Clinical Trials /

A Study of ONO-7475 in Patients With Acute Leukemias

NCT03176277

Description:

[Updated]: To assess the safety and tolerability of ONO-7475 monotherapy in patients with relapsed or refractory acute myeloid leukemia or relapsed or refractory myelodysplastic syndromes and to assess: i) safety and tolerability and ii) preliminary efficacy of the combination of ONO-7475 and venetoclax in patients with relapsed or refractory acute myeloid leukemia.

Related Conditions:
  • Acute Myeloid Leukemia
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Study of ONO-7475 in Patients With Acute Leukemias
  • Official Title: A Phase I/II Open Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics and Preliminary Clinical Efficacy of ONO-7475 in Patients With Acute Leukemias or Myelodysplastic Syndromes

Clinical Trial IDs

  • ORG STUDY ID: ONO-7475-01
  • NCT ID: NCT03176277

Conditions

  • Acute Leukemia
  • Myelodysplastic Syndromes

Interventions

DrugSynonymsArms
ONO-7475ONO-7475 (Part A)
ONO-7475 + venetoclaxONO-7475 + venetoclax (Part D)

Purpose

[Updated]: To assess the safety and tolerability of ONO-7475 monotherapy in patients with relapsed or refractory acute myeloid leukemia or relapsed or refractory myelodysplastic syndromes and to assess: i) safety and tolerability and ii) preliminary efficacy of the combination of ONO-7475 and venetoclax in patients with relapsed or refractory acute myeloid leukemia.

Trial Arms

NameTypeDescriptionInterventions
ONO-7475 (Part A)ExperimentalSuccessive dose escalation cohorts to determine MTD/OBD
  • ONO-7475
ONO-7475 + venetoclax (Part D)ExperimentalSuccessive dose escalation of ONO-7475 cohorts + venetoclax
  • ONO-7475 + venetoclax

Eligibility Criteria

        Inclusion Criteria:

          1. Patients aged ≥18 years at time of screening.

          2. Written informed consent by the patient (or their legal representative) prior to
             admission to this study. In addition, any locally required authorization (Health
             Insurance Portability and Accountability Act in the US), must be obtained from the
             patient prior to performing any protocol-related procedures, including screening
             evaluations.

          3. Adequate renal and hepatic function defined as:

               1. Total bilirubin within 1.5 x upper limit of normal (ULN), except those with
                  Gilberts syndrome for whom this must be ≤3 x ULN

               2. AST and ALT ≤2.5 x ULN

               3. Calculated creatinine clearance ≥45 mL/min

               4. Serum albumin ≥2.5 g/dL For any patient with laboratory values outside the ranges
                  outlined above that are considered due to the patient's underlying disease (AML
                  or MDS), the patient may be enrolled into the study following consultation
                  between the Investigator and the Sponsor's Medical Officer, if the patient is
                  likely to benefit from receiving ONO-7475 (based on the Investigator's
                  assessment).

          4. Eastern Cooperative Oncology Group (ECOG) performance status 0-2 as assessed during
             the screening period and then again anytime during the 2-day period immediately
             preceding the start of dosing in Parts A and D.

          5. Life expectancy of at least 3 months

          6. Sexually active female patients of childbearing potential and sexually active male
             patients must agree to use an effective method of birth control (e.g., barrier methods
             with spermicides, oral or parenteral contraceptives and/or intrauterine devices)
             during the entire duration of the study and for 4 months after final administration of
             study drug. Note that sterility in female patients must be confirmed in the patients'
             medical records and be defined as any of the following: surgical hysterectomy with
             bilateral oophorectomy, bilateral tubular ligation, natural menopause with last menses
             >1 year ago, radiation-induced oophorectomy with last menses >1 year ago,
             chemotherapy-induced menopause with last menses >1 year ago.

          7. Diagnosis of AML or MDS according to WHO criteria 2016 (Part A only).

          8. Either criterion is met (Part A only):

               1. Patients with R/R AML with at least 5% blasts by BM biopsy or aspirate, or at
                  least 1% blasts in peripheral blood, not likely to benefit from standard salvage
                  chemotherapy

               2. Patients with R/R MDS who are either not eligible for (or unlikely to benefit
                  from) other forms of therapy, including HSCT, according to the treating
                  Physician/Investigator .

          9. All patients must have received at least one previous line of therapy (Part A only).

         10. Diagnosis of AML according to WHO criteria (2016) (Part D only).

         11. Patients with R/R AML who have no standard-of-care options known to provide clinical
             benefit in patients with R/R AML (Part D only)

               1. Refractory AML: Patients who have not achieved complete remission after two
                  cycles of induction chemotherapy (i.e., anthracycline containing regimen), four
                  cycles of hypomethylating agents, or two cycles of other AML therapy

               2. Relapsed AML: Patients who have ≥5% BM blasts in BM, or reappearance of blasts in
                  the peripheral blood not attributable to another cause (e.g., recovery of normal
                  cells following chemotherapy-induced aplasia) or (re)appearance of extramedullary
                  disease after CR of prior AML therapy.

         12. All patients must have measured BM aspirate blast counts at Screening. Where the
             aspirate is hypo cellular or inaspirable a biopsy would be considered (Part D only).

         13. All patients must have received 1 to 3 (inclusive) prior AML therapies after first
             diagnosis of AML (Part D).

        Exclusion Criteria:

          1. Patients with active central nervous system leukemia.

          2. QT interval corrected according to Fredericia's formula (QTcF) prolongation defined as
             a QTcF interval >470 msec or other significant ECG abnormalities including second
             degree (type II) or third degree atrioventricular block or bradycardia (ventricular
             rate <50 beats/min).

          3. Clinically significant liver disease, including active viral or other hepatitis,
             current alcohol abuse, or severe cirrhosis.

          4. Human immunodeficiency virus (HIV), active hepatitis B (HBV) or C (HCV) infection.

          5. Retinal disease (e.g., retinitis pigmentosa including Mertk mutations), retinal
             hemorrhage or any disorder which may inhibit follow up for retinal toxicity.

          6. Serious intercurrent medical or psychiatric illness that will prevent participation or
             compliance with study procedures, including serious active infection (including
             COVID-19).

          7. Acute promyelocytic leukemia (the French-American-British M3 classification).

          8. Patients not recovered to Grade 1 or stabilized from the effects (excluding alopecia)
             of any prior therapy for their malignancies.

          9. Concurrent treatment with other investigational drugs.

         10. Daily requirement of ≥10 mg/day of prednisone or equivalent dose of other
             corticosteroids.

         11. Prior HSCT within 12 weeks of the first dose of study treatment or ongoing
             immunosuppressive therapy for graft-versus-host disease.

         12. Participation in another clinical trial with any investigational drug within 14 days
             or with any licensed drug within five half-lives, prior to the first ONO-7475 dosing
             (for Part A) or prior to the first venetoclax dosing (for Part D).

         13. Prior AML or MDS therapy (non-experimental) within 14 days or 5 half-lives, whichever
             is longer, prior to the first dose of ONO-7475 (for Part A) or prior to the first
             venetoclax dosing (for Part D) (except those permitted in Section 7.1) and no residual
             toxicity from the prior therapy hindering of the ONO-7475 dosing (for Part A) or
             ONO-7475 plus venetoclax dosing (for Part D).

         14. Prior radiotherapy within 21 days of screening, with the exception of localized
             palliative radiotherapy.

         15. Patients undergoing current treatments for other cancers.

         16. Pregnant or lactating women.

         17. Proliferative disease (white blood cell [WBC] counts >30 x 10e9/L) confirmed prior to
             the first dose of ONO-7475 (for Part A) or WBC >25 x 10e9/L in Part D.

         18. Active malignancy, other than AML (Parts A and D) or MDS (Part A), requiring systemic
             therapy except for those patients who have been diagnosed with either prostate or
             breast cancer and who have received a stable dose of hormone therapy for a minimum of
             6 months prior to entering this study.

         19. Known hypersensitivity to venetoclax (Part D only).
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Incidence, nature, and severity of (serious) Adverse Events (Part A)
Time Frame:Up to 12 months
Safety Issue:
Description:To determine the safety and tolerability of ONO-7475

Secondary Outcome Measures

Measure:Determination of Maximum Tolerated Dose (MTD) (Part A)
Time Frame:Up to 12 months
Safety Issue:
Description:As assessed by the incidence, nature, and severity of (serious) Adverse Events
Measure:Determination of recommended pharmacological dose (Part A)
Time Frame:Up to 12 months
Safety Issue:
Description:As assessed by the Plasma inhibitory activity (PIA)
Measure:Determination of recommended Phase 2 dose (Part D)
Time Frame:Up to 12 months
Safety Issue:
Description:As assessed by safety, PK and PD data
Measure:Pharmacokinetics (Tmax) (Part A)
Time Frame:Day 1 and Day 28 of Cycle 1 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the time to reach maximum observed plasma concentration of ONO-7475.
Measure:Pharmacokinetics (Tmax) (Part D)
Time Frame:Day 1 of Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the time to reach maximum observed plasma concentration of ONO-7475.
Measure:Pharmacokinetics (Cmax) (Part A)
Time Frame:Day 1 and Day 28 of Cycle 1(each cycle is 28 days)
Safety Issue:
Description:Assessment of the maximum plasma concentration of ONO-7475.
Measure:Pharmacokinetics (Cmax) (Part D)
Time Frame:Day 1 of Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the maximum plasma concentration of ONO-7475.
Measure:Pharmacokinetics (AUC) (Part A)
Time Frame:Day 1 and Day 28 of Cycle 1 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the plasma area under the curve (day 1 and 28) of ONO-7475.
Measure:Pharmacokinetics (AUC) (Part D)
Time Frame:Day 1 of Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the plasma area under the curve (day 1 of Cycle 2) of ONO-7475.
Measure:Pharmacokinetics (T1/2) (Part A)
Time Frame:Day 1 and Day 28 of Cycle 1 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the elimination half life of ONO-7475.
Measure:Pharmacokinetics (T1/2) (Part D)
Time Frame:Day 1 of Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the elimination half life of ONO-7475.
Measure:Pharmacokinetics (Ctrough) (Part A)
Time Frame:Cycle 1 predose Day 7, Day 15 and Day 28/ 7 days after the last dosing of ONO-7475 at investigator's discretion (PK follow-up) (each cycle is 28 days)
Safety Issue:
Description:Assessment of the trough concentration of ONO-7475 in the plasma.
Measure:Pharmacokinetics (Ctrough) (Part D)
Time Frame:Day 7 and Day 15 of Cycle 1 and Day 1 of Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the trough concentration of ONO-7475 in the plasma.
Measure:Pharmacokinetics (Cmax) - Food effect (Part A)
Time Frame:Day 57 (Cycle 3 Day 1) (each cycle is 28 days)
Safety Issue:
Description:Assessment of the food effect on the maximum plasma concentration of ONO-7475.
Measure:Pharmacokinetics (Tmax) - Food effect (Part A)
Time Frame:Day 57 (Cycle 3 Day 1) (each cycle is 28 days)
Safety Issue:
Description:Assessment of the food effect on the time to reach maximum observed plasma concentration of ONO-7475.
Measure:Pharmacokinetics (AUC) - Food effect (Part A)
Time Frame:Day 57 (Cycle 3 Day 1) (each cycle is 28 days)
Safety Issue:
Description:Assessment of the food effect on the plasma area under the curve of ONO-7475
Measure:Pharmacokinetics (T1/2) - Food effect (Part A)
Time Frame:Day 57 (Cycle 3 Day 1) (each cycle is 28 days)
Safety Issue:
Description:Assessment of the food effect on the elimination half life of ONO-7475.
Measure:Pharmacokinetics (Ctrough) - Food effect (Part A)
Time Frame:Day 57 (Cycle 3 Day 1) (each cycle is 28 days)
Safety Issue:
Description:Assessment of the food effect on the trough concentration of ONO-7475 in the plasma.
Measure:Pharmacokinetics (Tmax) - (Part D)
Time Frame:Day 1 of Cycle 1 and Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the time to reach maximum observed plasma concentration of venetoclax.
Measure:Pharmacokinetics (Cmax) - (Part D)
Time Frame:Day 1 of Cycle 1 and Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the maximum plasma concentration of venetoclax.
Measure:Pharmacokinetics (AUC) - (Part D)
Time Frame:Day 1 of Cycle 1 and Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the plasma area under the curve of venetoclax
Measure:Pharmacokinetics (T1/2) - (Part D)
Time Frame:Day 1 of Cycle 1 and Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the elimination half life of venetoclax
Measure:Pharmacokinetics (Ctrough) - (Part D)
Time Frame:Day 15 of Cycle 1 and on Day 1 of Cycle 2 (each cycle is 28 days)
Safety Issue:
Description:Assessment of the trough concentration of venetoclax in the plasma
Measure:Pharmacodynamics of ONO-7475 (Part A and D)
Time Frame:Up to 12 months
Safety Issue:
Description:Assessment of the pharmacodynamic activity of ONO-7475 as assessed by a PIA assay (pAxl/pMer inhibition).
Measure:Overall response rate (ORR) (Part A and D)
Time Frame:Up to 12 months
Safety Issue:
Description:CR/CRh (Part D only)/CRi/MLFS/PR for AML
Measure:Transfusion independence rate (Part D)
Time Frame:Up to 12 months
Safety Issue:
Description:Assessment by the usage of blood transfusions.
Measure:Duration of response (DOR) (Part A)
Time Frame:Up to 12 months
Safety Issue:
Description:Duration in months from CR/CRi/MLFS/PR to disease recurrence for AML.
Measure:Duration of response (DOR) (Part D)
Time Frame:Up to 12 months
Safety Issue:
Description:Duration in months from CR/CRh to disease recurrence for AML.
Measure:Event-free survival (Part A and D)
Time Frame:Up to 12 months
Safety Issue:
Description:Duration in months from date of first study treatment to disease recurrence/treatment failure or death for AML.
Measure:Complete Response rate (Part D)
Time Frame:Up to 12 months
Safety Issue:
Description:Assessment of the number of patients with complete response (CR)
Measure:Complete response with partial hematologic recovery rate (Part D)
Time Frame:Up to 12 months
Safety Issue:
Description:Assessment of the number patients with complete response with partial hematologic recovery (CRh)
Measure:Complete Response (Part A and D)/ Complete Response with partial hematologic recovery without minimal residual disease (MRD) AML (Part D only)
Time Frame:Up to 12 months
Safety Issue:
Description:Assessed by flow cytometry for patients who achieve CR or CRh (Part D only)
Measure:Overall Survival (Part D)
Time Frame:Up to 12 months
Safety Issue:
Description:Duration in months from the date of first study treatment to death from any cause.

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Ono Pharmaceutical Co. Ltd

Trial Keywords

  • Leukemia
  • Leukemia, Myeloid
  • Leukemia, Myeloid, Acute
  • MER
  • MERTK
  • TYRO3
  • AXL
  • AML
  • Relapsed/ Refractory AML
  • TAM
  • MDS
  • Myelodysplastic Syndrome
  • Relapsed/ Refractory MDS

Last Updated

July 28, 2021