Blincyto Amgen Acrotech BioPharma PH2 Blincyto Marqibo R/R Philadelphi CD19+ ALL

B-cell Acute Lymphoblastic Leukemia Clinical Trial

Official title:

A Phase 2 Single Arm, Multicenter Trial to Evaluate the Efficacy of the BiTE® Antibody Blinatumomab (Blincyto) and Vincristine Sulfate Liposomal Injection (Marqibo) in Adult Subjects With Relapsed/Refractory Philadelphia Negative CD19+ Acute Lymphoblastic Leukemia

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT04448834
• Other study ID #: Pro00104913
• Status: Withdrawn
• Phase: Phase 2
• Start date: January 2022
• Est. completion date: June 1, 2023

Study information

• Verified date: February 2022
• Source: Duke University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Hypotheses: The Investigator hypothesizes that targeting ALL cells with 2 different modalities, ie liposomal vincristine sulfate as a microtubule inhibitor and blinatumomab as a BITE immuno-oncology therapy, will have at least additive benefits and allow an effective, safe therapeutic option for patients. Further, the Investigator hypothesizes that the combination will result in a high rate of response and thus allow enhanced immunologic recovery.

Primary Objectives To evaluate whether the combination will result in a median progression-free survival (PFS) of at least 1 year.

To evaluate if the complete remission/complete remission with incomplete hematological recovery (CR/CRi*) rate is ≧ 75% following 2 cycles in adult subjects with R/R Ph- ALL and duration of remission Secondary Objectives To evaluate the rate of Minimal Residual Disease (MRD) and duration To evaluate the proportion of patients who are able to progress to allogeneic transplantation To evaluate the safety of blinatumomab and liposomal vincristine sulfate in combination To evaluate the effect of the combination and response on measures of immune reconstitution

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: June 1, 2023
• Est. primary completion date: June 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients with Ph-, CD19+ ALL, with any of the following:

• Relapsed or refractory to at least 2 prior regimens = 5% blasts in the bone marrow or peripheral blood or persistent extranodal/marrow site (such as skin).

• Eastern Cooperative Oncology Group (ECOG) performance status = 2

• Age = 18 years of age, at the time of informed consent.

• Subject has provided informed consent. Those unable to provide consent for themselves will not be eligible.

• Pts may have been exposed to either agent in the past if they had at least 6 months of response from start of therapy AND it has been at least 6 months since their last dose of either agent.

Exclusion Criteria:

• History of malignancy other than ALL within 3 years prior to start of protocol-required therapy with the exception of:

• Malignancy treated with curative intent and with no known active disease present for 2 years before enrollment and felt to be at low risk for recurrence by the treating physician

• Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease

• Adequately treated cervical carcinoma in situ without evidence of disease

• Adequately treated breast ductal carcinoma in situ without evidence of disease

• Prostatic cancer without evidence of progression for 1 year.

• History or presence of clinically relevant CNS pathology as adult seizures, recent stroke (within 1 year), severe brain injuries, Parkinson's disease, psychosis

• With the exception of CNS leukemia that is well controlled with therapy prior to enrolling on this study. A negative CNS evaluation for active disease is required within 3 months of enrollment in those with prior history within one year of active CNS disease .

• Current severe autoimmune disease or history of autoimmune disease with potential CNS involvement such as lupus, sjogren's, psoriasis, multiple sclerosis, wegener's granulomatosis.

• Allogeneic HSCT within 12 weeks prior to start of blinatumomab/marqibo

• Any active acute Graft-versus-Host Disease (GvHD) grade 2 to grade 4 according to the Glucksberg criteria or active chronic GvHD requiring systemic treatment of more than 10 mg prednisone daily (or equivalent)

• Cancer chemotherapy or immunotherapy within 2 weeks prior to start of blinatumomab/marqibo. Administration of dexamethasone and hydrea permitted within the 21 day screening period.

Subject received prior anti-CD19 therapy ARE eligible however if they received prior blinatumomab, however they are ineligible if they did not have a response to it lasting at least 6 months; also they are ineligible if they had exposure to blinatumomab within 6 months of starting therapy on this study.

• Abnormal screening laboratory values as defined below:

• AST (SGOT) and/or ALT (SGPT) and/or alkaline phosphatase = 5 x upper limit of normal (ULN)

• Total bilirubin = 3 x ULN (unless related to Gilbert´s or Meulengracht disease)

• Creatinine = 3 ULN or creatinine clearance < 40 mL/min (calculated)

• Known infection with human immunodeficiency virus (HIV) or chronic active infection with hepatitis B virus (PCR positive) or hepatitis C virus (PCR positive).

• Subject is pregnant or breast feeding

• Woman of childbearing potential and is not willing to use 2 highly effective methods of contraception while receiving blinatumomab/marqibo and for an additional 3 months after the last dose of protocol-specified therapy

• Male who has a female partner of childbearing potential, and is not willing to use 2 highly effective forms of contraception for at least an additional 3 months after the last dose of protocol-specified therapy

• Male who has a pregnant partner, and is not willing to use a condom during sexual activity for 3 months after the last dose of protocol-specified therapy

• Currently receiving treatment in another investigational device or drug study or less than 30 days since ending treatment on another investigational device or drug study(s). The 30 days is calculated from day 1 of blinatumomab treatment.

• Subject has known severe sensitivity to immunoglobulins or any of the products or components to be administered during dosing.

• History or evidence of any other clinically significant disorder, condition or disease (with the exception of those outlined above) that, in the opinion of the Investigator, would pose a risk to subject safety or interfere with the study evaluation, procedures or completion.

Related Conditions & MeSH terms

• B-cell Acute Lymphoblastic Leukemia
• Leukemia
• Leukemia, Lymphoid
• Precursor Cell Lymphoblastic Leukemia-Lymphoma

Intervention

Drug:
• Blinatumomab
liposomal vincristine 2.25 mg/m2 weekly x 3 per cycle (weeks 3-5 in cycle 1 and 2-4 in subsequent cycles)

Locations

Country	Name	City	State
United States	Duke University	Durham	North Carolina
United States	Moffitt Cancer Center	Tampa	Florida
United States	Novant Health Cancer Institute and Innovation Center	Winston-Salem	North Carolina

Sponsors (3)

Lead Sponsor	Collaborator
Dorothy Sipkins, MD, PhD	Acrotech Biopharma LLC, Amgen

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Progression-free survival (PFS)	patient report	At 1 year
Primary	Complete remission/complete remission with incomplete hematological recovery (CR/CRi*) rate	lab reports	End of Cycle 2 (1 cycle is 6 weeks in duration)
Secondary	Minimal Residual Disease (MRD) and duration	Flow Measurement	End of Cycle 2 (1 cycle is 6 weeks in duration)
Secondary	Minimal Residual Disease (MRD) and duration	Flow Measurement	End of Therapy (up to 58 weeks)
Secondary	Proportion of patients able to progress to allogeneic transplantation	Investigator reported	End of study (up to 58 weeks)
Secondary	Safety of blinatumomab and liposomal vincristine sulfate in combination, as measured by rate of toxicity	Investigator report of toxicities	Through all cycles of therapy (up to 58 weeks)
Secondary	Immune reconstitution, as measured by the immune reconstitution panel	immune reconstitution panel	End of study (up to 58 weeks)