Description:
A Phase 1/2a dose escalation and dose ranging study of FF-10101-01 in subjects with relapsed
or refractory acute myeloid leukemia to determine the safety, tolerability, PK and
preliminary efficacy. A total of 9 cohorts will be enrolled in Phase 1 to establish the
Maximum Tolerated Dose (MTD). Phase 2a will consist of up to 3 dose levels (high, medium, and
low) of which subjects with FLT3 mutations will randomly be assigned.
Title
- Brief Title: Study of FF-10101-01 in Patients With Relapsed or Refractory Acute Myeloid Leukemia
- Official Title: A First-in-Human Phase 1/2a Study to Assess the Safety, Tolerability, Efficacy, and Pharmacokinetics of FF-10101-01 in Subjects With Relapsed or Refractory Acute Myeloid Leukemia
Clinical Trial IDs
- ORG STUDY ID:
FF-10101-US101/201
- NCT ID:
NCT03194685
Conditions
Interventions
Drug | Synonyms | Arms |
---|
FF-10101-01 | FF-10101 succinate | Cohort 1: 10 mg |
Purpose
A Phase 1/2a dose escalation and dose ranging study of FF-10101-01 in subjects with relapsed
or refractory acute myeloid leukemia to determine the safety, tolerability, PK and
preliminary efficacy. A total of 9 cohorts will be enrolled in Phase 1 to establish the
Maximum Tolerated Dose (MTD). Phase 2a will consist of up to 3 dose levels (high, medium, and
low) of which subjects with FLT3 mutations will randomly be assigned.
Detailed Description
Subjects will receive FF-10101-01 orally once a day repeated every 28 days =1 cycle Frequent
blood draws will be collected to measure pharmacodynamic parameters and pharmacodynamic
activity.
Disease assessments, including bone marrow aspirates, will be performed at the beginning of
cycles 1-3, and every 3 months thereafter. Subjects who demonstrate objective response or
stable disease will be allowed to continue therapy with FF-10101-01 until , observation of
unacceptable adverse events, or until the subject is no longer deriving benefit based on the
opinion of the investigator.
For Phase 2a long term phone follow-up for assessment of overall survival will also occur.
Trial Arms
Name | Type | Description | Interventions |
---|
Cohort 1: 10 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 2: 20 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 3: 35 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 4: 50 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 5: 75 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 6: 100 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 7: 150 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 8: 225 mg | Experimental | Orally once a day (QD) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 20: 50 mg | Experimental | Orally twice daily (BID) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 21: 75 mg | Experimental | Orally twice daily (BID) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Cohort 22: 100 mg | Experimental | Orally twice daily (BID) on Days 1-28 of a 28-day cycle. Drug: FF-10101-01 | |
Eligibility Criteria
Subjects who are able and willing to give written informed consent
- Documented primary or secondary AML, as defined by the WHO criteria (2008), by
histopathology refractory to previous induction chemotherapy and/or relapsed after
achieving remission with a prior chemotherapy and who are not candidates for other
available therapy likely to confer clinical benefit.
- For Phase 2a only: in addition to inclusion criteria 2 above, patients must have a
FLT3 mutation of any type
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
- In the absence of rapidly progressing disease, the interval from prior treatment to
time of FF-10101-01 administration should be at least 14 days for cytotoxic agents
other than hydroxyurea, at least 5 half-lives for non-cytotoxic agents, and 14 days
for monoclonal antibody therapies. Hydroxyurea may be continued for a maximum of 14
days from the start of FF-10101-01 dosing, through Cycle 1 Day 14, with a maximal dose
of 5 grams/day
- Persistent chronic clinically significant toxicities from prior chemotherapy or
surgery must be ≤Grade 2
- If subject has had a hematopoietic stem cell transplant, subject must be ≥60 days
post-transplant with no clinically significant GVHD requiring systemic therapy
- Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤3 times the
upper limit of normal and total bilirubin of ≤1.5x the upper limit of normal. If total
bilirubin is equal to or exceeds 1.5x the upper limit of normal, the subject can still
be included if direct bilirubin is ≤1.5x the upper limit of normal
- Calculated creatinine clearance of ≥60 mL/min
- Female subjects of childbearing potential and sexually mature male subjects must agree
to use a medically accepted method of contraception other than an oral contraceptive
for the duration of the study.
Exclusion Criteria:
- Subjects diagnosed with acute promyelocytic leukemia
- Subjects with Bcr-Abl positive leukemia (chronic myelogenous leukemia in blast crisis)
- Subjects with clinically active CNS leukemia
- Subjects with major surgery within 28 days prior to the first administration of
FF-10101-01
- Subjects with radiation therapy within 28 days prior to the first administration of
FF-10101-01
- Subjects with active malignant disease requiring therapy other than AML or
myelodysplastic syndrome with transformation into AML
- Subjects with an active uncontrolled infection
- Subjects with a medical condition, serious intercurrent illness, or other circumstance
that, in the Investigator's judgment, could jeopardize the subject's safety as a study
subject, or that could interfere with the study objectives
- Subjects known to have human immunodeficiency virus infection, or who have active
hepatitis B or C infection as determined by serological testing
- Subjects with congestive heart failure, New York Heart Association (NYHA) Class 3 or
4, or subjects with a past history of congestive heart failure NYHA Class 3 or 4 and
in whom echocardiogram or multiple gate acquisition (MUGA) scan performed within 3
months prior to screening or at screening showed a LVEF <40%
- Female subjects who are pregnant or breast feeding
- Subjects on 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) or
other drugs known to have muscle toxicity
- Subjects taking strong inhibitors of CYP3A4 will be excluded from the study unless
therapeutic substitution is possible
- Subjects taking strong inducers of CYP3A4 will be excluded from the study unless
therapeutic substitution is possible
- Use of systemic immunosuppressive agents within 14 days prior to first dose of
FF-10101
- Subjects taking drugs known to cause Torsades de Pointes will be excluded from the
study unless therapeutic substitution is possible
- Subjects known to have long QT syndrome
- Subjects with mean QTcF values following 3 ECGs conducted 5 minutes apart of >470 msec
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Phase 1/2a: Frequency of adverse events |
Time Frame: | 12 months |
Safety Issue: | |
Description: | Safety Assessments include frequency of adverse events (AEs) in percentage (%) |
Secondary Outcome Measures
Measure: | Phase 2a Clinical response of FF-10101-01 to AML |
Time Frame: | Response and survival assessments at the beginning Cycle 1 Day 1, Cycle 2 Day 1, Cycle 3 Day 1 and every 3 months for 2 year |
Safety Issue: | |
Description: | RFS: Defined as the time from CR to recurrence or death due to any cause. DOR: Defined as time from CR, CRp or CRi to recurrence. OS: Defined as time from the first FF-10101-01 administration to the time of death, censored (if appropriate) at the date last known to be alive.
Recurrence (Relapse after confirmed CR): Reappearance of leukemia blats in peripheral blood or ≥5% blasts in the bone marrow not attributable in the Investigator's opinion to any other cause (e.g., bone marrow regeneration after consolidation therapy) or appearance of new dysplastic changes.
PR: Defined as ≥50% decrease in bone marrow blasts to 5% to 25 % abnormal cells in the bone marrow, or CR with ≤5% blasts if Auer rods are present Treatment failure: defined as failure to achieve CR, CRi, CRp or PR |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Maximum observed concentration (Cmax) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Maximum observed concentration (Cmax) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Time to maximum concentration (tmax) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Time to maximum concentration (tmax) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Area under the plasma concentration-time curve in the sampled matrix during a 24-hour dosing interval (AUC(τ)) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Area under the plasma concentration-time curve in the sampled matrix during a 24-hour dosing interval (AUC(τ)) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite -Plasma concentration-time curve (AUC(0-last)) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Area under the plasma concentration-time curve in the sampled matrix from time zero to the last quantifiable concentration, if concentrations are not quantifiable over the entire 24-hour dosing interval (AUC(0-last)) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Dose normalized AUC(τ) (AUC(τ)/dose) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Dose normalized AUC(τ) (AUC(τ)/dose) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Dose normalized Cmax (Cmax/dose) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Dose normalized Cmax (Cmax/dose) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Accumulation ratio for AUC |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Accumulation ratio for AUC [RaccAUC ie, ratio of Day 29/Day 1 of the PK parameter] |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Accumulation ratio for Cmax |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Accumulation ratio for Cmax [RaccCmax ie, ratio of Day 29/Day 1 of the PK parameter] |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Oral clearance (CL/F) for FF-10101 |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Oral clearance (CL/F) for FF-10101 |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Average concentrations (Cavg) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Average concentrations (Cavg) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Minimum observed concentration (Cmin) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Minimum observed concentration (Cmin) |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Fluctuation index |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Fluctuation index |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Metabolite (FF-10101M1) to parent (FF-10101) exposure ratios for Cmax |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Metabolite (FF-10101M1) to parent (FF-10101) exposure ratios for Cmax |
Measure: | Phase 1: Evaluate the Pharmacokinetic profile of FF-10101-01 and its Metabolite - Metabolite (FF-10101M1) to parent (FF-10101) exposure ratios for AUC(τ) |
Time Frame: | Cycle 1, Day 1 through Cycle 2, Day 1 |
Safety Issue: | |
Description: | Metabolite (FF-10101M1) to parent (FF-10101) exposure ratios for AUC(τ) |
Measure: | Phase 1/2a: Frequency of Serious Adverse Events |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety Assessments include frequency of Serious adverse events (SAEs) |
Measure: | Phase 1/2a: Frequency of Dose Limiting Toxicities |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety Assessments include frequency of dose-limiting toxicities (DLTs), dose reductions, delays, or withdrawals due to toxicity. |
Measure: | Phase 1/2a: Frequency of adverse events including assessment of Hematology laboratory parameters |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety assessments also include assessment of clinical laboratory parameters Hematology |
Measure: | Phase 1/2a: Frequency of adverse events including assessment of serum chemistry laboratory parameters |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety assessments also include assessment of clinical laboratory parameters serum chemistry |
Measure: | Phase 1/2a: Frequency of adverse events including assessment of urinalysis laboratory parameters |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety assessments also include assessment of clinical laboratory parameters urinalysis |
Measure: | Phase 1/2a: Frequency of Adverse events including assessment of vital signs |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety assessments also include assessment of Vital signs (Heart Rate and BP) |
Measure: | Phase 1/2a: Frequency of Adverse events including assessment of vital signs - Heart Rate |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety assessments also include assessment of Vital signs Heart Rate |
Measure: | Phase 1/2a: Frequency of Adverse events including assessment of vital signs - Blood Pressure |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety assessments also include assessment of Vital signs BP) |
Measure: | Phase 1/2a: Frequency of Adverse events including assessment of 12 lead ECG. |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Safety assessments also include assessment of 12 lead ECG. |
Measure: | Phase 1/2a: Composite complete remission rate (CRc) including CR |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Composite complete remission rate (CRc) which includes CR |
Measure: | Phase1/2a: Composite complete remission rate (CRc) including CR with incomplete platelet recovery (CRp) |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Composite complete remission rate (CRc) which includes CR with incomplete platelet recovery (CRp) |
Measure: | Phase1/2a: Composite complete remission rate (CRc) including CR with incomplete neutrophil recovery with or without platelet recovery (CRi)) |
Time Frame: | 12 Months |
Safety Issue: | |
Description: | Composite complete remission rate (CRc) which includes CR with incomplete neutrophil recovery with or without platelet recovery (CRi)) |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Fujifilm Pharmaceuticals U.S.A., Inc. |
Trial Keywords
Last Updated
July 21, 2021