Clinical Trials /

Allogeneic Engineered Hematopoietic Stem Cell Transplant (HCT) Lacking the CD33 Protein, and Post-HCT Treatment With Mylotarg, for Patients With CD33+ AML

NCT04849910

Description:

This is a Phase 1/2a, multicenter, open-label, first-in-human (FIH) study of VOR33 in participants with AML who are undergoing human leukocyte antigen (HLA)-matched allogeneic hematopoietic cell transplant (HCT).

Related Conditions:
  • Acute Myeloid Leukemia
Recruiting Status:

Not yet recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Allogeneic Engineered Hematopoietic Stem Cell Transplant (HCT) Lacking the CD33 Protein, and Post-HCT Treatment With Mylotarg, for Patients With CD33+ AML
  • Official Title: A First-In-Human, Open-Label, Multicenter Study of VOR33 in Patients With Acute Myeloid Leukemia Who Are at High-Risk for Leukemia Relapse Following Hematopoietic Cell Transplantation

Clinical Trial IDs

  • ORG STUDY ID: VBP101
  • NCT ID: NCT04849910

Conditions

  • Leukemia, Myeloid, Acute

Interventions

DrugSynonymsArms
VOR33Cohort 1
Mylotarggemtuzumab ozogamicinCohort 1

Purpose

This is a Phase 1/2a, multicenter, open-label, first-in-human (FIH) study of VOR33 in participants with AML who are undergoing human leukocyte antigen (HLA)-matched allogeneic hematopoietic cell transplant (HCT).

Detailed Description

      High risk acute myeloid leukemia (AML) frequently relapses despite hematopoietic stem cell
      transplant (HCT). Post-HCT targeted therapy to reduce relapse is limited by toxicity to the
      engrafted cells. VOR33, an allogeneic CRISPR/Cas9 genome-edited hematopoietic stem and
      progenitor cell (HSPC) therapy product, lacking the CD33 protein, is being investigated for
      participants with CD33+ AML at high risk for relapse after HCT to allow post-HCT targeting of
      residual CD33+ acute AML cells using Mylotarg™ without toxicity to engrafted VOR33 cells.
      Participants will undergo a myeloablative HCT with matched related or unrelated donor
      CD34+-selected hematopoietic stem and progenitor cells (HSPCs) engineered to remove CD33
      expression (VOR33 product). Mylotarg™ will be given after engraftment for up to 4 cycles. The
      primary endpoint assessing safety of VOR33 will be the incidence of successful engraftment at
      28 days. Part 1 of this study will evaluate the safety of escalating Mylotarg™ dose levels to
      determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D). Part 2 will
      expand the number of participants to evaluate the Mylotarg™ RP2D.
    

Trial Arms

NameTypeDescriptionInterventions
Cohort 1ExperimentalVOR33 infusion followed by Mylotarg Dose Level 1
  • VOR33
  • Mylotarg
Cohort 2ExperimentalVOR33 infusion followed by Mylotarg Dose Level 2
  • VOR33
  • Mylotarg
Cohort 3ExperimentalVOR33 infusion followed by Mylotarg Dose Level 3
  • VOR33
  • Mylotarg

Eligibility Criteria

        Inclusion Criteria:

          1. Must be ≥18 and ≤70 years of age.

          2. Must have confirmed diagnosis of AML in first or second complete remission (CR1 or
             CR2) or have bone marrow blasts ≤10% without circulating blasts.

          3. AML sample from the patient must have evidence of CD33 expression (>0%)

          4. AML must have intermediate or high-risk disease-related genetics and the presence of
             minimal residual disease (MRD). Subjects in CR2 or with persistent morphologic blasts;
             may have favorable disease-related genetics.

          5. Candidate for HLA-matched allogeneic HCT using a myeloablative conditioning regimen.

          6. Must have a related or unrelated stem cell donor that is a 10/10 match for HLA-A, -B,
             -C, -DRB1 and -DQB1.

          7. Must have adequate performance status and organ function as defined below:

               1. Performance Status: Karnofsky score of ≥70.

               2. Cardiac: left ventricular ejection fraction (LVEF) ≥50%

               3. Pulmonary: diffusing capacity of lung for carbon monoxide (DLCO), forced vital
                  capacity (FVC), and forced expiratory volume in one second (FEV1) ≥66%.

               4. Renal: estimated glomerular filtration rate (GFR) >60 mL/min

               5. Hepatic: total bilirubin <1.5 × ULN, or if ≥1.5 × ULN direct bilirubin <ULN and
                  ALT/AST <1.5 × ULN (per institutional criteria).

        Exclusion Criteria:

          1. Prior autologous or allogeneic stem cell transplantation.

          2. Presence of the following disease-related genetics: t(15; 17)(q22; q21), or t(9;
             22)(q34; q11), or other evidence of acute promyelocytic leukemia or chronic myeloid
             leukemia.

          3. Prior treatment with Mylotarg™ (gemtuzumab ozogamicin).

          4. Active central nervous system (CNS) leukemia or history of other active
             malignancy(ies).

          5. Patients diagnosed with Gilbert's syndrome.

          6. Uncontrolled bacterial, viral, or fungal infections; or known human immunodeficiency
             virus (HIV), Hepatitis B, or Hepatitis C infection.
      
Maximum Eligible Age:70 Years
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Incidence of neutrophil engraftment
Time Frame:Day 28
Safety Issue:
Description:Cumulative incidence of patients who achieve neutrophil engraftment (first day of 3 consecutive days of absolute neutrophil count (ANC) ≥500 cells/mm3) by Day 28.

Secondary Outcome Measures

Measure:Time to neutrophil engraftment
Time Frame:Up to approximately 28 days
Safety Issue:
Description:Time to neutrophil engraftment after HCT from Day 0; calculated as the first day of 3 consecutive laboratory values obtained on separate days where the ANC is ≥500 cells/mm3.
Measure:Time to platelet recovery
Time Frame:Up to approximately 60 days
Safety Issue:
Description:Time to platelet recovery defined as time from Day 0 to achieve platelet count ≥20,000/μL without transfusion in prior 7 days.
Measure:Incidence of acute GVHD Grade (G) G2-G4 and G3-G4
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Incidence of chronic GVHD (all and moderate-severe)
Time Frame:Up to 24 months
Safety Issue:
Description:
Measure:Incidence of primary and secondary graft failure
Time Frame:Up to 24 months
Safety Issue:
Description:Incidence of primary and secondary graft failure measured by day 28 post HCT. Secondary graft failure is defined as initial neutrophil engraftment by Day 28 followed by subsequent decline.
Measure:Incidence of toxicities to determine the MTD and RP2D of Mylotarg
Time Frame:Approximately day 60 until 24 months
Safety Issue:
Description:
Measure:Incidence of transplant-related mortality (TRM) post HCT
Time Frame:Day 100, 12 months, 24 months
Safety Issue:
Description:
Measure:Percentage of CD33-negative myeloid cells
Time Frame:Day 28, 60, 100, 180, and Months 12 and 24
Safety Issue:
Description:Percent donor myeloid chimerism and CD33-negative myeloid cells in peripheral blood.
Measure:Relapse-free Survival (RFS)
Time Frame:Months 12 and 24
Safety Issue:
Description:Cumulative incidence of RFS
Measure:Overall Survival (OS)
Time Frame:Months 12 and 24
Safety Issue:
Description:OS defined as the time from HCT to the date of death from any cause

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:Vor Biopharma

Trial Keywords

  • Leukemia
  • Acute Myeloid Leukemia
  • AML
  • Hematopoietic stem cell transplant
  • HCT
  • CD33
  • Allogeneic

Last Updated

April 19, 2021