E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10024288 |
E.1.2 | Term | Leukaemia |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
- Dose escalation: To determine the maximum tolerated dose (MTD) of SAR440234 administered as a single agent in patients with R/R AML (relapsed or refractory acute myeloid leukemia), HR-MDS (high risk myelodysplastic syndrome), or B-ALL (B-cell acute lymphoblastic leukemia), and determine the recommended phase 2 dose (RP2D) for the subsequent Expansion part.
- Expansion part: To assess the activity of single agent SAR440234 at the RP2D in patients with R/R AML or HR-MDS. |
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E.2.2 | Secondary objectives of the trial |
-To characterize the safety profile including cumulative adverse drug reactions.
-To evaluate the potential immunogenicity of SAR440234.
-To assess any preliminary evidence of hematologic response in the Dose Escalation Part. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Confirmed diagnosis of Acute Myeloblastic leukemia (AML) (except acute promyelocytic leukemia), or myelodysplastic syndrome (MDS) with a risk category of intermediate or higher.
- Patients with AML must be unlikely to benefit from cytotoxic chemotherapy.
- Patients with B-ALL (B acute lymphoid leukemia) in second or subsequent relapse.
- Patients with HR-MDS (high risk myelodysplastic syndrome) must have received ≥1 cycle of hypomethylating therapy or induction therapy and have ≥10% bone marrow blasts.
- Signed written informed consent. |
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E.4 | Principal exclusion criteria |
- Age <16 years old.
- Eastern Cooperative Oncology Group (ECOG) performance status >2.
- Patients with inadequate biological tests.
- Graft-versus-host disease following allogeneic stem cell transplantation requiring treatment with more than 10 mg of oral prednisone or equivalent daily. The stem cell transplant and/or donor lymphocyte infusion should have been performed more than 3 months before study treatment start.
- Second primary malignancy that requires active therapy. Adjuvant hormonal therapy is allowed.
- Previous treatment with radiotherapy or immunotherapeutic agents in the 4 weeks prior to IMP administration
- Previous treatment with any other investigational agent in the 4 weeks prior to IMP administration
- Receiving, at the time of first IMP administration, of concurrent steroids >10 mg/day of oral prednisone or the equivalent for ≥3 months
- Requirement for tociluzimab for any other diagnosis.
- Evidence of active central nervous system leukemia at the time of enrollment.
- Acquired immunodeficiency syndrome (AIDS-related illnesses) or HIV disease requiring antiretroviral treatment.
- Active hepatitis B viral infection or hepatitis C viral infection; HIV infection.
- Women of childbearing potential, male with a partner of childbearing potential who do not agree to use effective methods of birth control.
- Any clinically significant, uncontrolled medical conditions that, in the Investigator's opinion, would expose excessive risk to the patient or may interfere with compliance or interpretation of the study results. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1) Dose-limiting toxicities (DLTs): Incidence of DLTs observed, using NCI-CTCAE v4.03, during the first 42 days following the first
administration of IMP in the first cycle of treatment.
2) Incidence of allergic reactions/hypersensitivity and CRS/acute infusion reactions: Incidence of allergic reactions/hypersensitivity and CRS/acute infusion reactions
3) Overall response rate (ORR): ORR is defined as the proportion of patients with complete response (CR), CRi, and partial response (PR)
4) Duration of response (DOR): DOR is defined as the time from the date of the first response (≥PR) that is subsequently confirmed to the date of first confirmed disease progression or death, whichever happens first
5) Event-free survival: Event-free survival is defined as time from the first study treatment administration to the date of first documentation of progressive disease that is subsequently confirmed or the date of death from any cause |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1) Baseline to Day 42
2) and 3) Baseline to 30 days after last study treatment administration
4) and 5) Baseline to date of first documentation of disease progression |
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E.5.2 | Secondary end point(s) |
1) Adverse events: Number of adverse events
2) Preliminary Anti-leukemia Activity: Preliminary anti-leukemia activity as defined by IWG 2003 for MDS or AML or National Comprehensive Cancer Network (NCCN) for B-ALL. (Dose escalation part).
3) Immunogenicity of SAR440234: Anti-SAR440234 Antibodies (ADA) incidence is defined as the proportion of patients found to either have treatment induced ADA or boosted their pre-existing ADA response during the study. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1) Baseline to 30 days after last study treatment administration
2) and 3) Baseline to approximately 3 months after the last entered patient |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | Yes |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 7 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 18 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 18 |