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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT06372717
Registration number
NCT06372717
Ethics application status
Date submitted
11/03/2024
Date registered
18/04/2024
Titles & IDs
Public title
A Study to Investigate APL-4098 Alone and/or in Combination With Azacitidine in R/R AML and High-Risk MDS
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Scientific title
A Phase 1/2 Study to Assess the Safety and Antitumor Activity of APL-4098 Alone and/or in Combination With Azacitidine in Adults With Relapsed or Refractory (R/R) Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome/AML (MDS/AML) or Myelodysplastic Syndrome With Excess Blasts (MDS-EB)
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Secondary ID [1]
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AP30CP01
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Myeloid Leukemia Refractory
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Myelodysplastic Syndrome Acute Myeloid Leukemia
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Myelodysplastic Syndrome With Excess Blasts
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Acute Myeloid Leukemia, in Relapse
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Blood
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Haematological diseases
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Blood
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Other blood disorders
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Blood
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Anaemia
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Blood
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Haematological diseases
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Inflammatory and Immune System
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Other inflammatory or immune system disorders
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Other
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - APL-4098
Treatment: Drugs - Azacitidine and APL-4098
Experimental: Dose Escalation Phase: APL-4098 monotherapy - Dose escalation with different dosing levels of APL-4098.
Experimental: Dose Escalation Phase: APL-4098 and azacitidine - Dose escalation with different dosing levels of APL-4098 in combination with azacitidine (75 mg/m2).
Experimental: Phase 2 Dose Expansion: APL-4098 monotherapy -
Experimental: Phase 2 Dose Expansion: APL-4098 and azacitidine -
Treatment: Drugs: APL-4098
APL-4098 is administered orally in 28-day cycles
Treatment: Drugs: Azacitidine and APL-4098
Azacitidine is administered at the standard dose of 75mg/m2 on Day 1 - Day 7 of each 28-day cycle; APL-4098 is administered orally.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Incidence of Treatment Emergent Adverse Events [Safety] (Phase 1)
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Assessment method [1]
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Evaluation of safety parameters including treatment emergent adverse events as detected by hematology, chemistry, coagulation safety labs, physical exams, vital signs, Electrocardiogram results
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Timepoint [1]
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Through study completion, approximately one year
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Primary outcome [2]
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Incidence of Dose Limiting Toxicities [Tolerability] (Phase 1)
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Assessment method [2]
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Evaluation of tolerability parameters including dose limiting toxicities as detected by hematology, chemistry, coagulation safety labs, physical exams, vital signs, and Electrocardiogram results
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Timepoint [2]
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Cycle 1 Day 1 to Cycle 2 Day 1 (a cycle is 28 days)
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Primary outcome [3]
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Estimate the Maximum Tolerated Dose (MTD) of APL-4098 alone and/or in combination with azacitidine (Phase 1)
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Assessment method [3]
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Timepoint [3]
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Cycle 1 Day 1 to Cycle 2 Day 1 (a cycle is 28 days)
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Primary outcome [4]
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Determine Recommended Phase 2 Dose (RP2D) levels of APL-4098 alone and/or in combination with azacitidine (Phase 1)
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Assessment method [4]
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Timepoint [4]
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Approximately one year
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Primary outcome [5]
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Assess the Pharmacokinetics of APL-4098 alone and/or in combination with azacitidine (Phase 1)
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Assessment method [5]
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Evaluate PK parameters: Maximum plasma concentration (Cmax)
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Timepoint [5]
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On Days 1, 2, 4, 8, and 15 of Cycle 1, and on Day 1 of Cycle 2 (each cycle is 28 days)
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Primary outcome [6]
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Assess the Pharmacokinetics of APL-4098 alone and/or in combination with azacitidine (Phase 1)
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Assessment method [6]
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Evaluate PK parameters: area under the curve (AUC)
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Timepoint [6]
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On Days 1, 2, 4, 8, and 15 of Cycle 1, and on Day 1 of Cycle 2 (each cycle is 28 days)
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Primary outcome [7]
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Assess the Pharmacokinetics of APL-4098 alone and/or in combination with azacitidine (Phase 1)
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Assessment method [7]
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Evaluate PK parameters: Time to peak concentration (Tmax)
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Timepoint [7]
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On Days 1, 2, 4, 8, and 15 of Cycle 1, and on Day 1 of Cycle 2 (each cycle is 28 days)
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Primary outcome [8]
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Assess efficacy of APL-4098 alone and/or in combination with azacitidine (Phase 2)
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Assessment method [8]
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Response is assessed per European LeukemiaNet 2022 criteria
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Timepoint [8]
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Response is assessed at Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 7 Day 1 (each cycle is 28 days long), then every three cycles thereafter (assessed for up to 2 years)
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Secondary outcome [1]
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Assess response to disease with APL-4098 alone and/or in combination with azacitidine (Phase 1)
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Assessment method [1]
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R/R AML and MDS/AML participants: response is assessed per European LeukemiaNet (ELN) 2022 criteria MDS-EB participants: response is assessed per revised International Working Group 2023 response criteria
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Timepoint [1]
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Response is assessed at Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 7 Day 1 (each cycle is 28 days long), then every three cycles thereafter (assessed for up to 2 years)
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Secondary outcome [2]
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Duration of response with APL-4098 alone and/or in combination with azacitidine [Further efficacy] (Phase 2)
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Assessment method [2]
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Timepoint [2]
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From Cycle 1 Day 1 (a cycle is 28 days long) through end of study (approximately 2 years)
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Secondary outcome [3]
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Time to response with APL-4098 alone and/or in combination with azacitidine [Further efficacy] (Phase 2)
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Assessment method [3]
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Timepoint [3]
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From Cycle 1 Day 1 (a cycle is 28 days long) through end of study (approximately 2 years)
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Secondary outcome [4]
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Event Free Survival with APL-4098 alone and/or in combination with azacitidine [Further efficacy] (Phase 2)
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Assessment method [4]
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Timepoint [4]
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From Cycle 1 Day 1 (a cycle is 28 days long) through end of study (approximately 2 years)
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Secondary outcome [5]
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Overall Survival with APL-4098 alone and/or in combination with azacitidine [Further efficacy] (Phase 2)
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Assessment method [5]
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Timepoint [5]
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From Cycle 1 Day 1 (a cycle is 28 days long) through end of study (approximately 2 years)
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Secondary outcome [6]
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Incidence of Treatment Emergent Adverse Events [Further Safety] (Phase 2)
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Assessment method [6]
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Evaluation of safety parameters including treatment emergent adverse events as detected by hematology, chemistry, coagulation safety labs, physical exams, vital signs, Electrocardiogram results
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Timepoint [6]
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Through study completion (approximately 2 years)
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Secondary outcome [7]
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Incidence of Adverse Events leading to discontinuation of APL-4098 [Further Tolerability] (Phase 2)
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Assessment method [7]
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Timepoint [7]
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Through study completion (approximately 2 years)
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Secondary outcome [8]
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Further assess the PK of APL-4098 alone and/or in combination with azacitidine (Phase 2)
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Assessment method [8]
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Evaluate PK parameters: Maximum plasma concentration (Cmax)
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Timepoint [8]
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At Cycle 1 Day 1 and at Cycle 2 Day 1 (each cycle is 28 days)
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Secondary outcome [9]
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Further assess the PK of APL-4098 alone and/or in combination with azacitidine (Phase 2)
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Assessment method [9]
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Evaluate PK parameters: area under the curve (AUC)
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Timepoint [9]
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At Cycle 1 Day 1 and at Cycle 2 Day 1 (each cycle is 28 days)
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Secondary outcome [10]
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Further assess the PK of APL-4098 alone and/or in combination with azacitidine (Phase 2)
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Assessment method [10]
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Evaluate PK parameters: Time to peak concentration (Tmax)
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Timepoint [10]
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At Cycle 1 Day 1 and at Cycle 2 Day 1 (each cycle is 28 days)
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Eligibility
Key inclusion criteria
* 18 years or older
* Confirmed diagnosis of relapsed refractory acute myeloid leukemia (R/R AML), myelodysplastic syndrome (MDS)/ AML, or MDS-excess blasts (MDS-EB) with the following characteristics: - R/R AML (primary or secondary, including treatment-related), participant is intolerant to, or considered ineligible for available therapies known to provide clinical benefit.
* WBC count = 25,000/microliter
* ECOG Performance Status of = 2
* Weight = 40kg
* Female participants of childbearing potential must have negative serum pregnancy test at screening; must not plan to become pregnant or have ova harvested or breastfeed while on study; must we willing to use specific contraception or avoid intercourse
* Male participants must be willing to use specific contraception and not plan to impregnant a female partner or donate sperm while on study
* Participant must be willing and able to provide written informed consent and to comply with the requirements of the trial
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Certain prior therapies such as: received an allogeneic stem cell transplant within 6 months of screening, received an autologous stem cell transplant within 3 months of screening, received any anti-cancer treatments within 2 weeks of Cycle 1 Day 1, prior radiation therapy within 4 weeks of screening
* Certain medical conditions such as: other malignancies, myocardial infarction within 6 months of screening, symptomatic congestive heart failure, uncontrolled active infection, history of arterial thrombosis within 6 months of screening
* Diagnostic assessments: Left ventricular ejection fraction < 45%, Fridericia's corrected QT interval > 470msec, Aspartate aminotransferase and/or alanine aminotransferase > 3 x upper limit of normal (ULN), total bilirubin > 1.5 x ULN, calculated or measured creatinine clearance < 45 mL/minute (multiply by 0.85 if female)
* Infectious disease: HIV positive, active hepatitis B and/or C
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
4/06/2024
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/04/2027
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Actual
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Sample size
Target
112
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Apollo Investigative Site - Melbourne
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Recruitment postcode(s) [1]
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- Melbourne
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Apollo Therapeutics Ltd
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This is an open-label, Phase 1/2 study to determine the safety, tolerability, and efficacy of APL-4098 alone and/or in combination with azacitidine for the treatment of relapsed or refractory (R/R) acute myeloid leukemia (AML), myelodysplastic syndrome (MDS)/AML and MDS-excess blasts (EB). Participants with the MDS-EB subtype will be eligible for the Phase 1 part of the study only.
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Trial website
https://clinicaltrials.gov/study/NCT06372717
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Daniela Pignataro, MD
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Address
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Apollo Therapeutics
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Apollo Therapeutics
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Address
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Country
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Phone
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781-479-2267
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT06372717