A Phase I-II Open Label Non-Randomized Study Using TL32711 for Patients With Acute Myelogenous Leukemia, Myelodysplastic Syndrome and Acute Lymphoblastic Leukemia

Abramson Cancer Center at Penn Medicine

Status and phase: Terminated; Phase 2; Phase 1

Conditions: Acute Myelogenous Leukemia

Treatments: Drug: Birinapant

Study type: Interventional

Funder types: Other

Identifiers

NCT01486784

UPCC 15411

Details and patient eligibility

About

This was initially a phase I/II, open-label non-randomized study using an investigational new drug, TL32711, in patients with AML, MDS and ALL, however, the phase II portion was never initiated. This study initially targeted subjects 60 years of age and older (with non-M3 AML who have relapsed or refractory disease after standard therapy or who are newly diagnosed and subjects 18-59 (relapsed or refractory after failing 3 prior lines of therapy), and then targeted subjects 18 years of age and older with MDS and ALL.

Full description

This was initially a phase I/II, open-label, non-randomized study using an investigational new drug, TL 32711, in patients with acute myelogenous leukemia. This study targeted subjects 60 years of age and older (with non-M3 AML who have relapsed or refractory disease after standard therapy or who are newly diagnosed and not candidates for standard induction therapy) and subjects 18-59 (relapsed or refractory after failing 3 prior lines of therapy). Subjects would receive the study drug in 4 weeks dosing periods via one of three different treatment schedules (once weekly, twice weekly or three times weekly dosing). They would receive treatment for up to 6 cycles, however treatment may have been extended at the discretion of the study doctor if felt to be in the best interest of the subject. Up to 46 subjects were to be enrolled on this study at the University of Pennsylvania, depending on the number of subjects needed in the Phase I component in order to determine the MTD. The primary objective of the Phase 1 component was to determine the safety and tolerability of TL32711, and the MTD in this patient population. The primary objective of the Phase 2 portion of this study was to further define the safety and tolerability, and provide preliminary efficacy data, however, the Phase II portion was never initiated.

Enrollment: 27 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria

• Subjects with a diagnosis of non-M3 AML, Relapsed or refractory ALL or Intermediate Risk 2 or High Risk disease MDS as follows:

• Subjects with a diagnosis of non-M3 AML which meets one of the following criteria:

  1. Ages 60 or older: Relapsed or refractory after at least one prior therapy for AML
  2. Ages 60 or older: Newly diagnosed in a patient with a preceding history of myelodysplastic syndrome which has been treated with azacitidine or decitabine and who are not appropriate candidates for aggressive therapy including induction followed by allogeneic stem cell transplantation
  3. Ages 18-59: Relapsed or refractory disease after failing three prior lines of therapy

• Subjects with a diagnosis of relapsed or refractory ALL: must have failed three prior lines of therapy and be 18 years of age or older.

• Subjects with a diagnosis of Intermediate Risk 2 or High Risk disease (as defined by IPSS score):

  1. Must have failed to respond/intolerant to, or progressed after a hypomethylating agent, and must not be candidates for allogeneic stem cell transplantation
  2. Life expectancy of at least 4 weeks
  3. Must have recovered from toxic effects of prior chemotherapy
  4. Patients must be able to sign consent and be willing and able to comply with scheduled visits, treatment plan and laboratory testing.

Exclusion criteria

• Cytotoxic chemotherapy (including azacitidine or decitabine) within the past 28 days other than hydroxyurea
• Active participation in any other investigational treatment study for AML.
• ECOG performance status greater than 2
• Uncontrolled intercurrent illness including, but not limited to: uncontrolled ongoing infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
• QT interval corrected for heart rate (QTcB) greater than 480 msec (including subjects on medication). Subjects with a ventricular pacemaker for whom QT interval is not measurable may be eligible for enrollment after consultation with the drug manufacturer and study Medical Monitor, and written documentation of this approval.
• Female subjects who are pregnant or breastfeeding

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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27 participants in 6 patient groups

Phase 1 DL1

Experimental group

Description:

26mg/m2/dose IV once per week x 3 weeks of 4 week cycle

Treatment:

Drug: Birinapant

Phase 1 DL-1

Experimental group

Description:

17mg/m2 IV/dose once per week x 3 weeks of 4 week cycle

Treatment:

Drug: Birinapant

Phase 1 DL-1a

Experimental group

Description:

17mg/m2/dose IV twice per week x 3 weeks of 4 week cycle

Treatment:

Drug: Birinapant

Phase 1 DL-1b

Experimental group

Description:

17mg/m2/dose IV three times per week x 3 weeks of 4 week cycle

Treatment:

Drug: Birinapant

Phase 1 DL-1c

Experimental group

Description:

22mg/m2/dose IV twice per week x 3 weeks of 4 week cycle

Treatment:

Drug: Birinapant

Phase 1 DL-1d

Experimental group

Description:

17mg/m2/dose IV twice per week x 3 weeks of 4 week cycle

Treatment:

Drug: Birinapant