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Glutaminase Inhibitor CB-839 and Azacitidine in Treating Patients With Advanced Myelodysplastic Syndrome

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ClinicalTrials.gov Identifier: NCT03047993
Recruitment Status : Recruiting
First Posted : February 9, 2017
Last Update Posted : May 17, 2019
Sponsor:
Collaborator:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
M.D. Anderson Cancer Center

Brief Summary:
This phase I/II trial studies the side effects of glutaminase inhibitor CB-839 in combination with azacitidine in treating patients with myelodysplastic syndrome that has spread to other places in the body. Glutaminase inhibitor CB-839 and azacitidine may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Condition or disease Intervention/treatment Phase
Acute Myeloid Leukemia With Multilineage Dysplasia Blasts 20-30 Percent of Bone Marrow Nucleated Cells Blasts 20-30 Percent of Peripheral Blood White Cells Chronic Myelomonocytic Leukemia High Risk Myelodysplastic Syndrome IPSS Risk Category Intermediate-2 Myelodysplastic Syndrome Drug: Azacitidine Drug: Glutaminase Inhibitor CB-839 Phase 1 Phase 2

Detailed Description:

PRIMARY OBJECTIVES:

I. To determine the safety, tolerability and clinical activity of glutaminase inhibitor CB-839 (CB-839) in combination with azacitidine (AZA) for patients with advanced myelodysplastic syndrome (MDS).

SECONDARY OBJECTIVES:

I. To explore the pharmacokinetics (PK) of CB-839 in combination with AZA. II. To explore the pharmacodynamics (PDn) of CB-839 in combination with AZA. III. To assess overall survival, event-free survival and duration of response of CB-839 in combination with AZA.

OUTLINE:

Patients receive glutaminase inhibitor CB-839 orally (PO) twice daily (BID) on days 1-28 and azacitidine subcutaneously (SC) or intravenously (IV) over 10-40 minutes on days 1-7.

After completion of study treatment, patients are followed up at 28 days.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 40 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase Ib/II Study of the Glutaminase Inhibitor CB-839 in Combination With Azacitidine in Patients With Advanced Myelodysplastic Syndrome
Actual Study Start Date : November 15, 2017
Estimated Primary Completion Date : April 1, 2022
Estimated Study Completion Date : April 1, 2022


Arm Intervention/treatment
Experimental: Treatment (glutaminase inhibitor CB-839, azacitidine)
Patients receive glutaminase inhibitor CB-839 PO BID on days 1-28 and azacitidine SC or IV over 10-40 minutes on days 1-7.
Drug: Azacitidine
Given IV or SC
Other Names:
  • 5 AZC
  • 5-AC
  • 5-Azacytidine
  • 5-AZC
  • Azacytidine
  • Azacytidine, 5-
  • Ladakamycin
  • Mylosar
  • U-18496
  • Vidaza

Drug: Glutaminase Inhibitor CB-839
Given PO
Other Name: CB-839




Primary Outcome Measures :
  1. Incidence of adverse events Common Toxicity Criteria version 4.0 [ Time Frame: Up to 4 years ]
    Safety data will be summarized using frequency and percentage, by category and severity.


Secondary Outcome Measures :
  1. Rates of response (complete response + partial response) to therapy [ Time Frame: Up to 4 years ]
    Will be estimated along with the 95% confidence interval.

  2. Event-free survival [ Time Frame: Up to 4 years ]
    The Kaplan-Meier method will be used to estimate the probabilities. Log-rank tests will be used to compare among subgroups of patients.

  3. Overall survival [ Time Frame: Up to 4 years ]
    The Kaplan-Meier method will be used to estimate the probabilities. Log-rank tests will be used to compare among subgroups of patients.

  4. Duration of response [ Time Frame: Up to 4 years ]
    The Kaplan-Meier method will be used to estimate the probabilities. Log-rank tests will be used to compare among subgroups of patients.

  5. Anti-tumor activity [ Time Frame: Up to 4 years ]
    Will be summarized graphically and with descriptive statistics.

  6. Pharmacodynamic markers [ Time Frame: Up to 4 years ]
    Will be summarized graphically and with descriptive statistics.

  7. Exploratory biomarkers [ Time Frame: Up to 4 years ]
    Will be summarized graphically and with descriptive statistics.

  8. Drug exposure levels [ Time Frame: Up to 4 years ]
    Will be summarized graphically and with descriptive statistics.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Signed, informed consent must be obtained prior to any study specific procedures
  • Subjects with a histologically confirmed diagnosis of MDS, including both MDS and refractory anemia with excess blasts (RAEB)-T (acute myeloid leukemia [AML] with 20-30% blasts and multilineage dysplasia by French-American-British [FAB] criteria) by World Health Organization (WHO) and chronic myelomonocytic leukemia (CMML) are eligible
  • Subjects with high-risk MDS (i.e. International Prognostic Scoring System [IPSS] Intermediate-2 or high-risk; or R-IPSS high or very-high risk). Patients with Intermediate-1 risk by IPSS or Intermediate risk by R-IPSS and with IDH1 or IDH2, or high-risk molecular features including TP53, ASXL1, EZH2, and/or RUNX1 mutations are also eligible
  • Subjects with prior hypomethylating agent therapy exposure may be eligible based on discussion with the principal investigator (PI)
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
  • Serum bilirubin =< 2 x the upper limit of normal (ULN) (except for patients with Gilbert's disease)
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) =< 3 x the laboratory ULN
  • Creatinine clearance > 30 mL/min based on the Cockcroft-Gault equation
  • Able to understand and voluntarily sign a written informed consent, and willing and able to comply with protocol requirements
  • Resolution of all treatment-related, non-hematological toxicities, except alopecia, from any previous cancer therapy to < grade 1 prior to the first dose of study treatment
  • Female patients of childbearing potential must have a negative serum or urine pregnancy test within 3 days of the first dose of study drug and agree to use dual methods of contraception during the study and for a minimum of 3 months following the last dose of study drug. Post-menopausal females (>= 45 years old and without menses for >= 1 year) and surgically sterilized females are exempt from these requirements. Male patients must use an effective barrier method of contraception during the study and for a minimum of 3 months following the last dose of study drug if sexually active with a female of childbearing potential

Exclusion Criteria:

  • Any prior or coexisting medical condition that in the investigator's judgment will substantially increase the risk associated with the subject's participation in the study
  • Psychiatric disorders or altered mental status precluding understanding of the informed consent process and/or completion of the necessary study procedures
  • Active uncontrolled infection at study enrollment including known diagnosis of human immunodeficiency virus or chronic active hepatitis B or C infection
  • Clinically significant gastrointestinal conditions or disorders that may interfere with study drug absorption, including prior gastrectomy
  • Patients with known active central nervous system (CNS) disease, including leptomeningeal involvement
  • Impaired cardiac function, uncontrolled cardiac arrhythmia, or clinically significant cardiac disease including the following: a) New York Heart Association grade III or IV congestive heart failure, b) myocardial infarction within the last 6 months
  • Subjects with a corrected QT (QTc) > 480 ms (QTc > 510 msec for subjects with a bundle branch block at baseline)
  • Nursing or pregnant women
  • Subjects with known hypersensitivity to study drugs or their excipients

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03047993


Contacts
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Contact: Courtney DiNardo 713-794-1141 cdinardo@mdanderson.org

Locations
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United States, Texas
M D Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: Courtney DiNardo    713-794-1141      
Principal Investigator: Courtney DiNardo         
Sponsors and Collaborators
M.D. Anderson Cancer Center
National Cancer Institute (NCI)
Investigators
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Principal Investigator: Courtney DiNardo M.D. Anderson Cancer Center

Additional Information:
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Responsible Party: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT03047993     History of Changes
Other Study ID Numbers: 2016-0636
NCI-2018-01243 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
2016-0636 ( Other Identifier: M D Anderson Cancer Center )
P30CA016672 ( U.S. NIH Grant/Contract )
R01CA206210 ( U.S. NIH Grant/Contract )
First Posted: February 9, 2017    Key Record Dates
Last Update Posted: May 17, 2019
Last Verified: May 2019

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Leukemia
Preleukemia
Leukemia, Myelomonocytic, Chronic
Leukemia, Myelomonocytic, Juvenile
Myelodysplastic Syndromes
Syndrome
Disease
Pathologic Processes
Neoplasms by Histologic Type
Neoplasms
Leukemia, Myeloid
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions
Myelodysplastic-Myeloproliferative Diseases
Azacitidine
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Enzyme Inhibitors