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TK216 and Decitabine in Treating Patients With Relapsed and Refractory Acute Myeloid Leukemia

2 mai 2019 mis à jour par: M.D. Anderson Cancer Center

Phase I Study of TK216 in Patients With Relapsed and Refractory Leukemias

This phase I trial studies the side effects and best dose of TK216 and decitabine when given together in treating patients with acute myeloid leukemia that has come back or does not respond to treatment. Drugs used in chemotherapy, such as TK216 and decitabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.

Aperçu de l'étude

Description détaillée

PRIMARY OBJECTIVES:

I. To determine the maximum tolerated dose (MTD) and dose limiting toxicities (DLT) of Ets-family transcription factor inhibitor TK216 (TK216) in patients with relapsed and refractory (R/R) acute myeloid leukemia (AML). (Phase I Dose Escalation) II. To determine the safety and tolerability of TK216 combined with decitabine in patients with relapsed and refractory AML. (Combination Cohort)

SECONDARY OBJECTIVES:

I. Safety profile of TK216 as characterized by adverse event (AE) type, severity, timing and relationship to study drug, as well as laboratory abnormalities in the first and subsequent treatment cycles. (Phase I Dose Escalation) II. To explore the efficacy (complete remission [CR], complete remission without platelet recovery [CRp], complete remission without blood count recovery [CRi], or partial remission [PR]), of TK216 as a single-agent in patients with R/R AML. (Phase I Dose Escalation) III. To assess overall survival (OS), and disease free survival (DFS) in patients with R/R AML treated with TK216. (Phase I Dose Escalation) IV. Duration of disease control defined as first date of disease control identified (either CR/CRp/CRi, PR or SD) until the date of progression. (Phase I Dose Escalation) V. To explore biomarkers of response and resistance in patients with R/R AML treated with TK216. (Phase I Dose Escalation) VI. Safety profile of TK216 in combination with decitabine as characterized by adverse event (AE) type, severity, timing and relationship to study drug, as well as laboratory abnormalities in the first and subsequent treatment cycles. (Combination Cohort) VII. To explore the efficacy (complete remission [CR], complete remission without platelet recovery [CRp], complete remission without blood count recovery [CRi], or partial remission [PR], of TK216 in combination with decitabine in patients with R/R AML. (Combination Cohort) VIII. To assess overall survival (OS), and progression free survival (PFS) in patients with R/R AML treated with TK216 + decitabine. (Combination Cohort) IX. Duration of disease control defined as first date of disease control identified (either CR/CRp/CRi, PR or SD) until the date of progression. (Combination Cohort) X. To explore biomarkers of response and resistance in patients with R/R AML treated with TK216 + decitabine. (Combination Cohort)

OUTLINE: This is a dose-escalation study.

Patients receive TK216 intravenously (IV) continuously on days 1-7 every 21 days, or continuously on days 1-7 and 15-21 every 28 days. Patients also receive decitabine IV over 60 minutes on days 1-10 every 28 days. Treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up for 30 days.

Type d'étude

Interventionnel

Phase

  • La phase 1

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Patients with a diagnosis of histologically confirmed relapsed or refractory (R/R) acute myeloid leukemia for which no available standard therapies are indicated or anticipated to result in a durable response
  • Patients must not have had leukemia therapy for 14 days prior to starting TK216. However, patients with rapidly proliferative disease may receive hydroxyurea as needed until 24 hours prior to starting therapy on this protocol and during the first cycle of study
  • Bilirubin =< 2 mg/dL
  • Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) =< 3 x upper limit of normal (ULN) -- or =< 5 x ULN if related to leukemic involvement
  • Creatinine =< 1.5 x ULN
  • Known cardiac ejection fraction of > or = 45% within the past 3 months
  • Eastern Cooperative Oncology Group (ECOG) performance status of =< 2
  • A negative urine pregnancy test is required within 1 week for all women of childbearing potential prior to enrolling on this trial
  • Patient must have the ability to understand the requirements of the study and signed informed consent. A signed informed consent by the patient or his legally authorized representative is required prior to their enrollment on the protocol

Exclusion Criteria:

  • Pregnant women are excluded from this study because the agent used in this study has the potential for teratogenic or abortifacient effects. Because there is a potential risk for adverse events in nursing infants secondary to treatment of the mother with the chemotherapy agents, breastfeeding should also be avoided
  • Uncontrolled intercurrent illness including, but not limited to active uncontrolled infection, symptomatic congestive heart failure (New York Heart Association [NYHA] class III or IV), unstable angina pectoris, clinically significant cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Patient with documented hypersensitivity to any of the components of the therapy program
  • Patients with active, uncontrolled central nervous system (CNS) leukemia will not be eligible
  • Men and women of childbearing potential who do not practice contraception. Women of childbearing potential and men must agree to use at least 1 form of barrier birth control (such as condom) prior to study entry and for the duration of study participation
  • Patients with known history of serous retinopathy will not be eligible
  • Prior treatment with TK216

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation séquentielle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Group 1 Part 1 TK216: Days 1-7
Patients receive TK216 IV continuously on days 1-7 every 21 days.
Starting Dose: 288 mg/m2 given by vein on Days 1-7 of a 21 day cycle.
Expérimental: Group 2 Part 1 TK216: Days 1-7 and 15-28
Patients receive TK216 IV on days 1-7 and 15-21 every 28 days.
Starting Dose: 144 mg/m2 given by vein on Days 1-7 and 15-21 of a 23 day cycle.
Autres noms:
  • TK-216
  • TK216
Expérimental: Part 2 TK216 + Decitabine 10mg/m2
Patients receive recommended dose of TK216 from Part 1 plus Decitabine.
10mg/m2 by vein on Days 1-10 of a 28 day cycle.
Autres noms:
  • Dacogen
Recommended dose from Part 1.
Expérimental: Part 2 TK216 + Decitabine 20 mg/m2
Patients receive recommended dose of TK216 from Part 1 plus Decitabine.
Recommended dose from Part 1.
20 mg/m2 by vein on Days 1-10 of a 28 dayi cycle.
Autres noms:
  • Dacogen
Expérimental: Expansion Phase: TK216 + Decitabine
All patients in the expansion cohort will receive the RP2D of TK216 and Decitabine.
Expansion cohort will receive the RP2D of TK216
Expansion cohort will receive the RP2D of Decitabine
Autres noms:
  • Dacogen

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Incidence of adverse events
Délai: Up to 30 days
Will be tabulated with frequency and percentage by grade, attribution to treatment, and by dose level/schedule.
Up to 30 days
Response rate
Délai: Up to 30 days
Will be estimated alone with 95% confidence interval.
Up to 30 days
Overall survival
Délai: Up to 1 year
Will be estimated using the Kaplan-Meier method.
Up to 1 year
Disease free survival
Délai: Up to 1 year
Will be estimated using the Kaplan-Meier method.
Up to 1 year
Duration of disease control
Délai: Up to 1 year
Will be estimated using the Kaplan-Meier method.
Up to 1 year

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Tapan Kadia, M.D. Anderson Cancer Center

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Anticipé)

31 mars 2019

Achèvement primaire (Anticipé)

31 décembre 2020

Achèvement de l'étude (Anticipé)

31 décembre 2020

Dates d'inscription aux études

Première soumission

20 novembre 2018

Première soumission répondant aux critères de contrôle qualité

21 novembre 2018

Première publication (Réel)

23 novembre 2018

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

6 mai 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

2 mai 2019

Dernière vérification

1 mai 2019

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • 2018-0495 (Autre identifiant: M D Anderson Cancer Center)
  • P30CA016672 (Subvention/contrat des NIH des États-Unis)
  • NCI-2018-02667 (Identificateur de registre: CTRP (Clinical Trial Reporting Program))

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Oui

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

Essais cliniques sur Group 1: TK216

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