๐ฌIn plain words
What the trial is, and whether it could suit you
This is a dose-finding study of oral zelenirstat (PCLX-001) in patients with R/R AML. There are two parts to the study: Dose Escalation and Dose Expansion.
Sign in to get the eligibility rules as simple questions to take to your doctor.
๐ Eligibility rules (as published)
Inclusion Criteria:
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The following inclusion criteria apply to ALL (dose escalation and dose expansion) patients:
1. Ability to understand and the willingness to sign a written informed consent. A signed informed consent must be obtained before any study-specific procedures are performed.
2. Male or female patients aged โฅ 18 years
3. A diagnosis of AML as per 2016 WHO classification (Arber et al, 2016)
4. Patients must have received at least one prior therapy for AML
5. Patient must not be eligible for other therapies expected to provide clinical benefit
6. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 (Appendix A).
7. The use of chemotherapeutic or anti-leukemic agents is not permitted during the study with the following exceptions: (1) intrathecal (IT) therapy for patients with controlled CNS leukemia at the discretion of the Investigator. Controlled CNS leukemia is defined by the absence of active clinical signs of CNS disease and no evidence of CNS leukemia on the most recent 2 simultaneous cerebrospinal fluid (CSF) evaluations. (2) Use of hydroxyurea for patients with rapidly proliferative disease is allowed before the start of study therapy and for the first four weeks on therapy. These medications will be recorded in the case-report form.
8. Patients must have adequate liver function as assessed by the following laboratory tests to be conducted within 7 (ยฑ3) days before the first dose of study drug:
1. Total bilirubin โค 1.5 times the upper limit of normal (ULN) unless increase is due to hemolysis or congenital disorder such as Gilbert's syndrome
2. ALT and AST โค 2.5 times ULN or โค 5 times ULN for patients with malignant liver involvement
9. Patients must have adequate kidney function, as assessed by both:
1. the estimated glomerular filtration rate (eGFR) \>60 mL/min within 7 (ยฑ3) days before the first dose of study drug (eGFR to be calculated by the Cockcroft-Gault formula)
2. creatinine โค 1.5 times the ULN
10. Adequate cardiac function per institutional normal measured by echocardiography or multi-gated acquisition (MUGA) scan (Left ventricular ejection fraction (LVEF) โฅ 50%)
11. Ability to take oral medication
12. Women of childbearing potential must have a negative serum beta human chorionic gonadotropin (ฮฒ- human chorionic gonadotropin (HCG)) pregnancy test obtained within 7 (ยฑ3) days before the start of administration of study drug.
a. Note: A woman is of childbearing potential, i.e., fertile, following menarche and until becoming postmenopausal unless permanently sterile. Permanent sterilization methods include but are not limited to hysterectomy, bilateral salpingectomy and bilateral oophorectomy. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy.
13. Women of childbearing potential and fertile men must agree to use adequate contraception when sexually active from signing of the informed consent form for the full study until at least 6 months after the last study drug administration. Patients must agree to utilize 2 reliable and acceptable methods of contraception simultaneously. A man is considered fertile after puberty unless permanently sterile by bilateral orchiectomy. Men being treated with PCLX-001 are advised not to father a child during and up to 6 months after treatment; prior to treatment, advice should be sought for conserving sperm due to the chance of irreversible infertility as a consequence of treatment with PCLX-001. Female partners of childbearing potential from male study participants have to use adequate contraception / birth control between signing of the informed consent and 6 months after the last administration of the study drug if the male study participant is not sterilized. The investigator or a designated associate is requested to advise the patient how to achieve highly effective birth control. Highly effective (failure rate of less than 1% per year) contraception methods, when used consistently and correctly, include:
1. Combined (estrogen and progestin containing: oral, intravaginal transdermal and progestin-only (oral, injectable, implantable) hormonal contraception associated with inhibition of ovulation.
2. Intra-uterine device (IUD) or intrauterine hormone-releasing system (IUS).
3. Bilateral tubal occlusion or vasectomized partner (provided that partner is the sole sexual partner and has received medical assessment of the surgical success).
4. Sexual abstinence (reliability to be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient).
14. Male patients with a female partner of reproductive potential must use a condom and ensure that an additional form of contraception is also used during treatment and until 6 months after last study drug administration. Patients must agree to utilize reliable and acceptable methods of contraception simultaneously.
Exclusion Criteria:
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The following exclusion criteria apply to ALL (dose escalation and dose expansion) patients:
1. Acute promyelocytic leukemia.
2. Known hypersensitivity to the study drugs or excipients of the preparations or any agent given in association with this study
3. History of cardiac disease: congestive heart failure New York Heart Association (NYHA) class \> II, unstable angina (angina symptoms at rest), new-onset angina (within the past 6 months before study entry), myocardial infarction within the past 6 months before study entry, or uncontrolled cardiac arrhythmias
4. Uncontrolled arterial hypertension despite optimal medical management (per investigator's opinion)
5. Moderate or severe hepatic impairment, i.e., Child-Pugh class B or C
6. Known HIV infection that is not well controlled. All of the followin