Acute Myeloid LeukemiaPhase 1/2NCT01573247
Safety Study of AKN-028 in Patients With Acute Myelogenous Leukemia
A Phase 1/2 study testing AKN-028 in people with Acute Myeloid Leukemia, run by Akinion Pharmaceuticals AB at 8 sites in 4 countries.
Trial summary
This Phase 1/2 study consists of two parts. The purpose of Part 1 of the study is to examine the safety and tolerability of AKN-028 and to determine the recommended dose of AKN-028 for further evaluation in Part 2 of the study in patients with Acute Myelogenous Leukemia (AML). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Myeloid Leukemia
- What is being tested?
- AKN-028
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 25 participants
- Where
- 8 sitesin 4 countries
- Study dates
- Dec 2011to Mar 2016
- Phase
- Phase 1/2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Provide written informed consent prior to Screening;
- Male or female patients, age ≥ 18 years;
- For females of childbearing potential, a negative urine pregnancy test must be obtained
- Confirmed diagnosis of AML (≥ 20% blasts in bone marrow and / or peripheral blood) according to World Health Organization (WHO) classification [2] and meeting at least one of the following:
- Newly diagnosed AML, but according to the clinical judgment of the principal investigator, patient is not a candidate for induction chemotherapy because of age, comorbidity, performance status, or other factors;
- AML in first relapse with WBC < 60,000/mm3 and ineligible for further intensive induction chemotherapy;
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- AML in second relapse with low peripheral blast count (< 10,000/mm3) and with WBC < 60,000/mm3 and ineligible for intensive induction chemotherapy;
- Primary refractory disease, here defined as patients with AML not having achieved CR following up to 2 courses of chemotherapy for enrollment in Part 1 and patients with AML refractory following 1 course of chemotherapy for enrollment in Part 2;
- Note: Severe neutropenia per se (up to Grade 4) should be accepted if it is likely to be related to the AML. However, the severe neutropenia may be due to the recently administered chemotherapy (e.g. cytarabin). It may be prudent to perform a new bone marrow examination. In case the marrow is hypoplastic (due to cytarabin) the screening should be postponed and G-CSF should be administered for a short period and then the patient should be re-evaluated. In case the bone marrow is not hypoplastic but rather infiltrated with AML cells the patient can be screened.
- Performance status of 0-3 on the Eastern Cooperative Oncology Group (ECOG) Performance Status Scale;
- Adequate organ function, including the following:
- Serum creatinine ≤ 2.0 mg/dL (176.8 mMol/L) during screening;
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2x the upper limits of normal (ULN) during screening; and
- Total bilirubin ≤1.5 x ULN during screening.
Who cannot join
- Patients who are candidates for induction chemotherapy for AML
- Total WBC count ≥ 60,000/mm3;
- Evidence of active central nervous system (CNS) leukemia;
- Evidence of blast-phase chronic myelogenous leukemia (CML);
- Histological or cytogenetic diagnosis of AML with M3 subtype (Acute Promyelocytic Leukemia);
- Lack of recovery of non-hematological toxicity from systemic therapy for the underlying hematologic condition;
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- Previous or concurrent malignancy except non-invasive non-melanoma skin cancer, in situ carcinoma of the cervix, or other solid tumor treated curatively, and without evidence of recurrence for at least 2 years prior to study entry; this exclusion does not refer to the disease (AML) under study;
- Uncontrolled systemic infection (viral, bacterial, or fungal);
- Uncontrolled disseminated intravascular coagulation;
- Known positive serology for human immunodeficiency virus;
- Clinically significant cardiac dysfunction (New York Heart Association Class 3 or 4) at the time of screening, or a history of myocardial infarction or heart failure within 3 months preceding the first dose of AKN-028;
- Chronic Graft versus Host Disease (GVHD) with the exception of mild (Grade 1) skin or oral GVHD;
- Major surgery within the 28 days preceding the first dose of AKN-028;
- Concomitant administration of any other anti-leukemia or anti-neoplastic therapy (during the screening period, hydroxyurea is allowed for ≤ 7 days before Cycle 1, as well as for ≤ 7 days between cycles);
- Concomitant treatment with immunotherapy, or any investigational agent within 28 days preceding the first dose of AKN-028, or lack of recovery from toxicity of such treatment;
- Active autoimmune disease requiring immunosuppressive therapy;
- Radiotherapy, or lack of recovery of any radiotherapy-related acute toxicity, within the 28 days preceding the first dose of AKN-028;
- Previous treatment in any clinical study with AKN-028, any other FLT-3 inhibitor, or any other c-Kit inhibitor;
- Female patients who are pregnant or breast-feeding;
- Male, or female patients of childbearing potential, unwilling to use an approved, effective means of contraception (e.g., oral contraception, barrier contraception, intrauterine device) in accordance with the investigator's standards;
- Known current drug or alcohol abuse;
- Active viral Hepatitis B and /or C;
- Other severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that, in the opinion of the investigator, may compromise the safety of the patient during the study, affect the patient's ability to complete the study, or interfere with interpretation of study results;
- Any condition, which is judged by the Investigator to be inappropriate for study participation, including an inability to communicate or cooperate with the Investigator and the requirements of this study.
Trial locations and contacts
8 sites in 4 countries.
8 sites in 4 countries
Sweden3 sites
Sahlgrenska University Hospital
Gothenburg
Orebro University Hospital
Örebro
Uppsala University Hospital
Uppsala, SE-751 85
Czechia2 sites
University Hospital Brno
Brno, 625 00
University Hospital Kralovske Vinohrady
Prague, 100 34
Poland2 sites
MTZ Clinical Research Inc.
Warsaw, 02-106
Institute of Hematology and Transfusion Medicine
Warsaw, 02-776
United Kingdom1 site
St.Bartholomew's Hospital
West Smithfield, EC1A 7BE
About this study
Official title: A Phase 1/2, Open-Label, Multi-Center Dose Escalation, Safety and Tolerability Study of AKN-028 in Patients With Acute Myelogenous Leukemia (AML)
This Phase 1/2 study consists of two parts. The purpose of Part 1 of the study is to examine the safety and tolerability of AKN-028 and to determine the recommended dose of AKN-028 for further evaluation in Part 2 of the study in patients with Acute Myelogenous Leukemia (AML). The purpose of Part 2 of the study is to determine safety and efficacy in patients with AML.
- Conditions
- Acute Myeloid Leukemia
- Being tested
- AKN-028
- Keywords
- Acute myeloid leukemia, Refractory Acute myeloid leukemia, FLT3 inhibitor, kinase inhibitor
- Medical subject headings
- Leukemia, Myeloid, Acute
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AKN-028Drug
Part 1 of the study is a sequential dose-escalation evaluation of AKN-028. Part 1 started as an accelerated intra-patient dose escalation design in one patient at a time (the N=1 portion), and has switched to standard 3 + 3 design with inter-cohort dose escalation when AUC of 12 μM*hrs has been reached. Starting dose of AKN-028 was 60 mg twice a day.
During Part 2 of the study AKN-028 will be administered at the dose level selected in Part 1. Patients will be treated for a maximum of 3 cycles (first cycle of 14 days followed by 2 cycles of 21 days), with at least a 7-day treatment-free period between cycles. Patients with significant benefit after 3rd cycle may continue treatment at discretion of the investigator for as long as the patient continues to show significant benefit.
| Study group | Role | What they receive |
|---|---|---|
| AKN-028 | Experimental | Not described Receives: Drug: AKN-028 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Plasma pharmacokinetic profiles
Measured: up to 3 months
Adverse Events
Safety follow up
Measured: up to 3 months
Secondary outcomes (1)
Response
Biological respons
Measured: participants will be followed for the duration of up to 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Apr 2012 (estimated)
- Study startDec 2011
- Primary completionMar 2016
- Study completionMar 2016
Why it stopped: During the study two patients have experienced serious liver events related to AKN-028. The risk-benefit balance was judged to be negative.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Acute Myeloid LeukemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 25 participants (actual)
Sponsor and investigators
- Lead sponsor
- Akinion Pharmaceuticals AB
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Martin Höglund, MD, PhD, Principal investigator, Dept of Hematology, Uppsala University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01573247
- Sponsor's protocol ID
- AKN001
- Other IDs
- 2011-003285-33
- Status last verified
- Mar 2016
- First submitted
- 28 Mar 2012
- Last updated
- 25 Mar 2016
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Eriksson A, Kalushkova A, Jarvius M, Hilhorst R, Rickardson L, Kultima HG, de Wijn R, Hovestad L, Fryknas M, Oberg F, Larsson R, Parrow V, Hoglund M. AKN-028 induces cell cycle arrest, downregulation of Myc associated genes and dose dependent reduction of tyrosine kinase activity in acute myeloid leukemia. Biochem Pharmacol. 2014 Jan 15;87(2):284-91. doi: 10.1016/j.bcp.2013.10.022. Epub 2013 Nov 4.
PubMed 24200998
Study at a glance
From the registry record, last updated by the sponsor on 25 Mar 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1/2, Open-Label, Multi-Center Dose Escalation, Safety and Tolerability Study of AKN-028 in Patients With Acute Myelogenous Leukemia (AML)
- ClinicalTrials.gov ID
- NCT01573247
- Acronym / sponsor ID
- AKN001
- Conditions
- Acute Myeloid Leukemia
- Keywords
- Acute myeloid leukemia, Refractory Acute myeloid leukemia, FLT3 inhibitor, kinase inhibitor
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: During the study two patients have experienced serious liver events related to AKN-028. The risk-benefit balance was judged to be negative.
- Enrolment
- 25 participants (actual)
- Lead sponsor
- Akinion Pharmaceuticals ABIndustry (pharma, biotech, devices)
- Study start
- Dec 2011
- Primary completion
- Mar 2016 (actual)
- Study completion
- Mar 2016 (actual)
- First posted
- 9 Apr 2012 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This Phase 1/2 study consists of two parts. The purpose of Part 1 of the study is to examine the safety and tolerability of AKN-028 and to determine the recommended dose of AKN-028 for further evaluation in Part 2 of the study in patients with Acute Myelogenous Leukemia (AML). The purpose of Part 2 of the study is to determine safety and efficacy in patients with AML.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| AKN-028 | Experimental | Drug: AKN-028 |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- Provide written informed consent prior to Screening;
- Male or female patients, age ≥ 18 years;
- For females of childbearing potential, a negative urine pregnancy test must be obtained
- Confirmed diagnosis of AML (≥ 20% blasts in bone marrow and / or peripheral blood) according to World Health Organization (WHO) classification [2] and meeting at least one of the following:
- Note: Severe neutropenia per se (up to Grade 4) should be accepted if it is likely to be related to the AML. However, the severe neutropenia may be due to the recently administered chemotherapy (e.g. cytarabin). It may be prudent to perform a new bone marrow examination. In case the marrow is hypoplastic (due to cytarabin) the screening should be postponed and G-CSF should be administered for a short period and then the patient should be re-evaluated. In case the bone marrow is not hypoplastic but rather infiltrated with AML cells the patient can be screened.
Key exclusion criteria (24 listed)
- Patients who are candidates for induction chemotherapy for AML
- Total WBC count ≥ 60,000/mm3;
- Evidence of active central nervous system (CNS) leukemia;
- Evidence of blast-phase chronic myelogenous leukemia (CML);
- Histological or cytogenetic diagnosis of AML with M3 subtype (Acute Promyelocytic Leukemia);
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AKN-028Part 1 of the study is a sequential dose-escalation evaluation of AKN-028. Part 1 started as an accelerated intra-patient dose escalation design in one patient at a time (the N=1 portion), and has switched to standard 3 + 3 design with inter-cohort dose escalation when AUC of 12 μM*hrs has been reached. Starting dose of AKN-028 was 60 mg twice a day. During Part 2 of the study AKN-028 will be administered at the dose level selected in Part 1. Patients will be treated for a maximum of 3 cycles (first cycle of 14 days followed by 2 cycles of 21 days), with at least a 7-day treatment-free period between cycles. Patients with significant benefit after 3rd cycle may continue treatment at discretion of the investigator for as long as the patient continues to show significant benefit. | Drug | AKN-028 |
Primary outcome
Plasma pharmacokinetic profiles
Time frame: up to 3 months
Adverse Events
Time frame: up to 3 months
Safety follow up
1 secondary outcome
Response
Time frame: participants will be followed for the duration of up to 3 months
Results and safety
The study was stopped early (reason given: During the study two patients have experienced serious liver events related to AKN-028. The risk-benefit balance was judged to be negative.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Mar 2016.
- Derived from this study: PubMed 24200998Eriksson A, Kalushkova A, Jarvius M, Hilhorst R, Rickardson L, Kultima HG, de Wijn R, Hovestad L, Fryknas M, Oberg F, Larsson R, Parrow V, Hoglund M. AKN-028 induces cell cycle arrest, downregulation of Myc associated genes and dose dependent reduction of tyrosine kinase activity in acute myeloid leukemia. Biochem Pharmacol. 2014 Jan 15;87(2):284-91. doi: 10.1016/j.bcp.2013.10.022. Epub 2013 Nov 4.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Martin Höglund, MD, PhD principal investigator
Dept of Hematology, Uppsala University Hospital
8 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing AKN-028 in people with Acute Myeloid Leukemia, run by Akinion Pharmaceuticals AB at 8 sites in 4 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 14 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 25 Mar 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 8 sites in Sweden, Czechia, Poland, United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: During the study two patients have experienced serious liver events related to AKN-028. The risk-benefit balance was judged to be negative.). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Plasma pharmacokinetic profiles (time frame: up to 3 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01573247, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Mar 2016.