The purpose of this study is to explore the safety, pharmacokinetic (what the body does to the medication), pharmacodynamic (what the medication does to the body), and activity of JNJ-26481585 in patients with advanced or refractory leukemia and myelodysplastic syndrome (MDS).
This is an open-label (all people know the identity of the intervention), Phase 1 dose escalation, 2-part study (Part I and Part II). In Part I of the study, the Maximum Tolerated Dose (MTD) defined as the highest dose with an observed incidence of dose limiting toxicity (DLT) in no more than 1 in 6 patients, will be determined using rapid escalation (Stage 1) followed by conventional escalation (Stage 2). In Stage 1, at least 2 patients will be enrolled at each dose level; dose increments of 100% will be applied. In Stage 2, at least 3 patients will be enrolled at each dose level and dose increments of 20-50% will be implemented. Decisions on dose escalation or de-escalation, changes in the timing of pharmacokinetic/pharmacodynamic sampling, and the exploration of an alternative schedule were to be made by the Study Evaluation Team (SET), which consisted of all principal investigators, the medical monitor, and 1 of the sponsor's clinical pharmacologists. Part II of the study will be the expansion phase, which will begin after the MTD had been determined in Part I and an additional cohort of patients with MDS will be enrolled to further explore the safety and activity of JNJ 26481585 in patients with MDS. The starting dose for patients enrolled in Part II of the study was to be the MTD established in Part I. Depending on the outcome, the SET may decide to continue at the MTD dose, or dose-de-escalate to the next lower level (25 50% decrement from MTD). The cohort for MDS will be expanded to consist of 16 evaluable patients. Safety will be evaluated throughout the study and will include evaluations of adverse events clinical laboratory tests, electrocardiogram (ECG), vital signs, 24 hours Holter ECG, physical examination, Eastern Cooperative Oncology Group performance status and Multiple Gated Acquisition scan or echocardiography.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
In Part 1, Initial dose of JNJ-26481585 4 mg oral capsule is administered once daily on each day of a 21-day cycle. Dose will be escalated or de-escalated until Maximum tolerated dose (MTD) of JNJ-26481585 is determined in Part 1. MTD of JNJ-26481585 will be the initial dose in Part 2.
Unnamed facility
Baltimore, Maryland, United States
Unnamed facility
Houston, Texas, United States
Number of patients with adverse events
Time frame: Upto 14 days after last dose administration of study medication
Number of patients with dose limiting toxicity [DLT]
Only toxicities that occur during Treatment Cycle 1 will be used for the purposes of defining DLT.
Time frame: From the date of dosing upto 3 months after the date the last patient enrolled in Part I of the study, received the first dose of study medication
Maximum tolerated dose (MTD) of JNJ 26481585
The MTD is defined as the highest dose with an observed incidence of DLT in no more than 1 in 6 patients.
Time frame: From the date of dosing upto 3 months after the date the last patient enrolled in Part I of the study, received the first dose of study medication
Maximum plasma concentration (Cmax) of JNJ 26481585
Time frame: Days 1, 2, 8, 15 and 21 of Cycle 1
Time to reach maximum plasma concentration (tmax) of JNJ-26481585
Time frame: Days 1, 2, 8, 15 and 21 of Cycle 1
Area under the plasma concentration-time curve from time 0 to 24 hours (AUC0-24)
Time frame: Days 1, 2, 8, 15 and 21 of Cycle 1
Elimination half-life (t1/2) of JNJ-26481585
Time frame: Days 1, 2, 8, 15 and 21 of Cycle 1
Cumulative amount of drug excreted in urine over 24 hours (Ae24)
Time frame: Days 1 and 21 of Cycle 1
Renal clearance (CLR) of JNJ 26395018
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NONE
Enrollment
10
Time frame: Days 1 and 21 of Cycle 1
Concentration of biomarker histone acetylation
Time frame: Days 1 and 21 of Cycle 1; Day 21 of Cycles 2 to 20
Concentration of biomarker interleukin-6 (IL-6)
Time frame: Days 1 and 21 of Cycle 1; Day 21 of Cycles 2 to 20
Concentration of biomarker heat shock protein 90 (Hsp90)
Time frame: Days 1 and 21 of Cycle 1; Day 21 of Cycles 2 to 20
Complete Blood Count (CBC)
Anticancer activity of JNJ-26481585 explored by assessment of response parameters such as CBC.
Time frame: Pre-treatment (within 4 weeks prior to first dose of JNJ-26481585); Days 1, 3, 8, 15 and 21 of Cycle 1; Days 8, 15 and 21 of Cycle 2; Day 21 of Cycle 3 to 20; follow up (within 14 days after last dose of JNJ-26481585)
Assessment of Transfusion Record
Assessment of Transfusion Record is the parameter for assessment of response.
Time frame: From Day 1 of Cycle 1 upto 14 days after last dose
Radiological Tumor Mass assessment
Radiological Tumor Mass assessment is the parameter for assessment of response.
Time frame: Pre-treatment, Day 21 of Cycle 2 to 20 and follow up
Bone marrow aspirate/biopsy assessment
Bone marrow aspirate/biopsy assessment is the parameter for assessment of response.
Time frame: Pre-treatment, Day 21 of Cycles 1 to 20