A multi-center, open-label study to determine the dose and safety of oral asciminib in pediatric patients with Philadelphia chromosome positive chronic myeloid leukemia in chronic phase (Ph+ CML-CP), previously treated with one or more tyrosine kinase inhibitors

R
Rachael Schulte

Primary Investigator

Enrolling By Invitation
1 years - 18 years
All
Phase 1/2
1 participants needed
2 Locations

Brief description of study

What is the purpose of this study?
The aim of this study is to support development of asciminib in the pediatric population (1 to <18 years) with Philadelphia chromosome positive chronic myeloid leukemia in chronic phase (PH+ CML-CP) previously treated with one or more Tyrosine kinase inhibitor (TKIs).
 
THIS STUDY IS ENROLLING BY INVITATION ONLY - Consistent with most oncology trials, patients are not actively “recruited,” but are screened by their physician for appropriate clinical trial(s) at the time of their routine clinic visit. Occasionally, a patient may be a self-referral or physician referral, but are still screened for appropriate clinical trials at the time of their routine clinic visit. PI and staff may send copies of relevant consent forms to these patients to look over prior to actually consenting or enrolling them. This may take place at the patient's visit at which the consent is presented or the patient's next visit to the outpatient hematology/oncology clinic. 
 
Interested in participating? For more information about this research study or other cancer-related clinical trials at IU Simon Comprehensive Cancer Center, please contact:
IU Clinical Trials Office 
Phone: (317) 278-5632

Detailed description of study

What will happen during the study?
The pediatric formulation group will include at least 15 participants in each of the following two age categories: 1 to <12 years and 12 to <18 years; leading to at least 30 participants enrolled treated with the pediatric formulation. It will consist of a dose determination part (Part 1) and a cohort expansion (Part 2 BID regimen and Part 3 QD regimen).

In Part 1, 4-6 participants will be enrolled in order to obtain at least 4 participants evaluable for PK (these participants may be from either of the age categories described above). The initial starting dose will be based on body weight and will be administered BID with food.

Once the body weight adjusted dose has been determined in Part 1 of the study, the patients will be enrolled in Part 2 until at least 20 participants, including those who were included in Part 1, have been enrolled (10 per age group) in the pediatric formulation group. Once the interim safety and PK analysis 2 is completed for one of the age groups, the Part 3 QD regimen will open for the respective age group to enroll 10 patients (5 patients by age group).

Due to the fact that the pediatric formulation was in development and was not available, this study started with the recruitment of adolescent patients. These participants aged 14 to <18 years, weighing at least 40 kg receive the adult formulation at a flat dose of 40 mg BID under fasted conditions.

The total duration of the treatment period of the study will be 5 years (260 weeks). Participants who, according to Investigator's judgement, are benefiting from study treatment will remain on treatment up to the completion of the treatment period (Week 260/5 years). The primary analysis for the BID regimen is planned after all participants in Part 1 and 2 have completed at least 52 weeks of study treatment or discontinued earlier.

The primary analysis for combined regimen (BID+QD) is planned after all participants in Part 1, 2 and 3 have completed at least 52 weeks of study treatment or discontinued earlier.

Eligibility of study

You may be eligible for this study if you meet the following criteria:

  • Conditions: Philadelphia chromosome positive chronic myeloid leukemia, Ph+ CML-CP, Riley
  • Age: 1 years - 18 years
  • Gender: All

Inclusion Criteria:

  • - Male or female participants: Pediatric formulation group: ≥ 1 and less than 18 years of age at study entry. Adult formulation group: ≥ 14 and less than 18 years of age and body weight of ≥ 40 kg at study entry.
  •  Participants with Ph+ CML-CP must meet all of the following laboratory values at the screening visit. In the case where bone marrow blast and promyelocyte counts are available, these will be accepted if done within 56 days prior to the screening visit, to avoid unnecessary repetition of this test.
  •      < 15% blasts in peripheral blood and bone marrow
  •      < 30% combined blasts plus promyelocytes in peripheral blood and bone marrow
  •      < 20% basophils in the peripheral blood
  •      Neutrophils ≥ 1.5 x 10^9/L (or WBC ≥ 3 x 10^9/L if neutrophils are not available) and platelet count ≥ 100 x 10^9/L
  •      No evidence of extramedullary leukemic involvement, with the exception of hepatosplenomegaly
  •  Prior treatment with a minimum of one TKI
  •  Failure (adapted from the 2020 European Leukemia Net (ELN) Guidelines Hochhaus et al 2020 and 2013 ELN Guidelines Baccarani et al 2013) or intolerance to the most recent TKI therapy at the time of screening.
  •  Performance status: Karnofsky ≥ 50% for patients ≥ 16 years of age, and Lansky ≥ 50 for patients < 16 years of age at the time of screening
  •  Participants must have adequate renal, hepatic, pancreatic and cardiac function
  •  Participants must have electrolyte values within normal limits or corrected to be within normal limits with supplements prior to first dose of study medication: Evidence of typical BCR-ABL1 transcript [e14a2 and/or e13a2] at the time of screening which are amenable to standardized RQ-PCR quantification.
 

Exclusion Criteria:

  •     Known presence of the T315I mutation prior to study entry.
  •  Known second chronic phase of CML after previous progression to AP/BC.
  •  Previous treatment with a hematopoietic stem-cell transplantation.
  •  Patient planning to undergo allogeneic hematopoietic stem cell transplantation.
  •  Cardiac or cardiac repolarization abnormality
  •  Severe and/or uncontrolled concurrent medical disease that in the opinion of the Investigator could cause unacceptable safety risks or compromise compliance with the protocol
  •  History of acute pancreatitis within 1 year of study entry or past medical history of chronic pancreatitis.
  •  History of acute or chronic liver disease.
  •  Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug
  •  Pregnant or nursing (lactating) females.


Other protocol-defined inclusion/exclusion may apply.

Updated on 26 Nov 2024. Study ID: PHO-NOVARTIS-ASC4KIDS, 24015
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