Dose Escalation/ Expansion Study of CA-4948 as Monotherapy in Patients With Acute Myelogenous Leu… (NCT04278768) | Clinical Trial Compass
SuspendedPhase 1/2
Dose Escalation/ Expansion Study of CA-4948 as Monotherapy in Patients With Acute Myelogenous Leukemia (AML) or Myelodysplastic Syndrome (MDS)
Stopped: Dosing completed in all cohorts. Planning underway for potential additional patient cohorts.
United States366 participantsStarted 2020-07-06
Plain-language summary
This is a multicenter, open-label, Phase 1/2a dose escalation and expansion study of orally administered emavusertib (CA-4948) monotherapy in adult patients with AML or higher- risk Myelodysplastic Syndrome (hrMDS).
Patients enrolling in the Phase 1 dose escalation of the study must meet one of the following criteria prior to consenting to the study:
* Relapse/refractory (R/R) AML with FMS-like tyrosine kinase-3 (FLT3) mutations who have been previously treated with a FLT3 inhibitor
* R/R AML with spliceosome mutations of splicing factor 3B subunit 1 (SF3B1) or U2AF1
* R/R hrMDS with spliceosome mutations of SF3B1 or U2 small nuclear RNA auxiliary factor 1 (U2AF1)
* Number of pretreatments: 1 or 2
The Phase 2a Dose Expansion will be in 3 Cohorts of patients:
1. R/R AML with FLT3 mutations who have been previously treated with a FLT3 inhibitor;
2. R/R AML with spliceosome mutations of SF3B1 or U2AF1; and
3. R/R hrMDS (Revised International Prognostic Scoring System \[IPSS-R\] score \> 3.5) with spliceosome mutations of SF3B1 or U2AF1.
All patients above have had ≤ 2 lines of prior systemic anticancer treatment. In previous versions of this protocol there was a Phase 1b portion of the study, in which patients with AML or hrMDS received CA-4948 in combination with venetoclax. This part of the study is no longer open for enrollment.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
✓. Males and females ≥18 years of age
✓. Life expectancy of at least 3 months
✓. Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤1
✓. Cytomorphology based confirmed diagnosis of MDS or AML (as per World Health Organisation \[WHO\] 2016 classification) with the following characteristics.
✓. Acceptable organ function at screening
✓. Ability to swallow and retain oral medications
✓. Negative serum pregnancy test in women of childbearing potential
✓. Women of childbearing potential and men who partner with a woman of childbearing potential must agree to use highly effective contraceptive methods for the duration of the study and for 180 days after the last dose of emavusertib
Exclusion criteria
✕. Diagnosed with acute promyelocytic leukemia (APL, M3)
What they're measuring
1
Determine Maximum Tolerated Dose (MTD) of emavusertib (CA-4948) monotherapy (Phase 1)
Timeframe: 28 days
2
Determine the Recommended Phase 2 Dose (RP2D) of emavusertib monotherapy (Phase 1)
Timeframe: 24 months
3
Determine Maximum Tolerated Dose (MTD) of emavusertib in combination with venetoclax (Phase 1b)
Timeframe: 28 days
4
Determine the Recommended Phase 2 Dose (RP2D) of emavusertib in combination with venetoclax (Phase 1b)
Timeframe: 24 months
5
To assess anti-cancer activity (Phase 2a - AML patients)
Timeframe: 24 months
6
To assess anti-cancer activity (Phase 2a - hrMDS patients)
. Has known active central nervous system (CNS) leukemia
✕. Allogeneic hematopoietic stem cell transplant (Allo-HSCT) within 60 days of the first dose of emavusertib, or clinically significant graft-versus-host disease (GVHD) requiring ongoing up titration of immunosuppressive medications prior to start of emavusertib
✕. Chronic myeloid leukemia (CML)
✕. Any prior systemic anti-cancer treatment such as chemotherapy, immunomodulatory drug therapy, etc., received within 3 weeks (or 5 half-lives) prior to start of emavusertib.
✕. Use of any investigational agent within 3 weeks or 5 half-lives, whichever is shorter, prior to start of emavusertib
✕. Presence of an acute or chronic toxicity resulting from prior anti-cancer therapy, with the exception of alopecia that has not resolved to Grade ≤ 1 within 7 days prior to start of emavusertib.
✕. Known allergy or hypersensitivity to any component of the formulation of emavusertib