Clinical Trials /

A Study of E7820 in People With Bone Marrow (Myeloid) Cancers

NCT05024994

Description:

The researchers are doing this study to find out whether E7820 is an effective treatment for people with relapsed/refractory myeloid cancers with mutations in splicing factor genes. Participants will have acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), or chronic myelomonocytic leukemia (CMML).

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

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Study of E7820 in People With Bone Marrow (Myeloid) Cancers
  • Official Title: A Phase II Clinical Trial of E7820 for Patients With Relapsed/Refractory Myeloid Malignancies With Mutations in Splicing Factor Genes.

Clinical Trial IDs

  • ORG STUDY ID: 21-159
  • NCT ID: NCT05024994

Conditions

  • Acute Myeloid Leukemia
  • Myelodysplastic Syndromes
  • Chronic Myelomonocytic Leukemia

Interventions

DrugSynonymsArms
E7820E7820

Purpose

The researchers are doing this study to find out whether E7820 is an effective treatment for people with relapsed/refractory myeloid cancers with mutations in splicing factor genes. Participants will have acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), or chronic myelomonocytic leukemia (CMML).

Trial Arms

NameTypeDescriptionInterventions
E7820ExperimentalEach patient will receive daily administration of E7820. The starting dose for every patient will be 100 mg daily but the dose can subsequently be reduced if excessive toxicity is encountered.
  • E7820

Eligibility Criteria

        Inclusion Criteria:

        1. Subject is ≥ 18 years of age at the time of signing informed consent 2. Subject is
        willing and able to adhere to the study visit schedule and other protocol requirements. 3.
        Subject has relapsed or refractory MDS, AML or CMML with a previously defined hotspot
        splicing factor mutation in SF3B1, SRSF2, U2AF1, and U2AF2 (with hotspot mutations as
        defined by OncoKB) or a nonsense or frameshift mutation in ZRSR2. A splicing factor
        mutation is required to be detected on next generation sequencing from bone marrow aspirate
        or peripheral blood at any timepoint within the 6 months prior to screening for the study.

        a. Relapsed AML is defined as: i. The appearance of 5% or greater myeloblasts in the bone
        marrow or peripheral blood after achieving a CR (MRD positive or negative), CRh, or CRi

        1. Patients with mutations in FLT3, IDH1 or IDH2 must have failed or been intolerant of an
        FDA approved FLT3, IDH1 or IDH2 inhibitor before enrolling on study.

        b. Refractory AML is defined as failure to achieve a CR, CRh, or CRi after one of the
        following regimens: i. Two cycles of intensive induction chemotherapy with a cytarabine
        containing regimen (e.g. 7+3, MEC, HIDAC, etc.) ii. Two cycles of HMA/venetoclax or
        LDAC/glasdegib iii. 4 cycles of HMA monotherapy c. Relapsed MDS is defined as: i. Any
        relapse after achieving an IWG defined response. d. Refractory MDS is defined as: i. For
        patients with intermediate, high or very high risk disease by IPSS-R, the failure to
        achieve a response (as per IWG 2006 criteria) after 4 cycles of HMA monotherapy or 2 cycles
        of HMA + venetoclax.

        ii. For patients with very low and low risk disease by IPSS-R failure to achieve
        hematologic improvement or loss of hematologic improvement after treatment with standard of
        care agents such as ESAs, Luspatercept (for MDS with ringed sideroblasts) and lenalidomide
        (for pts with a 5q-).

        e. Relapsed CMML is defined as: i. Any relapse after achieving an IWG defined response. f.
        Refractory CMML is defined as: i. Failure to achieve a response (as per IWG 2006 criteria)
        after 4 cycles of HMA monotherapy or 2 cycles of HMA + venetoclax.

        4. Subject has an Eastern Cooperative Oncology Group (ECOG) performance status of 0-3 5.
        Subject has adequate organ function defined as:

          1. Serum aspartate aminotransferase/serum glutamic oxaloacetic transaminase (AST/SGOT)
             and alanine aminotransferase (ALT/SGPT) ≤ 3 x ULN, unless considered due to organ
             involvement by the patient's myeloid malignancy (in that case a cut off of ≤ 5 x ULN
             will be used)

          2. Serum direct bilirubin < 1.5 x ULN.

          3. Creatinine clearance ≥ 60 mL/min based on the Cockroft-Gault glomerular filtration
             rate (GFR) estimation.

          4. Females of childbearing potential may participate provided they have a negative serum
             pregnancy test at screening and a negative serum OR urine pregnancy test within 72
             hours of starting on treatment. Females and male participants with female partners of
             childbearing potential also must agree to either abstain from sexual intercourse or
             use a highly effective method of contraception while on study and for 4 months after
             completing the study treatment.

             6. There are no limits on transfusion and/or growth factor support for enrollment.

             7. In case of leukemic organ involvement, patients with creatinine clearance > 30
             ml/min and bilirubin ≤ 2.0 x ULN will be eligible to be included.

             Exclusion Criteria:

               1. Patients with acute promyelocytic leukemia

               2. Subject has immediate life-threatening, severe complications of their myeloid
                  malignancy such as uncontrolled bleeding, pneumonia with hypoxia or shock, and/or
                  disseminated intravascular coagulation

               3. Subject has significant active cardiac disease within 6 months prior to the start
                  of study treatment, including New York Heart Association (NYHA) class III or IV
                  congestive heart failure; acute coronary syndrome (ACS); and/or stroke; or left
                  ventricular ejection fraction (LVEF) < 40% by echocardiogram (ECHO) or
                  multi-gated acquisition (MUGA) scan obtained within 28 days prior to the start of
                  study treatment.

               4. Subject has active viral infection with human immunodeficiency virus (HIV), or
                  active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV).
                  Patients with HIV that is controlled with HAART are eligible to participate.

               5. Subject is known to have dysphagia, short-gut syndrome, gastroparesis, or other
                  conditions that limit the ingestion or gastrointestinal absorption of drugs
                  administered orally.

               6. Subject has active uncontrolled systemic fungal, bacterial, or viral infection
                  (defined as ongoing signs/symptoms related to the infection without improvement
                  despite appropriate antibiotics, antiviral therapy, and/or other treatment).

               7. Subject has QTc interval (i.e., Fridericia's correction [QTcF]) ≥ 480 ms or other
                  factors that increase the risk of QT prolongation or arrhythmic events (e.g.,
                  heart failure, hypokalemia, family history of long QT interval syndrome) at
                  screening.

               8. Female subject who is pregnant or lactating.

               9. Subject with known hypersensitivity to sulfa medications
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:response rate
Time Frame:1 year
Safety Issue:
Description:Response to treatment and treatment decisions in all participants will be determined based on the 2017 ELN criteria for AML 2 and the International Working Group 2006 criteria for MDS 3 and 2015 for CMML4.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Memorial Sloan Kettering Cancer Center

Trial Keywords

  • E7820
  • Bone Marrow cancers
  • Myeloid
  • Relapsed/Refractory
  • Mutations in Splicing Factor Genes
  • 21-159

Last Updated

August 27, 2021