The objective of this study is to determine the safety, tolerability, and anti-leukemic activity of S227928 as single agent and in combination with venetoclax, and to determine the recommended Phase 2 dose (RP2D) of this combination. The study will begin as a Phase 1 Dose Escalation study to determine the RP2D and then will transition to a Phase 2 Dose Expansion study to assess the efficacy of the selected RP2D. During the treatment period participants will have study visits every two weeks, with additional visits occurring during the first and second cycle. Approximately 30 days after treatment has ended, an end-of-treatment visit will occur and then participants will be followed for survival every 12 weeks for the next 6 months. Study visits may include a bone marrow aspirate and/or biopsy, blood and urine tests, ECG, vital signs, physical examination, and administration of study treatment.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
13
For administration via intravenous (IV) infusion
For oral administration
City of Hope
Duarte, California, United States
The University of Kansas
Fairway, Kansas, United States
START Midwest
Grand Rapids, Michigan, United States
Memorial Sloan Kettering
New York, New York, United States
Fred Hutch Cancer Center
Seattle, Washington, United States
Peter MacCallum Cancer Centre
Melbourne, Australia
Prince of Wales Hospital
Randwick, Australia
Helsinki University Hospital - Comprehensive Cancer Center
Helsinki, Finland
Institut Paoli Calmette
Marseille, France
Chu de Nice - Hôpital L'archet 1
Nice, France
...and 6 more locations
Dose Escalation: Number and severity of Dose Limiting Toxicities (DLTs)
Time frame: Through Cycle 1 (each cycle is 28 days)
Dose Escalation: Number of Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time frame: Through 30 days after the end of treatment (Approximately 3.5 years)
Dose Escalation: Number of dose reductions, interruptions, delays, or study withdrawal due to AEs
Time frame: Through 30 days after the end of treatment (Approximately 3.5 years)
Dose Expansion: Complete remission (CR)
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Cmax of S227928, total Monoclonal Antibody (mAb), and unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: Cmax of S227928, total mAb, and unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation: Tmax of S227928, total mAb, and unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: Tmax of S227928, total mAb, and unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation: Area Under the Curve (AUC) of S227928, total mAb, and unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: AUC of S227928, total mAb, and unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation: Plasma concentration vs. time profile of S227928
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: Plasma concentration vs. time profile of S227928
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation: Plasma concentration vs. time profile of unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: Plasma concentration vs. time profile of unconjugated S64315
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation: Plasma concentration vs. time profile of total mAb
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: Plasma concentration vs. time profile of total mAb
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation (Arm B ONLY): Plasma concentration vs. time profile of venetoclax
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: Plasma concentration vs. time profile of venetoclax
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation: Detection of Anti-Drug Antibodies (ADAs) against S227928
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Expansion: Detection of ADAs against S227928
Time frame: Through the end of treatment (Approximately 3.5 years)
Dose Escalation: Complete remission (CR)
For patients with R/R AML or MDS/AML, or R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Complete remission with incomplete hematologic recovery (CRi)
For patients with R/R AML or MDS/AML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: CRi
Cohort 1 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Morphologic leukemia-free state (MLFS)
For patients with R/R AML or MDS/AML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: MLFS
Cohort 1 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: CR with partial hematologic recovery (CRh)
For patients with R/R AML or MDS/AML, or R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: CRh
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Partial remission (PR)
For patients with R/R AML or MDS/AML, or R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: PR
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Overall survival (OS)
For patients with R/R AML or MDS/AML, or R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: OS
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Duration of response (DOR)
For patients with R/R AML or MDS/AML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: DOR
Cohort 1 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Time to first remission (CR or CRh or CRi)
For patients with R/R AML or MDS/AML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: Time to first remission (CR or CRh or CRi)
Cohort 1 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Red-blood cell (RBC) and platelet transfusion independence for at least 8 weeks
For patients with R/R AML or MDS/AML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: RBC and platelet transfusion independence for at least 8 weeks
Cohort 1 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: CR with limited count recovery (CRL)
For patients with R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: CRL
Cohort 2 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: CR equivalent
For patients with R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: CR equivalent
Cohort 2 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Hematologic improvement (HI)
For patients with R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: HI
Cohort 2 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Overall response rate (ORR)= CR + CR equivalent + CRh + CRL + PR + HI
For patients with R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: Overall response rate (ORR)= CR + CR equivalent + CRh + CRL + PR + HI
Cohort 2 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Progression-free survival (PFS)
For patients with R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: PFS
Cohort 2 only
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Escalation: Event-free survival (EFS)
For patients with R/R CMML
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: EFS
Time frame: Through 6 months after the end of treatment (Approximately 4 years)
Dose Expansion: Number and severity of Dose Limiting Toxicities (DLTs) of S227928 in combination with venetoclax
Time frame: Through Cycle 1 (each cycle is 28 days)
Dose Expansion: AEs and SAEs
Time frame: Through 30 days after the end of treatment (Approximately 3.5 years)
Dose Expansion: Number of dose reductions, interruptions, delays, or study withdrawal due to AEs
Time frame: Through 30 days after the end of treatment (Approximately 3.5 years)
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