Trial of DFP-10917 vs Non-Intensive or Intensive Reinduction for AML Patients in 2nd/3rd/4th Salvage

Launched by DELTA-FLY PHARMA, INC. · Apr 23, 2019

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment called DFP-10917 for patients with Acute Myeloid Leukemia (AML) who have not responded to previous treatments. The trial compares DFP-10917, given through a continuous IV infusion for 14 days, to standard reinduction treatments, which may be less intensive or more intensive based on what patients have already received. This study is currently looking for participants aged 18 and older who have had AML that has relapsed or hasn’t improved after two, three, or four prior treatments.

Participants in the trial will be randomly assigned to receive either the new treatment or the standard care. They can expect to be monitored closely by medical staff throughout the study to ensure their safety and well-being. To join, patients must meet certain health criteria, including having a confirmed diagnosis of AML and not having any serious ongoing health issues. It’s also important for participants to understand that they will need to provide informed consent and may need to follow specific guidelines, like using contraception during the trial. This trial is a chance to potentially access a new treatment option while contributing to important medical research.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Histologically or pathologically confirmed diagnosis of AML based on WHO classification that has relapsed after, or is refractory to, two, three, or four prior induction regimens that may have included intensive chemotherapy (e.g., "7+3" cytarabine and daunorubicin), epigenetic therapy (i.e., azacitidine or decitabine), or targeted therapy (e.g., FLT-3, IDH-1/2, BCL-2, monoclonal antibody).
• • (Relapse is defined as reemergence of ≥5% leukemia blasts in bone marrow or ≥1% blasts in peripheral blood ≥90 days after first CR or CR without complete platelet recovery (CRp). Refractory AML is defined as persistent disease ≥28 days after initiation of intensive induction therapy (up to two induction cycles) or relapse \<90 days after first CR or CRp. Refractory disease for patients undergoing hypomethylating agent induction is defined as lack of remission following at least 2 cycles of epigenetic therapy without reduction in bone marrow blast status.)
• • Patients with a history of IPSS-R high or very high risk MDS that transformed to AML during treatment with hypomethylating drugs and then relapse following or are refractory to a subsequent AML induction regimen may be enrolled as Second Salvage AML patients. Additionally, patients with a history of MPN in accelerated phase (MPN-AP) or high-risk primary myelofibrosis (PMF) that transformed to AML during treatment with hypomethylating drugs and then relapse following or are refractory to a subsequent AML induction regimen may be enrolled as Second Salvage AML patients.
• • 2. Aged ≥ 18 years.
• • 3. ECOG Performance Status of 0, 1 or 2.
• • 4. Adequate clinical laboratory values (i.e., plasma creatinine \<2.5 x upper limit of normal (ULN) for the institution, bilirubin \<2.5 x ULN, alanine transaminase (ALT) and aspartate transaminase (AST) ≤2.5 x ULN).
• • 5. Absence of active central nervous system (CNS) involvement by leukemia. Patients with previously diagnosed CNS leukemia are eligible if the CNS leukemia is under control and intrathecal treatment may continue throughout the study.
• • 6. Absence of uncontrolled intercurrent illnesses, including uncontrolled infections, cardiac conditions, or other organ dysfunctions.
• • 7. Signed informed consent prior to the start of any study specific procedures.
• • 8. Women of child-bearing potential must have a negative serum or urine pregnancy test.
• • 9. Male and female patients must agree to use acceptable contraceptive methods for the duration of the study and for at least one month after the last drug administration.
• Exclusion Criteria:
• • 1. The interval from prior treatment to time of study drug administration is \< 2 weeks for cytotoxic agents or \< 5 half-lives for noncytotoxic agents. Exceptions: Use of hydroxyurea is allowed before the start of study and is to be discontinued prior to the initiation of study treatment. At the investigator's discretion, for patients with significant leukocytosis that develops during the early treatment cycles, hydroxyurea may be administered. The hydroxyurea should be discontinued as soon as clinically appropriate.
• • 2. Any \>grade 1 persistent clinically significant toxicities from prior chemotherapy.
• • 3. Inadequate Cardiac (left ventricular ejection fraction ≤40%) function.
• • 4. White blood cell (WBC) count \>15,000/μL (Note: Patients considered for possible venetoclax-containing regimen must have WBC ≤10k/μL prior to initiating venetoclax treatment).
• 5. For patients with prior hematopoietic stem cell transplant (HSCT):
• • 1. Less than 3 months since HSCT
• • 2. Acute Graft versus Host Disease (GvHD) \>Grade 1
• • 3. Chronic GvHD \>Grade 1
• • 6. Any concomitant condition that in the opinion of the investigator could compromise the objectives of this study and the patient's compliance.
• • 7. A pregnant or lactating woman.
• • 8. Current malignancies of another type. Exceptions: Patients may participate if they have previously treated and currently controlled prostate cancer, or adequately treated in situ cervical cancer or basal cell skin cancer, or other malignancies with no evidence of disease for 2 years or more.
• • 9. Patient has acute promyelocytic leukemia (APL).
• • 10. Patients with known HIV, active HBV or active HCV infection (note: testing for these infections is not required). For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.
• • 11. Documented or known clinically significant bleeding disorder.