This Phase I open-label dose escalation study is conducted in two stages with a primary endpoint to identify the maximum tolerated dose (MTD) of FT538 when administered with daratumumab in patients 12 years and older with advanced acute myeloid leukemia (AML) and related myeloid diseases.
FT538 is an off the shelf product comprised of allogeneic natural killer (NK)-cell immunotherapy lacking CD38 and expressing hnCD16 and IL-15RF. Daratumumab is a targeted therapy (IgG1k human monoclonal antibody) that targets CD38. FT538 is administered once a week for 3 consecutive weeks (Day 1, Day 8, and Day 15). Up to 5 dose levels will be tested. Fixed dose subcutaneous daratumumab is given on Day -12 and Day 5 prior to the NK cells as lymphodepletion, and on Day +3, Day +10, and Day +17 to maximize targeting. A short course of outpatient lymphodepleting chemotherapy is given on Day -4 and Day -3 to promote adoptive transfer. Day 1, the day of the 1st FT538 infusion, must be a Monday. The primary analysis for Phase I is intent-to-treat in that all patients receiving the 1st infusion of FT538 are evaluable for toxicity and efficacy. Patients who discontinue therapy prior to the first FT538 will be replaced. There are five potential FT538 dose cohorts. The starting dose is FT538 1x10e8 cells per dose with a lower safety dose of 5x10e7 if needed (Dose Level -1). The subsequent planned FT538 cohorts are 3x10e8, 1x10e9, and 1.5 x10e9 FT538 cells per dose. Dosing is based on hnCD16 expression, where 90% ± 10% of administered FT538 cells express hnCD16. The trial is conducted with no intra-patient escalation.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
9
Daratumumab 1800 mg co-formulated with 30,000 units of hyaluronidase (rHuPH20) given subcutaneously into subcutaneous tissue of the abdomen approximately 3 inches \[7.5 cm\] to the right or left of the navel over approximately 3-5 minutes on Day -12 and Day -5 prior to the 1st FT538 infusion, and on Day +3, Day+10, and Day+17 approximately 48 hours after each FT538 infusion.
FT538 is administered as an IV infusion via gravity using an IV administration set with an in-line filter at the patient's assigned dose levels (DL) on Day 1, Day 8, and Day 15
Fludarabine 25 mg/m\^2 is administered as a 1 hour intravenous (IV) infusion per institutional guidelines once a day on 2 consecutive days (Day -4, and Day -3).
Masonic Cancer Center, University of Minnesota
Minneapolis, Minnesota, United States
Number of Participants Experiencing Dose Limiting Toxicity (DLT) Events
Dose limiting toxicity (DLT) is defined as any AE (based on CTCAE v5) that is at least possibly related to FT538 that occurs after the first FT538 infusion through the end of the DLT assessment period on Day 29 as defined below: Any Grade 4 non-hematologic AE, Grade 3 pulmonary or cardiac AE of any duration, Grade 3 immune cell associated neurotoxicity syndrome (ICANS) of any duration, Any other Grade 3 non-hematologic AE of \>72 hours duration or Grade ≥2 acute GvHD requiring systemic steroid administration
Time frame: 42 days from the 1st FT538 infusion
Number of Participants Achieving Complete Remission (CR + CRi)
Efficacy of treatment is measured by the objective response rate (Complete Remission \[CR\] + Complete Remission with Incomplete Hematologic Recovery \[CRi\]) assessed by Day 28 based on the 2017 European LeukemiaNet (ELN) response criteria CR - defined as bone marrow blast \<5%, absence of circulating blasts and blasts with auer rods, absence of extramedullary disease, Absolute neutrophil count \>= 1.0 × 10e9/L (1000/μL) and platelet count \>=100 × 10e9/L 100,000/μL) CRi - defined as all CR criterial except for residual neutropenia (\<1.0 × 10e9/L \[1000/μL\]) or thrombocytopenia (\<100 × 10e9/L \[100,000/μL\])
Time frame: 28 days from the 1st FT538 infusion
Overall Response Rate
Overall response rate is defined as number of patients who have a partial or complete response to therapy divided by the total number of patients who received treatment. Response criteria will be based on 2017 European LeukemiaNet (ELN) response criteria assessing the bone marrow blast percentage, presence/absence of circulating blasts, presence/absence of blasts with auer rods, presence/absence of extramedullary disease, Absolute neutrophil counts per liter pf blood and platelet counts per liter blood
Time frame: 12 months from the 1st FT538 infusion
Percentage of Participants With Progression Free Survival (PFS)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Cyclophosphamide 300 mg/m\^2 is administered as a 2 hour intravenous (IV) infusion per institutional guidelines once a day on the same days that fludarabine is given.
Percentage of participants experiencing progression free survival at one year follow up
Time frame: 12 months from the 1st FT538 infusion
Percentage of Participants With Overall Survival (OS)
Percentage of participants with Overall Survival (OS) at one year follow up
Time frame: 12 months from the 1st FT538 infusion
Number of Participants Experiencing Adverse Events
Number of participants experiencing adverse events with the combination of Daratumumab and FT538
Time frame: 12 months from the 1st FT538 infusion