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Trial record 4 of 8 for:    aptose

Clinical Trial to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Tuspetinib (HM43239) in Patients With Relapsed or Refractory Acute Myeloid Leukemia (APTIVATE)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03850574
Recruitment Status : Recruiting
First Posted : February 22, 2019
Last Update Posted : January 31, 2023
Sponsor:
Information provided by (Responsible Party):
Aptose Biosciences Inc.

Brief Summary:
A Phase 1/2, Open-label, Multicenter, Dose Escalation and Expansion Study of the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Tuspetinib (HM43239) in Patients with Relapsed or Refractory Acute Myeloid Leukemia (AML)

Condition or disease Intervention/treatment Phase
Relapsed or Refractory Acute Myeloid Leukemia Drug: Tuspetinib Drug: Venetoclax Oral Tablet Phase 1 Phase 2

Detailed Description:
This is a Phase 1/2, open-label, multi-center study to assess the efficacy, safety, tolerability, pharmacokinetics, including recommended phase 2 dose (RP2D) of tuspetinib (HM43239) monotherapy in subjects with relapsed or treatment-refractory acute myeloid leukemia (AML). This study will also evaluate the safety, tolerability, and PK parameters of tuspetinib (HM43239) in combination with venetoclax when administered in patients with R/R AML

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 218 participants
Allocation: Randomized
Intervention Model: Sequential Assignment
Intervention Model Description: Three parts in the study - Part A (dose escalation, tuspetinib as a single agent), Part B (dose exploration, tuspetinib as a single agent), Part C (dose expansion, tuspetinib as a single agent and combo arm of tuspetinib with venetoclax)
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2 Open Label, Multicenter, Dose Escalation and Expansion Study of the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of HM43239 in Patients With Relapsed or Refractory Acute Myeloid Leukemia (AML)
Actual Study Start Date : March 11, 2019
Estimated Primary Completion Date : February 2024
Estimated Study Completion Date : August 2024


Arm Intervention/treatment
Experimental: Part A Dose Escalation
For Part A (tuspetinib as a single agent), dose escalation cohort is planned up to 6 dose levels. If a subject in the dose escalation cohort at any dose level achieves clinical response then the dose level will continue to enroll in Part B. If one DLT or less is observed in the 6 patients (<1/6 DLT observed) in Part A, up to 20 evaluable patients can be enrolled in Part B at that dose level.
Drug: Tuspetinib
Daily (QD), continuous dosing
Other Name: HM43239

Experimental: Part B Dose Exploration
For Part B (tuspetinib as a single agent), dose exploration cohort is planned up to 4 dose levels.
Drug: Tuspetinib
Daily (QD), continuous dosing
Other Name: HM43239

Experimental: Part C Dose Expansion (tuspetinib as a single agent)
Part C, dose expansion, consists of 2 arms (tuspetinib as a single agent or tuspetinib plus venetoclax). Patients will be randomly assigned to either arm based on the number of slots available. The initial tuspetinib dose for the single arm will be 120mg.
Drug: Tuspetinib
Daily (QD), continuous dosing
Other Name: HM43239

Experimental: Part C Dose Expansion (Combination Arm - tuspetinib and venetoclax)
Part C, dose expansion, consists of 2 arms (tuspetinib or tuspetinib plus venetoclax). Patients will be randomly assigned to either arm based on the number of slots available. The initial tuspetinib dose for the combo arm will be 80mg.
Drug: Tuspetinib
Daily (QD), continuous dosing
Other Name: HM43239

Drug: Venetoclax Oral Tablet
Venetoclax will be given to patients in combo treatment group (Part C) either in 50 mg or 100 mg tablets
Other Name: Venetoclax




Primary Outcome Measures :
  1. Recommended Phase 2 dose [ Time Frame: 4 years ]
    To determine the recommended phase 2 dose based on safety, efficacy, pharmacokinetics (PK), and pharmacodynamics (PD) consideration

  2. Safety of HM43239 [ Time Frame: 4 years ]
    Determine the maximum tolerated dose at which no more than 1 out of 6 patients experience a dose-limiting toxicity or establish the safety of clinically effective dose below the MTD if the MTD is not reached.relapsed or treatment-refractory (R/R) AML

  3. Tolerability of HM43239 [ Time Frame: 4 years ]
    To determine the frequency and severity of drug-related adverse events across different dose levels when administered in patients with R/R AML

  4. Safety of HM43239 in combination with venetoclax [ Time Frame: 4 years ]
    Determine the maximum tolerated dose of HM43239 in combination with venetoclax at which no more than 1 out of 6 patients experience a dose-limiting toxicity or establish the safety of clinically effective dose below the MTD if the MTD is not reached.relapsed or treatment-refractory (R/R) AML

  5. Tolerability of HM43239 in combination with venetoclax [ Time Frame: 4 years ]
    To determine the frequency and severity of drug-related adverse events across different dose levels of HM43239 in combination with venetoclax when administered in patients with R/R AML


Secondary Outcome Measures :
  1. Anti-leukemic activity of HM43239 [ Time Frame: 4 years ]
    To investigate the rate of complete remission (CR), CR with partial hematologic recovery (CRh), CR with incomplete platelet recovery (CRp), CR with incomplete hematologic recovery (CRi), and partial remission (PR) of patients taking HM43239

  2. Anti-leukemic activity of HM43239 in combination with venetoclax [ Time Frame: 4 years ]
    To investigate the rate of complete remission (CR), CR with partial hematologic recovery (CRh), CR with incomplete platelet recovery (CRp), CR with incomplete hematologic recovery (CRi), and partial remission (PR) of patients taking HM43239 in combination with venetoclax

  3. Pharmacokinetic variables including maximum plasma concentration (Cmax) [ Time Frame: Cycle 1 (at least 28 days) ]
    Pharmacokinetic variables including maximum plasma concentration (Cmax)

  4. Pharmacokinetic variables including minimum plasma concentration (Cmin) [ Time Frame: Cycle 1 (at least 28 days) ]
    Pharmacokinetic variables including minimum plasma concentration (Cmin)

  5. Pharmacokinetic variables including area under the curve (AUC) [ Time Frame: Cycle 1 (at least 28 days) ]
    Pharmacokinetic variables including area under the curve (AUC)

  6. Pharmacokinetic variables including volume of distribution [ Time Frame: Cycle 1 (at least 28 days) ]
    Pharmacokinetic variables including volume of distribution

  7. Pharmacokinetic variables including clearance [ Time Frame: Cycle 1 (at least 28 days) ]
    Pharmacokinetic variables including clearance

  8. Pharmacodynamic variables [ Time Frame: 4 years ]
    Determine PD variables by using a plasma inhibitory activity assay (PIA assay) examining the reduction in phospho-STAT5 and phospho-FLT3 in cell lines exposed to plasma from subjects treated in the study.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient is defined as having morphologically documented primary or secondary AML by the World Health Organization (WHO) criteria (2016) and fulfills one of the following:

    1. Refractory to at least 1 cycle of prior therapy
    2. Relapsed after achieving remission with a prior therapy
  • Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
  • Patient's interval from prior treatment to time of study drug administration is at least 2 weeks for cytotoxic agents (except hydroxyurea given for controlling blast cells), at 4 weeks for biologic or cellular immunotherapies, or at least 5 half-lives for prior experimental agents or noncytotoxic agents, including immunosuppressive therapy post hematopoietic stem cell transplantation (HSCT). (upon discussion with the Medical Monitor, shorter than stated washout period may be considered provided that the patient has recovered from any clinically relevant safety issue and recovered to Grade ≤ 1 toxicity from prior therapies)
  • Patient must meet the following criteria as indicated on the clinical laboratory tests

    1. Serum aspartate aminotransferase(AST) and alanine aminotransferase(ALT) ≤ 2.5× institutional upper limit normal (ULN)
    2. Total serum bilirubin ≤ 1.5× institutional ULN
    3. Serum creatinine ≤ 1.5× institutional ULN or an estimated glomerular filtration rate (eGFR) of > 45 ml/min as calculated by the Modification of Diet in Renal Disease (MDRD) equation.
  • Patient is suitable for oral administration of study drug and has minimum life expectancy (≥ 3 months)
  • Female patient must be either:
  • Of non-child bearing potential

    1. Post-menopausal (defined as at least 1 year without any menses) prior to screening, or
    2. Documented surgically sterile or status post hysterectomy (at least 1 month prior to screening)
  • Or, if of childbearing potential,

    1. Must have a negative serum or urine pregnancy test at screening (within 72 hours prior to start of treatment), and
    2. Must use highly effective contraception starting at screening and throughout the study period and for 90 days after the final study drug administration.
  • Female patient must not be breastfeeding at screening and during the study period, and for 90 days after the final study drug administration
  • Female patient must not donate ova starting at screening and throughout the study period, and for 90 days after the final study drug administration.
  • Male patient and their female spouse/partners who are of childbearing potential must be using highly effective contraception starting at screening and continue throughout the study period and for 90 days after the final study drug administration.
  • Male patient must not donate sperm starting at screening and throughout the study period and for 90 days after the final study drug administration.
  • Patient agrees not to participate in another interventional study while on treatment

Exclusion Criteria:

Patients must not enter the study if any of the following exclusion criteria are fulfilled.

  • Patient was diagnosed as acute promyelocytic leukemia (APL)
  • Patient has BCR-ABL-positive leukemia
  • Patient has an active malignancy other than AML, or Myelodysplastic Syndrome (MDS).
  • Patient has persistent non-hematological toxicities of ≥ Grade 2 (CTCAE v4.03), with symptoms and objective findings, from prior AML treatment (including chemotherapy, kinase inhibitors, immunotherapy, experimental agents, radiation, or surgery)
  • Patient has had hematopoietic stem cell transplant (HSCT) and meets any of the following:

    1. Has undergone HSCT within the 2 month period prior to the first study dose
    2. Has clinically significant graft-versus-host-disease(GVHD) requiring treatment
    3. Has ≥ Grade 2 persistent non-hematological toxicity related to the transplant
    4. Has a donor lymphocytes infusion (DLI) ≤ 30 days prior to the first study dose or during the first two cycle of treatment on the study.
  • Patient has meningeal or central nervous system (CNS) involvement with leukemia or other CNS disease related to underlying and secondary effects of malignancy.
  • Patient has disseminated intravascular coagulation abnormality (DIC).
  • Patient has had major surgery within 4 weeks prior to the first study dose.
  • Patient has had radiation therapy within 4 weeks prior to the first study dose.
  • Patient has congestive heart failure New York Heart Association (NYHA) class 3 or 4, or patient with a history of congestive heart failure NYHA class 3 or 4 in the past, unless a screening echocardiogram or multigated acquisition (MUGA) scan performed within 3 months prior to study entry results in a left ventricular ejection fraction (LVEF) that is ≥ 45%.
  • Any of the following cardiac abnormalities of history

    1. Patient has any clinically important abnormalities in rhythm, conduction or morphology of resting ECG, e.g., complete left bundle branch block, third-degree heart block, second-degree heart block, or PR interval > 250 milliseconds (ms).
    2. Patient has a mean QT interval (QTc) by Friderica's method (QTcF) > 450ms in three successive Screening measurements.
    3. Patient has any factors that increase the risk of QTc prolongation or risk of arrhythmic events, such as congenital long QT, syndrome, family history of long QT syndrome.
    4. Patient is unable or unwilling to discontinue concomitant use of drugs that are known to prolong the QT interval.
  • Patient is known to have active infection including any identified active COVID-19 infection.
  • Patient is known to have human immunodeficiency virus infection.
  • Patient has known active hepatitis B or C, or other active hepatic disorder.
  • Patient has any condition which, in the investigator's opinion, makes the patient unsuitable for study participation.
  • Patient has a history of Grade 3 or 4 non-hematologic toxicity related to tyrosine kinase inhibitor.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03850574


Contacts
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Contact: Rafael Bejar, MD, PhD 858-401-6852 rbejar@aptose.com

Locations
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United States, Alabama
The Kirklin Clinic of UAB Hospital Not yet recruiting
Birmingham, Alabama, United States, 35233
Contact: Pankit Vachhani, MD       jsregister@uabmc.edu   
United States, California
University of California, Davis Recruiting
Sacramento, California, United States, 95817
Contact: Brian Jonas    916-703-9151    bajonas@ucdavis.edu   
United States, Florida
University of Miami - Miller School of Medicine Not yet recruiting
Miami, Florida, United States, 33136
Contact: Justin Watts, MD       jxw401@miami.edu   
United States, Georgia
Emory University Recruiting
Atlanta, Georgia, United States, 30322
Contact: Martha Arellano    404-712-0720    marella@emory.edu   
United States, Massachusetts
Massachusetts General Hospital Not yet recruiting
Boston, Massachusetts, United States, 02114
Contact: Amir Fathi, MD         
United States, Texas
MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Naval Daver, Dr    713-792-6477    NDaver@mdanderson.org   
Korea, Republic of
Kyungpook National University Hospital Recruiting
Daegu, Korea, Republic of, 41944
Contact: Sang-Kyun Sohn         
Pusan National University Hospital Not yet recruiting
Pusan, Korea, Republic of, 49241
Contact: Ho-Jin Shin         
Seoul National University Bundang Hospital Recruiting
Seongnam, Korea, Republic of, 13620
Contact: Jeong-Ok Lee         
Seoul National University Hospital Recruiting
Seoul, Korea, Republic of, 03080
Contact: Yoon Sung-Soo    +82-2-2072-0694    ssysmc@gmail.com   
Asan Medical Center Recruiting
Seoul, Korea, Republic of, 05505
Contact: Kyoo-Hyung Lee    +82-2-3010-716    khlee2@amc.seoul.kr   
Samsung Medical Center Recruiting
Seoul, Korea, Republic of, 06351
Contact: Chul-Won Jung    +82-2-3410-2980    chulwon1.jung@samsung.com   
Sponsors and Collaborators
Aptose Biosciences Inc.
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Responsible Party: Aptose Biosciences Inc.
ClinicalTrials.gov Identifier: NCT03850574    
Other Study ID Numbers: HM-FLTI-101
First Posted: February 22, 2019    Key Record Dates
Last Update Posted: January 31, 2023
Last Verified: January 2023

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Leukemia
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Neoplasms by Histologic Type
Neoplasms
Venetoclax
Antineoplastic Agents