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Trial record 17 of 74 for:    Venetoclax AND Acute Myeloid Leukemia

IMGN632 as Monotherapy or With Venetoclax and/or Azacitidine for Patients With CD123-Positive Acute Myeloid Leukemia

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ClinicalTrials.gov Identifier: NCT04086264
Recruitment Status : Recruiting
First Posted : September 11, 2019
Last Update Posted : November 22, 2019
Sponsor:
Collaborator:
Jazz Pharmaceuticals
Information provided by (Responsible Party):
ImmunoGen, Inc.

Brief Summary:
This is an open-label, multicenter, Phase 1b/2 study to determine the safety and tolerability of IMGN632 and assess the antileukemia activity of IMGN632 when administered in combination with azacitidine and/or venetoclax in patients with relapsed and frontline CD123-positive AML, and antileukemia activity of IMGN632 when administered as monotherapy in patients with MRD+ AML after frontline treatment.

Condition or disease Intervention/treatment Phase
Acute Myeloid Leukemia Drug: Azacitidine Drug: IMGN632 Drug: Venetoclax Phase 1 Phase 2

Detailed Description:

This is an open-label, multicenter, Phase 1b/2 study to determine the safety and tolerability of IMGN632 and assess the antileukemia activity of IMGN632 when administered in combination with azacitidine and/or venetoclax in patients with relapsed and frontline CD123-positive AML, and antileukemia activity of IMGN632 when administered as monotherapy in patients with MRD+ AML after frontline treatment.

This study explores multiple IMGN632 doses in combination and monotherapy Regimens, including (A) azacitidine, (B) venetoclax, (C) azacitidine+venetoclax, and (D) monotherapy in MRD+ AML. For combination Regimens A-C, a Phase 1b Dose Escalation Cohort will determine the recommended Phase 2 dose (RP2D) of IMGN632 in that specific combination Regimen, followed by a Phase 2 Dose Expansion Cohort for each combination Regimen to further characterize the safety profile and assess the antileukemia activity of the different combination Regimens. Regimen D will open with a Dose Expansion Cohort using the IMGN632 monotherapy dose and schedule based on safety data from the initial Phase 2 study (IMGN632-0801) and will not have a Dose Escalation Phase.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 212 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1b/2 Study of IMGN632 as Monotherapy or Combination With Venetoclax and/or Azacitidine for Patients With CD123-Positive Acute Myeloid Leukemia
Actual Study Start Date : November 6, 2019
Estimated Primary Completion Date : June 16, 2022
Estimated Study Completion Date : June 16, 2022


Arm Intervention/treatment
Experimental: Regimen A
IMGN632, administered intravenously on the first day of a 21 day cycle at 0.015 mg/kg, 0.045 mg/kg, or 0.09 mg/kg, in combination with azacitidine, administered subcutaneously or intravenously daily at 75 mg/m2 given for 7 days over a 28 day cycle
Drug: Azacitidine
IMGN632 in combination with azacitidine
Other Names:
  • Vidaza
  • Decitabine

Drug: IMGN632
IMGN632 in combination with azacitidine
Other Name: CD123-targeted ADC

Experimental: Regimen B
IMGN632, administered intravenously on the first day of a 21 day cycle at 0.015 mg/kg, 0.045 mg/kg, or 0.09 mg/kg, in combination with venetoclax, administered orally daily at 100 mg on the first day, 200mg on the second day, and 400 mg on the third day through the 21st day of a 21 day cycle
Drug: IMGN632
IMGN632 in combination with azacitidine
Other Name: CD123-targeted ADC

Drug: Venetoclax
IMGN632 in combination with venetoclax
Other Names:
  • Venclexta
  • Venclyxto

Experimental: Regimen C
IMGN632, administered intravenously on the first day of a 21 day cycle at 0.015 mg/kg, 0.045 mg/kg, or 0.09 mg/kg, in combination with azacitidine, administered subcutaneously or intravenously daily at 75 mg/m2 given for 7 days over a 28 day cycle and venetoclax, administered orally daily at 100 mg on the first day, 200mg on the second day, and 400 mg on the third day through the 28th day of a 28 day cycle
Drug: Azacitidine
IMGN632 in combination with azacitidine
Other Names:
  • Vidaza
  • Decitabine

Drug: IMGN632
IMGN632 in combination with azacitidine
Other Name: CD123-targeted ADC

Drug: Venetoclax
IMGN632 in combination with venetoclax
Other Names:
  • Venclexta
  • Venclyxto

Experimental: Regimen D
IMGN632, administered intravenously on the first day of a 21 day cycle at 0.045 mg/kg, as a monotherapy for MRD+ patients
Drug: IMGN632
IMGN632 in combination with azacitidine
Other Name: CD123-targeted ADC




Primary Outcome Measures :
  1. Safety and Tolerability [ Time Frame: approximately 7 months ]
    Evaluate the safety and tolerability and identify an RP2D of IMGN632 when administered in combination with azacitidine, with venetoclax, and with azacitidine and venetoclax, in patients with relapsed AML through review of Treatment Emergent Adverse Events and abnormal laboratory values that result in a failure to meet the criteria for re-treatment

  2. Preliminary antileukeumia activity [ Time Frame: approximately 20 months ]
    Assess preliminary antileukemia activity of IMGN632 when administered as a monotherapy and in combination with azacitidine, with venetoclax, and with azacitidine and venetoclax in patients with relapsed or untreated AML as assessed by complete response, complete remission with partial hematologic recovery, complete remission with incomplete recovery, morphologic leukemia-free state, partial response, and duration of response

  3. Minimal Residual Disease Levels [ Time Frame: approximately 18 months ]
    Assess Minimal Residual Disease Levels using central flow cytometry-based testing



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 120 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Patient Inclusion Criteria

  1. Patient must be ≥ 18 years of age.
  2. Patients must have confirmed diagnosis of AML (excluding acute promyelocytic leukemia) based on World Health Organization classification (Arber 2016).
  3. Disease characteristics and allowable prior therapy:

    1. Patients must be evaluated for any available standard of care therapies and, in the opinion of the treating physician, be deemed appropriate for this experimental therapy.
    2. Treatment-naïve (untreated) patients will be allowed in the Expansion Phase for Regimens A (IMGN632 + azacitidine) and C (IMGN632 + azacitidine + venetoclax). No prior treatments with HMAs for MDS are allowed.
    3. Patients must have CD123-positive AML as confirmed by local flow cytometry (or immunohistochemistry [IHC]).
    4. Patients may have received prior CD123-targeted therapies, except IMGN632, as long as CD123 remains detectable during screening.
    5. Relapsed AML patients will be allowed to enroll in the Escalation Phase of Regimens A, B, and C (IMGN632 + azacitidine, venetoclax, or azacitidine + venetoclax, respectively) and the Expansion Phase of Regimens A and B and may have received up to 2 prior lines of therapy, eg, frontline treatment (induction, consolidation [including transplant], and maintenance) and 1 salvage regimen.
    6. Patients enrolling in Regimen D must be in CR (CR/CRi) for no more than 6 months and be MRD+, confirmed by central laboratory testing, after intensive induction/consolidation therapy.
  4. Patients enrolling on Regimen D (MRD+ AML), must first have an evaluable screening bone marrow sample confirmed as MRD+ by central flow testing of MRD.
  5. Eastern Cooperative Oncology Group performance status ≤ 1. If nonambulatory due to a chronic disability, must be Karnofsky performance status > 70.
  6. Previous treatment-related toxicities must have resolved to Grade 1 or baseline (excluding alopecia).
  7. Total white blood cell count must be less than 25 x 10^9 cells/L. Hydroxyurea may be used to control blood counts before Cycle 1 Day 1, at the discretion of the treating physician, according to institutional practice. During the Escalation Phase in Regimens A-C, hydroxyurea may also be used during Cycle 1.
  8. Liver enzymes (AST and ALT) ≤ 3 × the upper limit of normal (ULN).
  9. Total bilirubin ≤ 1.5 × the ULN within 14 days of enrollment.
  10. Serum creatinine ≤ 1.5 mg/dL within 14 days of enrollment.
  11. Echocardiogram or multigated acquisition scan (MUGA) demonstrating an ejection fraction ≥ 45%.
  12. Patients with prior autologous and allogeneic bone marrow transplant are eligible. Patients with an allogeneic transplant must meet the following conditions: The transplant must have been performed more than 120 days before the date of dosing on this study, the patient must not have active ≥ Grade 2 graft versus host disease, and the patient must be off all systemic immunosuppression for at least 2 weeks before dosing.
  13. Voluntary written informed consent before performance of any study-related procedure not part of normal medical care.
  14. Women of childbearing potential (WCBP), defined as sexually mature women who have not undergone surgical sterilization or who have not been naturally postmenopausal for at least 12 consecutive months (ie, who have had menses any time in the preceding 12 consecutive months), must agree to use highly effective contraceptive methods (examples include oral, parenteral, or implantable hormonal contraceptive, intrauterine device, barrier contraceptive with spermicide, partner's latex condom or vasectomy) while on study drug and for at least 12 weeks after the last dose of study drug.
  15. WCBP must have a negative pregnancy test within 3 days before the first dose of study drug.
  16. A male patient must agree to use a latex condom even if he has had a successful vasectomy and must continue to follow these requirements for at least 12 weeks after the last dose of study drug.
  17. Patients with prior malignancy are eligible; however, the patient must be in remission from the prior malignancy and have completed all chemotherapy and radiotherapy for the prior malignancy at least 6 months before enrollment, and all treatment-related toxicities must have resolved to Grade 1 or less.

Patient Exclusion Criteria

  1. Patients who have received any anticancer therapy, including investigational agents, within 14 days (or within 28 days for checkpoint inhibitors) before drug administration on this study (hydroxyurea is allowed before beginning study treatment). Patients must have recovered to baseline from all acute toxicity from this prior therapy.
  2. Patients who have been previously treated with IMGN632.
  3. Patients with myeloproliferative neoplasm-related secondary AML are excluded from the Dose Expansion Phase of the study.
  4. Patients with active central nervous system (CNS) AML will be excluded. A lumbar puncture does not need to be performed unless there is clinical suspicion of CNS involvement per investigator judgement. Concurrent therapy for CNS prophylaxis or continuation of therapy for controlled CNS AML is allowed with the approval of the sponsor.
  5. Patients with a history of sinusoidal obstruction syndrome/venous occlusive disease of the liver.
  6. Myocardial infarction within 6 months before enrollment or New York Heart Association Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities before study entry.
  7. Clinically relevant active infection including known active hepatitis B or C, HIV infection, or cytomegalovirus or any other known concurrent infectious disease that, in the judgment of the investigator, would make a patient inappropriate for enrollment into this study (testing not required).
  8. Patients who have undergone a major surgery within 4 weeks (or longer if not fully recovered) before study enrollment.
  9. Serious or poorly controlled medical conditions that could be exacerbated by treatment or that would seriously compromise safety assessment or compliance with the protocol, in the judgment of the investigator.

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): NCT04086264


Contacts
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Contact: ImmunoGen Clinical Trials 781-895-0600 IMGN0802@immunogen.com

Locations
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United States, Florida
Moffitt Cancer Center Recruiting
Tampa, Florida, United States, 33612
Contact: Chelsea Pershing    813-745-4075    Chelsea.Pershing@moffitt.org   
United States, Texas
MD Anderson Recruiting
Houston, Texas, United States, 77030
Contact: Joie Alvarez    713-792-7321    JAlvarez1@mdanderson.org   
Sponsors and Collaborators
ImmunoGen, Inc.
Jazz Pharmaceuticals
Investigators
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Study Director: Patrick Zweidler-McKay, MD ImmunoGen, Inc.

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Responsible Party: ImmunoGen, Inc.
ClinicalTrials.gov Identifier: NCT04086264     History of Changes
Other Study ID Numbers: IMGN632-0802
First Posted: September 11, 2019    Key Record Dates
Last Update Posted: November 22, 2019
Last Verified: November 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by ImmunoGen, Inc.:
Acute Myeloid Leukemia
AML
Minimal detectable disease
MRD
CD123
Relapsed/refractory
Additional relevant MeSH terms:
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Leukemia
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Venetoclax
Neoplasms by Histologic Type
Neoplasms
Azacitidine
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Enzyme Inhibitors