Acute Myeloid Leukemia Clinical Trial
Official title:
A Phase II Open-label Study of the Efficacy and Safety of Recombinant Human Arginase 1 (PEG-BCT-100) in Patients With Relapsed or Refractory Acute Myeloid Leukemia
To evaluate the efficacy of PEG-BCT-100 in patients with relapsed or refractory acute myeloid leukemia (AML) in terms of remission rate.
This is a phase 2, non-randomised, open-label study that aims at evaluating the efficacy of
single agent PEG-BCT-100 in adult patients with relapsed/refractory AML. Eligible patients
will receive intravenous (IV) infusion of PEG-BCT-100 weekly until disease progression,
unacceptable drug-related toxicity(ies), allogeneic haematopoietic stem cell transplantation
or withdrawal of subject consent.
Pharmacokinetic (PK) of PEG-BCT-100 and pharmacodynamics (PD) activity of PEG-BCT-100 on
arginine depletion will be evaluated throughout the study. Plasma arginine level,
intracellular blast arginine level (IBAL) in peripheral blood (PB) and bone marrow (BM) will
be measured at specific time points. PEG-BCT-100 will be given once weekly at 1600 Units/kg
(2.7mg/kg) per dose for three weeks (Cycle 1). If the post-treatment IBAL-BM examined within
5 days prior to each cycle fails to drop at least 70% from baseline value and disease
response fails to achieve complete remission (CR) or complete remission with incomplete blood
count recovery (CRi), PEG-BCT-100 may be increased to 2500 U/kg (the maximum tolerated dose
as reported previously) at investigator's discretion. Disease response will be assessed
within 5 days prior to each cycle according to the International Working Group (IWG) AML
Response Criteria.
Safety and toxicity will be assessed through physical examinations, vital signs, blood tests
and urinalysis throughout the study. Adverse event (AE) and serious adverse events (SAE) will
be reported according to the National Cancer Institute Common Toxicity Criteria for Adverse
Events version 4.03 (CTCAE v4.03) until 28 days after the last dose of PEG-BCT-100.
Immunogenicity response including anti-drug antibody (ADA) level and neutralizing antibody
level will be assessed weekly for the first 2 cycles of PEG-BCT-100, pre-dose of each cycle
thereafter and End of Study (EoS). Specific response predictive biomarkers in circulating and
BM blasts, and emerging genetic markers will also be explored in the study.
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