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First in Human Study of KO-539 in Relapsed or Refractory Acute Myeloid Leukemia

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04067336
Recruitment Status : Recruiting
First Posted : August 26, 2019
Last Update Posted : February 6, 2020
Sponsor:
Information provided by (Responsible Party):
Kura Oncology, Inc.

Brief Summary:
This first-in-human (FIH) dose escalation will determine the maximum tolerated dose (MTD) of KO-539, a menin-MLL(KMT2A) inhibitor, in patients with refractory or relapsed AML who have failed or are ineligible for any approved standard of care therapies, including HSCT.

Condition or disease Intervention/treatment Phase
Advanced Malignant Neoplasm Drug: KO-539 Phase 1

Detailed Description:
This Phase 1, first-in-human (FIH), open-label, dose-escalation study of KO-539, a menin-MLL(KMT2A) inhibitor, will determine the safety and tolerability of escalating doses using a modified toxicity probability interval (mTPI) adaptive design when administered to patients with relapsed and/or refractory AML. If an maximum tolerated dose (MTD) cannot be identified, a recommended phase 2 dose (RP2D) will be determined. A expansion phase in specific genetic subgroups is planned following determination of the MTD/RP2D. KO-539 will be administered as a once daily oral dose in 28 continuous day cycles.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1 First in Human Study of the Menin-MLL(KMT2A) Inhibitor KO 539 in Patients With Relapsed or Refractory Acute Myeloid Leukemia
Actual Study Start Date : September 12, 2019
Estimated Primary Completion Date : January 26, 2021
Estimated Study Completion Date : June 26, 2021


Arm Intervention/treatment
Experimental: KO-539
dose escalation study - capsules
Drug: KO-539
Oral administration




Primary Outcome Measures :
  1. Determine the maximal tolerated dose (MTD) of KO-539 mono-therapy in 28-day cycles. [ Time Frame: DLTs will be evaluated during the first 28 days (1 cycle) of KO-539 mono-therapy ]
    MTD is defined as the highest dose that is not expected to cause dose limiting toxicity (DLT) in more than 20% of patients.


Secondary Outcome Measures :
  1. Number of patients that experience Adverse Events (AEs) and Serious Adverse Events (SAEs). [ Time Frame: During treatment and up to approximately 28 days after treatment discontinuation, or until immediately before the initiation of another anticancer therapy, whichever occurs first. ]
    Adverse Events (AEs) and Serious Adverse Events (SAEs) will be graded according to the NCI-CTCAE v5.01.

  2. Maximum observed plasma concentration (Cmax) of KO-539. [ Time Frame: Blood samples for determination of KO-539 concentration will be collected in Cycle 1 and Cycle 2. Each cycle is 28 days. ]
    Determine Cmax of KO-539.

  3. Time to reach maximum observed concentration (Tmax). [ Time Frame: Blood samples for determination of KO-539 concentration will be collected in Cycle 1 and Cycle 2. Each cycle is 28 days. ]
    Determine Tmax of KO-539.

  4. Area under plasma-concentration time curve from time 0 to time of last quantifiable concentration (AUC(0-last)). [ Time Frame: Blood samples for determination of KO-539 concentration will be collected in Cycle 1 and Cycle 2. Each cycle is 28 days. ]
    Determine AUC(0-last) of KO-539.

  5. Early evidence of antitumor activity. [ Time Frame: Up to 6 months following end of treatment. ]
    Antitumor activity will be assessed according to the criteria proposed by the 2017 European Leukemia Network (ELN).



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:

  1. Refractory or relapsed AML defined as the reappearance of > 5% blasts in the bone marrow and who have failed or are ineligible for any approved standard of care therapies, including HSCT.
  2. ≥ 18 years of age.
  3. Read, understood, and provided written informed consent and, if applicable, Health Insurance Portability and Accountability Act (HIPAA) authorization after the nature of the study has been fully explained and must be willing to comply with all study requirements and procedures including serial bone marrow and peripheral blood sampling.
  4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to
  5. Adequate organ function: creatinine ≤ 2.0 × upper limit of normal (ULN); serum bilirubin ≤ 1.5 × ULN; aspartate aminotransferase and alanine aminotransferase ≤ 2.0 × ULN.
  6. Adequate renal function: creatinine clearance (CLcr) ≥ 60 mL/min using the Cockcroft-Gault equation.
  7. Hydroxyurea will be allowed prior to enrollment and after the start of KO-539 to control and maintain peripheral white blood cell (WBC) counts ≤ 30,000/μL. Patients can continue on hydroxyurea through Cycle 1 Day 28 or until first disease assessment. After which, patients should be titrated off therapy.
  8. Both men and women enrolled in this trial must use adequate birth control measures during the course of the trial and for at least 28 days or hematologic recovery whichever is longest after discontinuing study treatment. Patients and/or partners who are surgically sterile or postmenopausal are exempt from this requirement.

Exclusion Criteria:

  1. Patient has a diagnosis of acute promyelocytic leukemia.
  2. Patient has a diagnosis of chronic myelogenous leukemia in blast crisis.
  3. Donor lymphocyte infusion < 30 days prior to study entry.
  4. WBC count > 30,000/mm3.
  5. Clinically active central nervous system (CNS) leukemia.
  6. Patients who have undergone HSCT and have not had adequate hematologic recovery (i.e. ANC >1000 and platelet count > 100K) or patients on immunosuppressive therapy post HSCT at the time of screening (must be off all immunosuppression therapy for at least 2 weeks), or with Grade > 2 active graft-versus-host disease (GVHD), moderate or severe limited chronic GVHD, or extensive chronic GVHD of any severity. The use of topical steroids for cutaneous GVHD is allowed and stable steroid doses less than or equal to 10 mg of prednisone daily is permitted with Medical Monitor approval.
  7. Patient has received chemotherapy immunotherapy, or radiotherapy or any ancillary therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation) < 14 days prior to the first dose of KO-539 or within 5 drug half-lives (whichever is longer) prior to the first dose of study drug. Patients must have recovered to NCI CTCAE v. 5.01 ≤ Grade 2 from all acute toxicities (excluding Grade 2 toxicities that are not considered a safety risk by the Sponsor and Investigator) or toxicity must be deemed irreversible by the Investigator.
  8. Patient requires treatment with concomitant drugs that are strong inhibitors or inducers of cytochrome P450-isozyme 3A4 (CYP3A4) with the exception of antibiotics, antifungals, and antivirals that are used as standard of care or to prevent or treat infections and other such drugs that are considered absolutely essential for the care of the patient.
  9. Patient has a known positive test for human immunodeficiency virus, hepatitis C, or hepatitis B surface antigen indicative of active infection.
  10. Patient has a pre-existing disorder predisposing the patient to a serious or life-threatening infection (e.g., cystic fibrosis, congenital or acquired immunodeficiency, bleeding disorder, or cytopenias not related to AML).
  11. Patient has an active uncontrolled acute or chronic systemic fungal, bacterial, viral, or other infection.
  12. Significant cardiovascular disease including unstable angina pectoris, uncontrolled hypertension or arrhythmia, history of cerebrovascular accident including transient ischemic attack within the past 6 months, congestive heart failure (NYHA Class III or IV) related to primary cardiac disease, ischemic or severe valvular heart disease, or a myocardial infarction within 6 months prior to the first dose of study treatment.
  13. Mean QTcF or QTcB of >480 ms on triplicate electrocardiograms (ECGs) performed within 5 minutes of each other as a guide to known drugs associated with QTc prolongation, please refer to the following Credible Meds web page for a list of drugs that prolong QT and/or cause torsades de pointes, https://crediblemeds.org/pdftemp/pdf/CombinedList.pdf.
  14. Major surgery within 4 weeks prior to the first dose of study treatment. Surgery requiring local/epidural anesthesia must be completed at least 72 hours before study drug administration and patients should be recovered.
  15. Underlying medical condition that, in the Principal Investigator's opinion, will make the administration of study treatment hazardous or obscure the interpretation of toxicity determination or adverse events (AEs).
  16. Women who are pregnant or lactating. All female patients with reproductive potential must have a negative pregnancy test prior to starting treatment.
  17. Known alcohol or drug abuse or dependence.

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): NCT04067336


Contacts
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Contact: Diana Hummel 617-588-2609 dhummel@kuraoncology.com
Contact: Bridget Martell, MD 858-500-8852 bridget@kuraoncology.com

Locations
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United States, Illinois
Northwestern University Not yet recruiting
Chicago, Illinois, United States, 40411
Contact: E. Lela Lartey    312-695-1377    emanuela.lartey@northwestern.edu   
United States, Massachusetts
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114
Contact: Jeannette Pacheco    617-726-0759    jpacheco@partners.org   
United States, Michigan
University of Michigan Hospitals Recruiting
Ann Arbor, Michigan, United States, 48109
Contact: Zakery Northrop    734-936-2635    nzakery@med.umich.edu   
United States, New York
Roswell Park Comprehensive Cancer Center Recruiting
Buffalo, New York, United States, 14263
Contact: Anna Krasopoulos    716-845-1516    Anna.Krasopoulos@roswellpark.org   
Sponsors and Collaborators
Kura Oncology, Inc.

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Responsible Party: Kura Oncology, Inc.
ClinicalTrials.gov Identifier: NCT04067336    
Other Study ID Numbers: KO-MEN-001
First Posted: August 26, 2019    Key Record Dates
Last Update Posted: February 6, 2020
Last Verified: February 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Kura Oncology, Inc.:
AML
Hematological malignancy
KMT2A
NPM1
Additional relevant MeSH terms:
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Leukemia, Myeloid, Acute
Neoplasms
Leukemia
Neoplasms by Histologic Type
Leukemia, Myeloid