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

Acute Myeloid Leukemia Clinical Trial

Official title:

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

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04953780
• Other study ID #: 2157GCCC ; HP-00096801
• Status: Active, not recruiting
• Phase: Phase 1
• Start date: September 27, 2021
• Est. completion date: December 31, 2025

Study information

• Verified date: March 2024
• Source: University of Maryland, Baltimore
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

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).

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 6
• Est. completion date: December 31, 2025
• Est. primary completion date: December 31, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

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

Related Conditions & MeSH terms

• Acute Myeloid Leukemia
• Leukemia
• Leukemia, Myeloid
• Leukemia, Myeloid, Acute

Intervention

Drug:
• Calaspargase pegol-mknl
Calaspargase pegol-mknl

Locations

Country	Name	City	State
United States	Greenebaum Cancer Center, University of Maryland Medical Systems	Baltimore	Maryland

Sponsors (1)

Lead Sponsor	Collaborator
University of Maryland, Baltimore

Country where clinical trial is conducted

United States, 

References & Publications (33)

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* Note: There are 33 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Exploratory Endpoint 1	Measurement of asparagine synthetase mRNA and protein expression in patients who have refractory disease or develop relapse	After the enrollment of the study subjects
Other	Exploratory Endpoint 2	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
Other	Exploratory Endpoint 3	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
Other	Exploratory Endpoint 4	Tissue banking for further molecular and functional testing in the future	After the enrollment of the study subjects
Primary	Primary Outcome Measure	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	1. CR+CRh+CRi	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
Secondary	2. The duration of CR/CRh/CRi.	The duration of Complete remission (CR) / complete remission with partial hematologic recovery (CRh) / complete remission with incomplete count recovery (CRi)	immediately after the intervention
Secondary	3. Achievement of MRD <0.02% at the end of Induction therapy with Calaspargase pegol-mknl.	Achievement of MRD <0.02% at the end of Induction therapy with Calaspargase pegol-mknl.	During the intervention
Secondary	4. Event-free survival (EFS).	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
Secondary	5. Overall survival (OS)	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
Secondary	6. Proceeding to allo-HSCT after Calaspargase pegol-mknl treatment	Proceeding to allo-HSCT after Calaspargase pegol-mknl treatment	Immediately after the intervention
Secondary	7. Plasma asparagine and glutamine and other amino acids levels 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
Secondary	8.Plasma asparaginase activity 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