Clinical Trials /

A Study Evaluating APG-115 as a Single Agent or in Combination With APG-2575 in Subjects With T-PLL

NCT04496349

Description:

This is a multi-center, open-label, phase IIa study to evaluate the pharmacokinetics (PK), safety, and efficacy of APG-115 as a single agent or in combination with APG-2575 in patients with T-PLL. The study consists of two parts. A total of 24-36 T-PLL patients will be enrolled.

Related Conditions:
  • T-Cell Prolymphocytic Leukemia
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Study Evaluating APG-115 as a Single Agent or in Combination With APG-2575 in Subjects With T-PLL
  • Official Title: A Phase IIa Study Evaluating the Pharmacokinetics, Safety and Efficacy of APG-115 as a Single Agent or in Combination With APG-2575 in Subjects With Relapsed/Refractory T-cell Prolymphocytic Leukemia (R/R T-PLL)

Clinical Trial IDs

  • ORG STUDY ID: APG115TU101
  • NCT ID: NCT04496349

Conditions

  • T-Prolymphocytic Leukemia

Interventions

DrugSynonymsArms
APG-115APG-115 + APG-2575 combination
APG-2575APG-115 + APG-2575 combination

Purpose

This is a multi-center, open-label, phase IIa study to evaluate the pharmacokinetics (PK), safety, and efficacy of APG-115 as a single agent or in combination with APG-2575 in patients with T-PLL. The study consists of two parts. A total of 24-36 T-PLL patients will be enrolled.

Detailed Description

      In Part 1, 12-18 participants will be enrolled using a 3+3 dose escalation design. Patients
      receive APG-115 orally once every day (QD) with meal on Days 1 to 5, and 23 days off in the
      28-day cycles.

      In Part 2, the recommended starting dose of APG-115 in combination with APG-2575 in Part 2
      will be determined by pooling available dose, PK, pharmacodynamics (PD), safety, and efficacy
      data of Part I, and the consequent results of conducting an integrated dose-response and
      exposure-response analyses on the data from Part 1, after discussion between the sponsor and
      investigators. APG-2575 will be administered orally once every day (QD) with meal (low fat
      meal preferred) in a 28-day cycle following a daily ramp-up schedule.
    

Trial Arms

NameTypeDescriptionInterventions
APG-115 monotherapyExperimentalAPG-115 will be given alone
  • APG-115
APG-115 + APG-2575 combinationExperimentalAPG-115 is given in combination with APG-2575
  • APG-115
  • APG-2575

Eligibility Criteria

        Inclusion Criteria:

          1. Age ≥ 18 years old

          2. Patients with relapsed/refractory T-PLL who have active disease and have received at
             least one prior therapy

          3. Patients must not have had chemotherapy or antibody therapy for 7 days prior to
             starting APG-115 and/or APG-2575. However, patients with rapidly proliferative disease
             may receive hydroxyurea or decadron until 24 hours prior to starting therapy on this
             protocol.

          4. Absolute neutrophil count (ANC) ≥ 500/mm˄3; hemoglobin ≥ 60 g/L; platelet count ≥
             30,000/mm˄3

          5. Total bilirubin ≤ 1.5 × upper limit of normal (ULN), unless related to leukemic
             involvement

          6. Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) ≤ 3× ULN or ≤ 5
             × ULN unless related to leukemic involvement

          7. Adequate kidney function, defined as a calculated creatinine clearance ≥ 50 mL/min;
             determined via urine collection for 24-hour creatinine clearance or by the Cockcroft
             Gault formula

          8. Require laboratory TLS parameters to be within acceptable range and clinical TLS
             parameters no higher than grade 2 at study baseline, with or without TLS treatment,
             before initiation of study treatment.

          9. Known cardiac ejection fraction of ≥ 45% within the past 3 months

         10. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2

         11. Has no malignancies other than T-PLL that: 1) currently require systemic therapies; 2)
             were not previously treated with curative intention (unless the malignant disease is
             in a stable remission according to the discretion of the treating physician); 3) or
             developed signs of progression after curative treatment

         12. A negative serum pregnancy test is required within 1 week for all women of
             childbearing potential prior to enrolling in this trial. Women of childbearing
             potential and men must agree to use contraception prior to study entry and for the
             duration of study participation.

         13. Patient must have the ability to understand the requirements of the study and signed
             informed consent. A signed informed consent by the patient or his/her legally
             authorized representative is required prior to their enrollment on the protocol.

        Exclusion Criteria:

          1. Uncontrolled intercurrent illness including, but not limited to active uncontrolled
             infection, symptomatic congestive heart failure (New York Heart Association [NYHA]
             class III or IV), unstable angina pectoris, clinically significant cardiac arrhythmia,
             or psychiatric illness/social situations that would limit compliance with study
             requirements.

          2. Patient with documented hypersensitivity to any of the components of the therapy
             program.

          3. Patient previously treated with a murine double minute 2 (MDM2) inhibitor.

          4. Known active, uncontrolled central nervous system (CNS) malignancy

          5. Patients require graft versus host therapy, or require continued treatment with
             systemic immunosuppressive agents (calcineurin inhibitors within 4 weeks prior to the
             first dose of study drug).

          6. Known history of human immunodeficiency virus (HIV) infection (HIV 1/2 antibodies)

          7. Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection that requires
             treatment or at risk for HBV reactivation. Hepatitis B virus deoxyribonucleic acid
             (DNA) and HCV ribonucleic acid (RNA) must be undetectable upon testing. At risk for
             HBV reactivation is defined as hepatitis B surface antigen positive or anti-hepatitis
             B core antibody positive. Prior test results obtained as part of standard of care that
             confirm a subject is immune and not at risk for reactivation (i.e., hepatitis B
             surface antigen negative, surface antibody positive) may be used for purposes of
             eligibility and tests do not need to be repeated. Subjects with prior positive
             serology results must have negative polymerase chain reaction results. Subjects whose
             immune status is unknown or uncertain must have results confirming immune status
             before enrollment.

          8. Failure to have recovered (Grade > 1) (except alopecia and pigmentation) from prior
             treatment (including chemotherapy, targeted therapy, immunotherapy, experimental
             agents, radiation, or surgery)

          9. Significant screening electrocardiogram (ECG) abnormalities including corrected QT
             interval (Fridericia) (QTcF) > 470 msec

         10. Patients who have any conditions or illness that, according to the opinions of the
             Investigators or the medical monitor, would compromise patient safety or interfere
             with the evaluation of safety and efficacy to the study drug(s).

         11. Patients who have used strong CYP2C8 inhibitors, or moderate or strong CYP3A4
             inhibitors or inducers within washout period of 14 days or 7 half-lives before the
             first administration of study drugs, whichever is longer.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Maximum tolerated dose of APG-115
Time Frame:28 days
Safety Issue:
Description:To evaluate the safety of APG-115 as a single agent

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Ascentage Pharma Group Inc.

Last Updated

July 14, 2021