The study objective is to evaluate patient safety for patients with refractory and relapsed AML being treated with Ceramide NanoLiposome (CNL) .
The research team has shown that C6 ceramide nanoliposome (CNL) has anti-cancer activity in laboratory models of AML and that when it is combined with other cancer-fighting drugs, it works better. The primary goal of this study is to evaluate the safety of CNL given without other cancer treatments in patients with AML where either their initial treatment didn't work or it stopped working and the AML came back (refractory or relapsed AML, aka RR-AML). This study seeks to determine the right dose to start with in later studies when CNL is combined with other drugs in potential future studies. CNL is given by intravenous (IV) infusion and will be given twice a week in this study. Participants will receive study treatment as long as it is considered safe for them to continue, though their disease status will be checked regularly to make sure that their disease has not gotten worse. Blood samples will be collected at many time-points to see how their bodies are responding to the drug and how long it stays in the blood. The first patients in the study will start at one dose of the drug and, if that is shown to be safe, the next group will be treated at a slightly higher dose. Participants will be given CNL by intravenous (IV) infusion twice a week over about 2 hours and then they will be monitored for about 2 hours to make sure they don't have any bad side effects, but initially patients will be required to stay at the site for about 6 hours after the start of the infusion in order to get blood draws to see how long the drug stays active in their system. Participants will have a bone marrow biopsy before their second "cycle" of drug (after about 1 month) and then again before their third cycle of drug in order to see how their disease is responding. After that, bone marrow biopsies will be about every other cycle based on what the study doctor recommends. If the doctor doesn't think that CNL is helping their disease, or if their doctor decides that it is not safe for them to continue, they will be taken off study treatment. Participants will be followed for safety and disease status for up to 6 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Ceramide NanoLiposome will be given by IV twice a week. The dose, which is based on body size, will be increased for the next group of patients if the first group of patients tolerates that dose and it will decrease for the next group if they do not tolerate the dose.
University of Virginia Cancer Center
Charlottesville, Virginia, United States
RECRUITINGNumber of Patients with Dose Limiting Toxicities as defined in Protocol Section 13.5
Dose Limiting Toxicities within the first cycle of CNL monotherapy. See section 13.5 of Protocol for the complete list of Dose Limiting Toxicities
Time frame: At the end of the the first cycle of administration (each cycle is 28 days)
Number of Patients with Adverse Events
Number of Patients with Adverse Events
Time frame: Through study completion, an average of 24 weeks
Severity of Adverse Events
Severity of Adverse Event As Described in Protocol
Time frame: Through study completion, an average of 24 weeks
Duration of Adverse Events
Duration of Adverse Events, As Described in Protocol, measured in days
Time frame: Length of Adverse Events as measured in days, measured through study completion, an average of 24 weeks
Duration of therapy
Duration of therapy provided as measured in days
Time frame: Through study completion, an average of 24 weeks
Dose Levels achieved during study
Dose levels administered in milligrams per m2
Time frame: Through study completion, an average of 24 weeks
Concentration Max (C Max)
Maximum Serum Concentration measured, in nanograms/milliliter
Time frame: Through cycle one, 28 days (each cycle is 28 days)
Time to Maximum Study Drug (T Max)
Time to maximum concentration measured, in minutes
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Time frame: Through cycle one, 28 days (each cycle is 28 days)
Half Life of Study Drug
Time for drug to be reduced to half of the starting concentration (in minutes)
Time frame: Through cycle one, 28 days (each cycle is 28 days)
Study Drug Clearance
The Amount of Study Drug Cleared per unit time (Nanograms/Minute)
Time frame: Through cycle one, 28 days (each cycle is 28 days)
Ratio of C16/C24 Ceramides
Ratio of Ceramide 16 to Ceramide 24 (ng of C16/ng of C18) from bone marrow biopsy
Time frame: After one cycle of therapy (Day 28)
Clinical Response - Complete Response
Complete Response
Time frame: After Cycle Two (56 days)
Clinical Response - Complete Response with Incomplete Hematologic Recovery (CRi)
Complete Response with Incomplete Hematological Recovery as defined by blasts in bone marrow
Time frame: After Cycle Two (56 days)
Clinical Response - Partial Remission
Partial Remission (as defined by blasts in bone marrow)
Time frame: After Cycle Two (56 days)
Number of Patients with Grade 3 or 4 Adverse Events
Grade 3 and 4 adverse events as defined by CTCAE v5.0
Time frame: Through study completion, an average of 24 weeks
Overall Response
Overall response of CNL monotherapy in patients with RR-AML: Complete remission (CR) + Complete remission with incomplete count recovery (CRi) + partial response (PR). CR, CRi and PR as defined as European LeukemiaNet 2017 (ELN 2017) response criteria
Time frame: Through study completion, an average of 24 weeks, and up to 24 weeks afterwards (total of 48 weeks)
Event Free Survival
Event-free survival (EFS): the time from registration until documented refractory disease, relapse after achieving CR/CRi, or death from any cause, whichever is observed first
Time frame: From registration to 24 weeks after completion of experimental drug treatment
Overall Survival
Overall survival (OS)
Time frame: From registration to 24 weeks following drug administration
Quality of Life according to EORTC Quality of Life Questionnaire (QLQ) C30
Quality of life according to EORTC Quality of Life Questionnaire C30
Time frame: Prior to starting study treatment, on day 1 of each cycle (each cycle is 28 days), and at end of treatment (which is expected to be 2 to 3 months (cycles) for most patients