First in Human Study to Determine the Safety, Tolerability and Preliminary Efficacy of an Anti-CXCR4 Antibody in Subjects With Acute Myelogenous Leukemia and Selected B-cell Cancers
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Purpose
The purpose of this study is to assess the safety and tolerability of BMS-936564 (MDX-1338) in relapsed Acute myelogenous leukemia (AML) and other selected B-cell cancers and to determine the maximum tolerated dose (MTD) of the drug alone in relapsed/refractory AML
| Condition | Intervention | Phase |
|---|---|---|
|
Acute Myelogenous Leukemia Diffuse Large B-Cell Leukemia Chronic Lymphocytic Leukemia Follicular Lymphoma |
Drug: BMS-936564 (Anti-CXCR4) |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase 1, Open-label, Multicenter Study of BMS-936564 (MDX-1338) in Subjects With Relapsed Acute Myelogenous Leukemia and Selected B-cell Malignancies |
- Safety and tolerability as monotherapy [ Time Frame: Within the first 7 days for AML ] [ Designated as safety issue: Yes ]Safety and tolerability measured by incidence of adverse events (AEs), AEs leading to discontinuation, Serious Adverse Events (SAEs), deaths, and laboratory abnormalities
- Safety and tolerability as monotherapy [ Time Frame: Within 28 days for the selected B-cell malignancies ] [ Designated as safety issue: Yes ]Safety and tolerability measured by incidence of adverse events (AEs), AEs leading to discontinuation, Serious Adverse Events (SAEs), deaths, and laboratory abnormalities
- Safety, as measured by vital signs, clinical laboratory tests,ECOG performance status, physical exams, 12 lead ECGs incidence and severity of adverse events [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: Yes ]ECOG - Eastern Cooperative Oncology Group ECG - Electrocardiograms
- Efficacy- including best overall response (BOR) derived from changes in tumor burden and metabolic response based on FDG-PET (for DLBCL) [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]FDG-PET - fluoro-2-deoxyglucose positron emission tomography DLBCL - Diffuse Large B-Cell Lymphoma
- Immunogenicity measurement for human anti human antibodies (HAHA) -characterizing the immunogenicity of BMS-936564 [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]Subjects will be called as immunogenicity positive/negative to antibodies against BMS-936564 (MDX-1338) using immunogenicity assay, and will be classified as negative, positive baseline, or negative baseline with at least one positive post-treatment. The number and percentage of subjects in each classification will be reported for each dose level.
- Maximum observed serum concentration (Cmax) of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Trough observed serum concentration (Cmin) of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Time of maximum observed concentration (Tmax) of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Area under the concentration-time curve from time zero extrapolated to infinite time [AUC(INF)] of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Area under the concentration-time curve from time zero to the time of the last quantifiable concentration [AUC(0-T)] of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Area under the concentration-time curve in one dosing interval [AUC(TAU)] of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Half life (T-HALF) of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Total body clearance(CLT) of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Volume of distribution at steady-state (Vss) of BMS-936564 (MDX-1338) will be derived from serum concentration versus actual time [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Biomarker- characterizing the pharmacodynamic (PD) profiles of BMS-936564 (MDX-1338). The main PD biomarkers are cell trafficking [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
- Exploratory Biomarkers- are detection of apoptosis, cytokine analyses, CXCR4 expression, ZAP-70 and CD38 expression [ Time Frame: For a maximum of thirteen 28-day cycles for the AML cohort and for a maximum of six 28-day cycles for the B-cell malignancies ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 82 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm 1: Dose Escalation and Expansion cohort (AML Patients)
Dose Escalation: BMS-936564 0.3-10 mg/kg solution, Intravenous, Single 60 minute infusion as monotherapy 7 days/cycle 1 and with chemotherapy for subsequent cycles (28 days/cycle) Dose Expansion: BMS-936564 maximum tolerated dose (MTD) based on dose escalation, solution, Intravenous, Single 60 minute infusion as monotherapy 7 days/cycle 1 and with chemotherapy for subsequent cycles (28 days/cycle) |
Drug: BMS-936564 (Anti-CXCR4)
Other Name: MDX-1338
|
|
Experimental: Arm 2: Dose Expansion cohort (DLBCL Patient)
BMS-936564 MTD based on Arm 1, weekly 60 minute infusion in cycle 1 (up to 56 days) and with chemotherapy for subsequent cycles (28 days/cycle)
|
Drug: BMS-936564 (Anti-CXCR4)
Other Name: MDX-1338
|
|
Experimental: Arm 3: Dose Expansion cohort (CLL Patient)
BMS-936564 MTD based on Arm 1, weekly 60 minute infusion in cycle 1 (up to 56 days) and with chemotherapy for subsequent cycles (28 days/cycle)
|
Drug: BMS-936564 (Anti-CXCR4)
Other Name: MDX-1338
|
|
Experimental: Arm 4: Dose Expansion cohort (FL Patient)
BMS-936564 MTD based on Arm 1, weekly 60 minute infusion in cycle 1 (up to 56 days) and with chemotherapy for subsequent cycles (28 days/cycle)
|
Drug: BMS-936564 (Anti-CXCR4)
Other Name: MDX-1338
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
A. Common to All Indications:
- Life expectancy at least 12 weeks
- ECOG Performance Status of 0-2
B. For Acute myelogenous leukemia (AML) Subjects:
- First Relapse and primary induction failure in AML (M3 excluded)
- Secondary AML subjects from myelodysplastic syndrome (MDS) or prior chemotherapy are eligible. MDS-only subjects are not eligible
C. For Follicular Lymphoma (FL), Diffuse Large B-Cell Lymphoma (DLBCL) Subjects:
- Must be at least 4 weeks (for FL) or 2 weeks (for DLBCL) since prior cytotoxic, biologic, monoclonal antibody, or investigational therapy
- Ability to undergo tumor biopsy pre-treatment and at end of monotherapy period (though not mandatory for all subjects)
- Subjects must have a histologically confirmed diagnosis of relapsed or refractory disease
D. For Chronic lymphocytic leukemia (CLL) Subjects:
- Subjects must have a histologically confirmed diagnosis of relapsed or refractory disease
- Must be at least 4 weeks since prior cytotoxic, biologic, monoclonal antibody, or investigational therapy, including corticosteroids
Exclusion Criteria:
A. Common to All indications:
- Prior anti-CXCR4 therapy including BMS-936564 (MDX-1338)
- Less than 3 months from prior hematopoietic stem cell transplant
- Presence of active graft versus host disease
B. For AML Subjects:
- Acute promyelocytic leukemia (M3)
- Left ventricular ejection fraction < institutional limits of normal
C. For FL, DLBCL Subjects:
- (For DLBCL): Inadequate renal function defined as creatinine clearance (by Cockcroft-Gault formula) < 60 mL/min
- Major surgery, not related to debulking procedures, within 21 days of first dose
- Myocardial infarction within 6 months prior to screening or Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia
- Myelodysplastic syndrome (MDS)
D. For CLL Subjects:
- No progression to more aggressive B-cell cancers, such as Richter's syndrome
- Major surgery within 21 days of Cycle 1, Day 1. Patients undergoing debulking procedures and minor surgery are allowed after a recovery period, in the judgment of the Investigator
- Myocardial infarction within 6 months prior to screening Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia
Contacts and Locations| Contact: For participation information at a USA site use a phone number below. For site information outside the USA please email: | Clinical.Trials@bms.com | |
| Contact: First line of email MUST contain NCT# & Site#. Only trial sites that are recruiting have contact information at this time. |
| United States, Alabama | |
| Uab Comprehensive Cancer Center | Recruiting |
| Birmingham, Alabama, United States, 35294 | |
| Contact: Kevin Harris, Site 004 | |
| United States, California | |
| Moores Ucsd Cancer Center | Recruiting |
| La Jolla, California, United States, 92037 | |
| Contact: Januario E Castro, Site 009 858-822-6083 | |
| Ucla-Division Of Hematology/Oncology | Recruiting |
| Los Angeles, California, United States, 90095 | |
| Contact: Gary Schiller, Site 002 | |
| Usc - Norris Comprehensive Cancer Center And Hospital | Recruiting |
| Los Angeles, California, United States, 90033 | |
| Contact: Ann Mohrbacher, Site 005 | |
| United States, Maryland | |
| B. Douglas Smith, M.D. | Recruiting |
| Baltimore, Maryland, United States, 21287 | |
| Contact: B. Douglas Smith, Site 007 | |
| United States, Massachusetts | |
| Local Institution | Not yet recruiting |
| Boston, Massachusetts, United States, 02215 | |
| Contact: Site 008 | |
| United States, Texas | |
| The University Of Texas Md Anderson Cancer Center | Recruiting |
| Houston, Texas, United States, 77030 | |
| Contact: Jan Burger, Site 006 713-792-2817 | |
| United States, Washington | |
| University Of Washington School Of Medicine | Recruiting |
| Seattle, Washington, United States, 98195 | |
| Contact: Pamela S Becker, Site 003 206-543-3207 | |
| Study Director: | Bristol-Myers Squibb | Bristol-Myers Squibb |
More Information
Additional Information:
No publications provided
| Responsible Party: | Bristol-Myers Squibb |
| ClinicalTrials.gov Identifier: | NCT01120457 History of Changes |
| Other Study ID Numbers: | CA212-001 |
| Study First Received: | May 7, 2010 |
| Last Updated: | February 1, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Lymphocytic, Chronic, B-Cell Leukemia, B-Cell Leukemia, Lymphoid Leukemia, Myeloid, Acute Leukemia, Myeloid Lymphoma Lymphoma, Follicular |
Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Lymphoma, Non-Hodgkin |
ClinicalTrials.gov processed this record on May 23, 2013