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    Clinical Trial Results:
    Dose Finding safety run in Phase followed by a randomized Phase II Trial of Intensive Chemotherapy With or Without Volasertib (BI 6727) Administered Prior or After Chemotherapy in Patients With Newly Diagnosed High-Risk Myelodysplastic Syndrome (MDS) and Acute Myeloid Leukemia (AML)

    Summary
    EudraCT number
    2014-000477-39
    Trial protocol
    DE  
    Global end of trial date
    28 Nov 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    12 Jun 2021
    First version publication date
    12 Jun 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AMLSG20-13
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02198482
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    University Hospital Ulm
    Sponsor organisation address
    Albert-Einstein-Allee 23, Ulm, Germany, 89081
    Public contact
    Hartmut Döhner, University Hospital Ulm, +49 73150045521, hartmut.doehner@uniklinik-ulm.de
    Scientific contact
    Hartmut Döhner, University Hospital Ulm, +49 73150045521, hartmut.doehner@uniklinik-ulm.de
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    13 Nov 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    28 Nov 2016
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    Primary efficacy objective • To evaluate efficacy (CR/CRi rate) of the combination of intensive chemo-therapy with volasertib administered prior or after chemotherapy Secondary efficacy objectives • To evaluate cumulative incidence of relapse (CIR) and death (CID), relapse-free survival (RFS), event-free survival (EFS), overall survival (OS) of the combination of intensive chemotherapy with volasertib administered prior or after chemotherapy Safety objectives • To evaluate incidence and intensity of adverse events (AEs) according to Common Terminology Criteria for Adverse Events (CTCAE) version v4.03 of the combination of intensive chemotherapy with Volasertib administered prior or after chemotherapy.
    Protection of trial subjects
    In this study, safety was assessed by evaluating the following: reported adverse events, clinical laboratory test results, vital signs measurements, ECG findings, chest X-ray, echo scan, physical examination findings, monitoring of concomitant therapy. For each safety parameter, all findings (whether normal or abnormal) were recorded in the eCRF.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    29 Mar 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 6
    Worldwide total number of subjects
    6
    EEA total number of subjects
    6
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    4
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    First patient in: 29.03.2016 Early termination date: 28.11.2016 On 22.11.2016 Boehringer Ingelheim decided to discontinue the development of Volasertib due to manufacturing problems. Recruitment of patients was already suspended since 01.06.2016 due to the manufacturing problems mentioned above.

    Pre-assignment
    Screening details
    Molecular genetic analysis (central AMLSG reference lab) of blood and bone marrow was performed at baseline within 48 hours to make an enrollment possible.

    Period 1
    Period 1 title
    Safety Run-in Phase (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Volasertib prior chemotherapy
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Volasertib
    Investigational medicinal product code
    BI6727
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Each vial of Volasertib contained 350 mg (vial with 175 ml, 2.0 mg/ml) and was ad-ministered as intravenous infusion over 2 hours in a total volume of 500 ml 0.9% physiological sodium chloride (NaCl). An initial safety run-in study was planned administering intensive induction therapy as well as consolidation therapy with the study drug Volasertib administered prior or after chemotherapy. A modified Fibonacci design had to be followed for the dose escalation; Volasertib dose levels were defined at level 0 of 170 mg/m2 BSA, level +1 of 200 mg/m2 BSA, and level -1 of 140 mg/m2 BSA. After establishing the Volasertib dose, a randomized Phase II portion of the trial was planned.

    Arm title
    Volasertib after chemotherapy
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Volasertib
    Investigational medicinal product code
    BI6727
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Each vial of Volasertib contained 350 mg (vial with 175 ml, 2.0 mg/ml) and was ad-ministered as intravenous infusion over 2 hours in a total volume of 500 ml 0.9% physiological sodium chloride (NaCl). An initial safety run-in study was planned administering intensive induction therapy as well as consolidation therapy with the study drug Volasertib administered prior or after chemotherapy. A modified Fibonacci design had to be followed for the dose escalation; Volasertib dose levels were defined at level 0 of 170 mg/m2 BSA, level +1 of 200 mg/m2 BSA, and level -1 of 140 mg/m2 BSA. After establishing the Volasertib dose, a randomized Phase II portion of the trial was planned.

    Number of subjects in period 1
    Volasertib prior chemotherapy Volasertib after chemotherapy
    Started
    4
    2
    Completed
    2
    1
    Not completed
    2
    1
         Adverse event, serious fatal
    1
    -
         Consent withdrawn by subject
    1
    -
         Lack of efficacy
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Safety Run-in Phase (overall period)
    Reporting group description
    -

    Reporting group values
    Safety Run-in Phase (overall period) Total
    Number of subjects
    6 6
    Age categorical
    Units: Subjects
        Age <=60 years
    4 4
        Age >60 years
    2 2
    Age continuous
    Units: years
        median (full range (min-max))
    53 (42 to 75) -
    Gender categorical
    Units: Subjects
        Female
    1 1
        Male
    5 5
    Subject analysis sets

    Subject analysis set title
    Analysis data set
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The analysis set contains all subjects which received at least one dose of study medication within the trial.

    Subject analysis sets values
    Analysis data set
    Number of subjects
    5
    Age categorical
    Units: Subjects
        Age <=60 years
    3
        Age >60 years
    2
    Age continuous
    Units: years
        median (full range (min-max))
    53 (42 to 75)
    Gender categorical
    Units: Subjects
        Female
    1
        Male
    4

    End points

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    End points reporting groups
    Reporting group title
    Volasertib prior chemotherapy
    Reporting group description
    -

    Reporting group title
    Volasertib after chemotherapy
    Reporting group description
    -

    Subject analysis set title
    Analysis data set
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The analysis set contains all subjects which received at least one dose of study medication within the trial.

    Primary: Rate of complete remission / complete remission with incomplete hematological recovery

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    End point title
    Rate of complete remission / complete remission with incomplete hematological recovery [1]
    End point description
    End point type
    Primary
    End point timeframe
    after induction therapy (within two months)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Since the trial was discontinued prematurely during the safety run-in phase after treatment of 5 patients, primary and secondary efficacy endpoints were not analyzed and follow-up of patients was terminated.
    End point values
    Analysis data set
    Number of subjects analysed
    Units: Patients with CR/CRi
        CR/CRi
    3
        no CR/CRi
    2
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    The adverse event reporting period for this trial began upon signing of informed consent and ended 28 days after the last treatment administration or until all study drug-related toxicities are resolved, whichever is later.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4.03
    Reporting groups
    Reporting group title
    Overall treatment period
    Reporting group description
    -

    Serious adverse events
    Overall treatment period
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 5 (40.00%)
         number of deaths (all causes)
    1
         number of deaths resulting from adverse events
    1
    Infections and infestations
    Soft tissue infection
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 1%
    Non-serious adverse events
    Overall treatment period
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    5 / 5 (100.00%)
    Vascular disorders
    hematoma
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Hypertension
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    2
    General disorders and administration site conditions
    Chills
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    2
    Edema limbs
         subjects affected / exposed
    3 / 5 (60.00%)
         occurrences all number
    5
    Fatigue
         subjects affected / exposed
    3 / 5 (60.00%)
         occurrences all number
    4
    Fever
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    2
    Injection site reaction
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    3
    Localised oedema
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    2
    Pain
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Dyspnoea
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Epistaxis
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Sore throat
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Psychiatric disorders
    Depression
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Investigations
    Lymphocyte count decreased
         subjects affected / exposed
    3 / 5 (60.00%)
         occurrences all number
    5
    Neutrophil count decreased
         subjects affected / exposed
    4 / 5 (80.00%)
         occurrences all number
    8
    Platelet count decreased
         subjects affected / exposed
    4 / 5 (80.00%)
         occurrences all number
    8
    Weight gain
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    White blood cell count decreased
         subjects affected / exposed
    4 / 5 (80.00%)
         occurrences all number
    8
    Cardiac disorders
    Sinus tachycardia
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    3
    Dysgeusia
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Headache
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    2
    Syncope
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    4 / 5 (80.00%)
         occurrences all number
    9
    Blood and lymphatic system disorders - Other
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Febrile neutropenia
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    2
    Lymph node pain
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Dry eye
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    3
    Constipation
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Diarrhea
         subjects affected / exposed
    3 / 5 (60.00%)
         occurrences all number
    3
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Gastrointestinal pain
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Mucositis oral
         subjects affected / exposed
    3 / 5 (60.00%)
         occurrences all number
    3
    Nausea
         subjects affected / exposed
    3 / 5 (60.00%)
         occurrences all number
    5
    Periodontal disease
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Small intestinal mucositis
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    2
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Rash maculo-papular
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorder - Other
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Renal and urinary disorders
    Urinary frequency
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    2
    Urinary retention
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Endocrine disorders
    Hypoparathyroidism
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    3
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Infections and infestations
    Lip infection
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Mucosal infection
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    2
    Sinusitis
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Tooth infection
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    3
    Hypercalcemia
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1
    Hypokalemia
         subjects affected / exposed
    2 / 5 (40.00%)
         occurrences all number
    2
    Metabolism and nutrition disorders - Other
         subjects affected / exposed
    1 / 5 (20.00%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    01 Jun 2016
    Recruitment of patients was suspended due to manufacturing problems regarding the IMP.
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Since the trial was discontinued prematurely during the safety run-in phase after treatment of 5 patients, primary and secondary efficacy endpoints were not analyzed and follow-up of patients was terminated.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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