Study of Tagraxofusp for Post-Transplant Maintenance for Patients With CD 123+ AML, MDS, MF and CMML (HSCT 002)

NCT ID: NCT05233618

Last Updated: 2025-05-28

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE1
• Total Enrollment: 44 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-07-13
• Study Completion Date: 2026-10-01

Brief Summary

In this study, tagraxofusp (Tag) is given to patients with CD 123+ myelofibrosis (MF), chronic myelomonocytic leukemia (CMML), and acute myeloid leukemia (AML) after allogeneic stem cell transplant (HCT) to help prevent relapse. Patients will receive up to about 9 cycles of treatment with Tag and have a bone marrow biopsy after cycle 4 and about 1 year after HCT.

Detailed Description

Relapsed disease is the primary cause of treatment failure after hematopoietic cell transplant (HCT). In this study, patients are given increasing levels of tagraxofusp (Tag) to evaluate the safety of each dose. Participants will start treatment with Tag starting between 60 and 120 days following HCT. Tag will be given by IV over about 15 minutes on days 1 through 3 of cycles 1-4 of treatment (28 day cycles) and then on days 1 and 2 of subsequent cycles, for up to 9 cycles or until disease progression or if you have a bad side effect. In the first cycle, Tag will be given while participants are inpatient. In all other cycles, Tag will be given outpatient and participants will be observed for 4 hours following each infusion. After about 4 cycles of treatment and again about 1 year after HCT, participants will have a bone marrow biopsy and also take a questionnaire about their quality of life. During the study, participants will have their blood checked regularly to monitor for side effects.

Conditions

Myelofibrosis; Chronic Myelomonocytic Leukemia; Acute Myeloid Leukemia

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Tagraxofusp (escalating doses)

IV tagraxofusp on days 1-3 of cycles 1-4 and days 1-2 of additional cycles for up to 9 cycles (some participants could receive more if considered in their best interest)

Group Type: EXPERIMENTAL

Tagraxofusp

Intervention Type: DRUG

inpatient on days 1-3 of cycles 1-4 and days 1-2 of additional cycles

Interventions

Tagraxofusp

inpatient on days 1-3 of cycles 1-4 and days 1-2 of additional cycles

Intervention Type: DRUG

Other Intervention Names

SL-701, Elzonris

Eligibility Criteria

Inclusion Criteria

1. The patient is ≥18 years old and ≤ 75 years old.

2. The patient has a life expectancy of >6 months.

3. The patient has an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-2.

4. The patient has adequate baseline organ function, including cardiac, renal, and hepatic function within 28 days of start of therapy:

• Left ventricular ejection fraction (LVEF) ≥ 50% as measured by multigated acquisition scan (MUGA) or 2-dimensional (2-D) echocardiogram (ECHO) and no clinically significant abnormalities on a 12-lead electrocardiogram (ECG)
• Serum Creatinine ≤ 1.5 mg/dL
• Bilirubin ≤1.5 mg/dL
• Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 times the upper limit of normal (ULN)
• Absolute neutrophil count (ANC) ≥0.5 × 10⁹/L
• Platelets ≥ 80,000/mm^3
• Serum albumin ≥3.2 (note that albumin infusions are not permitted in order to enable eligibility)

5. Patient meets the 2016 WHO diagnostic criteria for MF, is CD 123+, and has an IPSS/DIPSS/DIPSS-plus intermediate-1 with anemia (Hb < 10g/dl), splenomegaly (> 12 cm), leukocytosis (WBC > 25K) intermediate-2 or high-risk disease pre transplant.

Or

Patient has a 2016 WHO-defined diagnosis of CMML (persistent monocytosis ≥1 × 10⁹/L for at least 3 months, with other causes excluded, and monocytes ≥10% of WBC in peripheral blood, no criteria and no previous history of CML, ET, PV, and acute promyelocytic leukemia) pre transplant and is CD123+

Or

Patient has 2016 WHO-defined CMML-1 (2-4% blasts in peripheral blood and/or 5-9% blasts in bone marrow) and CMML-2 (5-19% blasts in peripheral blood and/or 10-19% blasts in bone marrow, and/or presence of Auer rods) pre transplant and is CD 123+

Or

Patient has CD 123+ AML in morphologic remission pre transplant

Or

Patient has Intermediate or high risk MDS by IPSS-R or moderate or high risk by IPSS-M pre transplant and has had no morphologic progression of disease post-transplant.

Receipt of first allogeneic stem cell transplant (related, unrelated, haploidentical or cord blood) 60-120 days prior to study registration

6. Patient is in morphologic remission according to bone marrow biopsy completed within 30 days prior to planned start of study treatment

7. Provision of signed and dated informed consent form

8. Stated willingness to comply with all study procedures and availability for the duration of the study

9. For females and males of reproductive potential: agreement to use adequate contraception for at least one month prior to screening, during study participation and for an additional one week after the end of study drug administration. Other (non-study) medications may require participants to use adequate contraception for longer.

10. For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner. Other (non-study) medications may require participants to use adequate contraception for longer.

11. Agreement to adhere to Lifestyle Considerations throughout study duration

4. Known active or suspected disease involvement of the central nervous system (CNS)

5. Receiving > 10 mg prednisone daily for GVHD

6. Overall Grade 2 or greater acute GVHD (per Magic criteria) at time of registration

7. Pregnant or breast feeding

8. Requirement of supplemental oxygen

9. Clinically significant cardiovascular disease (e.g., uncontrolled or any New York Heart Association Class 3 or 4 congestive heart failure, uncontrolled angina, history of myocardial infarction or stroke within 6 months of study entry, uncontrolled hypertension or clinically significant arrhythmias not controlled by medication)

10. Uncontrolled, clinically significant pulmonary disease (e.g., chronic obstructive pulmonary disease, pulmonary hypertension) that in the opinion of the Investigator would put the patient at significant risk for pulmonary complications during the study

11. Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, disseminated intravascular coagulation, or psychiatric illness/social situations that would limit compliance with study requirements

12. Known positive status for human immunodeficiency virus or active or chronic Hepatitis B or Hepatitis C

13. Receiving treatment for known or suspected fungal infection (prophylaxis is acceptable)

14. Known positive SARS-COV-2 test within 3 weeks of study entry. Exception: Tests that reflect past, resolved infection where the patient is determined to NOT be infectious, according to an infectious disease specialist, do not exclude the patient from participation.

15. Pedal edema ≥ grade 2

Exclusion Criteria

1. Treatment with any disease-related therapy, including radiation therapy or investigational agent, within 14 days of study entry

2. Previous treatment with tagraxofusp or known hypersensitivity to any components of the drug product

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Karen Ballen, MD

OTHER

Sponsor Role: lead

Responsible Party

Karen Ballen, MD

Chief of the Hematology/Oncology Division and the Medical Director of the Stem Cell Transplant Program

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Karen Ballen

Role: PRINCIPAL_INVESTIGATOR

UVA

Locations

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status: RECRUITING

University of Virginia

Charlottesville, Virginia, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Samantha Brooks

Role: CONTACT

SNB3GC@uvahealth.org

4349823365

Facility Contacts

Samantha Matusiak

Role: primary

samantha.matusiak@jefferson.edu

Samantha Brooks

Role: primary

SNB3GC@uvahealth.org

4345541718

Other Identifiers

HSR210434

Identifier Type: -

Identifier Source: org_study_id