Phase I Study of an Oncofetal Antigen Multi-Peptide Immunotherapy in Subjects With Hematologic Cancer (BBMPI03)

Benovus Bio

Status and phase

Unknown

Phase 1

Conditions

Myelodysplastic Syndrome (MDS)

Acute Myelogenous Leukemia (AML)

Smoldering Multiple Myeloma (sMM)

Multiple Myeloma (MM)

Treatments

Drug: Montanide

Drug: Sargramostim

Drug: BB-MPI-03

Study type

Interventional

Funder types

Industry

Identifiers

NCT02240537

BBMPI03-Hem-01

Details and patient eligibility

About

The study is designed to evaluate safety, immunogenicity, and preliminary anti-tumor activity of a multi-peptide immunotherapy (BB-MPI-03) at three peptide+adjuvant dose levels. The peptides stimulate cytotoxic T-cells targeting oncofetal antigen (OFA). Subjects with AML, MM, sMM, or MDS who are off treatment and with stable disease or better, or who are not eligible for or refuse allogeneic HSCT are to be enrolled. The study will be conducted at 2 to 4 study centers in the US.

Full description

The current study is a Phase I, open-label, multi-center, dose escalation study designed to evaluate safety, immunogencity, and potential anti-tumor activity of BB-MPI-03 at three peptide plus adjuvant dose levels. Subjects with acute myelogenous leukemia (AML), multiple myeloma (MM), smoldering multiple myeloma (sMM), or myelodysplastic syndrome (MDS) who are off treatment and with stable disease or better or who are not eligible for or refuse allogeneic hematopoietic stem cell transplantation (HSCT) are to be enrolled. The study will be conducted at 2 to 4 study centers in the United States (US).

The study employs a sequential group, open-label, 3+3 dose- escalation design to determine the safety and MTD of BB- MPI-03.

Enrollment

4 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

a. History of morphologically confirmed AML w/ classification other than WHO Acute Promyelocytic Leukemia (FAB M3), based on bone marrow examination.

i. not a candidate for allogeneic HSCT or no intention to move to HSCT at time of enrollment.

ii. Patient's AML could be in morphologic CR or no further cytotoxic chemotherapy is currently being considered.

iii. Completed consolidation chemotherapy, if available and/or appropriate for patient.

iv. Can have history of allogeneic HSCT transplant, but must be off immunosuppression for at least 2 wks. before enrollment and w/o GVHD and/or toxicities from HSCT.

b. Diagnosed in past 5 years w/ smoldering MM at high risk of progressing to symptomatic MM.

i. Diagnosis defined as: Bone marrow infiltration with plasma cells (PCs) ≥10% and presence of a monoclonal component, Ig G ≥3 g/dl or IgA ≥2 g/dl or Bence-Jones proteinuria >1 g/dl and absence of lytic lesions on skeletal survey, absence of hypercalcemia (corrected calcium <11 mg/dl), absence of renal failure (creatinine ≤1.5 x ULN), and absence of anemia (hemoglobin >10 g/dl or not 2 g/dl below LLN).

ii. Must meet one of following:

≥10% PCs in bone marrow and IgG ≥3 g/dl or IgA ≥2 g/dl,
≥10% PCs in bone marrow and serum FLC ratio (involved : uninvolved) >100 in blood, or
IgG ≥3 g/dl or IgA ≥2 g/dl and FLC ratio (involved: uninvolved) >100 in blood. c. MM post-treatment disease that is clinically stable and does not require treatment at least 4 weeks prior to enrollment.

i. At least one line of treatment and achieved at least PR by IMWG ii. Stable disease or better per IMWG based on 2 subsequent assessments at least one month apart d. history of morphologically confirmed MDS i. previously received at least one treatment for MDS, including but not limited to chemotherapy or hypomethylating agent(s). Subjects may be previously untreated if they refuse treatment with or are not appropriate candidates for chemotherapy or hypomethylating agent(s) in the investigator's opinion.

ii. intermediate, high, or very high risk MDS by IPSS-r iii. No curative intent option of allogeneic HSCT or refused consideration for allogeneic HSCT iv. Could have history of allogeneic HSCT transplant and relapsed, but must be off immunosuppression for at least 2 weeks before enrollment and without GVHD and/or toxicities from HSCT.

Low, moderate, to high levels of OFA expression by IHC analysis of tumor specimens.
HLA-A*02 haplotype.
ECOG performance status 0 to 2.
18 years or older.
life expectancy ≥3 months.
Has following laboratory parameters w/in 28 days:

ANC ≥500/mm3
ALC >500/mm3
PLT ≥25,000/mm3 and may be transfused
Hgb >8 g/dL (may have been transfused)
Serum creatinine ≤1.5 x ULN
Total bilirubin ≤2.0 mg/dL, unless elevated bilirubin due to Gilbert's syndrome
ALT and AST less than 5×ULN
1. If female of child-bearing potential, negative serum pregnancy test result w/in 28 of D1 and agree to abstain from heterosexual intercourse or use acceptable method of birth control (hormonal or barrier method) from Screening through 30 days after last dose
2. If male having sexual contact with a female of child-bearing potential, agrees to use a latex condom dor agrees to ensure partner uses an acceptable method of birth control (hormonal or barrier method)from Screening through 30 days after last dose
3. Able to provide written informed consent

Exclusion Criteria

Received chemotherapy, biological therapy, or radiation therapy less than one month before D1
No prior history of active CNS involvement
Grade 2 or higher peripheral neuropathy w/in 28 days
Acute promyelocytic leukemia (FAB M3)
Other active systemic malignancy treated w/ cytotoxic chemotherapy in previous 12 mos.
Monoclonal gammopathy of undetermined significance
For smoldering MM, baseline bone lesions or plasmacytomas
For smoldering MM, lytic lesions on skeletal surveys and hypercalcemia (i.e., ≥11 mg/dL)
Known HIV or hepatitis virus infection
Active infection requiring antibiotics
History of prior or active autoimmune disease such as Lupus or rheumatoid arthritis
Significant kidney or liver disease, uncontrolled severe cardiovascular or pulmonary disease, other uncontrolled medical condition that would compromise subject's ability to tolerate study treatment
Received any investigational treatment w/in 30 days
Receiving systemic glucocorticosteroid >10 mg daily. Concurrent use after registration on study should be restricted to equivalent of prednisone 10 mg per day. Prior or concurrent topical or localized glucocorticosteroid therapy to treat non-malignant comorbid disorders is permitted. Subject requiring routine use of steroid inhalers are not eligible.
Major surgery w/in 4 wks.
G-CSF w/in 30 days