Danvatirsen Monotherapy Followed by Combination With Venetoclax in Relapsed/Refractory MDS & AML

Launched by MONTEFIORE MEDICAL CENTER · Aug 1, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment approach for adults with advanced blood cancers known as relapsed or refractory acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS). The treatment being tested is called Danvatirsen, which will first be given alone and then in combination with another drug called Venetoclax. The goal of the trial is to see if this combination is safe and effective for patients who have not had success with standard treatments.

To be eligible for this trial, participants need to be at least 18 years old and have a confirmed diagnosis of AML or MDS that has not responded to previous therapies. They should also have certain health conditions stable enough to participate, such as not having active infections or severe heart problems. During the trial, participants will receive the study drugs and will be closely monitored by the research team for any side effects or changes in their condition. This trial is currently recruiting participants, so if you or a loved one think you might qualify, it could be an opportunity to access a new treatment option.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Subjects must be at least 18 years of age at the time of signing the Informed Consent Form (ICF); must voluntarily sign an ICF; and be able to meet all study requirements
• • Morphologically confirmed diagnosis of AML or MDS in accordance with World Health Organization (WHO) diagnostic criteria
• • Subjects with relapsed/refractory AML who are refractory or relapsed to all conventional therapy and do not have any FDA approved or standard therapeutic options \& subjects with intermediated/high/very high IPSS-R MDS who are refractory or relapsed to at least 4 cycles of hypomethylating agent based therapy (azacitidine / decitabine based) OR patients with rapid progression of disease regardless of number of cycles of therapy
• • WBC must be \<25,000 and may be reduced with hydroxyurea to reach this goal prior to study start
• • At least 3 months from Allogenic stem cell transportation and no clinical sign of active graft vs host disease (GVHD)
• • A post-consent bone marrow biopsy must be performed and tissue collected for correlative analysis for entrance to this trial. Correlative sample collection will not be optional on this study
• • Subjects must have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
• • Recovery to ≤ Grade 1 or baseline for any toxicities considered to be due to prior systemic treatments, excluding alopecia
• * Must have adequate hepatic and renal function as follows:
• • ALT (SGPT) and/or AST (SGOT) ≤ 3x upper limit of normal (ULN) or ≤ 5x ULN if considered to be leukemia related; Direct bilirubin ≤ 1.5 x ULN or ≤ 3x ULN (in patients with know Gilberts syndrome or if considered to be leukemia related)
• • Serum creatinine clearance ≥ 60 mL/min/1.73 m2 either measured or calculated using standard Cockroft-Gault formula
• Exclusion Criteria:
• • Acute Promyelocytic Leukemia
• • Low or very low risk MDS by IPSS-R after failure/progression of first line therapy with hypomethylating agents
• • Active, uncontrolled infection. Patients with infection under active treatment and controlled with antibiotics are eligible. Use of prophylactic anti-microbials per institutional standards is allowed.
• • Active documented central nervous system (CNS) leukemia. Patients with a known history of CNS leukemia will be eligible if they have at least two most recent consecutive LPs showing clearance of CNS disease and no active/progressive symptoms thought to be related to the CNS disease.
• • Concurrent treatment with a non-permitted concomitant medication (as noted in protocol appendix)
• • Concurrent anticancer treatment, major surgery, or the use of any investigational drug within 14 days before the start of trial treatment
• • Other malignancy currently being treated or likely to need treatment in next 6 months with the exception of basal or squamous cell carcinoma of the skin or cervical carcinoma in situ, surgically removed malignancies or malignancies definitively treated with chemotherapy, XRT and/or surgery with no evidence of active malignancy or not anticipated to need treatment in next 6 months or malignancies on maintenance therapy (e.g. tamoxifen for breast cancer) will be allowed after discussion and approval by both MPIs
• • Pregnant or breastfeeding females
• • Known current alcohol or drug abuse
• • Clinically significant cardiovascular disease within the past 6 months (e.g. percutaneous intervention, coronary artery bypass graft, documented NYHA class III/IV cardiac heart failure, unstable angina or MI, poorly controlled atrial or ventricular arrhythmia) as determined by the investigator
• • Any psychiatric condition that would prohibit the understanding or rendering of informed consent
• • Legal incapacity or limited legal capacity to sign consent and/or participate in the trial
• • Any condition deemed by the investigator to make the patient a poor candidate for clinical trial and/or treatment with investigational agents.
• • Previous exposure to the investigational agent (danvatirsen) or to other STAT3 inhibitors