- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT07723703
Phase 1 Open-label Study of AMX-883 Alone in Participants With AML and High-risk MDS and in Combination in Participants With AML (BRAMLIE)
A Phase 1, Open-Label, Multi-Centre Study to Assess the Safety, Pharmacokinetics, and Preliminary Efficacy of AMX-883 Monotherapy in Participants With Acute Myeloid Leukaemia and High-Risk Myelodysplastic Syndrome and in Combination With Anticancer Agents in Participants With Acute Myeloid Leukaemia
Studieoversigt
Status
Intervention / Behandling
Detaljeret beskrivelse
This is a modular, Phase 1, open-label, multi-centre dose-escalation study investigating AMX-883 in participants with relapsed/refractory AML and high-risk MDS. The study comprises Module 1, which will evaluate AMX-883 as monotherapy and in combination with posaconazole.
Module 1 consists of three parts:
- Part A consists of the monotherapy dose escalation cohorts and investigation of the food-effect at selected dose(s).
- Part B consists of AMX-883 in combination with posaconazole dose escalation cohorts.
Other modules may be added by protocol amendment. The study aims to establish optimal dosing and preliminary efficacy data to support further clinical development of AMX-883.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Fase 1
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Participants with relapsed or refractory AML who have failed all available standard therapies or relapsed or refractory high-risk MDS with BM blasts 10-19%
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
- Adequate washout from prior therapies
- Adequate kidney and liver function
- Female participants of childbearing potential must use highly effective contraception, and male participants must agree to use barrier contraception and avoid sperm donation for at least 120 days after last dose
- If enrolled in M1B: Participant must have no documented contraindication to treatment with posaconazole before start of treatment
Exclusion Criteria:
- Diagnosis of acute promyelocytic leukaemia or chronic myelogenous leukaemia in blast crisis
- Clinically active central nervous system (CNS) leukaemia
- Receiving immunosuppressive therapy post HSCT
- History of another malignancy that is active, progressing, or has required systemic treatment within the past 2 years
- Presence of >Grade 1 active graft versus host disease within 4 weeks prior to C1D1
- Significant cardiovascular disease
- Family history of sudden cardiac death before 40 years of age or a family history of long QT syndrome
- Clinically significant electrolyte imbalances (e.g., hypokalaemia, hypomagnesaemia, hypocalcaemia) that may contribute to QT interval prolongation
- Clinically significant bradycardia (<50 beats per minute) that is symptomatic or causes haemodynamic instability
- Major surgery within 4 weeks prior to C1D1 or inadequate recovery from prior surgery
- Uncontrolled intercurrent illness
- Inability to fast, swallow, ingest, or absorb oral medication due to a pre-existing condition
- History of interstitial lung disease or pneumonitis requiring systemic corticosteroid treatment
- Requirement for medications with a known risk of Torsades de Pointes that cannot be discontinued prior to study treatment
- Detectable human immunodeficiency virus (HIV) viral load
- Known serologic status reflecting active hepatitis B or C infection
- Active uncontrolled systemic fungal, bacterial, viral, or other infection or a condition predisposing to severe infection
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Ikke-randomiseret
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Module 1 Part A (M1A): AMX-883 monotherapy dose escalation cohort
Participants will receive escalating dose levels of AMX-883 administered as monotherapy.
|
AMX-883 will be administered orally.
|
|
Eksperimentel: Module 1 Part A (M1A): AMX-883 monotherapy food effect cohort
Participants will receive a selected dose of AMX-883 from the M1A dose escalation cohort, administered as monotherapy, under fed and fasted conditions.
|
AMX-883 will be administered orally.
|
|
Eksperimentel: Module 1 Part B (M1B): AMX-883 + posaconazole
Participants will receive a selected dose level for at least two escalating dose levels of AMX-883 selected from the M1A dose escalation cohort, administered in combination with posaconazole.
|
AMX-883 will be administered orally.
Posaconazole tablets will be administered orally.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Number of participants with adverse events (AEs), treatment-emergent adverse events (TEAEs), adverse events of special interests (AESIs) and serious adverse events (SAEs)
Tidsramme: Until 30 days after last dose (Approximately 2 years 8 months)
|
To determine the safety and tolerability of AMX-883 in participants with relapsed or refractory AML and high-risk MDS when administered as monotherapy and in combination with posaconazole.
|
Until 30 days after last dose (Approximately 2 years 8 months)
|
|
Number of participants with dose limiting toxicities (DLTs)
Tidsramme: During Cycle 1 (each cycle will be 28 days)
|
To determine the maximum tolerated dose (MTD)/optimal biological dose (OBD) and the recommended dose for expansion (RDE) of AMX-883 in participants with relapsed or refractory AML and high-risk MDS when administered as monotherapy and in combination with posaconazole.
|
During Cycle 1 (each cycle will be 28 days)
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Maximum plasma concentration (Cmax)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (Cmax) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (Cmax) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Minimum plasma concentration (Cmin)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (Cmin) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (Cmin) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Time to Cmax (Tmax)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (Tmax) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (Tmax) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Terminal plasma half-life (t½λz)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (t½λz) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (t½λz) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Area under the plasma concentration-time curve from zero to infinity (AUCinf)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (AUCinf) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (AUCinf) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Oral plasma clearance (CL/F)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (CL/F) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (CL/F) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Oral volume of distribution during terminal phase (Vz/F)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (Vz/F) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (Vz/F) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Mean residence time (MRT)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (MRT) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (MRT) of AMX-883.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
|
Area under the plasma concentration-time curve from zero to tau (AUC0-tau) where tau=12
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To characterise the PK (AUC0-tau) parameters of AMX-883 after a single dose and at steady state when administered as monotherapy and in combination with posaconazole and to characterise the effect of a high-fat meal on the PK (AUC0-tau) of AMX-883.
AUC at other timepoints may also be derived.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
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Composite complete remission (CRc) (AML)
Tidsramme: Approximately 2 years 8 months
|
CRc is defined as percentage of participants with Complete remission (CR) and complete remission with partial haematologic recovery (CRh) and complete remission with incomplete count recovery (CRi).
This will be used to explore early evidence of antileukaemic activity (ALA) of AMX-883 when administered as monotherapy and in combination with posaconazole in participants.
|
Approximately 2 years 8 months
|
|
Morphologic leukaemia-free state (MLFS) (AML)
Tidsramme: Approximately 2 years 8 months
|
MLFS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
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Overall Response rate (ORR) (AML)
Tidsramme: Approximately 2 years 8 months
|
ORR is defined as CR, CRh, or CRi with or without MRD.
ORR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Duration of remission (DOR) (AML)
Tidsramme: Approximately 2 years 8 months
|
DOR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Transfusion independence (TI) (AML)
Tidsramme: Approximately 2 years 8 months
|
TI will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Relapse-free survival (RFS) (AML)
Tidsramme: Approximately 2 years 8 months
|
RFS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Progression-free survival (PFS) (AML)
Tidsramme: Approximately 2 years 8 months
|
PFS is defined as the time from the first dose until which participants can continue receiving treatment without experience any progressive disease.
PFS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Event-free survival (EFS) (AML)
Tidsramme: Approximately 2 years 8 months
|
EFS is defined as the failure to achieve CR.
EFS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Time to response (TTR) (AML)
Tidsramme: Approximately 2 years 8 months
|
TTR is defined as the time taken to achieve CR, ORR and CRc after starting the treatment.
TTR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Overall survival (OS) (AML)
Tidsramme: Approximately 2 years 8 months
|
OS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
Treatment failure (AML)
Tidsramme: Approximately 2 years 8 months
|
Treatment failure will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
30-day and 60-day mortality rate (Extramedullary Disease- 30 [ED-30] and ED-60) (AML)
Tidsramme: Approximately 2 years 8 months
|
ED-30 and ED-60 will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with AML.
|
Approximately 2 years 8 months
|
|
CR (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
CR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
CR equivalent (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
CR equivalent will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
Partial remission (PR) (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
PR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
Complete remission with limited count recovery (CRL) (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
CRL will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
CRh (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
CRh will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
Haematologic improvement (HI) (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
HI will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
ORR (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
ORR is defined by CR (or CR equivalent) + PR + CRL + CRh + HI.
ORR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
DOR (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
DOR is defined as CR (or CR equivalent) + PR + CRL + CRh + HI.
DOR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
TTR (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
TTR is defined as the time from first dose of study treatment to the first documented evidence of achieving a CR, ORR and CRc. TTR will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS. |
Approximately 2 years 8 months
|
|
PFS (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
PFS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
EFS (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
EFS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
OS (high-risk MDS)
Tidsramme: Approximately 2 years 8 months
|
OS will be used to explore early evidence of ALA of AMX-883 when administered as monotherapy and in combination with posaconazole in participants with high-risk MDS.
|
Approximately 2 years 8 months
|
|
Change from baseline in BRD9 expression levels in peripheral blood mononuclear cells (PBMCs)
Tidsramme: At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
To investigate biomarkers potentially related to AMX-883 activity when administered as monotherapy and in combination with posaconazole.
|
At predefined intervals from Cycle 1 Day 1 (C1D1) until completion of treatment period (Approximately 2 years 8 months)
|
Samarbejdspartnere og efterforskere
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- AMX-883-C001
Plan for individuelle deltagerdata (IPD)
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IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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