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Study to Evaluate Adverse Events and Movement of Lemzoparlimab in Body When Used Intravenously (IV) With Azacitidine Subcutaneously or IV and Venetoclax Orally in Participants With Acute Myeloid Leukemia and With Azacitdine With or Without Venetoclax in Participants With Myelodysplastic Syndrome

NCT04912063

Description:

Acute myeloid leukemia (AML) is one of the most aggressive blood cancers, with a very low survival rate and few options for participants who are unable to undergo intensive chemotherapy, the current standard of care. This study is to evaluate how safe lemzoparlimab (TJ011133) is and how it moves within the body when used along with azacitidine and/or venetoclax in adult participants with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). Adverse events and maximum tolerated dose (MTD) of lemzoparlimab will be assessed. Lemzoparlimab (TJ011133) is being evaluated in combination with azacitidine and venetoclax for the treatment of acute myeloid leukemia (AML) and with azacitidine with/without venetoclax for myelodysplastic syndrome (MDS). Study doctors place the participants in 1 of 5 groups, called treatment arms. Each group receives a different treatment. Adult participants with a diagnosis of AML or MDS will be enrolled. Around 80 participants will be enrolled in the study in approximately 50 sites worldwide. Participants will receive lemzoparlimab (TJ011133) (IV) once weekly (Q1W), venetoclax oral tablets once daily (QD) for 28 days (AML participants) or 14 days (MDS participants) and Azacitidine by SC or IV route QD for 7 days of each 28-day cycle. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Related Conditions:
  • Acute Myeloid Leukemia
  • Myelodysplastic Syndromes
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Study to Evaluate Adverse Events and Movement of Lemzoparlimab in Body When Used Intravenously (IV) With Azacitidine Subcutaneously or IV and Venetoclax Orally in Participants With Acute Myeloid Leukemia and With Azacitdine With or Without Venetoclax in Participants With Myelodysplastic Syndrome
  • Official Title: A Phase 1b Dose Escalation Study of Lemzoparlimab (TJ011133) in Combination With Azacitidine and/or Venetoclax in Subjects With Acute Myeloid Leukemia (AML) or Myelodysplastic Syndrome (MDS)

Clinical Trial IDs

  • ORG STUDY ID: M20-866
  • SECONDARY ID: 2021-000514-41
  • NCT ID: NCT04912063

Conditions

  • Acute Myeloid Leukemia (AML)
  • Myelodysplastic Syndrome (MDS)

Interventions

DrugSynonymsArms
LemzoparlimabTJ011133, ABBV-IMAB-TJC4Lemzoparlimab + Azacitidine + Venetoclax in AML (Escalation)
AzacitidineLemzoparlimab + Azacitidine + Venetoclax in AML (Escalation)
VenetoclaxVenclexta, Venclyxto, ABT-199, GDC-0199Lemzoparlimab + Azacitidine + Venetoclax in AML (Escalation)

Purpose

Acute myeloid leukemia (AML) is one of the most aggressive blood cancers, with a very low survival rate and few options for participants who are unable to undergo intensive chemotherapy, the current standard of care. This study is to evaluate how safe lemzoparlimab (TJ011133) is and how it moves within the body when used along with azacitidine and/or venetoclax in adult participants with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). Adverse events and maximum tolerated dose (MTD) of lemzoparlimab will be assessed. Lemzoparlimab (TJ011133) is being evaluated in combination with azacitidine and venetoclax for the treatment of acute myeloid leukemia (AML) and with azacitidine with/without venetoclax for myelodysplastic syndrome (MDS). Study doctors place the participants in 1 of 5 groups, called treatment arms. Each group receives a different treatment. Adult participants with a diagnosis of AML or MDS will be enrolled. Around 80 participants will be enrolled in the study in approximately 50 sites worldwide. Participants will receive lemzoparlimab (TJ011133) (IV) once weekly (Q1W), venetoclax oral tablets once daily (QD) for 28 days (AML participants) or 14 days (MDS participants) and Azacitidine by SC or IV route QD for 7 days of each 28-day cycle. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Trial Arms

NameTypeDescriptionInterventions
Lemzoparlimab + Azacitidine + Venetoclax in AML (Escalation)ExperimentalLemzoparlimab (TJ011133) co-administered with azacitidine and venetoclax in escalated doses in participants with treatment-naïve acute myeloid leukemia (AML) who are ineligible for standard induction therapy.
  • Lemzoparlimab
  • Azacitidine
  • Venetoclax
Lemzoparlimab + Azacitidine + Venetoclax in MDS (Escalation)ExperimentalLemzoparlimab (TJ011133) co-administered with azacitidine and venetoclax in escalated doses in participants with treatment-naïve higher-risk myelodysplastic syndrome (MDS).
  • Lemzoparlimab
  • Azacitidine
  • Venetoclax
Lemzoparlimab + Azacitidine in MDS (Escalation)ExperimentalLemzoparlimab (TJ011133) co-administered with azacitidine in escalated doses in participants with treatment-naïve higher-risk myelodysplastic syndrome (MDS).
  • Lemzoparlimab
  • Azacitidine
Lemzoparlimab + Azacitidine + Venetoclax in AML (Expansion)ExperimentalLemzoparlimab (TJ011133) co-administered with azacitidine and venetoclax in expansion cohort in participants with treatment-naïve acute myeloid leukemia (AML) who are ineligible for standard induction therapy.
  • Lemzoparlimab
  • Azacitidine
  • Venetoclax
Lemzoparlimab + Azacitidine + Venetoclax in MDS (Expansion)ExperimentalLemzoparlimab (TJ011133) co-administered with azacitidine and venetoclax in expansion cohort in participants with treatment-naïve higher-risk myelodysplastic syndrome (MDS).
  • Lemzoparlimab
  • Azacitidine
  • Venetoclax

Eligibility Criteria

        Inclusion Criteria:

          -  Documented confirmation of acute myeloid leukemia (AML) according to the World Health
             Organization (WHO) criteria, previously untreated. [OR]

          -  Documented diagnosis of previously untreated de novo myelodysplastic syndrome (MDS)
             according to the 2017 WHO classification with presence of < 20% bone marrow blasts per
             marrow biopsy/aspirate.

          -  Participants with documented MDS must meet the following disease activity criteria:

               -  Overall revised international prognostic scoring system (IPSS-R) score > 3
                  (intermediate, high, or very high);

               -  Eastern cooperative oncology group (ECOG) performance status of 0 to 2;

               -  Hematopoietic stem cell transplant (HSCT) eligible with no pre-arranged HSCT at
                  the time of Study Day 1, or HSCT ineligible without plan for HSCT at the time of
                  Study Day 1.

          -  Participants with documented AML and considered ineligible for induction therapy
             defined by the following:

               -  75 years of age; [OR]

               -  18 to 74 years of age with at least one of the following comorbidities:

                    -  Eastern cooperative oncology group (ECOG) performance status of 2 to 3;

                    -  Cardiac history of congestive heart failure requiring treatment or ejection
                       fraction ≤ 50% or chronic stable angina;

                    -  Diffusion capacity of lung (DLCO) ≤ 65% or forced expiratory volume during
                       the first second (FEV1) ≤ 65%;

                    -  Creatinine clearance ≥ 30 mL/min to < 45 mL/min;

                    -  Moderate hepatic impairment with total bilirubin > 1.5 to ≤ 3.0 × upper
                       limit of normal (ULN);

                    -  Any other comorbidity that the physician judges to be incompatible with
                       intensive chemotherapy or the participant declines to receive intensive
                       chemotherapy.

        Exclusion Criteria:

          -  Participants with documented AML with acute promyelocytic leukemia and considered
             eligible for induction therapy.

          -  Participant with documented AML having prior diagnosis of:

               -  chronic myeloid leukemia with or without BCR-ABL1 translocation and AML with
                  BCR-ABL1 translocation;

               -  known active central nervous system involvement with AML.

        Participants with documented MDS having prior diagnosis of:

          -  Therapy-related MDS;

          -  MDS evolving from a pre-existing myeloproliferative neoplasm (MPN);

          -  MDS/MPN including chronic myelomonocytic leukemia, atypical chronic myeloid leukemia,
             juvenile myelomonocytic leukemia and unclassifiable MDS/MPN.

               -  History of allogeneic HSCT or solid organ transplantation.

               -  Previous exposure to azacitidine or venetoclax or anti-CD47 therapies.

               -  History of an active malignancy within the past 2 years prior to Screening, with
                  the exception of:

          -  Adequately treated carcinoma in situ of the cervix uteri or carcinoma in situ of the
             breast;

          -  Adequately treated basal cell carcinoma or localized squamous cell carcinoma of the
             skin;

          -  Asymptomatic prostate cancer without known metastatic disease and with no requirement
             for therapy;

          -  Previous malignancy confined and surgically resected (or treated with other
             modalities) with curative intent.

               -  Conditions that could interfere with drug absorption including but not limited to
                  short bowel syndrome.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Dose Limiting Toxicities (DLTs) of Lemzoparlimab (TJ011133) When Co-administered With Azacitidine and Venetoclax in Participants With Treatment-Naïve Acute Myeloid Leukemia (AML) Ineligible for Standard Induction Therapy
Time Frame:Up to 30 days after first dose of study drug
Safety Issue:
Description:DLT events are defined as clinically significant adverse events or abnormal laboratory values assessed as unrelated to disease progression, underlying disease, intercurrent illness, or concomitant medications and occurring during the first 4 weeks after administration of the first dose and that meets additional criteria as described in the protocol.

Secondary Outcome Measures

Measure:Best Overall Response of Complete Remission (CR) for AML
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Best overall response of complete remission (CR), defined as achieving CR at any time point during the study according to modified international working group (IWG) 2003 criteria for AML.
Measure:Best Overall Response of Composite CR (CRc) for AML
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Best overall response of composite CR (CRc), defined as achieving CR or CR with incomplete blood count recovery (CRi) at any time point during the study, according to modified IWG 2003 criteria for AML.
Measure:Best Overall Response of CRc or Partial Remission (PR) for AML
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Best overall response of CRc or partial remission (PR), defined as achieving CRc or PR at any time point during the study, according to modified IWG 2003 criteria for AML.
Measure:Duration of Response (DOR) for AML
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Duration of response (DOR), defined for subjects who achieve a best overall response of CRc or PR, as the time from the first occurrence of response (CRc or PR) to disease progression or death, whichever occurs first, according to the modified IWG 2003 criteria for AML.
Measure:Event-Free Survival (EFS) for AML
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Event-free survival (EFS), defined as time from first dose of any study drug (lemzoparlimab (TJ011133) or venetoclax or azacitidine) to the date of progressive disease (PD), relapse from CR or CRi, treatment failure defined as failure to achieve CR, CRi or MLFS after at least 6 cycles of study treatment, or death from any cause, whichever occurs first, according to modified IWG 2003 criteria for AML.
Measure:Overall Survival (OS ) for AML
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Overall survival (OS), defined as the time from the date of the first dose of any study drug (lemzoparlimab [TJ011133] or venetoclax or azacitidine) to death from any cause.
Measure:Best Overall Response of CR, for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Best overall response of CR defined as a subject achieving CR at any time point during the study per the modified IWG 2006 criteria for MDS.
Measure:Best Overall Response of Marrow-Complete Remission (mCR), for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Best overall response of marrow-complete remission (mCR), defined as a subject achieving mCR at any time point during the study per the modified IWG 2006 criteria for MDS.
Measure:Best Overall Response of CR or PR or mCR, for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Best overall response of CR or PR or mCR, defined as a subject achieving CR or PR or mCR at any time point during the study per the modified IWG 2006 criteria for MDS.
Measure:Hematologic Improvement (HI), for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Hematologic improvement (HI), defined as a subject achieving erythroid/platelet/neutrophil responses at any time point during the study.
Measure:Red Blood Cell Transfusion Independence (TI), for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Red blood cell transfusion independence (TI), defined as a subject who is transfusion dependent at baseline achieved TI post-baseline.
Measure:Platelet TI, for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Platelet TI, defined as a subject who is transfusion dependent at baseline achieved TI post-baseline.
Measure:DOR, for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:DOR, defined for subjects who achieve a best overall response, as the time from the first occurrence of response (CR or mCR or PR) to disease progression or death, whichever occurs first, according to the modified IWG 2006 criteria for MDS.
Measure:Progression Free Survival (PFS), for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Progression Free Survival (PFS) defined as the time from the date of the first dose of any study drug to PD or death from any cause.
Measure:OS, for MDS
Time Frame:Up to approximately 3 years
Safety Issue:
Description:OS, defined as the time from the date of the first dose of any study drug to death from any cause.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:AbbVie

Trial Keywords

  • Acute Myeloid Leukemia (AML)
  • Myelodysplastic Syndrome (MDS)
  • Lemzoparlimab
  • TJ011133
  • ABBV-IMAB-TJC4
  • Venetoclax
  • ABT-199
  • GDC-0199
  • VENCLEXTA
  • VENCLYXTO
  • Azacitidine
  • Cancer

Last Updated

June 18, 2021