Clinical Trials /

First in Human Study of KO-539 in Relapsed or Refractory Acute Myeloid Leukemia

NCT04067336

Description:

This first-in-human (FIH) dose-escalation and dose-validation/expansion study will assess KO-539, a menin-MLL(KMT2A) inhibitor, in patients with refractory or relapsed acute myeloid leukemia (AML).

Related Conditions:
  • Acute Myeloid Leukemia
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: First in Human Study of KO-539 in Relapsed or Refractory Acute Myeloid Leukemia
  • Official Title: A Phase 1/2A First in Human Study of the Menin-MLL(KMT2A) Inhibitor KO-539 in Patients With Relapsed or Refractory Acute Myeloid Leukemia

Clinical Trial IDs

  • ORG STUDY ID: KO-MEN-001
  • NCT ID: NCT04067336

Conditions

  • Advanced Malignant Neoplasm
  • Acute Myeloid Leukemia
  • Mixed Lineage Leukemia
  • Mixed Lineage Acute Leukemia
  • Acute Leukemia of Ambiguous Lineage
  • Mixed Phenotype Acute Leukemia

Interventions

DrugSynonymsArms
KO-539KO-539

Purpose

This first-in-human (FIH) dose-escalation and dose-validation/expansion study will assess KO-539, a menin-MLL(KMT2A) inhibitor, in patients with refractory or relapsed acute myeloid leukemia (AML).

Detailed Description

      This Phase 1/2a, first-in-human (FIH), open-label, dose-escalation and
      dose-validation/expansion study will assess KO-539, a menin-MLL(KMT2A) inhibitor, in patients
      with refractory or relapsed acute myeloid leukemia (AML). The dose-escalation part of the
      study (part 1a) will determine the maximal tolerated dose (MTD). The
      dose-validation/expansion part of the study (part 1b) will determine the safety,
      tolerability, and minimal biologically effective dose of KO-539 in dosing cohorts which have
      demonstrated early biological activity and have been determined to be safe as part of the
      dose-escalation part.
    

Trial Arms

NameTypeDescriptionInterventions
KO-539ExperimentalPart 1a: Dose Escalation Part 1b: Dose-Validation/Expansion Cohort 1: KMT2A/NPM1 patients will receive a dose previously studied in Part 1a Cohort 2: KMT2A/NPM1 patients will receive a dose previously studied in Part 1a
  • KO-539

Eligibility Criteria

        Key Inclusion Criteria:

          1. Refractory or relapsed AML defined as the reappearance of > 5% blasts in the bone
             marrow and who have also failed or are ineligible for any approved standard of care
             therapies, including HSCT.

          2. ≥ 18 years of age.

          3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.

          4. Adequate liver and kidney function according to protocol requirements.

          5. Peripheral white blood cell (WBC) counts ≤ 30,000/μL. Patients are allowed to receive
             hydroxyurea to control and maintain WBC count prior to enrollment.

          6. Both men and women (of childbearing potential) enrolled in this trial must use
             adequate birth control measures during the course of the trial and for at least 90
             days after their last dose of study treatment.

        Key Exclusion Criteria:

          1. Donor lymphocyte infusion < 30 days prior to study entry.

          2. Clinically active central nervous system (CNS) leukemia.

          3. Undergone HSCT and have not had adequate hematologic recovery (i.e. ANC >1000 and
             platelet count > 100,000).

          4. Receiving immunosuppressive therapy post HSCT at the time of screening (must be off
             all immunosuppression therapy for at least 2 weeks). The use of topical steroids for
             cutaneous GVHD is allowed and stable steroid doses less than or equal to 20 mg of
             prednisone daily is permitted.

          5. Grade > 2 active graft-versus-host disease (GVHD), moderate or severe limited chronic
             GVHD, or extensive chronic GVHD of any severity.

          6. Received chemotherapy immunotherapy, or radiotherapy or any ancillary therapy that is
             considered to be investigational (i.e., used for non-approved indications(s) and in
             the context of a research investigation) < 14 days prior to the first dose of KO-539
             or within 5 drug half-lives (whichever is longer) prior to the first dose of study
             drug.

          7. Treatment with concomitant drugs that are strong inhibitors or inducers of cytochrome
             P450-isozyme 3A4 (CYP3A4) with the exception of antibiotics, antifungals, and
             antivirals that are used as standard of care or to prevent or treat infections and
             other such drugs that are considered absolutely essential for the care of the patient.

          8. Known detectable viral load for human immunodeficiency virus, hepatitis C, or
             hepatitis B surface antigen indicative of active infection.

          9. Active uncontrolled acute or chronic systemic fungal, bacterial, viral, or other
             infection.

         10. Significant cardiovascular disease including unstable angina pectoris, uncontrolled
             hypertension or arrhythmia, history of cerebrovascular accident including transient
             ischemic attack within the past 6 months, congestive heart failure (NYHA Class III or
             IV) related to primary cardiac disease, ischemic or severe valvular heart disease, or
             a myocardial infarction within 6 months prior to the first dose of study treatment.

         11. QTcF >480 ms.

         12. Major surgery within 4 weeks prior to the first dose of study treatment.

         13. Women who are pregnant or lactating. All female patients with reproductive potential
             must have a negative pregnancy test prior to starting treatment.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Part 1a: Maximal tolerated dose (MTD).
Time Frame:Dose Limiting Toxicities (DLTs) will be evaluated during the first 28 days (1 cycle)
Safety Issue:
Description:MTD is defined as the highest dose that is not expected to cause dose limiting toxicity (DLT) in more than 20% of patients.

Secondary Outcome Measures

Measure:Part 1a: Number of patients that experience Adverse Events (AEs) and Serious Adverse Events (SAEs).
Time Frame:During treatment and up to approximately 28 days after treatment discontinuation, or until immediately before the initiation of another anticancer therapy, whichever occurs first.
Safety Issue:
Description:Assessed by NCI-CTCAE v5.0
Measure:Part 1a: Tmax
Time Frame:Cycle 1 and Cycle 2. Each cycle is 28 days.
Safety Issue:
Description:Time to observed maximum plasma concentration of KO-539
Measure:Part 1a: AUC(0-last)
Time Frame:Cycle 1 and Cycle 2. Each cycle is 28 days.
Safety Issue:
Description:Area under the plasma concentration-time curve from time 0 to time of last measurable concentration of KO-539
Measure:Part 1a: Cmax
Time Frame:Cycle 1 and Cycle 2. Each cycle is 28 days.
Safety Issue:
Description:Maximum plasma concentration of KO-539
Measure:Parts 1a and 1b: Composite definition of complete remission (CR) and complete remission with partial hematologic recovery (CRh)
Time Frame:Up to 6 months following discontinuation of treatment
Safety Issue:
Description:To assess the CR (CR+CRh) rate
Measure:Parts 1a and 1b: Complete response (CR) with and without minimal residual disease (MRD)
Time Frame:Up to 6 months following discontinuation of treatment
Safety Issue:
Description:To assess the CR rate with and without MRD
Measure:Parts 1a and 1b: Duration of remission (DOR)
Time Frame:Up to 6 months following discontinuation of treatment
Safety Issue:
Description:To assess the DOR
Measure:Part 1b: Transfusion independence (TI)
Time Frame:Up to 6 months following discontinuation of treatment
Safety Issue:
Description:To assess transfusion independence
Measure:Part 1b: Relapse-free survival (RFS)
Time Frame:Up to 6 months following discontinuation of treatment
Safety Issue:
Description:To assess relapse-free survival
Measure:Part 1b: Overall survival
Time Frame:Up to 6 months following discontinuation of treatment
Safety Issue:
Description:To assess overall survival

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Kura Oncology, Inc.

Trial Keywords

  • AML
  • Hematological malignancy
  • KMT2A
  • NPM1
  • Menin
  • MLLr
  • Leukemia
  • Acute Leukemia

Last Updated

August 24, 2021