2157GCCC:Phase 1 of Calaspargase Pegol-mknl W/ Cytarabine and Idarubicin in Newly Dx AML

March 3, 2025 updated by: Ashkan Emadi, MD PHD, West Virginia University

2157GCCC: a Phase I Trial of Calaspargase Pegol-mknl in Combination with High Dose Cytarabine and Idarubicin in Adult Patients with Newly Diagnosed Acute Myeloid Leukemia

Characterizing the regimen limiting toxicity (RLT) of chemotherapeutic drug Calaspargase Pegol-mknl as remission induction and consolidation chemotherapy in patients with newly diagnosed Acute Myeloid Leukemia (AML) and Identifying the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of Calaspargase Pegol-mknl.

Study Overview

Status

Active, not recruiting

Intervention / Treatment

Detailed Description

This is a single center, non-randomized, open-label, phase I study evaluating regimen-limiting toxicities of Calaspargase Pegol-mknl administered intravenously in Adult Patients with Newly Diagnosed Acute Myeloid Leukemia (AML).

The trial will consist of the induction and consolidation phases of therapy. At the induction phase ( it usually lasts for 29 days): a high-dose of Cytarabine will be administered IV for six doses, plus Idarubicin administered IV for three doses and Calaspargase Pegol-mknl administered IV one dose, using a dose-escalation scheme. At the consolidation phase (single cycle of consolidation lasts 4-8 weeks): a high-dose of Cytarabine will be administered IV for six doses, and Calaspargase Pegol-mknl administered IV for one dose, using a dose-escalation scheme.

The FDA (The US Food and Drug Administration) has not approved Calaspargase Pegol-mknl for Adult Patients with Newly Diagnosed Acute Myeloid Leukemia (AML).

Study Type

Interventional

Enrollment (Actual)

6

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Maryland
      • Baltimore, Maryland, United States, 21201
        • Greenebaum Cancer Center, University of Maryland Medical Systems
    • West Virginia
      • Morgantown, West Virginia, United States, 26506
        • West Virginia University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • A histologically or pathologically confirmed diagnosis of AML based on WHO classification. Patients with myelodysplastic syndromes (MDS) or myeloproliferative neoplasms (MPN) evolving into AML who are candidates for AML induction therapy are eligible for enrollment.
  • Age 18-65 years old.
  • ECOG performance status < 3.
  • Patients must have normal organ function as defined below:

    • Total bilirubin ≤2X the institutional upper limit of normal (ULN) (except in patients with leukemic infiltration of the liver)
    • AST(SGOT)/ALT(SGPT) ≤3X ULN (except if attributable to leukemic infiltration of the liver)
    • Creatinine Clearance (CrCl) ≥ 40 mL/min (except in patients with evidence of tumor lysis syndrome)
    • Left ventricular ejection fraction (LVEF) ≥50%
  • Female patients of childbearing potential must have a negative pregnancy test <1 week before enrollment. Female patients of childbearing potential who are sexually active and male patients who are sexually active and have female partners of childbearing potential must agree to use a highly effective method of non-hormonal contraception. Contraception should be used during treatment and for at least 3 months after the last dose of Calaspargase pegol-mknl.
  • Ability to understand and willingness to sign a written informed consent document.
  • Agree to comply with the study requirements and agrees to come to the clinic/hospital for required study visits

Exclusion Criteria:

  • Patients with the following clinical histories are excluded:

    • severe pancreatitis not related to cholelithiasis. Severe acute pancreatitis as defined by lipase elevation >5X ULN and with signs or symptoms
    • unprovoked DVT
    • PE
    • serious or life-threatening thrombosis in any location of the body
    • hemorrhagic or thromboembolic stroke
    • major hemorrhagic event within three weeks before signing ICF; hemorrhage due to thrombocytopenia from underlying AML is excluded
    • patients with hemorrhagic diathesis
    • neurologic/cerebellar disorders that may confound the toxicity monitoring of HiDAC
    • history of serious hypersensitivity reactions to pegylated L-asparaginase therapy
  • Patients receiving any other investigational agents or concurrent chemotherapy or immunotherapy. Hydroxyurea for blast count control is permitted before starting treatment and up to a maximum of 10 days after starting treatment on the study.
  • Patients with AML with any of the following cytogenetic abnormalities: t(15;17), t(8;21), inv(16), t(16;16).
  • Pregnant women and female patients who are lactating and do not agree to stop breast-feeding.
  • Uncontrolled undercurrent illness including, but not limited to, symptomatic congestive heart failure, unstable angina pectoris, uncontrolled active seizure disorder, or psychiatric illness/social situations that per site Principal Investigator's judgment would limit compliance with study requirements

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Calaspargase pegol-mknl dose level 1

Induction Phase (It usually lasts 29 days):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take Idarubicin 12 mg/m2 for three doses in an IV after the first, third, and fifth High-dose Cytarabine.
  • The subject will take a dose of 750 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine every 21 days ( per cycle).

Consolidation Phase ( One cycle of consolidation lasts 4-8 weeks):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take a dose of 750 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine.
  • A single cycle of consolidation may last between 4-8 weeks in duration.
Calaspargase pegol-mknl
Experimental: Calaspargase pegol-mknl dose level 2

Induction Phase (It usually lasts 29 days):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take Idarubicin 12 mg/m2 for three doses in an IV after the first, third, and fifth High-dose Cytarabine.
  • The subject will take a dose of 1,000 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine every 21 days ( per cycle).

Consolidation Phase ( One cycle of consolidation lasts 4-8 weeks):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take a dose of 1,000 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine(every 21 days ( per cycle).
  • A single cycle of consolidation may last between 4-8 weeks in duration.
Calaspargase pegol-mknl
Experimental: Calaspargase pegol-mknl dose level 3

Induction Phase (It usually lasts 29 days):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take Idarubicin 12 mg/m2 for three doses in an IV after the first, third, and fifth High- dose Cytarabine.
  • The subject will take a dose of 1,500 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine every 21 days ( per cycle).

Consolidation Phase ( One cycle of consolidation lasts 4-8 weeks):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take a dose of 1,500 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine.
  • A single cycle of consolidation may last between 4-8 weeks in duration.
Calaspargase pegol-mknl
Experimental: Calaspargase pegol-mknl dose level 4

Induction Phase (It usually lasts 29 days):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take Idarubicin 12 mg/m2 for three doses in an IV after the first, third, and fifth High-dose Cytarabine.
  • The subject will take a dose of 2,000 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine every 21 days ( per cycle).

Consolidation Phase ( One cycle of consolidation lasts 4-8 weeks):

  • The subject will take Cytarabine 3000 mg/m2 in an IV every 12 hours on days 1, 3, 5 for 6 doses.
  • The subject will take a dose of 2,000 U/m2 of Calaspargase pegol-mknl in an IV after the last (6th) dose of High-dose Cytarabine per cycle.
  • A single cycle of consolidation may last between 4-8 weeks in duration.
Calaspargase pegol-mknl

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Primary Outcome Measure
Time Frame: From the first day of treatment until 30 days after receiving Calaspargase Pegol-mknl
1. Incidence of regimen limiting toxicities (RLTs) and Incidence of treatment-emergent adverse events (TEAE).
From the first day of treatment until 30 days after receiving Calaspargase Pegol-mknl

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
1. CR+CRh+CRi
Time Frame: Within 4-8 weeks following completion of induction regimen and completion of consolidation therapy
Complete remission (CR) + complete remission with partial hematologic recovery (CRh) + complete remission with incomplete count recovery (CRi)
Within 4-8 weeks following completion of induction regimen and completion of consolidation therapy
2. The duration of CR/CRh/CRi.
Time Frame: immediately after the intervention
The duration of Complete remission (CR) / complete remission with partial hematologic recovery (CRh) / complete remission with incomplete count recovery (CRi)
immediately after the intervention
3. Achievement of MRD <0.02% at the end of Induction therapy with Calaspargase pegol-mknl.
Time Frame: During the intervention
Achievement of MRD <0.02% at the end of Induction therapy with Calaspargase pegol-mknl.
During the intervention
4. Event-free survival (EFS).
Time Frame: From the first date of intervention until the first documented progression or the date of death from any causes, whichever came first, assessed up to 100 months
Event-free survival (EFS).
From the first date of intervention until the first documented progression or the date of death from any causes, whichever came first, assessed up to 100 months
5. Overall survival (OS)
Time Frame: From the first date of intervention until the first documented progression or the date of death from any causes, whichever came first, assessed up to 100 months
Overall survival (OS)
From the first date of intervention until the first documented progression or the date of death from any causes, whichever came first, assessed up to 100 months
6. Proceeding to allo-HSCT after Calaspargase pegol-mknl treatment
Time Frame: Immediately after the intervention
Proceeding to allo-HSCT after Calaspargase pegol-mknl treatment
Immediately after the intervention
7. Plasma asparagine and glutamine and other amino acids levels at baseline and weekly after administration of Calaspargase pegol-mknl. for four weeks.
Time Frame: At baseline and weekly after administration of Calaspargase pegol-mknl for four weeks
Plasma asparagine and glutamine and other amino acids levels at baseline and weekly after administration of Calaspargase pegol-mknl. for four weeks.
At baseline and weekly after administration of Calaspargase pegol-mknl for four weeks
8.Plasma asparaginase activity at baseline and weekly after administration of Calaspargase pegol-mknl for four weeks
Time Frame: At baseline and weekly after administration of Calaspargase pegol-mknl for four weeks
Plasma asparaginase activity at baseline and weekly after administration of Calaspargase pegol-mknl for four weeks
At baseline and weekly after administration of Calaspargase pegol-mknl for four weeks

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Exploratory Endpoint 1
Time Frame: After the enrollment of the study subjects
Measurement of asparagine synthetase mRNA and protein expression in patients who have refractory disease or develop relapse
After the enrollment of the study subjects
Exploratory Endpoint 2
Time Frame: After the enrollment of the study subjects
Measurement of p90RSK expression and phosphorylation of p70S6K, 4EBP1, and eIF4E in bone marrow cells of Calaspargase pegol-mknl treated patients with AML
After the enrollment of the study subjects
Exploratory Endpoint 3
Time Frame: After the enrollment of the study subjects
Measurement of protein expression of MCL-1, BCL2 and BCL-XL in bone marrow cells of Calaspargase pegol-mknl treated patients with AML.
After the enrollment of the study subjects
Exploratory Endpoint 4
Time Frame: After the enrollment of the study subjects
Tissue banking for further molecular and functional testing in the future
After the enrollment of the study subjects

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Ashkan Emadi, MD, PhD, West Virginia University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 27, 2021

Primary Completion (Estimated)

December 31, 2025

Study Completion (Estimated)

December 31, 2025

Study Registration Dates

First Submitted

June 15, 2021

First Submitted That Met QC Criteria

June 28, 2021

First Posted (Actual)

July 8, 2021

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 3, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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