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Prevention of Chemotherapy-induced MyelosuppressionPhase 1NCT05622058

A Study of ALRN-6924 for Protection of Chemotherapy-Induced Side Effects in Patients With TP53-Mutant Breast Cancer

A Phase 1 study testing ALRN-6924 and TAC (doxorubicin 50 mg/m2; cyclophosphamide 500 mg/m2; docetaxel 75 mg/m2) in people with Prevention of Chemotherapy-induced Myelosuppression, run by Aileron Therapeutics, Inc. at 14 sites in 4 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a Phase 1b open-label, single arm, multicenter, study of ALRN-6924 as a chemoprotection agent in patients with TP53-mutated HER2- breast cancer (stages IIa to IIIb) receiving neoadjuvant or adjuvant chemotherapy with doxorubicin, docetaxel, and cyclophosphamide (TAC). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
ALRN-6924 and TAC (doxorubicin 50 mg/m2; cyclophosphamide 500 mg/m2; docetaxel 75 mg/m2)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6 participants
Where
14 sitesin 4 countries
Study dates
9 Jan 2023to 22 Feb 2023
Phase
Phase 1
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

  • Females and males, age ≥18years.
  • Patients who, in the investigator's judgment, are able to understand and willing to comply with the requirements of this clinical trial and to provide written informed consent.
  • Histologically confirmed diagnosis of HER2 negative breast cancer
  • Candidate to receive chemotherapy with TAC regimen
  • Presence of p53 mutation(s) in tumor tissue as assessed by next generation sequencing (NGS).
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤2
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  • Left ventricular ejection fraction > 55%.
  • Laboratory results obtained within 14 days prior to the first study treatment administration (Cycle 1, Day 0) demonstrating:
  • Absolute neutrophil count (ANC) ≥ 1500 cells/μL (without granulocyte colony stimulating factor [G-CSF] support within 2 weeks prior to the first study treatment administration)
  • Platelet count ≥ 100,000/μL (without transfusion within 2 weeks prior to the first study treatment administration)
  • Hemoglobin ≥ 10.0 g/dL
  • AST, ALT, and alkaline phosphatase ≤ 2.5 x the upper limit of normal (ULN)
  • Serum bilirubin ≤ 1.5× ULN (patients with known Gilbert's disease who have serum bilirubin level ≤ 3× ULN may be enrolled.)
  • Patients who are not receiving therapeutic anticoagulation: Calculated creatinine clearance (CrCl) ≥ 30 mL/min (Cockcroft-Gault formula).
  • Have not received prior chemotherapy or targeted systemic therapy for their breast cancer.

Who cannot join

  • Known hypersensitivity to any component of study treatment.
  • Prior chemotherapy for HER2 negative breast cancer.
  • 1. Presence of distant metastases. Nodal involvement is acceptable.
  • Uncontrolled intercurrent illness including but not limited to:
  • Clinically significant, active, uncontrolled infection including human immunodeficiency virus (HIV), or hepatitis B or C
  • Patients with HIV must be on effective antiretroviral therapy for ≥ 4 weeks prior to enrollment and have HIV viral load < 400 copies/mL, have had no acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections in the past 12 months, and have CD4+ count ≥ 350 cells/μL.
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  • Patients with chronic hepatitis B virus (HBV) must be on antiviral therapy and have HBV viral load below the limits of detection.
  • Patients with hepatitis C virus (HCV) must be on or have completed antiviral therapy and have an HCV viral load below the limits of detection.
  • Uncontrolled hypertension
  • Uncontrolled diabetes mellitus
  • Clinically unstable cardiac disease, including unstable atrial fibrillation, symptomatic bradycardia, unstable congestive heart failure, active myocardial ischemia, or indwelling temporary pacemaker.
  • Pregnant or lactating women.
  • Hereditary angioedema of any severity or severe or life-threatening angioedema due to any cause.
  • Treatment with an investigational agent for any indication within the shorter of 14 days or 5 half-lives, if the half-life is known.
  • The required use of any concomitant medications that are predominantly cleared by hepatobiliary transporters, OATP members OATP1B1 and OATP1B3, on the day of the first ALRN-6924 infusion to within 48 hours after the last ALRN-6924 infusion in a treatment cycle. This criterion does not apply to the patients in the control group.
  • Other medications, severe acute/chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the patient inappropriate for entry into this study.
  • Clinically evident alopecia of any grade at screening.

Trial locations and contacts

14 sites in 4 countries.

14 sites in 4 countries

United States5 sites
  • Gabrail Cancer Center

    Canton, Ohio, 44718

  • Pennsylvania Cancer Specialists & Resesrach Institute

    Gettysburg, Pennsylvania, 17325

  • Southern Oncology Specialists

    Huntersville, North Carolina, 28078

  • Oncology and Hematology Associates of West Broward

    Tamarac, Florida, 33321

  • Regional Medical Oncolgy Center

    Wilson, North Carolina, 27893

Other trials in United States

Bosnia and Herzegovina4 sites
  • University Clinical Center of the Republic of Srpska

    Banja Luka, 71000

  • University Clinical Hospital Mostar

    Mostar, 88000

  • Clinical Center University of Sarajevo, Oncology Clinic

    Sarajevo, 71000

  • University Clinical Center Tuzla

    Tuzla, 75000

Other trials in Bosnia and Herzegovina

Serbia3 sites
  • Kliničko bolnički centar "Bežanijska kosa"

    Belgrade, 11070

  • Oncology Institute of Vojvodina

    Kamenitz, 21204

  • Univerzitetski Klinički centar Kragujevac

    Kragujevac, 34000

Other trials in Serbia

Bulgaria2 sites
  • MBAL University Hospital OOD

    Panagyurishte, 4500

  • KOC (Complex Oncology Center) Plovdiv

    Plovdiv, 4000

Other trials in Bulgaria

About this study

Official title: A Phase 1b Clinical Study of the Dual MDMX/MDM2 Inhibitor, ALRN-6924, as a Chemoprotection Agent in Patients With TP53-Mutated, HER2 Negative Breast Cancer Receiving Neoadjuvant or Adjuvant Chemotherapy With Docetaxel, Doxorubicin, and Cyclophosphamide (TAC)

This is a Phase 1b open-label, single arm, multicenter, study of ALRN-6924 as a chemoprotection agent in patients with TP53-mutated HER2- breast cancer (stages IIa to IIIb) receiving neoadjuvant or adjuvant chemotherapy with doxorubicin, docetaxel, and cyclophosphamide (TAC). Chemotherapy affects cells that are dividing, whether they are tumor cells or healthy cells (including, bone marrow cells, hair follicle cells, and epithelial cells lining the gastrointestinal tract). ALRN-6924 is designed to stop cell division in healthy cells but not in tumor cells because they have a mutation of the TP53 gene. When this happens, tumor cells will still be destroyed by the chemotherapy but healthy cells that are not dividing may be spared from chemotherapy damage and the patient should have less side effects.

Read the detailed description

This is a Phase 1b, open-label, single-arm, multicenter clinical trial for evaluation of safety, tolerability and chemoprotection effects of ALRN-6924 combined with chemotherapy in patients with TP53-mutated, HER2 negative breast cancer without distant organ metastases. All patients will receive the neoadjuvant or adjuvant chemotherapy regimen known as TAC. TAC consists of doxorubicin 50 mg/m2 IV infusion, docetaxel 75mg/m2 IV infusion and cyclophosphamide 500 mg/m2 IV infusion, given on Day 1 of every 3-week cycle for a total of 4-6 treatment cycles according to each patient's individual needs, individual institutional policies and standards of care, as well as investigator discretion. ALRN-6924 1.2 mg/kg will be administered on 3 consecutive days in each treatment cycle, Days 0-2. Prophylactic administration of G-CSF prior to the first instance of Grade 4 neutropenia is not allowed in Cycle 1. Myeloid growth factor support with filgrastim should be administered immediately if a patient is diagnosed with Grade 4 neutropenia.

Being tested
ALRN-6924, TAC (doxorubicin 50 mg/m2; cyclophosphamide 500 mg/m2; docetaxel 75 mg/m2)
Keywords
ALRN-6924, Chemoprotection, Myelosuppression, Cell cycle arrest, p53 mutation, Breast cancer, Alopecia, Neutropenia
Medical subject headings
Breast Neoplasms, Alopecia, Neutropenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ALRN-6924Drug

    ALRN-6924 administered in every chemotherapy treatment cycle as an IV infusion over 1 hour on Days 0 (approximately 18 hours prior to chemotherapy administration), 1 (approximately 1 hour prior to chemotherapy administration), and 2 (approximately 24 hours after the second infusion of ALRN-6924).

  • TAC (doxorubicin 50 mg/m2; cyclophosphamide 500 mg/m2; docetaxel 75 mg/m2)Drug

    TAC will be administered as an IV infusion on Day 1 of every 3-week treatment cycle

Study groups in NCT05622058
Study groupRoleWhat they receive
ALRN-6924 Dose plus TACExperimentalALRN-6924 plus Docetaxel, Doxorubicin, and Cyclophosphamide (TAC)
Receives: Drug: ALRN-6924; Drug: TAC (doxorubicin 50 mg/m2; cyclophosphamide 500 mg/m2; docetaxel 75 mg/m2)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety and tolerability of ALRN-6924 in combination with TAC chemotherapy

    Proportion of patients with Common Terminology Criteria for Adverse Events (CTCAE) Grade 3/4 treatment emergent adverse events (TEAEs); proportion of patients with treatment-related adverse events and serious adverse events as assessed by NCI CTCAE v5.0

    Clinical and laboratory adverse events (AEs) will be coded using the Medical Dictionary for Regulatory Activities (MedDRA). System Organ Class (SOC) and Preferred Term (PT) will be attached to the clinical database. AE severity will be graded using the CTCAE.

    All AEs will be summarized (incidence) and listed by the System Organ Class (SOC), preferred term, toxicity/severity grade, and causal relationship to study medication. In addition, separate summaries of SAEs and Grade 3 and 4 AEs will be presented.

    Measured: Approximately 24 weeks

  2. Chemoprotective effects of ALRN-6924 on bone marrow toxicities

    Incidence and duration of Grade 4 neutropenia in Cycle 1

    for each treatment cycle and all cycles combined

    Measured: Approximately 3 weeks for each patient

Secondary outcomes (17)
  1. Chemoprotective effects of ALRN-6924 on alopecia induced by TAC

    Incidence of Grade 2 alopecia after treatment with ALRN-6924 plus TAC

    Measured: Approximately 24 weeks

  2. Chemoprotective effects of ALRN-6924 on neutropenia

    Incidence rate of grade 4 neutropenia for each treatment cycle and all cycles combined

    Measured: Approximately 24 weeks

  3. Time to absolute neutrophil count (ANC) recovery in Cycle 1

    Time in days from ANC nadir to recovery

    Measured: 3 weeks (cycle 1)

  4. Depth of ANC nadir in Cycle 1

    Lowest ANC count during cycle 1

    Measured: 3 weeks (cycle 1)

  5. Chemoprotective effects of ALRN-6924 on Grade ≥3 neutropenia for each cycle and all cycles

    CTCAE v5 grade 3 neutropenia

    Measured: Approximately 24 weeks

  6. Chemoprotective effects of ALRN-6924 on thrombocytopenia

    CTCAE v5 grade ≥3 thrombocytopenia

    Measured: Approximately 24 weeks

  7. Chemoprotective effects of ALRN-6924 on anemia

    CTCAE v5 grade ≥3 anemia

    Measured: Approximately 24 weeks

  8. Chemoprotective effects of ALRN-6924 on febrile neutropenia

    Incidence of febrile neutropenia for each cycle and all cycles

    Measured: Approximately 24 weeks

  9. Chemoprotective effects of ALRN-6924 on the need for chemotherapy dose reductions

    Number of dose reductions of chemotherapy due to chemotherapy-related toxicity for each cycle and all cycles

    Measured: Approximately 24 weeks

  10. Use of myeloid growth factors

    Number of instances of granulocyte colony-stimulating factors (G-CSF) use to treat Grade 4 neutropenia for each cycle and all cycles

    Measured: Approximately 24 weeks

  11. Need for red blood cell transfusions

    Number of red blood cell (RBC) transfusions during each cycle and all cycles

    Measured: Approximately 24 weeks

  12. Need for platelet transfusions

    Number of platelet transfusions during each cycle and all cycles

    The ALRN-6924 PK profile with and without AC chemotherapy will be compared.

    Measured: Approximately 24 weeks

  13. PK of ALRN-6924

    PK parameters (e.g., area-under-the-curve [AUC]) of ALRN-6924

    Measured: Cycle 1 (each cycle is 21 days)

  14. PK of ALRN-6924

    PK parameters (e.g., maximum concentration [Cmax] of ALRN-6924

    Measured: Cycle 1 (each cycle is 21 days)

  15. PK of ALRN-6924

    PK parameters (e.g., time of Cmax [tmax]) of ALRN-6924

    Measured: Cycle 1 (each cycle is 21 days)

  16. PK of ALRN-6924

    PK parameters (e.g., half-life [t1/2]) of ALRN-6924

    Measured: Cycle 1 (each cycle is 21 days)

  17. Efficacy of chemotherapy

    Tumor response after TAC chemotherapy: proportion of patients with pCR after completion of neoadjuvant chemotherapy and surgery, per local standard of care and institutional policies

    Measured: Approximately 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Nov 2022
  2. Study start9 Jan 2023
  3. Primary completion22 Feb 2023
  4. Study completion22 Feb 2023

Why it stopped: The study has been terminated early given that the first four patients enrolled have experienced Grade 4 neutropenia and alopecia after cycle 1 and as such failed to meet the primary endpoint and the main secondary endpoint.

Resources

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
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
6 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05622058
Sponsor's protocol ID
ALRN-6924-1-05
Other IDs
2022-000158-27
Status last verified
Feb 2023
First submitted
1 Jun 2022
Last updated
27 Feb 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing ALRN-6924 and TAC (doxorubicin 50 mg/m2; cyclophosphamide 500 mg/m2; docetaxel 75 mg/m2) in people with Prevention of Chemotherapy-induced Myelosuppression, run by Aileron Therapeutics, Inc. at 14 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 15 inclusion and 17 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 27 Feb 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in United States, Bosnia and Herzegovina, Serbia, Bulgaria. 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 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.

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: The study has been terminated early given that the first four patients enrolled have experienced Grade 4 neutropenia and alopecia after cycle 1 and as such failed to meet the primary endpoint and the main secondary endpoint.). 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?

Safety and tolerability of ALRN-6924 in combination with TAC chemotherapy (time frame: Approximately 24 weeks). 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?
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 27 Feb 2023.

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