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Safety, Tolerability, PK, PD, and Efficacy of AMG 427 in Subjects With Relapsed/Refractory Acute Myeloid Leukemia (20170528)

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ClinicalTrials.gov Identifier: NCT03541369
Recruitment Status : Terminated (Premature discontinuation of study, a strategic decision.)
First Posted : May 30, 2018
Last Update Posted : March 2, 2023
Information provided by (Responsible Party):

Brief Summary:
Evaluate the safety and tolerability of AMG 427 in adult subjects with relapsed/refractory AML. Estimate the maximum tolerated dose (MTD) and / or a biologically optimal dose (eg, recommended phase 2 dose [RP2D]).

Condition or disease Intervention/treatment Phase
Relapsed/Refractory Acute Myeloid Leukemia (AML) Drug: AMG 427 Phase 1

Detailed Description:
Evaluate the safety and tolerability of AMG 427 in adult subjects with relapsed/refractory AML. Estimate the maximum tolerated dose (MTD) and / or a biologically optimal dose (eg, recommended phase 2 dose [RP2D]). Approximately 80 subjects will be enrolled.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 64 participants
Allocation: Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1 First-In-Human Study Evaluating the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics and Efficacy of AMG 427 in Subjects With Relapsed/Refractory Acute Myeloid Leukemia.
Actual Study Start Date : September 14, 2018
Actual Primary Completion Date : February 28, 2023
Actual Study Completion Date : February 28, 2023

Arm Intervention/treatment
Experimental: Dose Escalation Phase
AMG 427 Dose-finding phase of the study
Drug: AMG 427
AMG 427 will be administered as an intravenous (IV) infusion in adult subjects with relapsed/refractory AML.
Other Name: AMG 427; 20170528

Experimental: Dose Expansion Phase
AMG 427 MTD identified in dose escalation phase (or lower) will be administered to subjects.
Drug: AMG 427
AMG 427 will be administered as an intravenous (IV) infusion in adult subjects with relapsed/refractory AML.
Other Name: AMG 427; 20170528

Primary Outcome Measures :
  1. Number of subjects who experience a dose limiting toxicity (DLT) [ Time Frame: 14 Months ]
    Number of subjects experiencing dose limiting toxicities (DLTs) while on treatment with AMG 427.

  2. Subject incidence of treatment-emergent adverse events (TEAEs) [ Time Frame: 14 Months ]
    Incidence of treatment-emergent adverse events (TEAEs) experienced by subjects while on treatment with AMG 427.

  3. Subject incidence of treatment-related adverse events (TRAEs) [ Time Frame: 14 Months ]
    Incidence of treatment-related emergent adverse events (TEAEs) experienced by subjects while on treatment with AMG 427.

Secondary Outcome Measures :
  1. Maximum observed concentration (Cmax) of AMG 427 [ Time Frame: 14 months ]
  2. Minimum concentration (Cmin) of AMG 427 [ Time Frame: 14 months ]
  3. Area under the concentration-time curve (AUC) of AMG 427 [ Time Frame: 14 months ]
  4. Half Life (t1/2) of AMG 427 [ Time Frame: 14 months ]
  5. Complete response/remission [CR] [ Time Frame: 14 months ]
  6. Complete response/remission with incomplete recovery of peripheral blood counts [CRi] [ Time Frame: 14 months ]
  7. Partial remission (per modified International Working Group IWG criteria) [ Time Frame: 14 months ]
  8. Morphologic leukemia-free state [ Time Frame: 14 months ]
  9. Complete remission with partial hematologic recovery (CRh) [ Time Frame: 14 months ]
  10. Duration of response [ Time Frame: 14 months ]

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

Inclusion Criteria:

  • Subject has provided informed consent prior to initiation of any study-specific activities/procedures.
  • Subjects greater than or equal to 18 years of age at the time of signing consent.
  • For relapsed/refractory AML subjects only, AML as defined by the WHO Classification as persisting or recurring following 1 or more treatment courses (exceptions noted in exclusion criteria).
  • Myeloblasts greater than or equal to 5% in bone marrow, as confirmed by immunophenotype by flow cytometry.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of less than or equal to 2.
  • Renal function as follows: serum creatinine less than 2.0 mg/dL (176.84 mol/L); estimated glomerular filtration rate (eGFR) greater than 30 mL/min/1.73 m2.
  • Hepatic function as follows: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than or equal to 3.0 x upper limit of normal (ULN); bilirubin less than or equal to 1.5 x ULN (unless considered due to Gilbert's syndrome or hemolysis).
  • No active tuberculosis in the setting of anti-TNF therapy - National guidelines should be followed for the appropriate tuberculosis screening in the setting of anti-TNF therapy, including a minimum of:

    • Subject has a negative test for tuberculosis during screening defined as either:

      • Negative purified protein derivative (PPD) (< 5 mm induration at 48 to 72 hours after test is placed) OR
      • Negative quantiferon test
    • Subjects with positive PPD and a history of bacillus Calmette-Guérin vaccination are allowed with a negative Quantiferon test.
    • Subjects with a positive PPD test (without a history of bacillus Calmette-Guérin vaccination) or subjects with a positive or indeterminate Quantiferon test are allowed if they have all of the following:

      • No symptoms, per tuberculosis worksheet provided by Amgen
      • Documented history of a completed course of adequate treatment or prophylaxis (per local standard of care) prior to the start of investigational product
      • No known exposure to a case of active tuberculosis after most recent prophylaxis
      • No evidence of active tuberculosis on chest radiograph within 3 months prior to the first dose of investigational product (substudy subjects only)

Exclusion Criteria:

  • Patients with acute promyelocytic leukemia (APML).
  • Active extramedullary AML in the central nervous system (CNS)
  • Known hypersensitivity to immunoglobulins.
  • White blood cells (WBC) greater than 15,000 cells/mcL (15 cells x 10^9/L) at screening (hydroxyurea is permitted to enable eligibility).
  • Subjects with a prior or concurrent malignancy whose natural history or treatment is anticipated to interfere with the safety or efficacy assessment of the investigational regimen. Exception: Subjects with prior or concurrent malignancy not anticipated to interfere with the safety or efficacy of the investigational regimen may be included only after discussion with the Amgen Medical Monitor.
  • Autologous HSCT within 6 weeks prior to start of AMG 427 treatment.
  • Allogeneic HSCT within 3 months prior to start of AMG 427 treatment.
  • Any graft-versus-host disease requiring systemic therapy with immunomodulators.
  • History or evidence of significant cardiovascular risk including any of the following: symptomatic congestive heart failure, unstable angina, clinically significant arrhythmias (eg, ventricular fibrillation, ventricular tachycardia etc.), recent coronary angioplasty, intra-cardiac defibrillators or any clinically relevant concurrent disorder that may pose a risk to subject safety or interfere with study evaluation, procedures, or completion.
  • History of arterial thrombosis (eg, stroke or transient ischemic attack) in the past 3 months.
  • Active infection requiring intravenous antibiotics within 1 week of study enrollment (day 1). Antibiotics may be administered for prophylaxis as per institutional standards up to and after enrollment.
  • Known positive test for human immunodeficiency virus (HIV).
  • Positive for hepatitis B surface antigen (HepBsAg).
  • Positive for hepatitis C or chronic hepatitis C. Possible exceptions: acute hepatitis C and completely cleared of the virus (demonstrated by negative viral load), chronic hepatitis C with undetectable viral load defined by sustained virologic response 24 weeks (SVR24) after completion of anti-hepatitis C treatment.
  • Live vaccination(s) within 4 weeks before the start of AMG 427 treatment on day 1, during treatment, and until the end of the last study dose.
  • Unresolved toxicities from prior antitumor therapy, defined as not having resolved to Common Terminology Criteria for Adverse Events (CTCAE), version 4.0 grade 1 (with the exception of myelosuppression, eg, neutropenia, anemia, thrombocytopenia), or to levels dictated in the eligibility criteria with the exception of alopecia or toxicities from prior antitumor therapy that are considered irreversible (defined as having been present and stable for greater than 2 months) which may be allowed if they are not otherwise described in the exclusion criteria AND there is agreement to allow by both the investigator and sponsor.
  • Antitumor therapy (chemotherapy, antibody therapy, molecular-targeted therapy, or investigational agent) within 14 days of day 1. Exception: hydroxyurea to control peripheral blood leukemic cell counts is allowed until start of investigational product treatment. Exception: antitumor therapies with short half-lives only require passing of 5 half-lives from last dose, and after discussion with sponsor.
  • Treatment with systemic immune modulators including, but not limited to, non-topical systemic corticosteroids, cyclosporine, and tacrolimus within 2 weeks before enrollment (day 1). Exceptions: physiologic replacement steroids or steroids for treatment of transfusion/hypersensitivity reactions.
  • Prior treatment with a FLT3 targeting chimeric antigen receptor T cell (CAR-T)
  • Major surgery within 28 days of study day 1 with the exception of biopsy and insertion of central venous catheter.
  • History or evidence of any other clinically significant disorder, condition or disease that, in the opinion of the investigator or Amgen medical monitor would pose a risk to subject safety or interfere with the study evaluation, procedures or completion.
  • Males and females of reproductive potential who are unwilling to practice a highly effective method(s) of birth control while on study through 4 weeks after receiving the last dose of study drug. Acceptable methods of highly effective birth control include sexual abstinence (males, females); vasectomy; bilateral tubal ligation/occlusion; or a condom with spermicide (men) in combination with hormonal birth control or intrauterine device (IUD) (women).
  • Females who are lactating/breastfeeding or who plan to breastfeed while on study through 4 weeks after receiving the last dose of study drug.
  • Females with a positive pregnancy test.
  • Females planning to become pregnant while on study through 4 weeks after receiving the last dose of study drug.
  • Subjects likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures to the best of the subject's and investigator's knowledge.
  • History of multiple sclerosis or any other demyelinating disease.
  • No active hepatitis secondary to alcoholic hepatitis or nonalcoholic steatohepatitis.
  • History or evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection unless agreed upon with Medical Monitor and meeting the following criteria:

    • Negative test for SARS-CoV-2 RNA by reverse transcriptase-polymerase chain reaction (RT-PCR) within 72 hours of first dose of investigational product
    • No acute symptoms of coronavirus disease 2019 (COVID-19) disease within 10 days prior to first dose of investigational product (counted from day of positive test for asymptomatic subjects)

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): NCT03541369

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United States, California
City of Hope National Medical Center
Duarte, California, United States, 91010
United States, Illinois
Northwestern University
Evanston, Illinois, United States, 60208
United States, Maryland
Johns Hopkins
Baltimore, Maryland, United States, 21287
United States, New York
Roswell Park Cancer Institute
Buffalo, New York, United States, 14263
Memorial Sloan Kettering Cancer Center
New York, New York, United States, 10065
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
United States, Texas
University of Texas MD Anderson Cancer Center
Houston, Texas, United States, 77030
Australia, Victoria
The Alfred Hospital
Melbourne, Victoria, Australia, 3004
The Royal Melbourne Hospital
Parkville, Victoria, Australia, 3050
Canada, Ontario
University Health Network-Princess Margaret Cancer Centre
Toronto, Ontario, Canada, M5G 2M9
Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden
Dresden, Germany, 01307
Klinikum der Universitaet Muenchen Campus Grosshadern
Muenchen, Germany, 81377
National Cancer Center Hospital East
Kashiwa-shi, Chiba, Japan, 277-8577
University of Fukui Hospital
Yoshida-gun, Fukui, Japan, 910-1193
Korea, Republic of
Seoul National University Hospital
Seoul, Korea, Republic of, 03080
Severance Hospital Yonsei University Health System
Seoul, Korea, Republic of, 03722
Sponsors and Collaborators
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Study Director: MD Amgen
Additional Information:
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Responsible Party: Amgen
ClinicalTrials.gov Identifier: NCT03541369    
Other Study ID Numbers: 20170528
BB-IND 138440 ( Other Grant/Funding Number: IND Number )
2018-001389-40 ( EudraCT Number )
First Posted: May 30, 2018    Key Record Dates
Last Update Posted: March 2, 2023
Last Verified: February 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Informed Consent Form (ICF)
Clinical Study Report (CSR)
Time Frame: Data sharing requests relating to this study will be considered beginning 18 months after the study has ended and either 1) the product and indication have been granted marketing authorization in both the US and Europe or 2) clinical development for the product and/or indication discontinues and the data will not be submitted to regulatory authorities. There is no end date for eligibility to submit a data sharing request for this study.
Access Criteria: Qualified researchers may submit a request containing the research objectives, the Amgen product(s) and Amgen study/studies in scope, endpoints/outcomes of interest, statistical analysis plan, data requirements, publication plan, and qualifications of the researcher(s). In general, Amgen does not grant external requests for individual patient data for the purpose of re-evaluating safety and efficacy issues already addressed in the product labelling. Requests are reviewed by a committee of internal advisors. If not approved, a Data Sharing Independent Review Panel will arbitrate and make the final decision. Upon approval, information necessary to address the research question will be provided under the terms of a data sharing agreement. This may include anonymized individual patient data and/or available supporting documents, containing fragments of analysis code where provided in analysis specifications. Further details are available at the URL below.
URL: https://www.amgen.com/datasharing

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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, Myeloid
Leukemia, Myeloid, Acute
Neoplasms by Histologic Type