Description:
Part 1 will be conducted as an open-label, non-randomized, non-placebo-controlled dose
escalation study using pre-specified doses. Subjects with the following advanced
hematological disorders and no available therapies, and who satisfy all inclusion/exclusion
criteria will be enrolled. The purpose is to identify the recommended dose of oral ORH-2014
in subjects with advanced hematological disorders.
Part 2 will be an expansion phase conducted as a single-arm, open-label study to further
evaluate the safety and tolerability of ORH-2014 at the maximum tolerated dose (MTD) or
recommended dose determined from Part 1 in the fasted state. Subjects with the same disease
types as in Part 1 will be enrolled. All subjects will receive oral ORH-2014, in the fasted
state, at the recommended dose for an initial period of up to 12 weeks. The purpose is to
evaluate the safety and tolerability of oral ORH-2014 in a population of subjects with
advanced hematological disorders when administered at the recommended dose.
Title
- Brief Title: A Phase I, Two-part Study to Determine the Recommended Dose and Evaluate the Safety and Tolerability of a Novel Oral Arsenic Trioxide Formulation (ORH-2014) in Subjects With Advanced Hematological Disorders
- Official Title: A Phase I, Two-part Study to Determine the Recommended Dose and Evaluate the Safety and Tolerability of a Novel Oral Arsenic Trioxide Formulation (ORH-2014) in Subjects With Advanced Hematological Disorders
Clinical Trial IDs
- ORG STUDY ID:
ORH2014-001
- NCT ID:
NCT03048344
Conditions
- Advanced Hematological Disorders
Interventions
Drug | Synonyms | Arms |
---|
ORH-2014 | | Part 1 |
ORH-2014 | | Part 2 |
Purpose
Part 1 will be conducted as an open-label, non-randomized, non-placebo-controlled dose
escalation study using pre-specified doses. Subjects with the following advanced
hematological disorders and no available therapies, and who satisfy all inclusion/exclusion
criteria will be enrolled. The purpose is to identify the recommended dose of oral ORH-2014
in subjects with advanced hematological disorders.
Part 2 will be an expansion phase conducted as a single-arm, open-label study to further
evaluate the safety and tolerability of ORH-2014 at the maximum tolerated dose (MTD) or
recommended dose determined from Part 1 in the fasted state. Subjects with the same disease
types as in Part 1 will be enrolled. All subjects will receive oral ORH-2014, in the fasted
state, at the recommended dose for an initial period of up to 12 weeks. The purpose is to
evaluate the safety and tolerability of oral ORH-2014 in a population of subjects with
advanced hematological disorders when administered at the recommended dose.
Trial Arms
Name | Type | Description | Interventions |
---|
Part 1 | Experimental | Subjects will receive oral ORH-2014 at a planned starting dose of 5 mg once daily (QD) in the fasted state. If escalation criteria are met, the administered dose will increase by 5 mg increments to a maximum of 50 mg QD. The starting daily dose is approximately half the typical IV dose (0.15 milligram per kilogram [mg/kg]) extrapolated to a 70-kg person. | |
Part 2 | Experimental | Subjects will receive a daily oral dose of ORH-2014 at the recommended dose identified in Part 1. ORH-2014 will be administered in the fasted state. | |
Eligibility Criteria
Inclusion Criteria:
- Female and male subjects ≥18 years of age with one of the following:
- Relapsed or refractory acute myelocytic leukemia (AML) with nucleophosmin-1
(NPM1) mutations and no available therapies.
- Relapsed or refractory acute promyelocytic leukemia (APL), with no available
therapies. Note: Prior exposure to arsenic trioxide is allowed; however, subjects
who have failed arsenic trioxide within the last 12 months are not allowed.
- Relapsed or refractory myelodysplastic syndrome (MDS), International Prognostic
Scoring System intermediate or high-risk, with no available therapies
- Relapsed or refractory chronic myelomonocytic leukemia (CMML), and other
MDS/myeloproliferative neoplasm (MPN) overlap syndromes, with no available
therapies
- Relapsed or refractory mantle cell lymphoma (MCL) with no adequate therapies.
- Negative pregnancy test at the Screening visit for women of childbearing potential and
willingness to use adequate birth control
- Not willing to undergo, not a candidate for, or not having a donor for immediate
(within 3 months from the Screening date) bone marrow transplantation.
Exclusion Criteria:
- Eastern Cooperative Oncology Group performance status of ≥3;
- Absolute myeloblast count ≥20,000/mm^3;
- Administration of any antineoplastic therapy within 5 half-lives of the antineoplastic
therapy before the first dose of ORH-2014, with the exception of hydroxyurea that
should be discontinued 1 day prior to the first dose of ORH-2014
- Presence of any remaining toxicities due to previous chemotherapy
- Participation in other clinical trials within at least 2 weeks of the first ORH-2014
dose;
- Clinical evidence of active central nervous system leukemia;
- Active and uncontrolled infection
- Major surgery within 2 weeks prior to trial entry;
- Liver function tests above the following limits at Screening: total bilirubin >1.5 x
upper limit of normal (ULN) unless related to Gilbert's syndrome or hemolysis;
aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >2.5 x ULN; for
subjects with liver involvement, AST and/or ALT >5 x ULN;
- Serum creatinine >1.5 x ULN and/or creatinine clearance or estimated glomerular
filtration rate <30 mL/min
- Impaired cardiac function
- Myocardial infarction of unstable angina within 6 months prior to the planned start
date of study drug.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | To identify the recommended dose |
Time Frame: | From baseline to Week 4 |
Safety Issue: | |
Description: | The recommended dose is determined by the number of patients who experience a dose limiting toxicity (DLT). |
Secondary Outcome Measures
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by maximum observed concentration (Cmax) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by time to maximum concentration (Tmax) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by apparent terminal elimination half-life (t1/2) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by area under the concentration-time curve from 0 to 24 hours (AUC0-24) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by area under the concentration-time curve extrapolated to infinity (AUC0-infinity) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by apparent terminal elimination rate constant (λZ) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by apparent total clearance (CL/F) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by apparent total clearance normalized by body weight (CL/F/kg) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by apparent total volume of distribution (Vz/F) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To determine the plasma pharmacokinetic (PK) profiles of total arsenic as measured by accumulation ratio (AR) |
Time Frame: | Baseline up to Week 24 |
Safety Issue: | |
Description: | |
Measure: | To evaluate the effect of ORH-2014 on QT-interval corrected for heart rate using Fridericia's formula (QTcF) |
Time Frame: | Baseline up to Week 28 |
Safety Issue: | |
Description: | |
Measure: | Safety Assessment during the expansion phase of the study on the effect of oral ORH-2014 on safety parameters |
Time Frame: | Baseline up to Week 28 |
Safety Issue: | |
Description: | During the expansion phase of the study, an aggregate clinical data review (ACDR) will be conducted. This review will collect data from electronic data capture, the ECG central review vendor (ERT), and other sources to include but is not limited to:
NCI-CTCAE Grade 3 and 4 AEs, SAEs, deaths;
Laboratory results;
Vital signs;
ECG's;
Individual subject profiles including, but not limited to: medical history, AEs, concomitant medications, laboratory results, and vital signs;
Subject disposition and screen failure rates. |
Measure: | The number of participants with a complete response (CR) or partial response (PR) according to International Working Group (IWG) response criteria |
Time Frame: | Up to Week 24 |
Safety Issue: | |
Description: | Bone marrow aspirates and/or biopsies will be obtained at the designated timepoints for evaluation of efficacy. Response criteria will be according to the International Working Group. Responders are participants who obtain complete remission (CR) or partial remission (PR), with or without cytogenetic response, and marrow complete remission. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | Orsenix LLC |
Trial Keywords
- acute promyelocytic leukemia
- APL
- arsenic trioxide
Last Updated
March 25, 2019