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    Clinical Trial Results:
    Phase I/II, international, multicentre, open-label, non-randomised, non-comparative study evaluating the safety, tolerability and clinical activity of intravenously administered S64315, a selective Mcl-1 inhibitor, in combination with azacitidine in patients with acute myeloid leukaemia (AML)

    Summary
    EudraCT number
    2019-004896-38
    Trial protocol
    FR  
    Global end of trial date
    25 Aug 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    28 Apr 2024
    First version publication date
    28 Apr 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CL1-64315-004
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04629443
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    IND: 136541
    Sponsors
    Sponsor organisation name
    Institut de Recherches Internationales Servier (I.R.I.S.)
    Sponsor organisation address
    50 rue Carnot, Suresnes Cedex, France, 92284
    Public contact
    Clinical Studies Department, Institut de Recherches Internationales Servier, +33 155724366, clinicaltrials@servier.com
    Scientific contact
    Clinical Studies Department, Institut de Recherches Internationales Servier, +33 155724366, clinicaltrials@servier.com
    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
    25 Aug 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    25 Aug 2023
    Global end of trial reached?
    Yes
    Global end of trial date
    25 Aug 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine the safety profile (including Dose-Limiting Toxicities (DLTs) and Maximum Tolerated Dose (MTD)) and tolerability of S64315 in combination with azacitidine in patients with Acute Myeloid Leukaemia (AML). This study was originally designed as 2 phases: Phase I for dose escalation and Phase II for dose expansion. The dose escalation Phase I part was further planned to have 2 arms: (Arm A and Arm B). However, the Phase I (Arm B) and Phase II (dose expansion) were not conducted due to recruitment discontinuation. Phase I of the study was only conducted.
    Protection of trial subjects
    The study was conducted in compliance with the protocol, GCP, ethical principles of the Declaration of Helsinki and the applicable regulatory requirements. All the patients were to give freely their written informed consent before the start of the screening process of the study.
    Background therapy
    -
    Evidence for comparator
    Not applicable
    Actual start date of recruitment
    01 Sep 2020
    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
    Spain: 10
    Country: Number of subjects enrolled
    France: 3
    Country: Number of subjects enrolled
    Australia: 2
    Country: Number of subjects enrolled
    United States: 2
    Worldwide total number of subjects
    17
    EEA total number of subjects
    13
    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)
    7
    From 65 to 84 years
    10
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Investigators were oncologists.

    Pre-assignment
    Screening details
    Patients at age 18+ years with cytologically confirmed and documented de novo, secondary or therapy-related AML: -With relapsed or refractory disease and without established alternative therapy -Secondary to myelodysplastic syndrome treated and without established alternative therapy

    Period 1
    Period 1 title
    Treatment period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    This was an open-label study. No study medication blinding was required.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    50 mg of S64315 + 75 mg/m² of azacitidine
    Arm description
    Patients received 50 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.
    Arm type
    Experimental

    Investigational medicinal product name
    S64315, 50 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    S64315 was administered via intravenous (IV) infusion over at least 2 hours, once a week. During the Lead-in Dose period S64315 was administered in quantity of 25 mg at D-13 and 50 mg at D-6. In treatment period 50 mg S64315 were administered weekly of each 28-day cycles (Cx) i.e. on CxD2, CxD9, CxD16 and CxD23. On days of concomitant administration of S64315 and azacitidine (CxD2), azacitidine was administered 2 hours prior to S64315.

    Investigational medicinal product name
    Azacitidine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for suspension for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Azacitidine was administered via subcutaneous (SC) injection, once a day over 7 consecutive days. 75 mg/m² of azacitidine administered daily for 7 days from CxD1 to CxD7 followed by a rest period of 21 days. On days of concomitant administration of S64315 and azacitidine (CxD2), azacitidine was administered 2 hours prior to S64315.

    Arm title
    100 mg of S64315 + 75 mg/m² of azacitidine
    Arm description
    Patients received 100 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.
    Arm type
    Experimental

    Investigational medicinal product name
    S64315, 100 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    S64315 was administered via intravenous (IV) infusion over at least 2 hours, once a week. During the Lead-in Dose period S64315 was administered in quantity of 25 mg at D-13 and 50 mg at D-6. In treatment period 100 mg S64315 were administered weekly of each 28-day cycles (Cx) i.e. on CxD2, CxD9, CxD16 and CxD23. On days of concomitant administration of S64315 and azacitidine (CxD2), azacitidine was administered 2 hours prior to S64315.

    Investigational medicinal product name
    Azacitidine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for suspension for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Azacitidine was administered via subcutaneous (SC) injection, once a day over 7 consecutive days. 75 mg/m² of azacitidine administered daily for 7 days from CxD1 to CxD7 followed by a rest period of 21 days. On days of concomitant administration of S64315 and azacitidine (CxD2), azacitidine was administered 2 hours prior to S64315.

    Arm title
    190 mg of S64315 + 75 mg/m² of azacitidine
    Arm description
    Patients received 190 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.
    Arm type
    Experimental

    Investigational medicinal product name
    S64315, 190 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    S64315 was administered via intravenous (IV) infusion over at least 2 hours, once a week. During the Lead-in Dose period S64315 was administered in quantity of 25 mg at D-13 and 50 mg at D-6. In treatment period 190 mg S64315 were administered weekly of each 28-day cycles (Cx) i.e. on CxD2, CxD9, CxD16 and CxD23. On days of concomitant administration of S64315 and azacitidine (CxD2), azacitidine was administered 2 hours prior to S64315.

    Investigational medicinal product name
    Azacitidine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for suspension for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Azacitidine was administered via subcutaneous (SC) injection, once a day over 7 consecutive days. 75 mg/m² of azacitidine administered daily for 7 days from CxD1 to CxD7 followed by a rest period of 21 days. On days of concomitant administration of S64315 and azacitidine (CxD2), azacitidine was administered 2 hours prior to S64315.

    Number of subjects in period 1
    50 mg of S64315 + 75 mg/m² of azacitidine 100 mg of S64315 + 75 mg/m² of azacitidine 190 mg of S64315 + 75 mg/m² of azacitidine
    Started
    5
    7
    5
    Completed
    0
    0
    0
    Not completed
    5
    7
    5
         Physician decision
    1
    3
    -
         Adverse event, non-fatal
    2
    1
    2
         Progressive disease
    2
    3
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    50 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients received 50 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Reporting group title
    100 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients received 100 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Reporting group title
    190 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients received 190 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Reporting group values
    50 mg of S64315 + 75 mg/m² of azacitidine 100 mg of S64315 + 75 mg/m² of azacitidine 190 mg of S64315 + 75 mg/m² of azacitidine Total
    Number of subjects
    5 7 5 17
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    1 4 2 7
        From 65-84 years
    4 3 3 10
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    71.6 ± 8.3 60.1 ± 14.1 64.8 ± 12.9 -
    Gender categorical
    Units: Subjects
        Female
    1 3 3 7
        Male
    4 4 2 10

    End points

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    End points reporting groups
    Reporting group title
    50 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients received 50 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Reporting group title
    100 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients received 100 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Reporting group title
    190 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients received 190 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Subject analysis set title
    Safety Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Safety Set (SS): All patients who signed the ICF and who received at least one dose of IMP (S64315 or azacitidine) during the dose escalation Phase I part of the study.

    Subject analysis set title
    DLT-Evaluable Set (DLTES)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All patients from the SS who were evaluable for DLT according to the DLT assessment at the end of Cycle 1.

    Primary: Dose-limiting toxicity (DLT)

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    End point title
    Dose-limiting toxicity (DLT) [1]
    End point description
    In the DLTES (N = 13), 2 patients experienced at least one DLT during the dose escalation: - 1 patient in the S64315 100 mg + 75 mg/m2 azacitidine dose level group. - 1 patient in the S64315 190 mg + 75 mg/m2 azacitidine dose level group.
    End point type
    Primary
    End point timeframe
    Dose-limiting toxicity that occurred during LID or Cycle 1.
    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: Only descriptive statistical analyses were provided. The Maximum Tolerated Dose could not be determined.
    End point values
    DLT-Evaluable Set (DLTES)
    Number of subjects analysed
    13
    Units: Presence of DLTs
        Cardiac disorders
    1
        Hepatic abnormalities
    1
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Since the administration of the first dose of the IMPs up to 30 calendar days after the participant’s last IMP administration.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    50 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients randomized to received 50 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Reporting group title
    100 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients randomized to received 100 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Reporting group title
    190 mg of S64315 + 75 mg/m² of azacitidine
    Reporting group description
    Patients randomized to received 190 mg S64315 in combination with 75 mg/m² of azacitidine following the study treatment scheme.

    Serious adverse events
    50 mg of S64315 + 75 mg/m² of azacitidine 100 mg of S64315 + 75 mg/m² of azacitidine 190 mg of S64315 + 75 mg/m² of azacitidine
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 5 (100.00%)
    7 / 7 (100.00%)
    4 / 5 (80.00%)
         number of deaths (all causes)
    2
    1
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood bilirubin increased
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Troponin I increased
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Skin injury
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebral atrophy
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cognitive disorder
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    4 / 5 (80.00%)
    2 / 7 (28.57%)
    1 / 5 (20.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Leukocytosis
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Psychiatric disorders
    Aggression
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Agitation
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Anorectal cellulitis
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Escherichia bacteraemia
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Bacterial sepsis
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Enterococcal sepsis
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Pseudomonal sepsis
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sinusitis aspergillus
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    50 mg of S64315 + 75 mg/m² of azacitidine 100 mg of S64315 + 75 mg/m² of azacitidine 190 mg of S64315 + 75 mg/m² of azacitidine
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    5 / 5 (100.00%)
    6 / 7 (85.71%)
    5 / 5 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Lipoma
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    General disorders and administration site conditions
    Oedema peripheral
         subjects affected / exposed
    2 / 5 (40.00%)
    1 / 7 (14.29%)
    1 / 5 (20.00%)
         occurrences all number
    3
    1
    1
    Pyrexia
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    1
    1
    0
    Administration site erythema
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Impaired healing
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Injection site haematoma
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Injection site rash
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Respiratory, thoracic and mediastinal disorders
    Epistaxis
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    1
    2
    0
    Pulmonary hypertension
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    4 / 5 (80.00%)
    2 / 7 (28.57%)
    3 / 5 (60.00%)
         occurrences all number
    6
    4
    3
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 5 (40.00%)
    2 / 7 (28.57%)
    2 / 5 (40.00%)
         occurrences all number
    2
    4
    3
    Troponin T increased
         subjects affected / exposed
    1 / 5 (20.00%)
    2 / 7 (28.57%)
    0 / 5 (0.00%)
         occurrences all number
    1
    4
    0
    Brain natriuretic peptide increased
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    1 / 5 (20.00%)
         occurrences all number
    0
    1
    2
    Blood bilirubin increased
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    2
    0
    0
    Blood creatine phosphokinase MB increased
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Blood creatinine increased
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Blood phosphorus decreased
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Blood thyroid stimulating hormone increased
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Neutrophil count decreased
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    3
    Injury, poisoning and procedural complications
    Febrile nonhaemolytic transfusion reaction
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Infusion related reaction
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Subdural haematoma
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Traumatic haematoma
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    2
    0
    0
    Syncope
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    2
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 5 (40.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    2
    1
    0
    Neutropenia
         subjects affected / exposed
    2 / 5 (40.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    11
    4
    0
    Thrombocytopenia
         subjects affected / exposed
    2 / 5 (40.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    6
    1
    0
    Hyperleukocytosis
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    2
    0
    Leukocytosis
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    3
    0
    0
    Ear and labyrinth disorders
    Deafness bilateral
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Vertigo
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Eye disorders
    Dry eye
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Eye haemorrhage
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Visual acuity reduced
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    4 / 5 (80.00%)
    2 / 7 (28.57%)
    0 / 5 (0.00%)
         occurrences all number
    5
    2
    0
    Diarrhoea
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    2 / 5 (40.00%)
         occurrences all number
    1
    1
    2
    Abdominal pain
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    1
    1
    0
    Haemorrhoids
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    1
    1
    0
    Nausea
         subjects affected / exposed
    1 / 5 (20.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    3
    1
    0
    Abdominal pain upper
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Anal fissure
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Aphthous ulcer
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Gingival bleeding
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Haemorrhoidal haemorrhage
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Rectal haemorrhage
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Tongue ulceration
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Vomiting
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    3
    0
    0
    Skin and subcutaneous tissue disorders
    Decubitus ulcer
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Rash
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Polyuria
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Proteinuria
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Renal impairment
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    3
    0
    Urinary incontinence
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Musculoskeletal and connective tissue disorders
    Spinal osteoarthritis
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Infections and infestations
    COVID-19
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Device related sepsis
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Folliculitis
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Herpes simplex reactivation
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Pneumonia
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    0 / 5 (0.00%)
         occurrences all number
    1
    0
    0
    Rhinitis
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1
    Vulvovaginal candidiasis
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    2 / 5 (40.00%)
    1 / 7 (14.29%)
    1 / 5 (20.00%)
         occurrences all number
    2
    2
    3
    Hypophosphataemia
         subjects affected / exposed
    2 / 5 (40.00%)
    0 / 7 (0.00%)
    2 / 5 (40.00%)
         occurrences all number
    2
    0
    2
    Hyperglycaemia
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    2 / 5 (40.00%)
         occurrences all number
    0
    0
    2
    Hypomagnesaemia
         subjects affected / exposed
    1 / 5 (20.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    1
    0
    1
    Hyperkalaemia
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    6
    0
    Hyperuricaemia
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Hyponatraemia
         subjects affected / exposed
    0 / 5 (0.00%)
    1 / 7 (14.29%)
    0 / 5 (0.00%)
         occurrences all number
    0
    1
    0
    Polydipsia
         subjects affected / exposed
    0 / 5 (0.00%)
    0 / 7 (0.00%)
    1 / 5 (20.00%)
         occurrences all number
    0
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    22 Feb 2021
    Amendment No. 1 was applicable in all countries. It mainly concerned: - Removal of non-screening criterion #6 (patients previously treated with HMA) - Modification of DLT definition for isolated AST or ALT elevation - Modification of treatment dose adaptations and readministration criteria based on AST or ALT values - Additional timepoints for monitoring of AST, ALT and total bilirubin - Update of criteria for study discontinuation during the LID period - Update on pharmacokinetic timepoints - Clarification of inclusion criteria 29 - Update of exclusion criteria 43 - Additional recommendations for management of IRR - Update of the reporting of fatal events during inclusion period - Modification of the deadlines for obtaining certain examinations for inclusion (Chest X-Ray and hepatitis markers) - Clarification in case of TLS Grade 3 or 4 in the protocol Table (8.12) 1 - Clarification on cardiac marker samples - Update of the protocol Table (4.4.1) 1 in accordance with the investigational medicinal product dossier-Quality - Modification implemented in Not statistically Significant Amendment n°1 - Typo corrections
    25 Nov 2021
    Amendment No. 2 was applicable in all countries. It mainly concerned: - Updates following FDA’s recommendations: • Addition of safety stopping rules and dose modification rules in expansion part • Addition of study safety stopping rules for any death suspected to be related to S64315 occurring within 30 days of study treatment administration • Monitoring of DLTs implemented at all cycles of treatment in escalation and expansion parts • Update of DLT definition for haematologic toxicity and troponin increase • Update of eligibility criteria 16 and 43 • Update of management of S64315 dose modifications for QTc interval, creatine phosphokinase elevation and troponin elevation • Update of dose modifications for non-hematologic toxicities • Sub-Arm A3 enrolling patients with newly diagnosed AML removed from the Phase II expansion part • Phase II expansion part primary objective updated to CR rate • Clarifications added on study design for the expansion cohorts • Addition of treatment failure definition - Addition of recommendation in case of coronavirus disease 2019 (COVID-19) infection - Addition of recommendation in case of C1D9 infusion missed - Implementation of non-substantial amendment #2
    12 Apr 2022
    Amendment No. 3 was applicable in all countries. It mainly concerned: - To allow the possibility to include more than 6 DLT-evaluable patients in a cohort - To remove the collection of blood samples for PK that are considered unnecessary - Update of blood sampling timepoints for PK - Update of blood sampling timepoints for peripheral blood mononuclear cells assessment - Change in instructions that one of the 2 IMPs is permanently discontinued or discontinued for more than 28 days - Update for re-starting of study treatment after COVID-19 infection - Clarification of wording related to treatment discontinuation during LID period (LID2 or C1D2) - Clarification about the investigations to be performed in the case of the need for an additional LID period - Clarification of the definition of DLT - Clarification about any new concomitant medication administration - Clarification in the wording of the one-week safety window between C1D2 of the first patient and C1D2 of subsequent patients in the same cohort - Clarification added in the situation where MTD is not be reached in some situations - Clarification for a secondary objective during expansion Phase II: CRi is defined according to ELN recommendations - Update of statistical analysis sets for the expansion Phase II part - Update for attesting authenticity of the data collected in the eCRF
    14 Oct 2022
    Amendment No. 4 was applicable in all countries. It mainly concerned: - Update of inclusion criteria #13 due to EU SmPC of azacitidine update (April 2022)

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    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
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