Clinical trial NCT05140811: A Study of IMM01 Combined With Azacitidine in Patients With Acute Myeloid Leukemia and Myelodysplastic Syndrome
Official title: Phase 1/Phase 2 Study of IMM01 Combined With Azacitidine in Patients With AML and MDS
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE1
PHASE2
Conditions: Acute Myeloid Leukemia
Myelodysplastic Syndromes
Lead sponsor: ImmuneOnco Biopharmaceuticals (Shanghai) Inc.
Sponsor class: OTHER
Collaborators: name: Institute of Hematology & Blood Diseases Hospital, China
First posted: 2021-12-01
Enrollment: 126
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This trial is an open-lable , multi-center, Phase 1/Phase 2 study that will evaluate the safety, tolerability, Pharmacokinetics, Pharmacodynamics and and immunogenicity of IMM01 combined with Azacitidine in patients with Acute Myeloid Leukemia (AML) and Myelodysplastic Syndrome (MDS).

Detailed description: Main study purpose:

* To evaluate the safety and tolerability of IMM01 combined with Azacitidine in patients with AML and MDS.
* To explore the Maximum Tolerated Dose (MTD) of IMM01 combined with Azacitidine, and determine the phase 2 clinical recommended dose (RP2D) of IMM01 combined with Azacitidine.

Secondary study purpose:

* To evaluate the efficacy of IMM01 combined with Azacitidine in patients with AML and MDS.
* To evaluate the Pharmacokinetics and Pharmacodynamics of IMM01 combined with Azacitidine, in patients with AML and MDS.

Exploratory study purpose:

• To evaluate the immunogenicity of IMM01 combined with Azacitidine in patients with AML and MDS.

Eligibility criteria: Inclusion Criteria:

1. Voluntary participation and written informed consent.
2. Males and females ≥18 years of age
3. The Eastern Oncology Collaboration (ECOG) Status of ≤2
4. Life expectancy of at least 3 months.
5. Women and men of reproductive age must agree and use effective contraception during the study period and for three months after the last administration of IMM01, and women of reproductive age must have negative pregnancy test results within seven days prior to administration.
6. White blood cell count ≤ 20×10⁹/L before the first treatment of the study drug (treatment with hydroxyurea is permitted, but not within 3 days before the first treatment of the study drug).
7. Bone marrow aspiration and bone marrow biopsy were agreed during screening and treatment.
8. For those who have received previous chemotherapy or targeted drug therapy, the interval between the first drug administration should be more than 2 weeks;Prior treatment with chimeric antigen receptor T cells (CAR T cells) should be discontinued for at least 12 weeks after initial dosing(for Cohort 1 and 2).
9. Non-hematological adverse reactions have been restored to grade 1 and below (NCI-CTC AE v5.0, except residual hair loss effect),in patients with previous chemotherapy and targeted drug therapy. Hematologic adverse reactions recovered to investigatory-determined acceptance of study drug administration (for cohort 1 and 2).
10. Appropriate organ functions.

Exclusion Criteria:

1. Received anti-CD47 antibody or SIRPα fusion protein research drugs.
2. Who has received allogeneic hematopoietic stem cell transplantation and other organ transplants; Autologous hematopoietic stem cell transplantation less than six months.
3. Central nervous system leukemia orcentral nervous system invasion.
4. Developed other malignant tumors within 5 years prior to enrollment.Except:

   Cured carcinoma in situ and non-melanoma skin cancer of the cervix; Complete remission of disease at least 2 years prior to initial administration and no need for antineoplastic therapy.
5. Patients with a history of active autoimmune diseases;
6. Major surgery within 4 weeks prior to initial treatment;
7. Subjects requiring systemic corticosteroids (equivalent to \>10 mg prednisone/day) or other immunosuppressive agents within 14 days prior to initial treatment or during the study period;
8. Hypertension (systolic blood pressure ≥ 140mmHg and/or diastolic blood pressure ≥ 90mmHg) or pulmonary hypertension or unstable angina that is also not controlled by medication;
9. Patients with a history of arterial or deep vein thrombosis within the 6 months prior to enrollment, or evidence or history of bleeding tendency within the 2 months prior to enrollment, regardless of severity.
10. Severe gastrointestinal diseases;
11. With acute lung disease, pulmonary fibrosis, Severe dyspnea, lung insufficiency or continuous oxygen inhalation.
12. Patients who have been severely infected within 4 weeks prior to initial administration;
13. Active hepatitis B or hepatitis C ; human immunodeficiency virus (HIV) antibody is positive.
14. Live attenuated vaccine should be administered within 4 weeks prior to initial administration.
15. Patients with a history of severe allergy to protein drugs (CTCAE V5.0 grade \> 3); Or the patient is allergic to azacytidine.
16. Participate in clinical trials of other drugs 28 days prior to initial dosing.
17. A history of prior neurological or mental disorders, such as epilepsy, dementia, or alcohol, drug or substance abuse, affects compliance.
18. Other conditions that the investigator considers inappropriate for participation in this clinical trial.

Primary outcomes:
measure: Incidence rate and the grade (severity) of dose-limiting toxicities (DLTs) of IMM01 combination azacitidine
timeFrame: Though end of DLT evaluation period,up to approximately 28 days.
measure: Maximum Tolerated Dose (MTD)
timeFrame: Dose-limiting toxicities will be evaluated during the first cycle (28 days) of treatment.
Secondary outcomes:
measure: Pharmacokinetics - Cmax
timeFrame: Within 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).
measure: Pharmacokinetics - AUC
timeFrame: Within 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).
measure: Pharmacokinetics - tmax
timeFrame: Within 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).
measure: Pharmacokinetics - T1/2
timeFrame: Within 60 minutes prior to infusion on Cycle 1 Day 1, Day 8, Day 15 and Cycle 2-6 Day 1 (28 days cycle).10 minutes post-infusion on Cycle 1 Day 15 and Cycle 6 Day 22 (28 days cycle ) .10 minutes and 4 hours post-infusion on Cycle 1 Day 1 (28 days cycle).
measure: Response Rate
timeFrame: When the last subject enrolled completes approximately 12 months of treatment
measure: Overall Remission (OR):
timeFrame: When the last subject enrolled completes approximately 12 months of treatment
Other outcomes:
measure: Exploratory Endpoint
timeFrame: In cycle 1(each cycle is 28 days) and cycle 4, 6, 8, 10, and 12, at the end of treatment or early study withdrawal, and 30 days after the last dose.
Locations:
city: Beijing
country: China
facility: Beijing gobroad boren hospital
city: Beijing
country: China
facility: Peking university third hospital
city: Beijing
country: China
facility: Xuanwu Hospital, Capital Medical University
city: Chongqing
country: China
facility: Chongqing university cancer hospital
city: Chongqing
country: China
facility: Second Affliated Hospital of Army Medical University
city: Fuzhou
country: China
facility: Fujian medical university union hospital
city: Ganzhou
country: China
facility: Ganzhou People's Hospital
city: Guangzhou
country: China
facility: Guangdong provincial people hospital
city: Guangzhou
country: China
facility: Nanfang Hospital, Southern Medical University
city: Guangzhou
country: China
facility: Zhujiang Hospital, Southern Medical University/The Second School of Clinical Medicine, Southern Medical University
city: Hangzhou
country: China
facility: The first affiliated hospital zhejiang university school of medicine
city: Nanchang
country: China
facility: The first affiliated hospital of nanchang University
city: Shanghai
country: China
facility: Ruijin Hospital, Shanghai Jiaotong University School of Medicine
city: Shanghai
country: China
facility: Shanghai sixth's hospital
city: Shanghai
country: China
facility: Tongren hospital shanghai jiaotong university school of medicine
city: Shenyang
country: China
facility: Shengjing Hospital Affiliated to China Medical University
city: Shenyang
country: China
facility: The First Hospital of China Medical University
city: Tianjin
country: China
facility: Tianjin Blood Disease Hospital
city: Wuhan
country: China
facility: Union Hospital Tongji Medical College Huazhong University of Science and Technology
city: Xuzhou
country: China
facility: The affiliated hospital of Xuzhou medical university
city: Zhengzhou
country: China
facility: Henan Cancer Hospital
city: Zhengzhou
country: China
facility: The first affiliated hospital of Zhengzhou University
Study officials:
References: