A Study of CFI-400945 With or Without Azacitidine or Decitabine in Patients With AML, MDS or CMML (TWT-202)
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ClinicalTrials.gov Identifier: NCT04730258 |
Recruitment Status :
Recruiting
First Posted : January 29, 2021
Last Update Posted : February 6, 2023
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Condition or disease | Intervention/treatment | Phase |
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Acute Myeloid Leukemia Myelodysplastic Syndromes Chronic Myelomonocytic Leukemia AML MDS CMML | Drug: CFI-400945 Drug: Azacitidine Drug: Decitabine | Phase 1 Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 72 participants |
Allocation: | Non-Randomized |
Intervention Model: | Sequential Assignment |
Intervention Model Description: | Dose escalation and expansion for monotherapy and combination arms with azacitidine or decitabine |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Phase 1b/2 Clinical Study of the Safety, Tolerability, and Pharmacokinetic and Pharmacodynamic Profiles of CFI-400945 as a Single Agent or in Combination With Azacitidine or Decitabine in Patients With AML, MDS or CMML |
Actual Study Start Date : | April 16, 2021 |
Estimated Primary Completion Date : | January 2024 |
Estimated Study Completion Date : | January 2024 |

Arm | Intervention/treatment |
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Experimental: 1A: Monotherapy escalation and expansion
Dose escalation and expansion arm with CFI-400945
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Drug: CFI-400945
The starting dose is 32 mg/day for escalation arms and the recommended starting dose for the expansion arms.
Other Names:
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Experimental: 1B: Food Effect
Food effect at the recommended phase 2 dose
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Drug: CFI-400945
The starting dose is 32 mg/day for escalation arms and the recommended starting dose for the expansion arms.
Other Names:
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Experimental: 2A: Combination escalation and expansion
Dose escalation and expansion arm with CFI-400945 and azacitidine
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Drug: CFI-400945
The starting dose is 32 mg/day for escalation arms and the recommended starting dose for the expansion arms.
Other Names:
Drug: Azacitidine Azacitidine will be given at its labeled dose and schedule |
Experimental: 2B: Combination escalation and expansion
Dose escalation and expansion arm with CFI-400945 and decitabine
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Drug: CFI-400945
The starting dose is 32 mg/day for escalation arms and the recommended starting dose for the expansion arms.
Other Names:
Drug: Decitabine Decitabine will be given at its labeled dose and schedule |
- Incidence of treatment emergent AEs [ Time Frame: 36 months ]The number of subjects who experience an adverse event that was possibly related to study drug
- Treatment emergent changes in vital signs [ Time Frame: 36 months ]The number of subjects who experience changes in blood pressure, heart rate, respiratory rate, body temperature that was possibly related to study drug.
- Treatment emergent changes in clinical laboratory tests [ Time Frame: 36 months ]The number of subjects who experience a change in laboratory parameters that was possibly related to study drug.
- Treatment emergent changes in physical examinations, ECOG performance status, electrocardiograms (ECGs), echocardiograms and cardiac troponins [ Time Frame: 36 months ]The number of subjects who experience changes in physical examinations, performance status, ECG, troponins that were possibly related to study drug.
- Composite Complete Remission Rate, CRc (complete remission + complete remission with incomplete blood count recovery + complete remission with incomplete platelet count recovery [CR + CRi + CRp]) [ Time Frame: 36 months ]Response rate will be summarized by dose cohort and overall using the percent of patients in patient with AML
- Overall response rate (ORR, defined as Complete remission + Marrow CR + Partial remission + Hematologic Improvement (CR + mCR+ PR + HI) [ Time Frame: 36 months ]Response rate will be summarized by dose cohort and overall using the percent of patients in patients with MDS, CMML
- The pharmacokinetics of CFI-400945 will be assessed through AUC. [ Time Frame: 36 months ]Area under the plasma concentration (AUC) versus time curve from time 0 to time of least measurable concentration tabulated by dose group.
- To assess the pharmacokinetic profile of CFI-400945 through Cmax. [ Time Frame: 36 months ]Cmax will be assessed through the maximum measured plasma concentration occurring at Tmax tabulated by dose group.
- To assess the pharmacokinetic profile of CFI-400945 through T1/2. [ Time Frame: 36 months ]Elimination half life will be calculated and tabulated by dose group.

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients must be >18 years of age
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For Parts 1A and 1B, the following malignancy types will be included:
- Relapsed or refractory AML.
- MDS, after prior hypomethylating agents.
- CMML, with progressive disease/lack of response after hypomethylating agents
For Parts 1A and 1B, Patients may have relapsed or refractory disease.
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For Parts 2A and 2B, the following malignancy types will be included:
- Relapsed or Refractory AML.
- MDS patients should be limited to high risk disease
- MDS or CMML should be previously untreated and patients with AML may have relapsed or refractory disease;
- Have clinically acceptable laboratory screening results (i.e., clinical chemistry, hematology, and urinalysis) within certain limits per protocol.
- Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
Exclusion Criteria:
- Patients who have received investigational therapy, radiotherapy, immunotherapy, monoclonal antibodies, or chemotherapy within 14 days or 5 half-lives (whichever is shorter)
- Allogeneic or autologous transplant for AML with infusion of stem cells within 90 days before Cycle 1 Day 1, or on active immunosuppressive therapy for graft-versus-host disease (GVHD) or GVHD prophylaxis within 2 weeks of Cycle 1 Day 1.
- Any Grade ≥ 2 persistent non-hematological toxicity related to allogeneic transplant, such as those requiring systemic immunosuppressive therapy.

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): NCT04730258
Contact: Treadwell Therapeutics Clinical Trials | +1-416-455-7510 | clinicaltrials@treadwelltx.com |
United States, California | |
City of Hope | Recruiting |
Duarte, California, United States, 91010 | |
Contact: Paul Koller | |
Contact: Felicia Lewis flewis@coh.org | |
University of California Davis Comprehensive Cancer Center | Recruiting |
Sacramento, California, United States, 95817 | |
Contact: Brian Jonas, MD brian.jonas@ucdmc.ucdavis.edu | |
Contact: Linh Dang-Chu ldangchu@ucdavis.edu | |
United States, Kentucky | |
Norton Cancer Institute - Saint Matthews | Completed |
Louisville, Kentucky, United States, 40207 | |
United States, New York | |
New York Presbyterian Weill Cornell Medical Center | Recruiting |
New York, New York, United States, 10021 | |
Contact: Gail Roboz | |
Contact: Ameenah Sukkur ams4015@med.cornell.edu | |
United States, Ohio | |
The Ohio State University Comprehensive Cancer Center | Recruiting |
Columbus, Ohio, United States, 43210 | |
Contact: Alice Mims | |
Contact: Stacey Dillon stacey.dillion@osumc.edu | |
United States, Texas | |
The University of Texas MD Anderson Cancer Centre | Recruiting |
Houston, Texas, United States, 77030 | |
Contact: Gautam Borthakur gborthak@mdanderson.org | |
Canada, Alberta | |
University of Alberta | Recruiting |
Edmonton, Alberta, Canada, T6G2B7 | |
Contact: Joseph Brandwein | |
Contact: Brent Howie brent.howie@primesiteresearch.com | |
Canada, Ontario | |
Princess Margaret Cancer Center | Recruiting |
Toronto, Ontario, Canada, M5G2C1 | |
Contact: Karen Yee | |
Contact: Hong Song hong.song@uhn.ca |
Principal Investigator: | Gautam Borthakur, MD | The University of Texas MD Anderson Cancer Centre |
Responsible Party: | Treadwell Therapeutics, Inc |
ClinicalTrials.gov Identifier: | NCT04730258 |
Other Study ID Numbers: |
TWT-202 |
First Posted: | January 29, 2021 Key Record Dates |
Last Update Posted: | February 6, 2023 |
Last Verified: | July 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Plan Description: | It is too early to determine whether we will make IPD available - we do not yet have a process written on this. Field will be updated once our policy / process is written. |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Treadwell Therapeutics Polo-like kinase 4 PLK4 serine/threonine kinase Polo-like kinase 4 CFI-400945 945 Polo-Like Kinase 4 inhibitors/antagonists |
hematologic malignancies PLK-4 UHN University Health Network Treadwell Treadwell Tx |
Leukemia Leukemia, Myelomonocytic, Chronic Leukemia, Myelomonocytic, Juvenile Myelodysplastic Syndromes Neoplasms by Histologic Type Neoplasms Leukemia, Myeloid Bone Marrow Diseases Hematologic Diseases Myelodysplastic-Myeloproliferative Diseases |
Chronic Disease Disease Attributes Pathologic Processes Azacitidine Decitabine Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Enzyme Inhibitors |