Description:
This study will treat patients with previously untreated high grade myleodysplastic syndromes
(MDS) with both omacetaxine mepesuccinate and azacitidine.
Title
- Brief Title: Omacetaxine + Azacitidine in Untreated Patients With High Grade MDS
- Official Title: Concomitant Omacetaxine Mepesuccinate and Azacitidine for Patients With Previously Untreated High Grade Myelodysplastic Syndromes
Clinical Trial IDs
- ORG STUDY ID:
17-2215.cc
- NCT ID:
NCT03564873
Conditions
- High Grade Myelodysplastic Syndromes
Interventions
Drug | Synonyms | Arms |
---|
Omacetaxine | | Phase I |
Azacitidine | | Phase I |
Omacetaxine | | Phase II |
Azacitidine | | Phase II |
Purpose
This study will treat patients with previously untreated high grade myleodysplastic syndromes
(MDS) with both omacetaxine mepesuccinate and azacitidine.
Detailed Description
This is an open-label, phase I/II study for previously untreated patients with high grade MDS
using omacetaxine and azacitidine. Phase I features dose escalation, where patients will be
assigned to one of three cohorts to receive different doses of omacetaxine with the standard
dose and schedule of azacitidine, over a 28 day cycle. Phase II features the maximum
tolerated dose from the Phase 1 study.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase I | Experimental | Up to 18 patients will be enrolled to one of three cohorts to receive various doses of omacetaxine over a 28 day cycle. Azacitidine will be given at the standard dose over a 28 day cycle. | |
Phase II | Experimental | Up to 33 patients will be enrolled to receive the maximum tolerated dose (determined in phase I) over a 28 day cycle. Azacitidine will be given at the standard dose over a 28 day cycle. | |
Eligibility Criteria
Inclusion Criteria:
A subject will be eligible for study participation if he/she meets the following criteria
within 14 days prior to the first day of therapy (bone marrow biopsy can be performed 28
days prior to the first day of therapy).
1. Subject must have confirmation of high grade MDS (MDS with excess blasts by WHO
criteria) or chronic myelomonocytic leukemia (CMML)-1 with greater than 5% bone marrow
blasts or CMML-2, also by WHO criteria
2. Subject must have received no prior treatment with a hypomethylating agent for MDS
3. Subject must be ≥ 18 years of age
4. Subject must have a projected life expectancy of at least 12 weeks
5. Subject must have an Eastern Cooperative Oncology Group (ECOG) Performance status of
≤2
6. Subject must have adequate renal function as demonstrated by a calculated creatinine
clearance ≥ 30 mL/min; determined via urine collection for 24-hour creatinine
clearance or by the Cockcroft Gault formula
7. Subject must have adequate liver function as demonstrated by:
- aspartate aminotransferase (AST) ≤ 3.0 × ULN
- alanine aminotransferase (ALT) ≤ 3.0 × ULN
- bilirubin ≤ 3.0 × ULN, unless due to Gilbert's syndrome
8. Non-sterile male subjects must use contraceptive methods with partner(s) from time of
enrollment and continuing up to 90 days after the last dose of study drug. Male
subjects must agree to refrain from sperm donation from initial study drug
administration until 90 days after the last dose of study drug.
9. Female subjects must agree to use two reliable forms of contraception simultaneously
or to practice complete abstinence from heterosexual intercourse during the following
time periods related to this study:
1) for at least 28 days before starting omacetaxine; 2) throughout the entire duration of
omacetaxine treatment; 3) during dose interruptions; and 4) for at least 90 days after
omacetaxine discontinuation.
10. Subject must voluntarily sign and date an informed consent, approved by an
Institutional Review Board (IRB), prior to the initiation of any screening or
study-specific procedures.
Exclusion Criteria:
A subject will not be eligible for study participation if he/she meets any of the following
criteria:
1. Subject is known to be positive for HIV. HIV testing is not required.
2. Subject is known to be positive for hepatitis B or C infection with the exception of
those with an undetectable viral load. Hepatitis B or C testing is not required and
subjects with serologic evidence of prior vaccination to HBV (i.e., HBs Ag-, anti-HBs+
and anti-HBc-) may participate.
3. Subject has any history of clinically significant condition(s) that in the opinion of
the investigator would adversely affect his/her participating in this study including,
but not limited to:
- New York Heart Association heart failure > class 2
- Renal, neurologic, psychiatric, endocrine, metabolic, immunologic, hepatic,
cardiovascular disease, or bleeding disorder independent of leukemia
4. Subject exhibits evidence of uncontrolled systemic infection requiring therapy (viral,
bacterial or fungal). Patients on antibiotics with controlled systemic symptoms will
not be excluded.
5. Subject has uncontrolled diabetes
6. Subject has had a recent major hemorrhage or has a bleeding diathesis associated with
a high risk of bleeding
7. Pregnant and breastfeeding females.
8. Subject has a history of other malignancies prior to study entry, except for:
- Adequately treated in situ carcinoma of the breast or cervix uteri
- Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin
- Prostate cancer with no plans for therapy of any kind
- Previous malignancy confined and surgically resected (or treated with other
modalities) with curative intent.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Recommended Dose |
Time Frame: | Start of study to end of study, for up to four years |
Safety Issue: | |
Description: | Determine the recommended dose of omacetaxine based on the maximum tolerated dose. |
Secondary Outcome Measures
Measure: | Overall Survival |
Time Frame: | Study start date to study end date, or death, whichever comes first, up to 4 years. |
Safety Issue: | |
Description: | Overall Survival will be defined as the time from administration of the initial dose of omacetaxine and azacitidine until death from any cause. This will be measured using Kaplan-Meier survival analysis curves. |
Measure: | Progression Free Survival |
Time Frame: | Study start date to study end date, or death, whichever comes first, up to 4 years. |
Safety Issue: | |
Description: | Progression Free Survival will be defined as the amount of time from administration of the initial dose of omacetaxine and azacitidine that a patient lives with the disease but does not get worse. This will be measured using Kaplan-Meier survival analysis curves. |
Measure: | Duration of Response |
Time Frame: | Study start date to study end date, or death, whichever comes first, up to 4 years. |
Safety Issue: | |
Description: | Duration of Response will be defined as Time from documentation of tumor response to disease progression.This will be measured using Kaplan-Meier survival analysis curves. |
Measure: | Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]). |
Time Frame: | Start of study to end of study, up to four years |
Safety Issue: | |
Description: | Safety and tolerability analysis of omacetaxine and azacitidine will be summarized by dose and severity as assessed by the Common Toxicity Criteria for Adverse Events (CTCAE) version 4.0 and relationship to study drug. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | University of Colorado, Denver |
Trial Keywords
- Omacetaxine
- Azacitidine
- Previously Untreated
- Phase I/II
- Dose Escalation
- Maximum Tolerated Dose
Last Updated
January 11, 2021