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Phase 1 Study of Shattuck Labs (SL)-172154 in Subjects With MDS or AML

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ClinicalTrials.gov Identifier: NCT05275439
Recruitment Status : Recruiting
First Posted : March 11, 2022
Last Update Posted : December 8, 2022
Sponsor:
Information provided by (Responsible Party):
Shattuck Labs, Inc.

Brief Summary:
SL03-Old Hundred(OHD)-104 is designed as a Phase 1a/1b open label, trial to evaluate the safety, pharmacokinetics (PK), pharmacodynamic (PD), and preliminary efficacy of SL-172154 monotherapy as well as in combination with azacitidine or in combination with Azacitidine and Venetoclax.

Condition or disease Intervention/treatment Phase
Acute Myeloid Leukemia Myelodysplastic Syndromes Drug: SL-172154 Phase 1

Detailed Description:
This Phase 1a/1b study is an open label, multicenter trial in subjects with higher-risk (i.e., intermediate, high or very high risk by IPSS-R) MDS or AML. The study is designed to evaluate the safety, PK, pharmacodynamic effects, and preliminary anti tumor activity of SL-172154 monotherapy and SL-1712154 administered with either Azacitidine or Azacitidine and Venetoclax. Subjects will receive SL-172154 as monotherapy or administered with Azacitidine with or without Venetoclax until documented disease progression, unacceptable toxicity or intolerance, withdrawal of consent, or the subject meets other criteria for discontinuation (whichever occurs first).

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 107 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-Label Phase 1a/1b Dose Escalation and Expansion Cohort Study of SL-172154 (SIRPα-Fc-CD40L) in Combination With Azacitidine or With Azacitidine and Venetoclax for the Treatment of Subjects With Higher-Risk Myelodysplastic Syndrome (MDS) or Acute Myeloid Leukemia (AML)
Actual Study Start Date : March 17, 2022
Estimated Primary Completion Date : February 2024
Estimated Study Completion Date : October 2024


Arm Intervention/treatment
Experimental: SL-172154
Patients will receive intravenous administration
Drug: SL-172154
The investigational product (IP), SL-172154, is a novel fusion protein consisting of human SIRPα and CD40L (SIRPα -Fc-CD40L) linked via a human Fc.
Other Names:
  • Azacitidine
  • Venetoclax

Experimental: SL-172154 + Azacitidine
Patients will receive intravenous administration of SL-172154 and Azacitidine.
Drug: SL-172154
The investigational product (IP), SL-172154, is a novel fusion protein consisting of human SIRPα and CD40L (SIRPα -Fc-CD40L) linked via a human Fc.
Other Names:
  • Azacitidine
  • Venetoclax

Experimental: SL-172154 + Azacitidine + Venetoclax
Patients will receive intravenous administration of SL-172154 and Azacitidine plus oral venetoclax.
Drug: SL-172154
The investigational product (IP), SL-172154, is a novel fusion protein consisting of human SIRPα and CD40L (SIRPα -Fc-CD40L) linked via a human Fc.
Other Names:
  • Azacitidine
  • Venetoclax




Primary Outcome Measures :
  1. To evaluate the safety and tolerability of SL-172154 administered alone or with Azacitidine OR Azacitidine + Venetoclax in subjects with higher-risk MDS or AML [ Time Frame: From Day 1 to 90 days after Last Dose of SL-172154 ]
    Incidence of all treatment emergent adverse events

  2. To select the recommended Phase 2 dose (RP2D) for SL-172154 administered with Azacitidine OR Azacitidine + Venetoclax in subjects with higher-risk MDS or AML [ Time Frame: From Day 1 to 90 days after Last Dose of SL-172154 ]
    Defined based on the rate of dose limiting toxicities (DLTs)


Secondary Outcome Measures :
  1. Assess preliminary evidence of anti-tumor activity of SL-172154 administered alone or with Azacitidine OR Azacitidine + Venetoclax in subjects with higher-risk MDS or AML [ Time Frame: Approximately 24 months ]
    Investigator assessed disease response according to International Working Group (IWG) 2006 criteria (MDS) or European LeukemiaNet (ELN) 2017 criteria (AML)

  2. To evaluate immunogenicity to SL-172154 during and after treatment of SL-172154 administered alone or with Azacitidine OR Azacitidine + Venetoclax in subjects with higher-risk MDS or AML [ Time Frame: Approximately 24 months ]
    Number/proportion of subjects with positive or negative anti-drug antibody (ADA) titer

  3. Maximum serum concentration (Cmax) of SL-172154 [ Time Frame: Approximately 24 months ]
    To assess the pharmacokinetic profile of SL-172154 when administered alone or with azacitidine OR azacitidine + venetoclax in subjects with higher-risk MDS or AML

  4. Time at which maximum concentration of SL-172154 is observed (Tmax) [ Time Frame: Approximately 24 months ]
    The Tmax is the time at which the maximum concentration of SL-172154 is observed following single and multiple doses

  5. Area under the serum concentration-time curve (AUC) [ Time Frame: Approximately 24 months ]
    The AUC is the area under the serum concentration time curve following single and multiple doses of SL-172154

  6. Terminal elimination half-life (t1/2) [ Time Frame: Approximately 24 months ]
    Terminal elimination half-life (t1/2) of SL-172154

  7. Clearance (CL) [ Time Frame: Approximately 24 months ]
    Clearance of Sl-172154

  8. Volume of distribution [ Time Frame: Approximately 24 months ]
    Volume of distribution of SL-172154



Information from the National Library of Medicine

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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:

  1. Subject has voluntarily agreed to participate by giving written informed consent in accordance with International Council for Harmonisation/Good Clinical Practice (ICH/GCP) guidelines and applicable local regulations.
  2. Age ≥ 18 years.
  3. For subjects with AML, confirmation of AML diagnosis by 2016 World Health Organization (WHO) criteria [Arber, 2016] classification, excluding acute promyelocytic leukemia (APL).
  4. Subjects with MDS must have:

    1. morphologically confirmed diagnosis of MDS by 2016 WHO criteria [Arber, 2016] with <20% blasts in bone marrow per bone marrow biopsy/aspirate or peripheral blood.
    2. confirmation of intermediate, high or very high risk category by Revised International Prognostic Scoring System (IPSS-R)
  5. Subjects with AML must have relapsed/refractory disease (>5% blasts by manual aspirate differential, flow cytometry, or immunohistochemistry) following at least 1 prior line of therapy but no more than 4 prior lines of therapy.
  6. Subjects with relapsed/refractory disease (as defined in Inclusion criterion 5) following at least 1 prior line of therapy but no more than 4 prior lines of therapy for AML or MDS.
  7. Subjects diagnosed with MDS must be previously untreated. Prior MDS therapy with lenalidomide or supportive care in the form of transfusions or growth factors is allowed.
  8. All subjects must have documentation of at least one tumor protein 53 (TP53) gene mutation/deletion based on local test.
  9. Subjects with previously untreated de novo AML or secondary AML with TP53 gene mutation or deletion and who are unlikely to benefit from standard intensive induction therapy or refuse intensive induction therapy at time of enrollment are eligible. All subjects must have documentation of at least one TP53 gene mutation/deletion based on local test. Subjects with secondary AML after MDS must not have received prior chemotherapy or no more than 2 cycles of prior hypomethylating agent for MDS.
  10. Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0, 1, or 2
  11. Laboratory values must meet the criteria outlined in the protocol.
  12. Willing to provide consent for bone marrow aspirate samples for exploratory research at baseline and on-treatment per schedule described in the Schedule of Assessments.
  13. For subjects with relapsed/refractory disease, recovery from prior anti-cancer treatments including surgery, radiotherapy, chemotherapy or any other anti-cancer therapy to baseline or ≤ Grade 1.
  14. Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test within 72 hours of the first dose of study treatment.
  15. Male subjects with female partners of childbearing potential must have azoospermia from a prior vasectomy or underlying medical condition or agree to use an acceptable method of contraception during treatment and for 30 days (which exceeds 5 half-lives) or for the duration required by local regulatory guidance, whichever is longer, after last dose of study treatment.

Exclusion Criteria:

  1. Subject with relapsed or refractory disease has received treatment for AML or MDS with any of the following:

    1. Chimeric antigen receptor (CAR)-T cell therapy
    2. Prior treatment with anti-cluster of differentiation 47 (CD47) targeting agent or cluster of differentiation 40 (CD40) agonist within 28 days prior to
    3. the first dose of study treatment.
    4. Prior treatment with signal-regulatory protein alpha (SIRPα)-targeting antibody
    5. Other experimental therapies for AML or MDS within 14 days or at least 5 half- lives (whichever is shorter) prior to the first dose of study treatment
  2. Evidence of active central nervous system (CNS) involvement with leukemia
  3. Subjects requiring agents other than hydroxyurea to control blast counts within 14 days prior to the first dose of study treatment.
  4. Evidence of active bleeding or bleeding diathesis or major coagulopathy (including familial)
  5. [Only for Cohorts including Venetoclax in the regimen] Subject has received strong and/or moderate cytochrome P450, family 3, subfamily A (CYP3A) inducers within 7 days prior to the first dose of study treatment.
  6. Use of corticosteroids or other immunosuppressive medication, current or within 14 days of the first dose of study treatment
  7. Receipt of live attenuated vaccine within 30 days of first dose of SL-172154 treatment, the exception is that vaccines for coronavirus disease 19 (COVID-19) are permitted.
  8. Subject has active, uncontrolled infection (e.g, viral, bacterial, or fungal). Subjects are eligible if infection is controlled with antibiotics, antivirals and/or antifungals.
  9. [Only for Cohorts including Venetoclax in the regimen] Subject has a malabsorption syndrome or other condition that precludes enteral route of administration.
  10. Symptomatic peptic ulcer disease or gastritis, active diverticulitis, other serious gastrointestinal disease associated with diarrhea within 6 months of first dose of study treatment.
  11. Clinically significant or uncontrolled cardiac disease including any of the following:

    • Myocarditis
    • Unstable angina within 6 months from D1 of study treatment
    • Acute myocardial infarction within 6 months from D1 of study treatment
    • Uncontrolled hypertension
    • New York Heart Association (NYHA) Class III or IV congestive heart failure
    • Clinically significant (symptomatic) cardiac arrhythmias (e.g., sustained ventricular tachycardia, second- or third- degree atrioventricular (AV) block without a pacemaker, circulatory collapse requiring vasopressor or inotropic support, or arrhythmia not stabilized on therapy)
  12. Subject has chronic respiratory disease that requires continuous oxygen, or significant history of renal, neurologic, psychiatric, endocrinologic, metabolic, immunologic, hepatic, cardiovascular disease, or any other medical condition that in the opinion of the investigator would adversely affect his/her participation in the study.
  13. Subjects who have had any major surgical procedure within 14 days of first dose of study treatment.
  14. Subject is a woman who is pregnant or breast feeding or planning to become pregnant or breast feed while enrolled in this study.
  15. Psychiatric illness/social circumstances that would limit compliance with study requirements and substantially increase the risk of adverse events (AEs) or compromised ability to provide written informed consent.
  16. Presence of another malignancy that requires active therapy and that in the opinion of the investigator and Sponsor would interfere with the monitoring of disease assessments in this study.
  17. Known hypersensitivity to any of the study medications including excipients of Azacitidine.
  18. Has undergone solid organ transplantation.
  19. Known or active human immunodeficiency virus (HIV) infection
  20. Known or active infection with hepatitis B (positive for hepatitis B surface antigen [HBsAg]) or hepatitis C virus ([HCV]; if hepatitis C virus (HCV) antibody (Ab) test is positive check for HCV ribonucleic acid [RNA]).

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): NCT05275439


Contacts
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Contact: Shattuck Clinical Trials 919-864-2700 clinicaltrials@shattucklabs.com

Locations
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United States, California
City of Hope Recruiting
Duarte, California, United States, 91010
Contact: Manjoyt Nanhwan, SC    626-218-0446      
UCLA Medical Center-Bowyer Oncology Center Recruiting
Los Angeles, California, United States, 90095
Contact: Wanxing Chai-Ho, MD    310-206-6909    WChaiHo@mednet.ucla.edu   
Contact: Bruck Habtemariam    310-794-0242    bhabtemariam@mednet.ucla.edu   
United States, Connecticut
Yale Cancer Center Recruiting
New Haven, Connecticut, United States, 06510
Contact: Amer Zeidan, MD    203-605-6619    amer.zeidan@yale.edu   
Contact: Fernando Rodriguez-Laguna, IMG, CRC    203-605-6619    Fernando.rodriguez-laguna@yale.edu   
United States, Kentucky
Norton Cancer Institute Recruiting
Louisville, Kentucky, United States, 40202
Contact: Don Stevens, MD    502-394-6350    Don.Stevens@nortonhealthcare.org   
United States, Michigan
University of Michigan Recruiting
Ann Arbor, Michigan, United States, 48109
Contact: Dale Bixby, MD    734-647-8902    dbixby@med.umich.edu   
Contact: Roxana Taralunga    734-232-0773    roxanat@med.umich.edu   
START Midwest Recruiting
Grand Rapids, Michigan, United States, 49546
Contact: Andrew Sochaski, MD    616-954-5554    andrew.sochacki@startmidwest.com   
Contact: Jade Blakeman, RN    616-954-5551    jade.blakeman@startmidwest.com   
United States, Ohio
Gabrail Cancer Center Recruiting
Canton, Ohio, United States, 44718
Contact: Nashal Gabrail, MD    330-492-3345      
University of Cincinnati Medical Center Recruiting
Cincinnati, Ohio, United States, 45219
Contact: Emily Curran, MD    513-558-2115    curraney@ucmail.uc.edu   
United States, Pennsylvania
UPMC Hillman Cancer Center Recruiting
Pittsburgh, Pennsylvania, United States, 15232
Contact: Sawa Ito, MD    412-647-9600    itos3@upmc.edu   
Contact: Maria Lamonde    412-647-6241    lamondeme@upmc.edu   
United States, Texas
Baylor Scott & White Research Institute Recruiting
Dallas, Texas, United States, 75246
Contact: Tarah Satterfield    214-818-8472    CORCHemeBMT@BSWHealth.org   
Contact: Jana Reynolds, MD       Jana.Reynolds@usoncology.com   
MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Naval Daver, MD    713-792-0970    ndaver@mdanderson.org   
Contact: Kathleen Doyle, RN    713-792-0970    KMDoyle@mdanderson.org   
Sponsors and Collaborators
Shattuck Labs, Inc.
Investigators
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Study Director: Shattuck Labs Shattuck Labs
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Responsible Party: Shattuck Labs, Inc.
ClinicalTrials.gov Identifier: NCT05275439    
Other Study ID Numbers: Shattuck Labs (SL) 03-OHD-104
First Posted: March 11, 2022    Key Record Dates
Last Update Posted: December 8, 2022
Last Verified: December 2022

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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
Preleukemia
Myelodysplastic Syndromes
Neoplasms by Histologic Type
Neoplasms
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions
Azacitidine
Venetoclax
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Enzyme Inhibitors