A Phase I, Two-part Study to Determine the Recommended Dose and Evaluate the Safety and Tolerability of a Novel Oral Arsenic Trioxide Formulation (ORH-2014) in Subjects With Advanced Hematological Disorders

NCT ID: NCT03048344

Last Updated: 2019-03-25

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1
• Total Enrollment: 12 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-12-02
• Study Completion Date: 2019-02-28

Brief Summary

Part 1 will be conducted as an open-label, non-randomized, non-placebo-controlled dose escalation study using pre-specified doses. Subjects with the following advanced hematological disorders and no available therapies, and who satisfy all inclusion/exclusion criteria will be enrolled. The purpose is to identify the recommended dose of oral ORH-2014 in subjects with advanced hematological disorders.

Part 2 will be an expansion phase conducted as a single-arm, open-label study to further evaluate the safety and tolerability of ORH-2014 at the maximum tolerated dose (MTD) or recommended dose determined from Part 1 in the fasted state. Subjects with the same disease types as in Part 1 will be enrolled. All subjects will receive oral ORH-2014, in the fasted state, at the recommended dose for an initial period of up to 12 weeks. The purpose is to evaluate the safety and tolerability of oral ORH-2014 in a population of subjects with advanced hematological disorders when administered at the recommended dose.

Conditions

Advanced Hematological Disorders

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Part 1

Subjects will receive oral ORH-2014 at a planned starting dose of 5 mg once daily (QD) in the fasted state. If escalation criteria are met, the administered dose will increase by 5 mg increments to a maximum of 50 mg QD. The starting daily dose is approximately half the typical IV dose (0.15 milligram per kilogram \[mg/kg\]) extrapolated to a 70-kg person.

Group Type: EXPERIMENTAL

ORH-2014

Intervention Type: DRUG

ORH-2014 capsule 5 mg orally with dose escalations of 5 mg intervals.

Part 2

Subjects will receive a daily oral dose of ORH-2014 at the recommended dose identified in Part 1. ORH-2014 will be administered in the fasted state.

Group Type: EXPERIMENTAL

ORH-2014

Intervention Type: DRUG

ORH-2014 capsule at recommended dose orally.

Interventions

ORH-2014

ORH-2014 capsule 5 mg orally with dose escalations of 5 mg intervals.

Intervention Type: DRUG

ORH-2014

ORH-2014 capsule at recommended dose orally.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Female and male subjects ≥18 years of age with one of the following:

• Relapsed or refractory acute myelocytic leukemia (AML) with nucleophosmin-1 (NPM1) mutations and no available therapies.
• Relapsed or refractory acute promyelocytic leukemia (APL), with no available therapies. Note: Prior exposure to arsenic trioxide is allowed; however, subjects who have failed arsenic trioxide within the last 12 months are not allowed.
• Relapsed or refractory myelodysplastic syndrome (MDS), International Prognostic Scoring System intermediate or high-risk, with no available therapies
• Relapsed or refractory chronic myelomonocytic leukemia (CMML), and other MDS/myeloproliferative neoplasm (MPN) overlap syndromes, with no available therapies
• Relapsed or refractory mantle cell lymphoma (MCL) with no adequate therapies.
• Negative pregnancy test at the Screening visit for women of childbearing potential and willingness to use adequate birth control
• Not willing to undergo, not a candidate for, or not having a donor for immediate (within 3 months from the Screening date) bone marrow transplantation.

Exclusion Criteria

• Eastern Cooperative Oncology Group performance status of ≥3;
• Absolute myeloblast count ≥20,000/mm^3;
• Administration of any antineoplastic therapy within 5 half-lives of the antineoplastic therapy before the first dose of ORH-2014, with the exception of hydroxyurea that should be discontinued 1 day prior to the first dose of ORH-2014
• Presence of any remaining toxicities due to previous chemotherapy
• Participation in other clinical trials within at least 2 weeks of the first ORH-2014 dose;
• Clinical evidence of active central nervous system leukemia;
• Active and uncontrolled infection
• Major surgery within 2 weeks prior to trial entry;
• Liver function tests above the following limits at Screening: total bilirubin >1.5 x upper limit of normal (ULN) unless related to Gilbert's syndrome or hemolysis; aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >2.5 x ULN; for subjects with liver involvement, AST and/or ALT >5 x ULN;
• Serum creatinine >1.5 x ULN and/or creatinine clearance or estimated glomerular filtration rate <30 mL/min
• Impaired cardiac function
• Myocardial infarction of unstable angina within 6 months prior to the planned start date of study drug.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Orsenix LLC

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Farhad Ravandi-Kashani, MD

Role: PRINCIPAL_INVESTIGATOR

MD Anderson

Locations

Memorial Sloan-Kettering Cancer Center

New York, New York, United States

Weill Cornell Medical College

New York, New York, United States

Vanderbilt University

Nashville, Tennessee, United States

MD Anderson

Houston, Texas, United States

Countries

United States

References

Ravandi F, Koumenis I, Johri A, Tallman M, Roboz GJ, Strickland S, Garcia-Manero G, Borthakur G, Naqvi K, Meyer M, Pudipeddi M, Nidarmarthy S, Vaddi K, Kantarjian H. Oral arsenic trioxide ORH-2014 pharmacokinetic and safety profile in patients with advanced hematologic disorders. Haematologica. 2020 Jun;105(6):1567-1574. doi: 10.3324/haematol.2019.229583. Epub 2019 Sep 26.

Reference Type: DERIVED

PMID: 31558670 (View on PubMed)

Other Identifiers

ORH2014-001

Identifier Type: -

Identifier Source: org_study_id