Study to Evaluate Imetelstat in Patients With High-Risk MDS or AML Failing HMA-based Therapy

Acute Myeloid Leukemia Clinical Trial

— IMpress  

Official title:

A Phase II Study Evaluating the Efficacy and Safety of Imetelstat in Patients With HR Myelodysplastic Syndromes or AML Failing HMA-based Therapy

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05583552
• Other study ID #: IMpress_001
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: June 5, 2023
• Est. completion date: June 2026

Study information

• Verified date: June 2024
• Source: GCP-Service International West GmbH
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the efficacy, in terms of hematologic improvement, and safety of imetelstat in participants with high-risk (HR) myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) that is relapsed/refractory to hypomethylating agents (HMAs) treatment. Responding patients are eligible to continue treatment until loss of response/disease progression.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 23
• Est. completion date: June 2026
• Est. primary completion date: February 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Signed written informed consent
• Male and female = 18 years at the first screening
• Must be able to adhere to the study visit schedule and other protocol requirements
• Initial diagnosis of AML or MDS according to WHO 2016 classification
• At least one cytopenia
• Failure to achieve complete or partial response or hematological improvement observed after at least six azacitidine monotherapy or four decitabine monotherapy based 4-week treatment cycles administered during the past two years OR Failure to achieve complete or partial response or hematological improvement observed after at least two 4-week treatment cycles with azacitidine plus venetoclax or with decitabine plus venetoclax during the past two years OR Relapse after initial complete or partial response or hematological improvement observed after at least six (azacitidine) or four (decitabine) based 4-week treatment cycles administered during the past two years OR Relapse after initial complete or partial response or hematological improvement observed after at least two 4-week treatment cycles with azacitidine plus venetoclax or with decitabine plus venetoclax during the past two years OR Intolerance to treatment with HMA-based therapy during the past two years
• Not eligible for allogeneic stem cell transplantation
• = 5% bone marrow blasts at screening
• Off all other treatments for AML/MDS for at least 14 days; granulocyte colony-stimulating factor (G-CSF) and erythropoietin are allowed before and during the study as clinically indicated
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
• Biochemical laboratory test values must be within the defined limits.
• Availability of blood counts and transfusion events for previous 16 weeks
• Women of childbearing potential and practicing a highly effective method of birth control consistent with local regulations regarding the use of birth control methods for subjects participating in clinical studies. For females, these restrictions apply for 3 months after the end of dosing.
• A woman of childbearing potential must have a negative serum or urine pregnancy test at screening and agree to be tested on day 1 of every cycle and at End of Treatment (EOT)
• A man who is sexually active with a woman of childbearing potential and has not had a vasectomy must agree to use a barrier method of birth control. For males, these restrictions apply for 3 months after the end of dosing

Exclusion Criteria:

• Chemotherapy within the 14 days prior to the first dose of imetelstat being administered (other than hydroxyurea)
• Participant has known allergies, hypersensitivity, or intolerance to imetelstat or its excipients (refer to the Investigators Brochure (IB))
• Participant has received an experimental or investigational drug or used an invasive investigational medical device within 30 days prior to day 1 of Cycle 1
• Prior treatment with imetelstat
• Prior history of intensive chemotherapy or hematopoietic stem cell transplant
• Major surgery within 4 weeks prior to day 1 of Cycle 1 (excluding the placement of vascular access and other minor surgical procedures)
• Diagnosed or treated for malignancy other than MDS or AML, except:

Malignancy treated with curative intent and with no known active disease present for 3 years before day 1 of Cycle 1 Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease Adequately treated cervical carcinoma in situ without evidence of disease

• Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of day 1 of Cycle 1, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification
• Known history of human immunodeficiency virus (HIV) or any uncontrolled active systemic infection requiring IV antibiotics
• Active systemic hepatitis infection requiring treatment (carriers of hepatitis virus are permitted to enter the study), or known acute or chronic liver disease including cirrhosis
• Any life-threatening illness, medical condition, or organ system dysfunction which, in the investigator's opinion, could compromise the participant 's safety, interfere with the imetelstat metabolism, or put the study outcomes at undue risk; Participant has any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg, compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments
• Females who are pregnant or are currently breastfeeding or planning to become pregnant while enrolled in this study or within 3 months after the end of dosing
• Participant is a man who plans to father a child while enrolled in this study or within 3 months after the end of dosing
• Other:

Participant is in custody by order of an authority or a court of law Participation in another interventional clinical study within the last 3 months prior to signing the Informed consent form (ICF) or simultaneous participation in other interventional clinical studies Previous assignment to treatment during this study Close affiliation with the investigator (e.g., a close relative) or persons working at the study site Participant is an employee of the sponsor or involved Contract Research Organization (CRO) Criteria which in the opinion of the investigator preclude participation for scientific reasons, for reasons of compliance, or for reasons of the Participant's safety

Related Conditions & MeSH terms

• Acute Myeloid Leukemia
• Myelodysplastic Syndromes
• Preleukemia
• Syndrome

Intervention

Drug:
• Imetelstat
Intravenous injection

Locations

Country	Name	City	State
Australia	Royal Adelaide Hospital	Adelaide
Australia	Royal Brisbane and Women's Hospitals	Brisbane
Australia	Royal Hobart Hospital	Hobart
Australia	Linear Clinical Research	Nedlands
France	CHU Nantes - Hôtel Dieu	Nantes
France	Hôpital Archet 1	Nice
France	Hôpital Saint-Louis	Paris
France	CHU de Toulouse	Toulouse
Germany	Marien Hospital Düsseldorf	Düsseldorf
Germany	Universität Jena, Medizinische Fakultät	Jena
Germany	Universität Leipzig, Medizinische Fakultät	Leipzig
Germany	Klinikum rechts der Isar	München

Sponsors (8)

Lead Sponsor	Collaborator
GCP-Service International West GmbH	Australasian Leukaemia and Lymphoma Group, German Myelodysplastic Syndrome Study Group, Geron Corporation, Groupe Francophone des Myelodysplasies, QIMR Berghofer Medical Research Institute, Saint-Louis Hospital, Paris, France, Universitätsklinikum Leipzig

Countries where clinical trial is conducted

Australia,  France,  Germany, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall Hematological Response Rate of Participants after Treatment with Imetelstat	The combined response assessment criteria for MDS and AML based on IWG 2018 criteria (MDS) and the criteria of the European LeukemiaNet (AML) will be used to define responders.; The response rate is calculated as number of responders divided by the number of all participants of the analysis set.	After 4 Months of Treatment