ABT-348 as Monotherapy and in Combination With Azacitidine to Treat Advanced Hematologic Malignancies

A Phase 1 Study Evaluating the Safety and Pharmacokinetics of ABT-348 as Monotherapy and in Combination With Azacitidine in Subjects With Advanced Hematologic Malignancies

The purpose of this study is to determine the safety, pharmacokinetics and maximum tolerated dose of ABT-348 as monotherapy and when given in combination with azacitidine.

Study Overview

• Status: Completed
• Conditions: Acute Lymphoblastic Leukemia; Acute Myelogenous Leukemia; Chronic Myelogenous Leukemia; B-cell Chronic Lymphocytic Leukemia; Myelodysplasia
• Intervention / Treatment: Drug: ABT-348; Drug: ABT-348; Drug: ABT-348; Drug: ABT-348 and azacitidine

Detailed Description

The primary objectives of this study are to determine safety and pharmacokinetics of ABT-348 as monotherapy and when given in combination with azacitidine. The secondary objectives are to determine the maximum tolerated dose and recommended Phase 2 dose of ABT-348 when administered as monotherapy and when given in combination with azacitidine in subjects with advanced hematologic malignancies.

• Study Type: Interventional
• Enrollment (Actual): 52
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Scottsdale, Arizona, United States, 85259
      • Site Reference ID/Investigator# 59324
  • Georgia
    • Atlanta, Georgia, United States, 30322
      • Site Reference ID/Investigator# 26523
  • Texas
    • Houston, Texas, United States, 77030-4009
      • Site Reference ID/Investigator# 26522

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 99 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Histological or cytological confirmation of one of the following (Arms A, B and D):

   • Relapsed or refractory acute myelogenous leukemia (AML), untreated AML in subjects who are > 60 years of age and do not have favorable cytogenetics (i.e., lack t(8,21) or inv(16)/t(16,16) or acute lymphoblastic leukemia (ALL) in subjects who have failed or are unsuitable for standard therapy.
   • Chronic myelogenous leukemia (CML) subjects that have not responded or relapsed on imatinib and failed second line Tyrosine Kinase Inhibitor (TKI) therapy and are not a candidate for allogeneic bone marrow transplant.
   • B-cell chronic lymphocytic leukemia (CLL) subjects that have not responded or relapsed on fludarabine or in the opinion of the Principal Investigator are unsuitable for fludarabine therapy and have not responded to or relapsed on alkylating therapy.

   • Myelodysplasia (MDS) including chronic myelomonocytic leukemia (CMML) subjects with International Prognostic Scoring System (IPSS) risk categories of Intermediate-2 (INT-2) or High risk, or any myelodysplasia with symptomatic anemia resistant to erythropoietin, immunosuppressant, or DNA methyltransferase inhibitor therapy (e.g., azacitidine/decitabine).

     1a. Histological or cytological confirmation of one of the following (Arm C):

   • Relapsed or refractory AML, untreated AML in subjects who are > 60 years of age and do not have favorable cytogenetics (i.e., lack t(8,21).
   • Untreated MDS including CMML with IPSS risk categories of INT-2 or High risk or with more than 10% blasts in the bone marrow, or any myelodysplasia with symptomatic anemia resistant to erythropoietin, or immunosuppressant, or subject has no response after four cycles of DNA methyltransferase inhibitor therapy or subject has progressed on DNA methyltransferase inhibitor therapy.
2. Eastern Cooperative Oncology Group Status of 0-2
3. Hematologic function for subjects with CLL and CML demonstrated by hemoglobin > 9 g/dL, platelets > 100,000/µL, ANC > 1500/mm3
4. Serum creatinine value of ≤ 1.8 times the upper limit of normal (ULN) and either an estimated creatinine clearance value as determined by the Cockcroft-Gault formula or based on a 24 hour urine collection creatinine clearance value of ≥ 50 mL/min
5. Adequate liver function as demonstrated by serum bilirubin < 2 x ULN and AST and ALT < 2.5 x ULN
6. QTc interval < 500 msec
7. Left Ventricular Ejection Fraction > 50%
8. Women of child-bearing potential and men must agree to use adequate contraception prior to the study entry, for the duration of study participation and up to 3 months following completion of therapy.
9. Capable of understanding and complying with parameters as outlined in the protocol and able to sign informed consent, approved by an Institutional Review Board (IRB) prior to the initiation of any screening or study-specific procedures.

Exclusion Criteria:

1. Subject has known active CNS involvement. The subject has untreated brain or meningeal metastases.
2. ALL or AML subject has received acute anti-cancer therapy within 14 days prior to Study Day 1
3. CML, CLL or myelodysplasia (MDS) subjects has received acute anti-cancer therapy within 28 days or biologic therapy within 6 weeks prior to Study Day 1. Per Investigator discretion, hydroxyurea may be used anytime during the study. Tyrosine kinase inhibitors may not be administered 7 days prior to Study Day 1.
4. Subjects with poorly controlled diabetes mellitus
5. Subject has unresolved toxicities from prior anti-cancer therapy, grade 2 or higher clinically significant toxicity (excluding alopecia)
6. Subject has had major surgery within 28 days prior to Study Day 1
7. Subject currently exhibits symptomatic or persistent, uncontrolled hypertension defined as diastolic blood pressure > 90 mmHg or systolic blood pressure > 140 mmHg
8. Subject has proteinuria grade > 1
9. Subject is unable to swallow or absorb oral tablets normally
10. Subject is receiving therapeutic anticoagulation therapy. Low-dose anticoagulation (e.g., low-dose heparin or warfarin) for catheter prophylaxis will be allowed
11. Subject has infection with HIV, Hepatitis B, or Hepatitis C
12. Female subjects who are pregnant or breast feeding
13. Any medical condition which in the opinion of the study investigator places the subject at an unacceptably high risk for toxicities
14. Clinically significant uncontrolled condition(s)
15. Subjects in Arm C who have advanced malignant hepatic tumors
16. Subjects in Arm C who have hypersensitivity to azacitidine or mannitol
17. Subjects have received CYP3A inhibitors or inducers within 7 days prior to the first dose of study drug.
18. Subjects enrolled in Arm D who have hypersensitivity to drugs formulated with polyethoxylated castor oil (Cremophor).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Monotherapy, once daily	Drug: ABT-348; An oral dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.; Drug: ABT-348; An oral dose of ABT-348, twice daily on Day 1, Day 8, and Day 15 of each 28 day cycle; Drug: ABT-348; An intravenous dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.
Experimental: Monotherapy, twice daily	Drug: ABT-348; An oral dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.; Drug: ABT-348; An oral dose of ABT-348, twice daily on Day 1, Day 8, and Day 15 of each 28 day cycle; Drug: ABT-348; An intravenous dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.
Experimental: Combination with Azacitidine	Drug: ABT-348; An oral dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.; Drug: ABT-348; An oral dose of ABT-348, twice daily on Day 1, Day 8, and Day 15 of each 28 day cycle; Drug: ABT-348; An intravenous dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.; Drug: ABT-348 and azacitidine; An oral dose of ABT-348 on Day 1, Day 8, and Day 15 of each 28 day cycle. An IV or injection of azacitidine on Days 1-7 of each 28 day cycle.
Experimental: IV monotherapy, once daily	Drug: ABT-348; An oral dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.; Drug: ABT-348; An oral dose of ABT-348, twice daily on Day 1, Day 8, and Day 15 of each 28 day cycle; Drug: ABT-348; An intravenous dose of ABT-348, once daily on Day 1, Day 8, and Day 15 of each 28 day cycle.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Determine the safety profile (adverse events by toxicity grade and relationship to study drug, serious adverse events, adverse events leading to discontinuation and relevant clinical laboratory abnormalities) of ABT-348 as monotherapy or in combination	At each treatment visit
Study the pharmacokinetic interaction (plasma concentrations and pharmacokinetic parameter values) of ABT-348 as monotherapy and in combination	At study visits

Secondary Outcome Measures

Outcome Measure	Time Frame
Determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RPTD) of ABT-348 when administered as a monotherapy and in combination in subjects with advanced hematologic malignancies	At each treatment visit

Collaborators and Investigators

• Sponsor: AbbVie (prior sponsor, Abbott)

Publications and helpful links

General Publications

• Garcia-Manero G, Tibes R, Kadia T, Kantarjian H, Arellano M, Knight EA, Xiong H, Qin Q, Munasinghe W, Roberts-Rapp L, Ansell P, Albert DH, Oliver B, McKee MD, Ricker JL, Khoury HJ. Phase 1 dose escalation trial of ilorasertib, a dual Aurora/VEGF receptor kinase inhibitor, in patients with hematologic malignancies. Invest New Drugs. 2015 Aug;33(4):870-80. doi: 10.1007/s10637-015-0242-6. Epub 2015 May 2.

Study record dates

Study Major Dates

• Study Start: April 1, 2010
• Primary Completion (Actual): June 1, 2013
• Study Completion (Actual): June 1, 2013

Study Registration Dates

• First Submitted: March 26, 2010
• First Submitted That Met QC Criteria: April 23, 2010
• First Posted (Estimate): April 26, 2010

Study Record Updates

• Last Update Posted (Actual): November 20, 2017
• Last Update Submitted That Met QC Criteria: November 16, 2017
• Last Verified: November 1, 2013

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Immune System Diseases; Neoplasms by Histologic Type; Neoplasms; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Neoplasms by Site; Bone Marrow Diseases; Hematologic Diseases; Myeloproliferative Disorders; Leukemia, Lymphoid; Leukemia, B-Cell; Hematologic Neoplasms; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Antimetabolites, Antineoplastic; Antimetabolites; Antineoplastic Agents; Protein Kinase Inhibitors; Azacitidine; Ilorasertib
• Other Study ID Numbers: M10-943