This is a Phase 1/2a, multicenter, open-label, first-in-human (FIH) study of VOR33 in participants with AML or MDS who are undergoing human leukocyte antigen (HLA)-matched allogeneic hematopoietic cell transplant (HCT).
High risk acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) frequently relapses despite hematopoietic stem cell transplant (HCT). Post-HCT targeted therapy to reduce relapse is limited by toxicity to the engrafted cells. VOR33, an allogeneic CRISPR/Cas9 genome-edited hematopoietic stem and progenitor cell (HSPC) therapy product, lacking the CD33 protein, is being investigated for participants with CD33+ AML or MDS at high risk for relapse after HCT to allow post-HCT targeting of residual CD33+ acute AML cells using Mylotarg™ without toxicity to engrafted VOR33 cells. Participants will undergo a myeloablative HCT with matched related or unrelated donor CD34+-selected hematopoietic stem and progenitor cells (HSPCs) engineered to remove CD33 expression (VOR33 product). Mylotarg™ will be given after engraftment for up to 4 cycles. The primary endpoint assessing safety of VOR33 will be the incidence of successful engraftment at 28 days. Part 1 of this study will evaluate the safety of escalating Mylotarg™ dose levels to determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D). Part 2 will expand the number of participants to evaluate the Mylotarg™ RP2D.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
67
University of California San Diego Moores Cancer Center
La Jolla, California, United States
Stanford Cancer Institute
Stanford, California, United States
Incidence of neutrophil engraftment
Cumulative incidence of patients who achieve neutrophil engraftment (first day of 3 consecutive days of absolute neutrophil count (ANC) ≥500 cells/mm3) by Day 28.
Time frame: Day 28
Time to neutrophil engraftment
Time to neutrophil engraftment after HCT from Day 0; calculated as the first day of 3 consecutive laboratory values obtained on separate days where the ANC is ≥500 cells/mm3.
Time frame: Up to approximately 28 days
Time to platelet recovery
Time to platelet recovery defined as first day of a sustained platelet count \>20,000/ μL with no platelet transfusion in the preceding seven days.
Time frame: Up to approximately 60 days
Incidence of acute GVHD Grade (G) G2-G4 and G3-G4
Time frame: Up to 24 months
Incidence of chronic GVHD (all and moderate-severe)
Time frame: Up to 24 months
Incidence of primary and secondary graft failure
Incidence of primary and secondary graft failure measured by day 28 post HCT. Secondary graft failure is defined as initial neutrophil engraftment by Day 28 followed by subsequent decline.
Time frame: Up to 24 months
Incidence of toxicities to determine the MTD and RP2D of Mylotarg™
Time frame: Approximately day 60 until 24 months
Incidence of transplant-related mortality (TRM) post HCT
Time frame: Day 100, 12 months, 24 months
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Miami Cancer Institute
Miami, Florida, United States
Winship Cancer Institute Emory University
Atlanta, Georgia, United States
The University of Kansas Cancer Center
Fairway, Kansas, United States
National Institutes of Health, Clinical Center
Bethesda, Maryland, United States
Masonic Cancer Center, University of Minnesota
Minneapolis, Minnesota, United States
Washington University School of Medicine Siteman Cancer Center
St Louis, Missouri, United States
John Theurer Cancer Center at Hackensack University Medical Center
Hackensack, New Jersey, United States
Columbia University Medical Center - Herbert Irving Comprehensive Cancer Center
New York, New York, United States
...and 5 more locations
Percentage of CD33-negative myeloid cells
Percent donor myeloid chimerism and CD33-negative myeloid cells in peripheral blood.
Time frame: Day 28, 60, 100, 180, and Months 12 and 24
Relapse-free Survival (RFS)
Cumulative incidence of RFS
Time frame: Months 12 and 24
Overall Survival (OS)
OS defined as the time from HCT to the date of death from any cause
Time frame: Months 12 and 24