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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT03465540




Registration number
NCT03465540
Ethics application status
Date submitted
8/03/2018
Date registered
14/03/2018
Date last updated
12/04/2023

Titles & IDs
Public title
Safety, Tolerability, Pharmacokinetics and Efficacy of AMG 397 in Subjects With Selected Relapsed or Refractory Hematological Malignancies
Scientific title
A Phase 1 Open-label Study Evaluating the Safety, Tolerability, Pharmacokinetics and Efficacy of AMG 397 in Subjects With Selected Relapsed or Refractory Hematological Malignancies
Secondary ID [1] 0 0
20170173
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Multiple Myeloma 0 0
Acute Myeloid Leukemia 0 0
Non-Hodgkins Lymphoma 0 0
Myelodysplastic Syndrome 0 0
AML 0 0
MDS 0 0
NHL 0 0
Condition category
Condition code
Cancer 0 0 0 0
Leukaemia - Acute leukaemia
Cancer 0 0 0 0
Leukaemia - Chronic leukaemia
Cancer 0 0 0 0
Children's - Leukaemia & Lymphoma
Blood 0 0 0 0
Haematological diseases
Blood 0 0 0 0
Other blood disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - AMG 397
Treatment: Drugs - Dexamethasone
Treatment: Drugs - Azacitidine

Experimental: Part 1A: AMG 397 Dose Escalation - This arm includes subjects with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL).

Experimental: Part 1B: AMG 397 Dose Escalation - This arm includes subjects with acute myeloid leukemia (AML).

Experimental: Part 2A: AMG 397 Monotherapy - This arm includes subjects with AML or myelodysplastic syndrome (MDS).

Experimental: Part 2B: AMG 397 Monotherapy - This arm includes subjects with AML in Japan only.

Experimental: Part 2C: AMG 397 Monotherapy - This arm includes subjects with MM.

Experimental: Part 3A: AMG 397 + Azacitidine Combotherapy - This arm includes subjects MDS.

Experimental: Part 3B: AMG 397+ Azacitidine Combotherapy - This arm includes subjects AML.

Experimental: Part 3C: AMG 397+ Dexamethasone Combotherapy - This arm includes subjects MM.


Treatment: Drugs: AMG 397
AMG 397 will be administered orally once or twice weekly as part of a 28-day treatment cycle.

Treatment: Drugs: Dexamethasone
Dexamethasone will be administered intravenously (IV) or orally on Days 1, 8, 15, and 22 of each 28-day cycle.

Treatment: Drugs: Azacitidine
Azacitidine will be administered intravenously (IV) or subcutaneously (SC) daily for the first 7 days of a 28-day cycle.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Number of Participants Who Experienced a Dose-limiting Toxicity (DLT)
Timepoint [1] 0 0
28 days
Primary outcome [2] 0 0
Number of Participants Who Experienced a Treatment-emergent Adverse Event (TEAE)
Timepoint [2] 0 0
Up to 30 days after last dose (Maximum time on treatment was 18 weeks for part 1a and 13 weeks for part 1b)
Secondary outcome [1] 0 0
Overall Response Rate (ORR) for Participants With Multiple Myeloma (MM)
Timepoint [1] 0 0
Up to end of study (a maximum of 48 weeks)
Secondary outcome [2] 0 0
Overall Response Rate (ORR) for Participants With Non-Hodgkin's Lymphoma (NHL)
Timepoint [2] 0 0
Up to end of study (a maximum of 48 weeks)
Secondary outcome [3] 0 0
Overall Response Rate (ORR) for Participants With Acute Myeloid Leukemia (AML)
Timepoint [3] 0 0
Up to end of study (a maximum of 48 weeks)
Secondary outcome [4] 0 0
Progression-free Survival (PFS)
Timepoint [4] 0 0
Up to end of study (a maximum of 48 weeks)
Secondary outcome [5] 0 0
Overall Survival (OS)
Timepoint [5] 0 0
Up to end of study (a maximum of 48 weeks)
Secondary outcome [6] 0 0
Time to Response (TTR)
Timepoint [6] 0 0
Up to end of study (a maximum of 48 weeks)
Secondary outcome [7] 0 0
Duration of Response (DOR)
Timepoint [7] 0 0
Up to end of study (a maximum of 48 weeks)
Secondary outcome [8] 0 0
Maximum Observed Concentration (Cmax) of AMG 397
Timepoint [8] 0 0
Cycle 1 (cycle = 28 days): Predose, 1, 2, 3, 5, 8 & 12 hours postdose on Day 1; predose, 1, 2, 3, 5, 8, 12, 24 & 48 hours postdose on Day 2
Secondary outcome [9] 0 0
Time to Maximum Observed Concentration (Tmax) for AMG 397
Timepoint [9] 0 0
Cycle 1 (cycle = 28 days): Predose, 1, 2, 3, 5, 8 & 12 hours postdose on Day 1; predose, 1, 2, 3, 5, 8, 12, 24 & 48 hours postdose on Day 2
Secondary outcome [10] 0 0
Area Under the Concentration Time Curve From Time 0 to 168 Hours (AUC0-168) for AMG 397
Timepoint [10] 0 0
Cycle 1 (cycle = 28 days): Predose, 3, 5, & 8 hours postdose on days 1 (12 hours postdose on Day 1 only), 8 & 15, predose & 8 hours postdose on Day 22 & days 2, 3, 4, 9, 16, 17, 18 & 23; Cycles 2, 3 & 4 (cycle = 28 days): Predose on days 2, 8, 15 & 22
Secondary outcome [11] 0 0
Clearance (CL) of AMG 397
Timepoint [11] 0 0
Cycle 1 (cycle = 28 days): Predose, 3, 5, & 8 hours postdose on days 1 (12 hours postdose on Day 1 only), 8 & 15, predose & 8 hours postdose on Day 22 & days 2, 3, 4, 9, 16, 17, 18 & 23; Cycles 2, 3 & 4 (cycle = 28 days): Predose on days 2, 8, 15 & 22
Secondary outcome [12] 0 0
Half-life (t1/2) of AMG 397
Timepoint [12] 0 0
Cycle 1 (cycle = 28 days): Predose, 3, 5, & 8 hours postdose on days 1 (12 hours postdose on Day 1 only), 8 & 15, predose & 8 hours postdose on Day 22 & days 2, 3, 4, 9, 16, 17, 18 & 23; Cycles 2, 3 & 4 (cycle = 28 days): Predose on days 2, 8, 15 & 22

Eligibility
Key inclusion criteria
- Subject has provided informed consent prior to initiation of any study-specific
activities/procedures

- Age = 18 years old

- Pathologically-documented, definitively-diagnosed relapsed or refractory multiple
myeloma (MM), myelodysplastic syndrome (MDS), or acute myeloid leukemia (AML) and is
intolerant to, or considered ineligible for available therapies known to provide
clinical benefit

- MM subjects only: Measurable disease per the International Myeloma Working Group
(IMWG) response criteria (assessed within 21 days prior to enrollment), as indicated
by one or more of the following: cytogenic risk factor: 1q21 amplification/gain, serum
M-protein = 0.5 g/dL, Urine M-protein = 200 mg/24 hours. For Subjects who do not meet
1 of the 2 prior criteria: Serum Free Light Chain (sFLC) = 10 mg/dL (= 100 mg/L) and
an abnormal sFLC ratio (< 0.26 or > 1.65) as per the IMWG response criteria

- MM subjects only: Hematological function, as follows without transfusion or growth
factor support within 2 weeks prior to study day 1: absolute neutrophil count = 1.0 X
109/L, hemoglobin > 8 g/dL and platelet count = 75 X 109/L

- AML subjects only: Pathologically confirmed diagnosis of AML as defined by the World
Health Organisation (WHO) Classification, more than 5% blasts in bone marrow and
persisting or recurring following one or more treatment courses

- MDS subjects only: pathologically confirmed diagnosis of MDS as defined by the WHO
Classification, intermediate and high risk MDS and intolerant or refractory to HMA
treatment

- Eastern Cooperative Oncology Group (ECOG) performance status of = 2

- Life expectancy of > 3 months, based on the opinion of the investigator

- Able to swallow and retain orally administered medication and does not have any
clinically significant gastrointestinal abnormalities that may alter absorption.

- Hepatic function, as follows:

- aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3 x upper
limit of normal (ULN)

- total bilirubin (TBL) < 1.5 X ULN (except subjects with Gilbert's syndrome)

- Cardiac function, as follows:

- Cardiac ejection fraction = 50% and no evidence of pericardial effusion as
determined by echocardiogram or multigated acquisition (MUGA) scan

- no ECG findings representing a recent cardiac injury within 6 months before
enrollment

- Renal function as follows:

- Calculated or measured creatinine clearance (CrCl) of = 30 mL/minute calculated
using the formula of Cockcroft and Gault [(140 - Age) × Mass (kg) / (72 × serum
creatinine mg/dL)]. Multiply result by 0.85 if female
Minimum age
18 Years
Maximum age
65 Years
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Disease Related

- Previously received an allogeneic stem cell transplant within 6 months of study day 1
OR having signs or symptoms of acute or chronic graft-versus-host disease

- Autologous stem cell transplant < 90 days before enrollment

- Candidates for stem cell transplant should have failed or are not considered eligible
for either allogeneic and autologous transplant

Other Medical Conditions

- History of other malignancy except:

- Malignancy treated with curative intent and with no known active disease present
for = 2 years before enrollment and felt to be at low risk for recurrence by the
treating physician

- Adequately treated non-melanoma skin cancer or lentigo maligna without evidence
of disease

- Adequately treated cervical carcinoma in situ without evidence of disease

- Adequately treated breast ductal carcinoma in situ without evidence of disease

- Prostatic intraepithelial neoplasia without evidence of prostate cancer

- Adequately treated urothelial papillary noninvasive carcinoma or carcinoma in
situ

- Myocardial infarction within 6 months before enrollment

- Symptomatic congestive heart failure (New York Heart Association > Class II)

- History of arterial thrombosis (eg, stroke or transient ischemic attack) in the past 6
months before enrollment

- Uncontrollable active infection requiring intravenous anti-infective treatments within
1 week before enrollment

- Known positive results for human immunodeficiency virus (HIV)

- Active hepatitis B and C based on the following results: Positive for hepatitis B
surface antigen (HBsAg) (indicative of chronic, hepatitis B or recent acute hepatitis
B), Negative HBsAg and positive for hepatitis B core antibody: hepatitis B virus DNA
by polymerase chain reaction (PCR) is necessary. Detectable hepatitis B virus DNA
suggests occult hepatitis B. Positive Hepatitis C virus antibody (HCVAb): hepatitis C
virus RNA by PCR is necessary. Detectable hepatitis C virus RNA suggests chronic
hepatitis C

- Unresolved toxicities from prior anti-tumor therapy, defined as not having resolved to
Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 grade 1, or to
levels dictated in the eligibility criteria with the exception of grade 2peripheral
neuropathy, alopecia or toxicities from prior anti-tumor therapy that are considered
irreversible (defined as having been present and stable for > 4 weeks prior to study
day 1 may be allowed if they are not otherwise described in the exclusion criteria AND
there is agreement to allow by both the investigator and sponsor)

- Antitumor therapy (chemotherapy, antibody therapy, molecular-targeted therapy,
retinoid therapy, or investigational agent or procedures) within 14 days of day 1

- Prior systemic radiation therapy must have been completed at least 28 days before
study day 1. Prior focal radiotherapy completed at 14 days before study day 1

- Females of reproductive potential who are unwilling to practice acceptable methods of
highly effective contraception while on study through 8 months after receiving the
last dose of study drug. Males who are unwilling to practice sexual abstinence
(refrain from heterosexual intercourse) or use a condom with or without spermicide
while on study through 5 months after receiving the last dose of study drug if
sexually active with a female of childbearing potential

- Females who are lactating/breastfeeding or who plan to breastfeed while on study
through 8 months after receiving the last dose of study drug

- Females with a positive pregnancy test or planning to become pregnant while on study
through 8 months after receiving the last dose of study drug

- Males who are unwilling to abstain from sperm donation while on study through 8 months
after receiving the last dose of study drug

- History or evidence of any other clinically significant disorder, condition or disease
that, in the opinion of the investigator or Amgen physician, if consulted, would pose
a risk to subject safety or interfere with the study evaluation, procedures or
completion

- Use of any over-the-counter or prescription medications within 14 days or 5 half-lives
(whichever is longer), prior to study day 1 that was not reviewed and approved by the
principal investigator and the Amgen medical monitor

- Use of herbal medicines (eg, St. John's wort), vitamins, and supplements consumed by
the subject within 14 days prior to study day 1 that was not reviewed and approved by
the principal investigator and the Amgen medical monitor

- Use of any known inhibitors of P-gp within 14 days or 5 half-lives (whichever is
longer) or grapefruit juice or grapefruit containing products within 7 days prior to
study day 1 that was not reviewed and approved by the principal investigator and the
Amgen medical monitor

- Use of known CYP3A4 sensitive substrates, (with a narrow therapeutic window), within
14 days or 5 half-lives (whichever is longer) of the drug or its major active
metabolite, whichever is longer, prior to study day 1 that was not reviewed and
approved by the principal investigator and the Amgen medical monitor

- Use of known P-gp substrates (with a narrow therapeutic window) within 14 days or 5
half-lives (whichever is longer) prior to study day 1 that was not reviewed and
approved by the principal investigator and the Amgen medical monitor

- Subject likely to not be available to complete all protocol-required study visits or
procedures, and/or to comply with all required study procedures (eg, long term
follow-up) to the best of the subject and investigator's knowledge

- Known sensitivity to any of the products or component to be administered during dosing

- MM subjects with any of the following criteria are excluded:

- Multiple myeloma with IgM subtype

- POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein,
and skin changes)

- Existing plasma cell leukemia

- Waldenstrom's macroglobulinemia

- Amyloidosis

- AML subjects with the following criteria are excluded:

- Circulating white blood cells > 25,000/µl. Hydroxyurea to control peripheral
blood leukemic cell counts, within 24 hours of study day 1 is permitted

- Promyelocytic leukemia

- AML/MDS subjects fit for intensive salvage therapy

- Subjects with elevated cardiac troponin above the manufacturer's 99th percentile upper
reference limit for ADVIA Centaur XP assay at screening performed by the central
laboratory (Covance)

- Subjects with evidence of recent cardiac injury at screening based on creatine
kinase-muscle/brain (CK-MB), N-terminal prohormone of brain natriuretic peptide
(NT-pro-BNP), and ECG assessments at screening

- Subjects with MDS that are eligible for hematopoietic stem cell transplant (HSCT)

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Other
Other design features
Phase
Phase 1
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Terminated
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
17/08/2018
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
25/07/2019
Sample size
Target
Accrual to date
Final
24
Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
Recruitment hospital [1] 0 0
Royal Prince Alfred Hospital - Camperdown
Recruitment hospital [2] 0 0
Princess Alexandra Hospital - Woolloongabba
Recruitment hospital [3] 0 0
The Alfred Hospital - Melbourne
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment postcode(s) [2] 0 0
4102 - Woolloongabba
Recruitment postcode(s) [3] 0 0
3004 - Melbourne
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Alabama
Country [2] 0 0
United States of America
State/province [2] 0 0
Arizona
Country [3] 0 0
United States of America
State/province [3] 0 0
Florida
Country [4] 0 0
United States of America
State/province [4] 0 0
Kansas
Country [5] 0 0
United States of America
State/province [5] 0 0
Maryland
Country [6] 0 0
United States of America
State/province [6] 0 0
Massachusetts
Country [7] 0 0
United States of America
State/province [7] 0 0
Minnesota
Country [8] 0 0
United States of America
State/province [8] 0 0
Missouri
Country [9] 0 0
United States of America
State/province [9] 0 0
New York
Country [10] 0 0
United States of America
State/province [10] 0 0
Texas
Country [11] 0 0
United States of America
State/province [11] 0 0
Wisconsin
Country [12] 0 0
France
State/province [12] 0 0
Marseille Cedex 09
Country [13] 0 0
France
State/province [13] 0 0
Villejuif
Country [14] 0 0
Greece
State/province [14] 0 0
Athens
Country [15] 0 0
Italy
State/province [15] 0 0
Bergamo
Country [16] 0 0
Italy
State/province [16] 0 0
Bologna
Country [17] 0 0
Japan
State/province [17] 0 0
Gifu

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Amgen
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
Evaluate the safety and tolerability of AMG 397. Estimate the maximum tolerated doses (MTDs)
and/or biologically active doses.
Trial website
https://clinicaltrials.gov/ct2/show/NCT03465540
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
MD
Address 0 0
Amgen
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT03465540