This is a Phase 1, open-label, multicenter, dose-escalation \& expansion study to evaluate the safety,tolerability and pharmacokinetics (PK) of LP-108, a BCL-2 inhibitor, combined with azacitidine, to determine the dose limiting toxicity (DLT) and the recommended Phase 2 dose (RP2D), and to assess the preliminary efficacy of this combination.
This Phase 1 study will look at different doses and different treatment schedules in order to better understand the effects of the combined regimens on the newly diagnosed or refractory/relapsed adult participants with AML ,MDS or CMML. The procedures include screening for eligibility, study treatments, and blood \& bone marrow tests. All the safety events will be record, pharmacokinetic parameters (Tmax, Cmax,T1/2, AUC et al.) will be calculated, response and survival will be assess during the study. Participants will be treated indefinitely until disease progression, unacceptable toxicity or withdrawal for other reasons.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
198
Oral administration for 21 or 28 days on a 28-day cycle
Subcutaneous administration for 7 days on a 28-day cycle at the dose of 75mg/m2 2-2.5h hours after LP-108.
The First Affiliated Hospital of Nanchang University
Nanchang, China
RECRUITINGFirst Affiliated Hospital of Soochow University
Suzhou, China
RECRUITINGAffiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital
Zhengzhou, China
RECRUITINGMaximum Tolerated Dose(MTD)
Standard phase I 3+3 design. The first 3 subjects will be assigned to dose level 1 cohort. If none of the first three subjects experiences DLT, escalation to dose level 2 cohort is permitted. If one of the first three subjects' experiences DLT, a total of six subjects will be required in that dose cohort, and escalation will only be permitted if five of six subjects do not experience DLT. If more than one DLT is observed in the dose level 2 cohort, this will be determined to be the maximally administered dose, and three more subjects will be enrolled in the dose level 1 cohort if only three were previously treated at that dose. Escalation from dose level 2 to level 3 cohort will be with the same method as before. The MTD will be the cohort in which ≤1/6 subjects have dose limiting toxicity at the dose prior to the maximally administered dose. If the dose level 3 cohort has ≤1/6 subjects with a DLT, the MTD will not have been reached.
Time frame: Up to 42 days after initial dose of study drug at the designated cohort dose.
Recommended Phase 2 Dose(RP2D)
RP2D will be determined using available safety and pharmacokinetics data upon completion of the dose escalation phase.
Time frame: Up to 1.5 years
Incidence of AEs
Type, frequency and severity of AEs, relationship of AEs to study treatment
Time frame: From first dose of study drug to 28 days after last dose of study drug
Incidence of clinically significant changes in clinical laboratory results
Clinically significant changes in hematology, chemistry, coagulation and urinalysis tests results.
Time frame: From first dose of study drug to 28 days after last dose of study drug
Cmax of LP-108
Maximum plasma concentration (Cmax) of LP-108.
Time frame: Up to 24 hours post dose
Tmax of LP-108
Time to maximum plasma concentration (Tmax) of LP-108.
Time frame: Up to 24 hours post dose
t1/2 of LP-108
The terminal elimination half-life (t1/2).
Time frame: Up to 24 hours post dose
AUC0-t of LP-108
Area under the plasma concentration-time curve (AUC) from 0 to the time of the last measurable concentration of LP-108.
Time frame: Up to 24 hours post dose
CL/F of LP-108
Apparent clearance (CL/F) of LP-108.
Time frame: Up to 24 hours post dose
Vd/F of LP-108
Apparent volume of distribution of LP-108.
Time frame: Up to 24 hours post dose
Objective Response Rate (ORR)
Response criteria follows the 2017 European Leukemia Net (ELN) recommendations for AML( CR, CRi, PR) , the International Working Group (IWG) response criteria for MDS(CR, PR, marrow CR, HI), the international consortium proposal of uniform response criteria for myelodysplastic/myeloproliferative neoplasms (MDS/MPN) in adults(CR, PR, Marrow response, Clinical benefit).
Time frame: Measured from Cycle 1 Day 1 to 28 days after last dose of study drug, and assessed up to 24 months.
Progression-Free Survival(PFS) (only for MDS or CMML)
PFS is defined as the number of days from the date of the first dose of study drug to the date of earliest disease progression or death.
Time frame: Measured from the date of first dose of study drug to the date of earliest disease progression or death or last visit, and assessed up to 24 months.
Time to Response(TTR)
TTR is defined as the number of days from the date of the first dose of study drug to the date of earliest response.
Time frame: Measured from the date of the first dose of study drug to the date of earliest response, and assessed up to 6 months.
Duration of Response(DOR)
DOR is defined as the number of days from the date of the first remission to the date of earliest disease progression or death.
Time frame: Measured from the date of the first remission to the date of earliest disease progression or death, and assessed up to 24 months.
DOCR (only for CR/CRi participants)
DOCR is defined as the number of days from the date of the first CR/CRi to the date of earliest disease progression or death.
Time frame: Measured from the date of the first CR/CRi to the date of earliest disease progression or death, and assessed up to 24 months.
Event-free Survival (EFS)
EFS is defined as the number of days from the date of first dose to the date of earliest evidence of disease progression/relapse, or initiation of new non-protocol-specified antitumor therapy without documented progression, or death.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Measured from the date of first dose to the date of earliest evidence of disease progression, initiation of new non-protocol-specified antitumor therapy without documented progression, death, and for up to 5 years after the last subject is enrolled.
OS
OS is defined as the number of days from the date of first dose to the date of death.
Time frame: Measured from the date of date of first dose to the date of death or last visit, and for up to 5 years after the last subject is enrolled.