Description:
The purpose of this study is to evaluate the safety and tolerability of Palbociclib in
combination with investigational (experimental) drug, CPX-351 and evaluate the efficacy of
Palbociclib in combination with chemotherapy as measured by overall response rate (ORR), i.e.
complete response (CR) and CR with incomplete blood count recovery (CRi) by 2003 IWG
criteria.
Title
- Brief Title: Phase I/II Trial of CPX-351 + Palbociclib in Patients With Acute Myeloid Leukemia
- Official Title: Phase I/II Trial of CPX-351 + Palbociclib in Patients With Acute Myeloid Leukemia
Clinical Trial IDs
- ORG STUDY ID:
CASE1918
- NCT ID:
NCT03844997
Conditions
- Acute Myeloid Leukemia
- AML
Interventions
Drug | Synonyms | Arms |
---|
Palcociclib | IBRANCE | Palbociclib + CPX-351 |
CPX-351 | VYXEOS | Palbociclib + CPX-351 |
Purpose
The purpose of this study is to evaluate the safety and tolerability of Palbociclib in
combination with investigational (experimental) drug, CPX-351 and evaluate the efficacy of
Palbociclib in combination with chemotherapy as measured by overall response rate (ORR), i.e.
complete response (CR) and CR with incomplete blood count recovery (CRi) by 2003 IWG
criteria.
Detailed Description
The objectives of this study are to evaluate the safety and tolerability of Palbociclibin
combination with CPX-351, and to evaluate the efficacy of Palbociclibin combination with
chemotherapy as measured by overall response rate (ORR), i.e. complete response (CR) and CR
with incomplete blood count recovery (CRi) by IWG criteria.
CPX-351 is an investigational drug that works as formulation of a fixed combination of the
antineoplastic (acting to prevent, inhibit or halt the development of a neoplasm (a tumor))
drugs cytarabine and daunorubicin.
Palbociclibis an investigational drug that works to induce early G1 arrest by inhibiting
CDK4/6, which are two types of CDKs that are overexpressed in AML cell cancer lines.
CPX-351 and Palbociclib is experimental because it is not approved by the Food and Drug
Administration (FDA).
This is a single arm, open label study of the combination of Palbociclib with CPX-351 in
adults with AML. The trial consists of two components: phase I to evaluate the safety with
dose escalation of Palbociclib in combination with CPX-351 and phase II to evaluate the
overall response rate of the combination in the targeted participant population.
Trial Arms
Name | Type | Description | Interventions |
---|
Palbociclib + CPX-351 | Experimental | Palbociclib will be administered orally on day -1 and -2 at 125 mg PO during the phase IIaportion (dose level 0).Day 0 will be rest and then CPX-351 at 100 u/m2 will be started on days 1, 3, and 5 along with Palbociclib day 2, 4, and 6 followed by rest/monitoring period (day 7-28).
If Grade 3-4 non-hematologic toxicity is observed in 1 or less of 6 patients treated, the study will move to Phase IIb. If Grade 3-4 non-hematologic toxicity is observed in 2 or more of 6 patients treated, 6 additional patients will be treated on the Phase IIa portion at a lower dose level (100 mg po) until a Phase IIb safe dose schedule is defined at which 1 or less out of 6 patients on the Phase IIa experience Grade 3-4 non-hematologic toxicity. After the Phase IIa portion ensures safety, the study will proceed with phase IIb. The phase IIb component is a Simon 2-stage design trial whose objective is to assess the clinical efficacy of the combination of Palbociclib and CPX-351. | |
Eligibility Criteria
Inclusion Criteria:
- Newly diagnosed acute myeloid leukemia according to 2016 WHO criteria(excluding APL
[AML-M3]).
- Eastern Cooperative Oncology Group (ECOG) Performance Status <2
- Subjects must have normal organ function as defined below:
- Total bilirubin <2 times upper limit of normal ((≤ 3 x ULN if considered to be due to
leukemic involvement or Gilbert's syndrome) or if higher than 2 times upper limit of
normal with approval from the PI
- Serum Creatinine <2 x ULNor if higher than 2 times upper limit of normal with approval
from the PI
- Left ventricular ejection fraction of ≥45%
- Patients with secondary AML arising out of MDS (all subtypes under WHO
classification), chronic myelomonocytic leukemia (CMML) and therapy-related AML are
eligible.
- Women of childbearing potential should be advised to avoid becoming pregnant and men
should be advised to not father a child while receiving treatment. All men and women
of childbearing potential must use acceptable methods of birth control throughout the
study
- Subjects must have the ability to understand and the willingness to sign a written
informed consent document.
Exclusion Criteria:
- Prior treatment with CPX-351, Palbociclib or other cell cycle inhibitors.
- Any serious medical condition, laboratory abnormality, or psychiatric illness that, in
the view of the treating physician, would place the participant at an unacceptable
risk if he or she were to participate in the study or would prevent that person from
giving informed consent.
- Any active malignancy (unrelated, non-hematological malignancy) diagnosed within the
past 6 months of starting the study drug (other than curatively treated
carcinoma-in-situ of the cervix or non-melanoma skin cancer).
- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to CPX-351, Palbociclib or other cell cycle inhibitors.
- Subjects with uncontrolled intercurrent illness including, but not limited to ongoing
or active infection, symptomatic congestive heart failure, unstable angina pectoris,
uncontrolled cardiac arrhythmia, or psychiatric illness/social situations that would
limit compliance with study requirements.
- Known history of HIV or active hepatitis B or C.
- No major surgery within 2 weeks prior to study enrollment.
- Pregnancy or breast feeding
- Male and female patients who are fertile who do not agree to use an effective barrier
methods of birth control (i.e. abstinence) to avoid pregnancy while receiving study
treatment.
- Acute promyelocytic leukemia (APL)
Maximum Eligible Age: | 65 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety and tolerability of experimental dose of Palbociclibin combination with CPX-351 as measured by number of participants with dose limiting toxicities. |
Time Frame: | Between days 28-35 of starting treatment |
Safety Issue: | |
Description: | If Grade 3-4 non-hematologic toxicity is observed in 1 or less of 6 patients treated, the dose of the study drug will be considered safe/tolerable. If Grade 3-4 non-hematologic toxicity is observed in 2 or more of 6 patients treated, 6 additional patients will be treated on the Phase IIa portion at a lower dose level (100 mg po). |
Secondary Outcome Measures
Measure: | Time to response (TTR) |
Time Frame: | Up to 2 years from end of treatment |
Safety Issue: | |
Description: | TTR measured between start of treatment and the date of achievement of response (responses defined per 2003 IWG criteria). |
Measure: | Duration of response (DOR) |
Time Frame: | Up to 2 years from end of treatment |
Safety Issue: | |
Description: | DOR is measured between the date of response to date of loss of response. |
Measure: | Event-free survival (EFS) |
Time Frame: | Up to 2 years from end of treatment |
Safety Issue: | |
Description: | EFS measured from the date of entry into a study to the date of primary refractory disease, or relapse from CR, or CRi, or death from any cause; patients not known to have any of these events are censored on the date they were last examined |
Measure: | Overall Survival (OS) probability |
Time Frame: | Up to 2 years from end of treatment |
Safety Issue: | |
Description: | OS probability measured from the date of entry into a clinical trial to the date of death from any cause; patients not known to have died at last follow-up are censored on the date they were last known to be alive |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Sudipto Mukherjee |
Last Updated
June 18, 2021