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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/NCT03541369




Registration number
NCT03541369
Ethics application status
Date submitted
18/05/2018
Date registered
30/05/2018
Date last updated
2/03/2023

Titles & IDs
Public title
Safety, Tolerability, PK, PD, and Efficacy of AMG 427 in Subjects With Relapsed/Refractory Acute Myeloid Leukemia
Scientific title
A Phase 1 First-In-Human Study Evaluating the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics and Efficacy of AMG 427 in Subjects With Relapsed/Refractory Acute Myeloid Leukemia.
Secondary ID [1] 0 0
BB-IND 138440
Secondary ID [2] 0 0
20170528
Universal Trial Number (UTN)
Trial acronym
20170528
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Relapsed/Refractory Acute Myeloid Leukemia (AML) 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

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - AMG 427

Experimental: Dose Escalation Phase - AMG 427 Dose-finding phase of the study

Experimental: Dose Expansion Phase - AMG 427 MTD identified in dose escalation phase (or lower) will be administered to subjects.


Treatment: Drugs: AMG 427
AMG 427 will be administered as an intravenous (IV) infusion in adult subjects with relapsed/refractory AML.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Number of subjects who experience a dose limiting toxicity (DLT)
Timepoint [1] 0 0
14 Months
Primary outcome [2] 0 0
Subject incidence of treatment-emergent adverse events (TEAEs)
Timepoint [2] 0 0
14 Months
Primary outcome [3] 0 0
Subject incidence of treatment-related adverse events (TRAEs)
Timepoint [3] 0 0
14 Months
Secondary outcome [1] 0 0
Maximum observed concentration (Cmax) of AMG 427
Timepoint [1] 0 0
14 months
Secondary outcome [2] 0 0
Minimum concentration (Cmin) of AMG 427
Timepoint [2] 0 0
14 months
Secondary outcome [3] 0 0
Area under the concentration-time curve (AUC) of AMG 427
Timepoint [3] 0 0
14 months
Secondary outcome [4] 0 0
Half Life (t1/2) of AMG 427
Timepoint [4] 0 0
14 months
Secondary outcome [5] 0 0
Complete response/remission [CR]
Timepoint [5] 0 0
14 months
Secondary outcome [6] 0 0
Complete response/remission with incomplete recovery of peripheral blood counts [CRi]
Timepoint [6] 0 0
14 months
Secondary outcome [7] 0 0
Partial remission (per modified International Working Group IWG criteria)
Timepoint [7] 0 0
14 months
Secondary outcome [8] 0 0
Morphologic leukemia-free state
Timepoint [8] 0 0
14 months
Secondary outcome [9] 0 0
Complete remission with partial hematologic recovery (CRh)
Timepoint [9] 0 0
14 months
Secondary outcome [10] 0 0
Duration of response
Timepoint [10] 0 0
14 months

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

- Subjects greater than or equal to 18 years of age at the time of signing consent.

- For relapsed/refractory AML subjects only, AML as defined by the WHO Classification as
persisting or recurring following 1 or more treatment courses (exceptions noted in
exclusion criteria).

- Myeloblasts greater than or equal to 5% in bone marrow, as confirmed by
immunophenotype by flow cytometry.

- Eastern Cooperative Oncology Group (ECOG) Performance Status of less than or equal to
2.

- Renal function as follows: serum creatinine less than 2.0 mg/dL (176.84 mol/L);
estimated glomerular filtration rate (eGFR) greater than 30 mL/min/1.73 m2.

- Hepatic function as follows: aspartate aminotransferase (AST) and alanine
aminotransferase (ALT) less than or equal to 3.0 x upper limit of normal (ULN);
bilirubin less than or equal to 1.5 x ULN (unless considered due to Gilbert's syndrome
or hemolysis).

- No active tuberculosis in the setting of anti-TNF therapy - National guidelines should
be followed for the appropriate tuberculosis screening in the setting of anti-TNF
therapy, including a minimum of:

- Subject has a negative test for tuberculosis during screening defined as either:

- Negative purified protein derivative (PPD) (< 5 mm induration at 48 to 72
hours after test is placed) OR

- Negative quantiferon test

- Subjects with positive PPD and a history of bacillus Calmette-Guérin vaccination
are allowed with a negative Quantiferon test.

- Subjects with a positive PPD test (without a history of bacillus Calmette-Guérin
vaccination) or subjects with a positive or indeterminate Quantiferon test are
allowed if they have all of the following:

- No symptoms, per tuberculosis worksheet provided by Amgen

- Documented history of a completed course of adequate treatment or
prophylaxis (per local standard of care) prior to the start of
investigational product

- No known exposure to a case of active tuberculosis after most recent
prophylaxis

- No evidence of active tuberculosis on chest radiograph within 3 months prior
to the first dose of investigational product (substudy subjects only)
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
- Patients with acute promyelocytic leukemia (APML).

- Active extramedullary AML in the central nervous system (CNS)

- Known hypersensitivity to immunoglobulins.

- White blood cells (WBC) greater than 15,000 cells/mcL (15 cells x 10^9/L) at screening
(hydroxyurea is permitted to enable eligibility).

- Subjects with a prior or concurrent malignancy whose natural history or treatment is
anticipated to interfere with the safety or efficacy assessment of the investigational
regimen. Exception: Subjects with prior or concurrent malignancy not anticipated to
interfere with the safety or efficacy of the investigational regimen may be included
only after discussion with the Amgen Medical Monitor.

- Autologous HSCT within 6 weeks prior to start of AMG 427 treatment.

- Allogeneic HSCT within 3 months prior to start of AMG 427 treatment.

- Any graft-versus-host disease requiring systemic therapy with immunomodulators.

- History or evidence of significant cardiovascular risk including any of the following:
symptomatic congestive heart failure, unstable angina, clinically significant
arrhythmias (eg, ventricular fibrillation, ventricular tachycardia etc.), recent
coronary angioplasty, intra-cardiac defibrillators or any clinically relevant
concurrent disorder that may pose a risk to subject safety or interfere with study
evaluation, procedures, or completion.

- History of arterial thrombosis (eg, stroke or transient ischemic attack) in the past 3
months.

- Active infection requiring intravenous antibiotics within 1 week of study enrollment
(day 1). Antibiotics may be administered for prophylaxis as per institutional
standards up to and after enrollment.

- Known positive test for human immunodeficiency virus (HIV).

- Positive for hepatitis B surface antigen (HepBsAg).

- Positive for hepatitis C or chronic hepatitis C. Possible exceptions: acute hepatitis
C and completely cleared of the virus (demonstrated by negative viral load), chronic
hepatitis C with undetectable viral load defined by sustained virologic response 24
weeks (SVR24) after completion of anti-hepatitis C treatment.

- Live vaccination(s) within 4 weeks before the start of AMG 427 treatment on day 1,
during treatment, and until the end of the last study dose.

- Unresolved toxicities from prior antitumor therapy, defined as not having resolved to
Common Terminology Criteria for Adverse Events (CTCAE), version 4.0 grade 1 (with the
exception of myelosuppression, eg, neutropenia, anemia, thrombocytopenia), or to
levels dictated in the eligibility criteria with the exception of alopecia or
toxicities from prior antitumor therapy that are considered irreversible (defined as
having been present and stable for greater than 2 months) which 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, or
investigational agent) within 14 days of day 1. Exception: hydroxyurea to control
peripheral blood leukemic cell counts is allowed until start of investigational
product treatment. Exception: antitumor therapies with short half-lives only require
passing of 5 half-lives from last dose, and after discussion with sponsor.

- Treatment with systemic immune modulators including, but not limited to, non-topical
systemic corticosteroids, cyclosporine, and tacrolimus within 2 weeks before
enrollment (day 1). Exceptions: physiologic replacement steroids or steroids for
treatment of transfusion/hypersensitivity reactions.

- Prior treatment with a FLT3 targeting chimeric antigen receptor T cell (CAR-T)

- Major surgery within 28 days of study day 1 with the exception of biopsy and insertion
of central venous catheter.

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

- Males and females of reproductive potential who are unwilling to practice a highly
effective method(s) of birth control while on study through 4 weeks after receiving
the last dose of study drug. Acceptable methods of highly effective birth control
include sexual abstinence (males, females); vasectomy; bilateral tubal
ligation/occlusion; or a condom with spermicide (men) in combination with hormonal
birth control or intrauterine device (IUD) (women).

- Females who are lactating/breastfeeding or who plan to breastfeed while on study
through 4 weeks after receiving the last dose of study drug.

- Females with a positive pregnancy test.

- Females planning to become pregnant while on study through 4 weeks after receiving the
last dose of study drug.

- Subjects likely to not be available to complete all protocol-required study visits or
procedures, and/or to comply with all required study procedures to the best of the
subject's and investigator's knowledge.

- History of multiple sclerosis or any other demyelinating disease.

- No active hepatitis secondary to alcoholic hepatitis or nonalcoholic steatohepatitis.

- History or evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
infection unless agreed upon with Medical Monitor and meeting the following criteria:

- Negative test for SARS-CoV-2 RNA by reverse transcriptase-polymerase chain
reaction (RT-PCR) within 72 hours of first dose of investigational product

- No acute symptoms of coronavirus disease 2019 (COVID-19) disease within 10 days
prior to first dose of investigational product (counted from day of positive test
for asymptomatic subjects)

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled 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
14/09/2018
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
28/02/2023
Sample size
Target
Accrual to date
Final
64
Recruitment in Australia
Recruitment state(s)
VIC
Recruitment hospital [1] 0 0
The Alfred Hospital - Melbourne
Recruitment hospital [2] 0 0
The Royal Melbourne Hospital - Parkville
Recruitment postcode(s) [1] 0 0
3004 - Melbourne
Recruitment postcode(s) [2] 0 0
3050 - Parkville
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
Country [2] 0 0
United States of America
State/province [2] 0 0
Illinois
Country [3] 0 0
United States of America
State/province [3] 0 0
Maryland
Country [4] 0 0
United States of America
State/province [4] 0 0
New York
Country [5] 0 0
United States of America
State/province [5] 0 0
North Carolina
Country [6] 0 0
United States of America
State/province [6] 0 0
Texas
Country [7] 0 0
Canada
State/province [7] 0 0
Ontario
Country [8] 0 0
Germany
State/province [8] 0 0
Dresden
Country [9] 0 0
Germany
State/province [9] 0 0
Muenchen
Country [10] 0 0
Japan
State/province [10] 0 0
Chiba
Country [11] 0 0
Japan
State/province [11] 0 0
Fukui
Country [12] 0 0
Korea, Republic of
State/province [12] 0 0
Seoul

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 427 in adult subjects with relapsed/refractory
AML. Estimate the maximum tolerated dose (MTD) and / or a biologically optimal dose (eg,
recommended phase 2 dose [RP2D]).
Trial website
https://clinicaltrials.gov/ct2/show/NCT03541369
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/NCT03541369