syndrome (CRS) management
Time Frame:During study drug administration (up to 8 months)
Safety Issue:
Description:Determine safety and efficacy of tocilizumab in the treatment of IRR/CRS as measured by incidence of IRR/CRS

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:MacroGenics

Trial Keywords

  • AML
  • leukemia
  • myelogenous
  • myeloid
  • refractory

Last Updated

May 25, 2021