Clinical trial • Phase II • Oncology|Haematology

ELTANEXOR for Acute myeloid leukemia|NPM1-mutated acute myeloid leukemia|Relapsed/refractory acute myeloid leukemia

Phase II trial of ELTANEXOR for Acute myeloid leukemia|NPM1-mutated acute myeloid leukemia|Relapsed/refractory acute myeloid leukemia. open-label.

Overview

Trial Therapeutic Area
Oncology|Haematology
Trial Disease
Acute myeloid leukemia|NPM1-mutated acute myeloid leukemia|Relapsed/refractory acute myeloid leukemia
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
07-11-2024
First CTIS Authorization Date
13-01-2025

Trial design

open-label Phase II trial across 3 sites in Italy.

Open Label
Yes
Biomarker Stratified
True, biomarker: NPM1 mutation
Target Sample Size
10

Eligibility

Recruits 10 Vulnerable population not selected. Written informed consent signed prior to any screening procedures and in accordance with local, and institutional guidelines..

Pregnancy Exclusion
Female patients with childbearing potential.
Vulnerable Population
Vulnerable population not selected. Written informed consent signed prior to any screening procedures and in accordance with local, and institutional guidelines.

Inclusion criteria

  • {"criterion_text":"- Written informed consent signed prior to any screening procedures and in accordance with local, and institutional guidelines.\n- Ability to swallow oral study medication.\n- Adequate hepatic function: a) total bilirubin ≤2 times the upper limit of normal (ULN) (except patients with Gilbert’s syndrome [hereditary indirect hyperbilirubinemia]. b) aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3 times ULN (except patients with known liver involvement of their tumor who must have their AST and ALT ≤5.0 times ULN).\n- Adequate renal function: estimated creatinine clearance of ≥30 mL/min, calculated using the formula of Cockcroft and Gault (140-Age) × Mass (kg)/(72 × creatinine mg/dL); multiply by 0.85 if female.\n- Female patients must be postmenopausal.\n- Male patients must use an effective barrier method of contraception if sexually active. Effective methods of contraception must be used throughout the study and for 6 months following the last dose.\n- Age ≥60 years.\n- Documented diagnosis of relapsed or refractory NPM1-mutated AML\n- Life expectancy of at least 3 months at the time of screening.\n- Patient must fall into one of these two categories: a) Patients eligible for standard treatment (intensive chemotherapy) at diagnosis that have received at least one line of standard chemotherapy and one venetoclax-based regimen, unless contraindicated. Additionally, patients with concomitant FLT3 mutations must have received at least one FLT3 inhibitor, unless contraindicated. b) Patients not eligible for standard treatment at diagnosis that have received at least one venetoclax-based regimen, unless contraindicated. Additionally, patients with concomitant FLT3 mutations must have received at least one FLT3 inhibitor, unless contraindicated.\n- Ineligibility for bone marrow transplantation at the time of screening.\n- White blood cell count ≤ 10 x 109/L.\n- A washout time of at least 14 days from the last cytotoxic treatment (except hydroxyurea) and 7 days from the last FLT3 inhibitor.\n- Eastern Cooperative Oncology Group (ECOG) performance status of <2."}

Exclusion criteria

  • {"criterion_text":"- Major surgery within 4 weeks before C1D1.\n- Patients unwilling to comply with the protocol including required biopsies and sample collections required to measure disease.\n- Impaired cardiac function or clinically significant cardiac diseases, including any of the following: a) Unstable angina or acute myocardial infarction ≤3 months prior to C1D1 b) Clinically significant heart disease (e.g., symptomatic congestive heart failure [e.g., >NYHA Class 2]; uncontrolled arrhythmia, or hypertension; history of labile hypertension or poor compliance with an antihypertensive regimen).\n- Uncontrolled active severe systemic infection requiring parenteral antibiotics, antivirals, or antifungals within 1 week prior to C1D1\n- Known CNS involvement by AML.\n- Known history of human immunodeficiency virus (HIV)\n- Known, active hepatitis A, B, or C infection; or known to be positive for HCV RNA or HBsAg (HBV surface antigen).\n- Patients with gastrointestinal tract disease (or uncontrolled vomiting or diarrhea) that could interfere with the absorption of eltanexor.\n- Serious psychiatric or medical conditions that, in the opinion of the Investigator, could interfere with treatment, compliance, or the ability to give consent.\n- Female patients with childbearing potential."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Response rate (sum of CR, CRi, MLFS) by the end of cycle 2","definition_or_measurement_approach":"Response rate defined as the sum of complete remission (CR), CR with incomplete hematologic recovery (CRi), and morphologic leukemia-free state (MLFS) assessed by the end of cycle 2."}
  • {"endpoint_text":"- Rate of Grade 5, non-hematological Grade 4 and long-lasting non-hematological Grade 3 adverse events","definition_or_measurement_approach":"Rate of specified severe non-hematological adverse events (Grade 5, Grade 4 non-hematological, and long-lasting Grade 3 non-hematological events) as reported in safety assessments."}

Recruitment

Planned Sample Size
10
Recruitment Window Months
47
Consent Approach
Written informed consent signed prior to any screening procedures and in accordance with local, and institutional guidelines. Adult subject information sheets and informed consent forms are documented (L1_SIS and ICF documents present).

Geography

Total Number Of Sites
3
Total Number Of Participants
10

Italy

Earliest CTIS Part Ii Submission Date
07-11-2024
Latest Decision Or Authorization Date
13-04-2026
Processing Time Days
522
Number Of Sites
3
Number Of Participants
10

Sites

Site Name
Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco Di Catania
Department Name
Divisione di Ematologia
Principal Investigator Name
Andrea Duminuco
Principal Investigator Email
andrea.duminuco@gmail.com
Contact Person Name
Andrea Duminuco
Contact Person Email
andrea.duminuco@gmail.com
Site Name
Azienda Ospedaliero Universitaria Delle Marche
Department Name
Clinica di Ematologia
Principal Investigator Name
Lorenzo Brunetti
Principal Investigator Email
lorenzo.brunetti@staff.univpm.it
Contact Person Name
Lorenzo Brunetti
Site Name
University Hospital Of Perugia
Department Name
Ematologia
Principal Investigator Name
MARIA PAOLA MARTELLI
Principal Investigator Email
maria.martelli@unipg.it
Contact Person Name
MARIA PAOLA MARTELLI
Contact Person Email
maria.martelli@unipg.it

Sponsor

Primary sponsor

Full Name
Azienda Ospedaliero Universitaria Delle Marche
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Italy

Third parties

  • {"country":"","full_name":"Ministero della Salute","duties_or_roles":"Source of monetary support","organisation_type":""}
  • {"country":"","full_name":"Karyopharm Therapeutics Inc.","duties_or_roles":"Source of monetary support","organisation_type":""}

Investigational products

Investigational Product Name
Eltanexor
Active Substance
ELTANEXOR
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
ORAL USE
Maximum Dose
20 mg per day

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