A Pivotal Study of HQP1351 in Patients of Chronic Myeloid Leukemia in Chronic Phase With T315I Mutation

Sponsor

Ascentage Pharma Group Inc. (Industry)

Overall Status

Active, not recruiting

CT.gov ID

NCT03883087

Collaborator

(none)

Enrollment

Locations

Arm

69.8

Anticipated Duration (Months)

4.1

Patients Per Site

0.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to evaluate the efficacy of HQP1351 in patients with chronic myeloid leukemia in chronic phase (CML-CP) harboring T315I mutation. The efficacy of HQP1351 was determined by evaluating the subjects' major cytogenetic response (MCyR).

Condition or Disease	Intervention/Treatment	Phase
Chronic Myeloid Leukemia, Chronic Phase	Drug: HQP1351	Phase 2

Detailed Description

This is an open, single-arm, multi-center phase 2 clinical study to evaluate the efficacy and safety of oral administrated HQP1351(40mg, QOD) in CML-CP patients with T315I mutation in China. A total of 40 CML-CP patients will be included in this pivotal study. After screening, eligible subjects will receive oral HQP1351 40mg on a continues once every other day dosing regimen , until disease progression, drug intolerance, or meet other treatment conditions to discontinue the study. During the course of treatment, each subject will be assessed regularly for hematological, cytogenetic and molecular responses. At the same time, safety information also will be evaluated.

Study Design

Study Type:

Interventional

Actual Enrollment :

41 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

A Phase II Multi-center, Open Label Study of HQP1351 in Chinese Patients of Chronic Myeloid Leukemia With T315I Mutation in Chronic Phase

Actual Study Start Date :

Apr 8, 2019

Anticipated Primary Completion Date :

May 1, 2024

Anticipated Study Completion Date :

Feb 1, 2025

Arms and Interventions

Arm	Intervention/Treatment
Experimental: HQP1351	Drug: HQP1351 40 mg tablet, taken orally once every other day of a 28-day cycle

Arm

Intervention/Treatment

Experimental: HQP1351

Drug: HQP1351

40 mg tablet, taken orally once every other day of a 28-day cycle

Outcome Measures

Primary Outcome Measures

Major cytogenetic response (MCyR) [By the end of Cycle 24 (each cycle is 28 days)]
MCyR is the proportion of patients achieving Complete cytogenetic response (CCyR: defined as 0% Philadelphia chromosome-positive [Ph+] metaphases by cytogenetic analysis of bone marrow) or Partial Cytogenetic Response (PCyR: defined as >0% to 35% Ph+ metaphases by cytogenetic analysis of bone marrow). It is defined as the best response obtained by the subjects during the whole treatment process of the study. And MCyR can only be considered as CCyR if the subject meets PCyR at baseline.

Secondary Outcome Measures

Complete cytogenetic response (CCyR) [By the end of Cycle 24 (each cycle is 28 days)]
CCyR is the proportion of patients achieving CCyR after being treated with HQP1351. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Complete hematologic response (CHR) [By the end of Cycle 24 (each cycle is 28 days)]
CHR requires that all of the following are present: white blood cell<10×10E9/ liter; blood platelet count<450×10E9/ liter; no medullary immature granulocytes in the peripheral blood (such as protocell, promyelocyte and myelocyte); basophils in peripheral blood are less than 5%; no disease symptoms, signs and palpable splenomegaly has disappeared; the duration of the above criteria is no less than 4 weeks. We will calculate the proportion of patients achieving CHR after being treated with HQP1351. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Major molecular response (MMR) [By the end of Cycle 24 (each cycle is 28 days)]
MMR is the proportion of patients achieving a ratio of ≤0.1% breakpoint cluster region (BCR) abelson leukemia (ABL) to ABL transcripts on the international scale (≤0.1% BCR-ABL/ABL[IS]) after being treated with HQP1351. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
BCR-ABL1(IS) transcript ≤1% [By the end of Cycle 24 (each cycle is 28 days)]
BCR-ABL1(IS) ≤1% is the proportion of patients achieving BCR-ABL1(IS) ≤1% by quantitative polymerase chain reaction detection. It is defined as the best response obtained by the subjects during the whole treatment process of the study.
Time to response [By the end of Cycle 24 (each cycle is 28 days)]
The time to response is defined as the interval between the first use of HQP1351 and the first date at which the criteria for response are met. The subject who isn't met the response criteria will be censored at the last assessment time.
Duration of response [By the end of Cycle 24 (each cycle is 28 days)]
Duration of response is defined as the interval between the first assessment at which the criteria for response are met until the earliest date at which the criteria for progression are met, and the subject who isn't met the progression criteria will be censored at the last assessment time. The duration of response is calculated only for subjects who achieved response.
Progression free survival (PFS) [By the end of Cycle 24 (each cycle is 28 days)]
PFS is defined as the interval between the first dose date of HQP1351 treatment and the first date at which the criteria for progression are met, or death. The subject who isn't progression or death will be censored at the last response assessment.
Overall survive (OS) [By the end of Cycle 24 (each cycle is 28 days)]
OS is defined as the interval between the first dose date of HQP1351 treatment and date of death, censored at the last contact date to be alive.
Safety: adverse events (AEs), and serious AEs (SAEs) [By the end of Cycle 24 (each cycle is 28 days)]
Patients with HQP1351 treatment related AE, SAE will be assessed according NCI CTCAE Version 5.0.

Other Outcome Measures

The relationship between mutation and efficacy. [By the end of Cycle 24 (each cycle is 28 days)]
During the course of HQP1351 therapy, the relationship between BCR-ABL1 kinase region/other mutations and drug resistance/disease progression will be measured.
Quality of life (QOL) [By the end of Cycle 24 (each cycle is 28 days)]
Objects' quality of life will be measured during the course of HQP1351 therapy by European Organization for Research and Treatment quality of life questionnaire core-30 version3.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Male or non-pregnant, non-lactating female patients who are 18 years of age or older.
CML-CP patients with positive Ph chromosome or BCR-ABL fusion genes.
After any targeted BCR-ABL1 tyrosine kinase inhibitors (TKI) treatment, CML-CP patients with T315I mutation.
Ability to understand and willingness to sign a written informed consent form. The consent form must be signed by the patient prior to any study-specific procedures.
Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2.
Predicted life expectancy of ≥3 months.
Organ function as indicated by the following laboratory indicators must be met（Hematological indicators require that no blood transfusion or any blood products or cytokines be used within 14 days prior to testing）:

Hemoglobin ≥8.0g/dL.
White blood cell count ≥ 3.0×10^9/L.
Platelet count ≥ 75×10^9/L.
Serum creatinine ≤ 1.5×upper limit of normal (ULN) or 24 hours calculated creatinine clearance ≥ 50mL/min when serum creatinine >1.5×ULN (with Cockcroft-Gault formula).
Serum albumin ≥ 3.0 g/dL.
Total bilirubin ≤ 1.5 x ULN.
Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 x ULN.
Amylase≤1.5×ULN. Lipase≤1.5×ULN.
PT、APTT、INR≤1.5×ULN.

Cardiac function index: ejection fraction (EF) > 50%, pulmonary arterial systolic pressure (PASP) ≤50 mmHg.
Corrected QT interval (QTc) on electrocardiogram (ECG) evaluation: QTc≤450ms in males or ≤470ms in females.
Males and females of childbearing potential and their partners voluntarily take contraceptive measures that the researchers believe are effective within 120 days from the signing of the informed consent to the last use of the research drug, or confirm that sterilization has been performed (at least one month before screening).
Willingness and ability to comply with study procedures and follow-up examination.

Exclusion Criteria:

Received chemotherapy or radiotherapy within 28 days prior to the first administration, interferon or antitumor effect Chinese herbal medicine or Chinese patent medicine within 14 days prior to the first administration, or targeted BCR-ABL1 TKI within 7 days prior to the first administration, or hydroxyurea or anagrelide within 24 hours after the first administration, or adverse events (except alopecia) caused by previous treatment and have not recovered.
The patients who received any other investigating drugs within 14 days prior to first administration.
Patients who have progressed to accelerated phase (AP) or blast phase (BP) in the past.
Patients who are currently receiving treatment with a medication that has the potential to interact with research drug
Have previously been treated with ponatinib or HQP1351 (or drugs of similar composition).
Absorption disorder syndrome or other diseases affecting oral drug absorption.
Have any history of heart or vascular disease, such as hypertension (systolic blood pressure (HBP)> 140mmHg and/or diastolic blood pressure > 90mmHg), or take medications that are known to cause QT prolongation. The patients with well controlled HBP can be considered to be included.
Pulmonary systolic pressure (PSP) of echocardiography is more than 50 mmHg, or there is clinical symptom related to pulmonary hypertension.
Have a history of serious cardiovascular diseases during the previous treatment of chronic myeloid leukemia with TKI, including myocardial infarction, unstable angina pectoris, severe arrhythmia and congestive heart failure.
Underwent autologous or allogeneic stem cell transplant.
CML-CP patient currently diagnosed as Complete cytogenetic remission (CCyR).
Have diseases with abnormal bleeding and coagulation function, or have a bleeding disorder unrelated to CML within 3 months before first dose of study drug.
Underwent major surgery (except minor surgical procedures, such as placement or bone marrow biopsy) with 14 days prior to the first dose of study drug.
Require concurrent treatment with immunosuppressive agents, other than corticosteroids prescribed for a short course of therapy (It is defined as a daily dose of corticosteroids less than 30 mg prednisone or the same amount of other corticosteroids within 7 days).
Have active nervous system (CNS) disease as evidence by cytology or pathology. In the absence of clinical CNS disease, lumbar puncture is not required.
History of another primary malignancies.
Active symptomatic infection.
Known to be allergic to study drug ingredients or their analogues.
Female patients with blood β-Human chorionic gonadotropin (HCG)positive, pregnant or lactating or expecting pregnancy during the study program.
Suffer from any condition or illness that, in the opinion of the Investigator or the medical monitor, would compromise patient safety or interfere with the evaluation of the safety of the research drug.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Peking University People's Hospital	Beijing	Beijing	China	100044
2	Shenzhen Second People's Hospital	Shenzhen	Guandong	China
3	Sun Yat-sen University Cancer Center	Guangzhou	Guangdong	China
4	Nanfang Hospital of Southern Medical University	Guanzhou	Guangdong	China	510515
5	Henan Tumor Hospital	Zhengzhou	Henan	China
6	Union Hospital medical college Huazhong University of Science and Technology	Wuhan	Hubei	China	430022
7	Tongji medical college Huazhong University of Science and Technology	Wuhan	Hubei	China
8	The First Hospital Affiliated of Soochow University	Suzhou	Jiangsu	China
9	West China Hospital of Sichuan University	Chengdu	Sichuan	China
10	Blood Diseases Hospital Chinese Academy of Medical Sciences	Tianjin		China

Sponsors and Collaborators

Ascentage Pharma Group Inc.

Investigators

Principal Investigator: Xiaojun Huang, Professor, Peking University People's Hospital
Principal Investigator: Qian Jiang, Professor, Peking University People's Hospital