The objective of this study is to evaluate the safety, tolerability, and pharmacokinetics (PK) of S241656 and to determine the recommended dose for expansion (RDE) of S241656 in participants with relapsed/refractory (R/R) acute myeloid leukemia (AML), myelodysplastic syndrome/acute myeloid leukemia (MDS/AML), or chronic myelomonocytic leukemia (CMML). Part 1A dose escalation will determine the RDE to be used in a future expansion stage of the trial. An optional Part 1B drug-drug interaction (DDI) substudy will evaluate the effect of posaconazole on the PK of S241656. The study consists of a screening period of up to 21 days, a treatment period consisting of continuous 28-day cycles of treatment, an end-of-treatment visit, a safety follow-up period, and long-term disease and survival follow-up every 3 months. Participants in the optional DDI substudy may continue treatment in the main study following completion of the DDI assessment period. Participants may undergo bone marrow aspirates and/or biopsies, blood tests, electrocardiograms (ECGs), echocardiograms or multigated acquisition (MUGA) scans, physical examinations, ophthalmologic assessments, and disease response questionnaires.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
64
Tablets taken by mouth.
Tablets taken by mouth
(Part 1A and 1B) Dose limiting toxicity (DLTs) associated with S241656 during the first cycle of treatment
Time frame: Through Cycle 1 (28 days)
(Part 1A and 1B) Number of Adverse Events (AEs)
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Number of Serious Adverse Events (SAEs)
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Severity of AEs
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Severity of SAEs
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Duration of AEs
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Duration of SAEs
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Number of changes in safety laboratory results
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Number of changes in physical examination
Time frame: Through 30 days after the last dose of treatment, up to approximately 4 years
(Part 1A and 1B) Number of dose reductions due to AEs
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A and 1B) Number of dose interruptions due to AEs
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A and 1B) Number of dose delays due to AEs
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A and 1B) Number of study withdrawals due to AEs
Time frame: Through end of treatment, up to approximately 4 years
(Part 1B only) Maximum concentration (Cmax) of S241656
Time frame: Through Cycle 1 (28 days)
(Part 1B only) Cmax of metabolite S243796
Time frame: Through Cycle 1 (28 days)
(Part 1B only) Time corresponding to Cmax (Tmax) of S241656
Time frame: Through Cycle 1 (28 days)
(Part 1B only) Tmax of metabolite S243796
Time frame: Through Cycle 1 (28 days)
(Part 1B only) Terminal half-life (t1/2) of S241656
Time frame: Through Cycle 1 (28 days)
(Part 1B only) t1/2 of metabolite S243796
Time frame: Through Cycle 1 (28 days)
(Part 1B only) Area under the curve (AUC) of S241656
Time frame: Through Cycle 1 (28 days)
(Part 1B only) AUC of metabolite S243796
Time frame: Through Cycle 1 (28 days)
(Part 1A only) Cmax of S241656
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A only) Cmax of metabolite S243796
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A only) Tmax of S241656
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A only) Tmax of metabolite S243796
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A only) AUC of S241656
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A only) AUC of metabolite S243796
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A only) t1/2 of S241656
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A only) t1/2 of metabolite S243796
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A and 1B) Complete remission (CR)
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Complete remission with incomplete hematologic recovery (CRi)
In participants with AML or MDS/AML only
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Morphologic leukemia free state (MLFS)
In participants with AML or MDS/AML only
Time frame: Through study completion, approximately 4 years
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(Part 1A and 1B) Complete remission with partial hematologic recovery (CRh)
In participants with AML or MDS/AML only
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Partial response (PR)
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Objective response (OR)
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Composite complete remission (CRc)
In participants with AML or MDS/AML only
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Red blood cell (RBC) and platelet transfusion independence for at least 8 weeks
In participants with AML or MDS/AML only
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A and 1B) Duration of response (DOR)
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Time to response (TTR)
In participants with AML or MDS/AML only
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Event free survival (EFS)
In participants with AML or MDS/AML only
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Overall survival (OS)
Time frame: Through study completion, approximately 4 years
(Part 1A and 1B) Marrow response
In participants with CMML only
Time frame: Through end of treatment, up to approximately 4 years
(Part 1A and 1B) Number of participants with erythroid-, neutrophil-, platelet or spleen-response
In participants with CMML only
Time frame: Through end of treatment, up to approximately 4 years