Dose-escalation Study of Oral Administration of S 055746 in Patients With Acute Myeloid Leukaemia or Myelodysplastic Syndrome

Servier

Status and phase

Completed

Phase 1

Conditions

Myelodysplastic Syndrome (MDS)

Acute Myeloid Leukaemia (AML)

Treatments

Drug: S 055746

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT02920541

2014-002559-24 (EudraCT Number)

CL1-055746-002

ISRCTN73586707 (Registry Identifier)

Details and patient eligibility

About

The purpose of this study is to determine the safety profile and tolerability of S 055746 in patients with AML, and high or very high risk MDS, in terms of Dose-Limiting Toxicities (DLTs), Maximum Tolerated Dose (MTD) and determine the Recommended Phase 2 Dose (RP2D) through safety profile (DLT, MTD), PK profile, PD profile and preliminary efficacy.

Enrollment

48 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Women or men aged >= 18 years
Patients with cytologically confirmed and documented de novo, secondary or therapy-related AML excluding acute promyelocytic leukaemia:
- with relapsed or refractory disease or
- > or = 65 years not previously treated for AML, who are not candidates for intensive chemotherapy or not candidates for standard chemotherapy
Patients with cytologically confirmed and documented MDS or non proliferative Chronic Myelomonocytic Leukaemia (CMML) in relapse or refractory after previous treatment line including at least one hypomethylating agent therapy:
- with high or very high risk MDS and without established alternative therapy
- transformed to AML and without established alternative therapy
Ability to swallow oral tablet(s)
World Health Organization (WHO) performance status 0-2
Circulating white blood cells < or = 30 x 10^9 /L and < or = 13 x10^9 for non proliferative CMML
Adequate renal and hepatic functions
Negative serum pregnancy test within 7 days prior to the first day of study drug administration
Patients must use effective contraception
Written informed consent

Exclusion criteria

Foreseeable poor compliance to the study procedures
Legally incapacitated person under guardianship or trusteeship
Pregnant or breast-feeding women
Participation in therapeutic interventional study involving investigational drug intake at the same time or within 2 weeks or at least 5 half-lives or patient already enrolled
Previous treatment with a BH3 mimetic
Patients who have not recovered to baseline or CTCAE< or = Grade 1 from toxicity due to all prior therapies received for the studied disease
Any previous anti-leukaemic treatment for the studied disease within at least 5 half-lives or 2 weeks (hydroxycarbamide permitted)
Any radiotherapy within 4 weeks before first intake (except palliative radiotherapy at localized lesions)
Major surgery within 3 weeks before first intake of S 055746
Allogenic stem cell transplant within 6 months before the first intake of S 055746 and for patients who still need immunosuppressive treatment
Leukaemic leptomeningeal or leukaemic central nervous system involvement
Concomitant uncontrolled infection, organ dysfunction or medical disease likely to interfere with evaluation of S 055746 safety or study outcome
Human immunodeficiency virus (HIV) infection, hepatitis B or active hepatitis C infection
Within 6 months prior to the first intake of S 055746, history of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty, and/or stenting, ischemic/haemorrhagic stroke, atrial fibrillation, digestive haemorrhagic risk, deep venous/arterial thromboembolic complication or bleeding diathesis
Decreased Left Ventricular Ejection Fraction (LVEF)
QTcF prolongation
Patients who are receiving QT prolonging drug
Coagulopathies with increased risk of bleeding complications
Other malignancy within 2 years prior to the first intake
Strong or moderate CYP3A4 inhibitors or inducers (treatment, food or drink products) within 7 days prior to the first intake
Treatment highly metabolised by the CYP3A4 or CYP2D6 and/or with a narrow therapeutic index, multi-enzymes and/or OATP and/or P-gp substrates or herbal products within 7 days prior to the first intake.
Patients receiving proton pump inhibitor
Patients having received anticoagulant oral drugs, aspirin > 325 mg/day and antiplatelets within 7 days prior to first S 055746 intake