An open label single-arm clinical trial to evaluate the safety, tolerability, PK, PD, and preliminary efficacy of SH1573 in subjects with advanced relapsed, refractory acute myelogenous leukemia that harbor an IDH2 mutation.
SH1573 is an IDH2 mutation inhibitor. This is a phase 1, open-label, multicenter, single-arm study to evaluate safety, tolerability, PK, PD, and preliminary efficacy of SH1573 capsules in treatment of subjects with advanced relapsed, refractory acute myeloid leukemias (AML) that harbor an IDH2 mutation. The study consists of 2 parts: a dose-escalation part (Phase Ia) and a dose-expansion part (Phase Ib). The dose-escalation part will determine the MTD/R2PD. The dose-expansion part will administer the MTD/RP2D to subjects with mIDH2-positive AML.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
41
Patients from each cohort will be administered SH1573 capsules every day of 28-day treatment cycles until disease progression or unacceptable toxicities.
Fujian Medical University Union Hospital
Fuzhou, Fujian, China
RECRUITINGRuijin Hospital, Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, China
RECRUITINGDose-limiting toxicity (DLT)
DLT is defined as an adverse event (AE) that meets protocol defined DLT criteria during cycle 1 (28 days every cycle)and is at least possibly related to study drug.
Time frame: Up to 28 days after first dose of study drug
Number of Participants With Adverse Events (AEs)
The intensity of each AE was graded from 1 to 5 according to the NCI CTCAE Version 5.0.
Time frame: From the first dose of the study drug to 30 days after the last dose of study drug
Rate of CR/CRh (complete remission with incomplete hematologic recovery)
CR was defined as \< 5% blasts in the bone marrow and full recovery of peripheral blood counts (platelets \> 100 x 10\^9/L and ANC \> 1.0 x 10\^9/L); CRh was defined as \< 5% blasts in the bone marrow and partial recovery ofperipheral blood counts (platelets \> 50 x 10\^9/L and ANC \> 0.5 x 10\^9/L).
Time frame: From the first dose of study drug to the time of progressive disease, assessed up to 36 months
Overall Response Rate (ORR)
ORR is defined as the percentage of participants achieving an overall response of CR, CRi, CRp, PR, or MLFS based on the 2003 revised IWG criteria for AML.
Time frame: From the first dose of study drug to the time of progressive disease, assessed up to 36 months.
Complete Response (CR) Rate
CR was defined as \< 5% blasts in the bone marrow and full recovery of peripheral blood counts (platelets \> 100 x 10\^9/L and ANC \> 1.0 x 10\^9/L).
Time frame: From the first dose of study drug to the time of progressive disease, assessed up to 36 months
Duration of Response(DOR)
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DOR was defined as the time from the date of first documented response until the date of documented progression or death in the absence of disease progression.
Time frame: From the first dose of study drug to the time of progressive disease, assessed up to 36 months
Overall Survival
Overall survival was defined as the time from the date of first dose until death from any cause and was used to further assess the efficacy of SH1573.
Time frame: From the first dose of study drug to the end of study or death, assessed up to 36 months
Time to response (TTR)
TTR is defined as the time from the date of first dose to the date of the first occurrence of response of CR, CRi, CRp, PR, or MLFS based on the 2003 revised IWG criteria for AML.
Time frame: From the first dose of study drug to the first response, assessed up to 36 months
Proportion of non-blood transfusion dependent subjects
It is defined as the proportion of subjects who do not need blood transfusion for any sequential period ≥8 weeks during the study treatment period.
Time frame: From the first dose of study drug to last dose of study drug, assessed up to 36 months
Maximum serum drug concentration
Blood samples will be obtained from all patients for determination of the maximum serum concentration of SH1573.
Time frame: 0, 1, 2, 4, 8, 12, 24, 48, 72 hours post-dose on single dose; 0 hour of cycle1 day 15; 0, 1, 2, 4, 8, 12, 24 hours post-dose on cycle 2 day 1; 0 hour of cycle 2 day 15 and cycle 3 day 1. Each cycle is 28 days.
Area under the concentration-time curve (AUC)
Blood samples will be obtained from all patients for determination of AUC of SH1573.
Time frame: 0, 1, 2, 4, 8, 12, 24, 48, 72 hours post-dose on single dose; 0 hour of cycle1 day 15; 0, 1, 2, 4, 8, 12, 24 hours post-dose on cycle 2 day 1; 0 hour of cycle 2 day 15 and cycle 3 day 1. Each cycle is 28 days.
α-Hydroxyglutaric acid (2-HG)
Plasma 2-HG was measured using qualified LC-MS/MS in order to characterize the pharmacodynamic (PD) effects of SH1573.
Time frame: 0, 24, 48 hours post-dose on single dose; Day1, Day15 pre-dose on cycle 1 and cycle 2; Day 1 pre-dose on cycle 3 and every 2 cycles afterwards. Each cycle is 28 days.