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This is a Phase 1, multi-center, open-label study with a dose-escalation phase (Phase 1a) and a cohort expansion phase (Phase 1b), to evaluate the safety, tolerability, and PK profile of LP-118 under a once daily oral dosing schedule in up to 100 subjects.
Primary objectives of the study are to assess the safety and tolerability profile, determine the maximum tolerated dose (MTD), and/or the recommended Phase 2 dose (RP2D) of LP-118 administered once daily (QD) as a single agent dosed orally in adult subjects with relapsed/refractory (low risk tumor lysis) CLL/SLL (Group 1a); relapsed/refractory MF, CMML-2, MDS/MPN, MDS-BP, MDS; AML with WBC ≤ 25 × 10^9 cells/L (Group 1b); relapsed/refractory NHL, RT, MM, T-PLL (Group 1c); relapsed/refractory ALL (Group 1d); relapsed/refractory (intermediate and high tumor lysis risk) CLL/SLL, NHL, RT, T-PLL (Group 2);
Secondary objectives of the study are to evaluate preliminary efficacy regarding the effect of LP-118 on objective response rate (ORR) using disease specific response criteria, progression-free survival (PFS), and duration of response (DOR), and overall survival (OS) in adult subjects with relapsed/refractory (low risk tumor lysis) CLL/SLL (Group 1a); relapsed/refractory MF, CMML-2, MDS/MPN, MDS-BP, MDS; AML with WBC ≤ 25 × 10^9 cells/L (Group 1b); relapsed/refractory NHL, RT, MM, T-PLL (Group 1c); relapsed/refractory ALL (Group 1d); relapsed/refractory (intermediate and high tumor lysis risk) CLL/SLL, NHL, RT, T-PLL (Group 2);
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Escalation Phase | Experimental | Phase 1a dose-escalation will begin with group 1 and proceed until DLT is observed and MTD is established, or until an RP2D is established. Subjects enrolled in the dose cohorts will follow the 3+3 study design, starting with an accelerated step-up dosing schedule (with a starting dose of 20 mg, 50 mg, 100 mg once daily) until they reach the designated target dose (50 mg, 100 mg, 200 mg, 300 mg, 400 mg, 500 mg, 600 mg, 800 mg). Once the MTD or RP2D is established for group 1, the phase 1a dose escalation can proceed for group 2. The starting dose level for group 2 will be one dose level below the MTD or RP2D established for group 1. |
|
| Dose Expansion Phase | Experimental | Additional subjects will be recruited to further explore the safety, tolerability, PK, and efficacy in specific subject subgroups. One or more RP2D may be explored. Definition of these cohorts will be accomplished by protocol amendment, and in light of emerging data from Phase 1a. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LP-118 | Drug | novel, oral, selective treatment for hematological malignancies tested through ascending dose levels |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose (MTD) | If 2 out of 6 subjects in an expanded cohort experience a DLT then this dose is considered the MTD. | At the end of cycle 1 (each cycle is 28 days) |
| Recommended Phase 2 Dose (RP2D) or Optimal Biological Dose (OBD) | The RP2D pr OBD may be as high as the MTD or a lower dose and will be selected in discussion with the Investigators and the Sponsor based on longer term safety data, preliminary efficacy, and PK data. OBD is defined as the lowest dose providing the highest rate of efficacy while being safely administered. | At the end of cycle 1 (each cycle is 28 days) |
| Pharmacokinetic (PK) profile of LP-118: Maximum Plasma Concentration (Cmax) | At Cycle 0 Day 1, Cycle 1 Day 1, Cycle 1 Day 2, Cycle 1 Day 15, Cycle 1 Day 16, Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 5 Day 1, Cycle 6 Day 1, Cycle 7 Day 1, Cycle 8 Day 1, Cycle 9 Day 1 (28-day cycles)) | |
| Pharmacokinetic (PK) profile of LP-118: Area Under the Curve (AUC) of LP-118 | At Cycle 0 Day 1, Cycle 1 Day 1, Cycle 1 Day 2, Cycle 1 Day 15, Cycle 1 Day 16, Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 5 Day 1, Cycle 6 Day 1, Cycle 7 Day 1, Cycle 8 Day 1, Cycle 9 Day 1 (28-day cycles) | |
| Pharmacokinetic (PK) profile of LP-118: Time at Maximum Concentration (Tmax) of LP-118 | At Cycle 0 Day 1, Cycle 1 Day 1, Cycle 1 Day 2, Cycle 1 Day 15, Cycle 1 Day 16, Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 5 Day 1, Cycle 6 Day 1, Cycle 7 Day 1, Cycle 8 Day 1, Cycle 9 Day 1 (28-day cycles) |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-Free Survival (PFS) | The number of days from the date the subject started study drug to the date the subject experiences an event of disease progression (radiographic or clinical), or to the date of death if disease progression is not reached. | Approximately 36 cycles (each cycle has 28 days) |
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Inclusion Criteria:
Male or female subjects, ≥ 18 years of age at the time of Screening with the following exception as outlined below:
-For T cell and B cell ALL subjects with age between 13 - 18 years, their body weight shall be ≥ 40 kg.
Eligible subject must have an advanced hematologic malignancy including:
Group 1:
Group 1a
Group 1b
Group 1c
Group 1d
Group 2
For Group 1d ALL subjects only, white blood cell (WBC) count ≤ 25 × 109 cells/L at the time of enrollment (glucocorticoids or hydroxyurea is permitted to control WBC count prior to and during therapy).
Eastern Cooperative Oncology Group (ECOG) performance score ≤ 2.
Adequate cardiac function defined as shortening fraction of ≥ 40% by 2D echocardiogram without Doppler.
Subject must have adequate bone marrow (independent of growth factor support), coagulation, renal, and hepatic function, per laboratory reference ranges at Screening as follows:
Bone marrow criteria:
Females of childbearing potential (i.e., non-postmenopausal for at least 2 years or surgically sterile) and non-sterile males must practice at least 1 of the following methods of birth control with their partner(s) throughout the study and for 90 days after discontinuing study drug:
Females of childbearing potential must have a negative pregnancy result as follows:
Male subjects must refrain from sperm donation, from initial study drug administration until 90 days after the last dose of study drug.
Subject must be able to understand and voluntarily sign and date an informed consent form (ICF), approved by an IRB, prior to any protocol-related procedures.
Exclusion Criteria:
A subject will not be eligible for study participation if he/she meets any of the following criteria.
Subjects who have undergone autologous/allogeneic hematopoietic stem cell transplantation (HSCT) therapy within 60 days of the first dose of LP-118, or subjects on immunosuppressive therapy post-HSCT at the time of Screening, or currently with clinically significant graft-versus-host disease (GVHD) as per treating physician (Subjects in relapse after allogeneic transplantation must be off treatment with systemic immunosuppressive agents for at least 4 weeks. The use of topical steroids and/or up to 20 mg/day prednisone or equivalent systemic steroids for ongoing GVHD is permitted.
Subject has a history of other malignancies within past 12 months that are active and could result in competing risks. These cases shall be discussed with the Medical Monitor with the exception below.
Subject has received any of the following therapies within 14 days or 5 half-lives (whichever is shorter) prior to the first dose of LP-118, or has not recovered to ≤ Grade 2 clinically significant AEs of the previous therapy (excluding neuropathy):
Subject has received the following medications, therapies, or natural products within 7 days prior to the first dose of LP-118:
Subject has a significant history of renal, neurologic, psychiatric, pulmonary, endocrinologic, metabolic, immunologic, cardiovascular, or hepatic disease that, in the opinion of the Investigator, would adversely affect his/her participation in this study. Any other medical or social condition deemed by the investigator to be likely to interfere with a subject's ability to participate in the study, place the subject at unacceptable risk or interfere with the interpretation of the results. For subjects who have required surgical intervention for any above diseases within the past 6 months, a discussion with the Investigator and the Medical Monitor is needed.
Subject has baseline prolongation of the heart rate-corrected QT (QTcF) interval ≥ 480 ms (calculated per Fridericia's formula [QTcF = QT/RR (1/3)])), a cardiovascular disability status of New York Heart Association Class ≥ 2 or associated other significant screening ECG or ultrasonic cardiogram abnormalities, per Investigator's judgement. For any subject with underlying RBBB or LBBB, cardiology review is needed to correct QTcF calculation using Sponsor recommended formula.
Subject has significant a history of congenital long QT syndrome or Torsades de Pointes (TdP), uncontrolled or symptomatic arrhythmias, congestive heart failure, myocardial infarction, stroke, or intracranial hemorrhage within 6 months prior to the first dose of LP-118.
Subject exhibits evidence of other clinically significant uncontrolled condition(s) including, but not limited to:
A female subject is pregnant or breast-feeding.
Subject incapacity to swallow oral medications, with any malabsorption condition, known dysphagia, short-gut syndrome, gastroparesis, or other conditions that, in the opinion of the Investigator, may limit the ingestion or gastrointestinal absorption, distribution, metabolism and excretion of drugs administered orally.
Subjects with known and active central nervous system (CNS) involvement at Screening.
Subjects with known hypersensitivity to any of the components of LP-118 (see Investigators Brochure for a list of components).
Subjects who are taking QT-prolonging drugs that are known to cause Torsades de Pointes (TdP) (See Appendix 17 for the list of medications that are associated with TdP). In the event a prohibited medication might cause TdP, the PI must first determine if the risk to benefit is in favor of the subject and then discuss with the Medical Monitor about that particular medication on a case-by-case basis.
Major surgery within 14 days prior to the first dose of study drug.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Anna Chen, MD, PhD | Contact | (206) 335-3820 | yu@newavepharma.com | |
| Stephen Anthony, DO | Contact | s.anthony@newavepharma.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Chicago | Recruiting | Chicago | Illinois | 60637 | United States | |
| Dana Farber Cancer Institute |
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The study will start at lower doses (20 mg) and adopt an "accelerated titration" design for these cohorts. Once the safety of the 20 mg dose level is established, we will continue dose escalation using a classic "3+3" design to establish DLT, MTD, and RP2D, starting also with an accelerated step-up dosing schedule.
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| Duration of Response (DOR) |
The number of days from the date the subject started study drug to the date of the subject's death due to any cause. |
| Approximately 36 cycles (each cycle is 28 days) |
| Overall Survival (OS) | The number of days from the date the subject started study drug to the date of the subject's death due to any cause. | Approximately 36 cycles (each cycle is 28 days) |
| Recruiting |
| Boston |
| Massachusetts |
| 02215 |
| United States |
| University of North Carolina | Recruiting | Chapel Hill | North Carolina | 27514 | United States |
| Cincinnati Children's Hospital Medical Center | Recruiting | Cincinnati | Ohio | 45229 | United States |
| University of Cincinnati | Recruiting | Cincinnati | Ohio | 45229 | United States |
| The Ohio State University | Recruiting | Columbus | Ohio | 43210 | United States |
| MD Anderson Cancer Center | Recruiting | Houston | Texas | 77030 | United States |
| University of Utah | Recruiting | Salt Lake City | Utah | 84112 | United States |
| ID | Term |
|---|---|
| D008228 | Lymphoma, Non-Hodgkin |
| D009101 | Multiple Myeloma |
| D015461 | Leukemia, Prolymphocytic, T-Cell |
| D015470 | Leukemia, Myeloid, Acute |
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| D054437 | Myelodysplastic-Myeloproliferative Diseases |
| D055728 | Primary Myelofibrosis |
| D015451 | Leukemia, Lymphocytic, Chronic, B-Cell |
| D019337 | Hematologic Neoplasms |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D054219 | Neoplasms, Plasma Cell |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006402 | Hematologic Diseases |
| D006474 | Hemorrhagic Disorders |
| D015463 | Leukemia, Prolymphocytic |
| D007945 | Leukemia, Lymphoid |
| D007938 | Leukemia |
| D015458 | Leukemia, T-Cell |
| D007951 | Leukemia, Myeloid |
| D001855 | Bone Marrow Diseases |
| D009196 | Myeloproliferative Disorders |
| D015448 | Leukemia, B-Cell |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009371 | Neoplasms by Site |
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