Expanded Access Study of Gilteritinib (ASP2215) in Patients With FMS-like Tyrosine Kinase 3 (FLT3) Mutated Relapsed or Refractory Acute Myeloid Leukemia (AML) or FLT3-Mutated AML in Complete Remission (CR) With Minimal Residual Disease (MRD)

Acute Myeloid Leukemia (AML) Clinical Trial

Official title:

A Multicenter, Open-label Treatment Protocol of Gilteritinib (ASP2215) in Patients With FMS-like Tyrosine Kinase 3 (FLT3) Mutated Relapsed or Refractory Acute Myeloid Leukemia (AML) or FLT3-Mutated AML in Complete Remission (CR) With Minimal Residual Disease (MRD)

Clinical Trial Details — Status: Approved for marketing

Administrative data

• NCT number: NCT03070093
• Other study ID #: 2215-CL-9100
• Status: Approved for marketing

Study information

• Verified date: April 2021
• Source: Astellas Pharma Inc
• Contact: n/a
• Is FDA regulated: No
• Study type: Expanded Access

Clinical Trial Summary

The purpose of this study is to provide expanded access to ASP2215 for subjects with FLT3-mutated relapsed or refractory AML or FLT3-mutated AML in composite complete remission (CRc) (complete remission [CR], complete remission with incomplete hematologic recovery [CRi], complete remission with incomplete platelet recovery [CRp]) with MRD without access to comparable or alternative therapy.

Description:

The United States Food and Drug Administration (FDA), the Japanese Ministry of Health, Labour and Welfare (MHLW) and Health Canada have approved ASP2215/Gilteritinib (XOSPATA®) for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FLT3 mutation.

This treatment protocol is being conducted while phase 3 ASP2215 studies are ongoing in FLT3-mutated AML subjects.

Subjects will complete visits on cycle 1 - days 1, 4, 8, 15; cycle 2 - days 1, 15; cycles 3 to 6 - day 1; and day 1 of every 2 cycles thereafter (i.e., cycle 8 day 1, cycle 10 day 1, etc.) until discontinued from the study.

Subjects will be provided with study medication until the investigator determines the subject is no longer receiving clinical benefit.

An end of treatment visit will be performed within 7 days after last dose of investigational product (ASP2215), or prior to initiation of another anticancer therapy, whichever occurs earlier, followed by a 30-day follow-up. [Specific to investigational sites in Japan: Study population does not include subjects with FLT3-mutated AML in CRc (CR, CRi, CRp) with MRD. Hence, efficacy (MRD response rate and duration of response) data will not be collected for subjects enrolled in Japan.]

Recruitment information / eligibility

• Status: Approved for marketing
• Enrollment: 0
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Subject is considered an adult according to local regulation at the time of signing informed consent.

• Subject has a diagnosis of primary AML or AML secondary to myelodysplastic syndrome (MDS) or therapy-related AML according to World Health Organization (WHO) classification.

• Subject has presence of the FLT3-mutated relapsed or refractory AML or FLT3-mutated AML in CRc (CR, CRi, CRp) with MRD in bone marrow or peripheral blood. [Specific to investigational sites in Japan: FLT3-mutated AML in CRc (CR, CRi, CRp) with MRD subjects will not be included.]

• Subject has refractory or relapsed AML (with or without hematopoietic stem cell transplant [HSCT]) or AML in CRc (CR, CRi, CRp) with MRD by flow cytometry or genetic testing for the FLT3 mutation after induction/consolidation regimen or HSCT. [Specific to investigational sites in Japan: FLT3-mutated AML in CRc (CR, CRi, CRp) with MRD subjects will not be included.]

• Subject must wait for at least 5 half-lives after stopping therapy with any investigational agent and before starting ASP2215.

• Subject must meet the following criteria as indicated on clinical laboratory tests:

• Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) = 3x institutional upper limit of normal (ULN)

• Serum total bilirubin = 2.5 mg/dL, except for subjects with Gilbert's syndrome

• Serum potassium and serum magnesium = institutional lower limit of normal (LLN).

• Subject is able to tolerate oral administration of study drug.

• Subject who has developed overall grades II-IV acute graft-versus-host disease (GVHD) must satisfy the following criteria:

• No requirement of > 0.5 mg/kg of prednisone (or equivalent) daily dose within 1 week of enrollment

• No escalation of immunosuppression in terms of increase of corticosteroids or addition of new agent/modality in prior 2 weeks (note that increasing calcineurin inhibitors or sirolimus to achieve therapeutic trough levels is allowed)

• Female subject must either:

• Be of nonchildbearing potential:

• Postmenopausal (defined as at least 1 year without any menses) prior to screening, or

• Documented surgically sterile (e.g., hysterectomy, bilateral salpingectomy, bilateral oophorectomy) at least 1 month prior to screening.

• Or, if of childbearing potential,

• Agree not to try to become pregnant during the study and for at least 180 days after the final study drug administration

• And have a negative urine pregnancy test at screening

• And, if heterosexually active, agree to use consistently 2 forms of effective contraception per locally accepted standards (1 of which must be a barrier method) starting at screening and throughout the study period and for at least 180 days after the final study drug administration.

• Female subject must agree not to breastfeed or donate ova starting at screening and throughout the study period, and for at least 180 days after the final study drug administration.

• Male subject (even if surgically sterilized) and partners who are women of childbearing potential must agree to practice 2 forms of effective contraception per locally accepted standards

(1 of which must be a barrier method), starting at screening and throughout the study period and for 120 days after the final study drug administration.

• Male subject must not donate sperm starting at screening and throughout the study period and for 120 days after the final study drug administration.

• Subject agrees not to participate in another interventional study for AML while on treatment.

• Subject who has a diagnosis of HIV may be enrolled as long as the disease is under control on antiretroviral therapy. Precautions should be taken to modify highly active antiretroviral therapy (HAART) regimen to minimize drug interactions.

• There is no comparable or satisfactory alternative therapy to treat the subject's AML.

Exclusion Criteria:

• Subject is eligible to participate in an ongoing clinical study of ASP2215; or has previously participated in a randomized clinical study of ASP2215 with a primary endpoint of overall survival that is not closed for efficacy.

• Subject with QTcF > 450 ms at screening based on local reading.

• Subject with a known history of Long QT Syndrome at screening.

• Subject was diagnosed with acute promyelocytic leukemia (APL).

• Subject has BCR-ABL-positive leukemia (chronic myelogenous leukemia in blast crisis).

• Subject has clinically significant coagulation abnormality unless secondary to AML.

• Subject has active hepatitis B or C or an active hepatic disorder.

• Subject has uncontrolled angina, severe uncontrolled ventricular arrhythmias, electrocardiographic evidence of acute ischemia, or New York Heart Association (NYHA) Class IV heart failure.

• Subject requires treatment with concomitant drugs that are strong inducers of CYP3A.

• Subject has any condition which makes the subject unsuitable for study participation.

• Subject has hypersensitivity to any of the study drug components.

Related Conditions & MeSH terms

• Acute Myeloid Leukemia (AML)
• FMS-like Tyrosine Kinase-3 (FLT3) Mutations
• Leukemia
• Leukemia, Myeloid
• Leukemia, Myeloid, Acute
• Neoplasm, Residual

Intervention

Drug:
• gilteritinib
oral

Locations

Country	Name	City	State
Canada	Site CA15002	Halifax	Nova Scotia
Canada	Site CA15001	Montreal	Quebec
Canada	Site CA15003	Toronto	Ontario
Canada	Site CA15005	Vancouver
Japan	Site JP81003	Fukuoka
Japan	Site JP81001	Nagoya	Aichi
Japan	Site JP81002	Shinagawa-ku	Tokyo
United States	New Mexico Cancer Care Alliance	Albuquerque	New Mexico
United States	Northside Hospital	Atlanta	Georgia
United States	Georgia Cancer Center at Augusta University	Augusta	Georgia
United States	Rocky Mountain Cancer Center-M	Aurora	Colorado
United States	Johns Hopkins Hospital	Baltimore	Maryland
United States	The Sidney Kimmel Comprehensive Cancer Center -Johns Hopkins University	Baltimore	Maryland
United States	University of Maryland Medical Center	Baltimore	Maryland
United States	Beth Israel Deaconess Medical Center	Boston	Massachusetts
United States	Dana Farber Cancer Institute	Boston	Massachusetts
United States	Massachusetts General Hospital	Boston	Massachusetts
United States	Roswell Park Cancer Institute	Buffalo	New York
United States	Northwestern University Medical Center	Chicago	Illinois
United States	University of Chicago	Chicago	Illinois
United States	Ohio State University	Columbus	Ohio
United States	Duke University Medical Center	Durham	North Carolina
United States	Penn State Hershey Medical Center	Hershey	Pennsylvania
United States	Indiana Blood and Marrow Transplantation at Franciscan Health Indianapolis	Indianapolis	Indiana
United States	West Michigan Regional Cancer Center	Kalamazoo	Michigan
United States	UCLA	Los Angeles	California
United States	Norton Cancer Institute	Louisville	Kentucky
United States	WVU Medicine Cancer	Morgantown	West Virginia
United States	Vanderbilt University	Nashville	Tennessee
United States	Tulane University	New Orleans	Louisiana
United States	Memorial Sloan Kettering	New York	New York
United States	Weill Cornell Medical College	New York	New York
United States	Memorial Healthcare System	Pembroke Pines	Florida
United States	Thomas Jefferson University	Philadelphia	Pennsylvania
United States	UPCI	Pittsburgh	Pennsylvania
United States	Providence Portland Medical Center	Portland	Oregon
United States	Washington University School of Medicine	Saint Louis	Missouri
United States	Huntsman Cancer Institute University of Utah	Salt Lake City	Utah
United States	Wake Forest Baptist Hospital	Winston-Salem	North Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Astellas Pharma Global Development, Inc.

Countries where clinical trial is conducted

United States,  Canada,  Japan,