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Recruiting Phase 1

A Study to Assess Safety and Preliminary Efficacy of LP-108 Combined With Azacitidine In Subjects With AML, MDS, CMML

NCT05641259 · tracked via the Priya Life Science China tracker
Phase
Phase 1
Started
2023-02-14
Last updated
2026-09-11

Condition(s) studied

Acute Myeloid LeukemiaMyelodysplastic SyndromesChronic Myelomonocytic Leukemia

Investigational drug(s) / intervention(s)

LP-108Azacitidine →

LP-108: Oral administration for 21 or 28 days on a 28-day cycle

Azacitidine: Subcutaneous administration for 7 days on a 28-day cycle at the dose of 75mg/m2 2-2.5h hours after LP-108.

Study summary

This is a Phase 1, open-label, multicenter, dose-escalation \& expansion study to evaluate the safety,tolerability and pharmacokinetics (PK) of LP-108, a BCL-2 inhibitor, combined with azacitidine, to determine the dose limiting toxicity (DLT) and the recommended Phase 2 dose (RP2D), and to assess the preliminary efficacy of this combination.

Eligibility

Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria: * Subject must has a diagnosis of one of the following: relapsed or refractory (R/R) or untreated ineligible for treatment with a standard induction chemotherapy acute myeloid leukemia (AML) ; R/R myelodysplastic syndrome(MDS) or untreated MDS with excess blasts defined as ≥ 5% blasts in either bone marrow or blood or with high risk (high and very high-risk groups according to IPSS-R) ;CMML-1 or 2 by WHO, no requirements for prior therapy. * ECOG performance status ≤ 2. * Estimated survival ≥ 12 weeks. * Baseline white blood cell count (WBC) ≤ 25 x 109/L. * Subject must has adequate organ function as defined below: Aspartate transaminase (AST) and alanine transaminase (ALT)≤3 x ULN; Bilirubin ≤1.5 x ULN (unless bilirubin rise is due to Gilbert's syndrome or of non-hepatic origin); adequate renal function as demonstrated by a creatinine clearance ≤1.5 x ULN ; calculated by the Cockcroft Gault formula; APTT ≤ 1.5 x ULN, INR ≤ 1.5 x ULN. * Prior treatment-related toxicities must be grade 1 or baseline except for alopecia. * If subject is sexually active, he/she must agree to carry out birth control throughout the study and 90 days after the last dose of LP-108. Subject must agree to have a negative serum β-HCG test result within 7 days prior to study drug. * Subject must voluntarily sign and date an informed consent. Exclusion Criteria: * Subject is allergic to LP-108, Azacitidine or excipients, or with poor tolerance to Azacitidine. * Subject has received prior therapy with a BH3 mimetic. * Subject has acute promyelocytic leukemia. * Subject has t(9;22) karyotype abnormality or positive BCR/ABL1 fusion gene. * Subject has known and active CNS involvement. * Subject has myeloid sarcoma but no bone marrow involvement. * Subject has Acute unidentified leukemia. * Subject has treatment related MDS or AML. * Subject has AML/MDS/CMML with myelofibrosis ≥ grade 2. * Subject has received allogeneic Hematopoietic Stem Cell Transplantation (HSCT) or autologous HSCT within 3 months prior to the first dose of study drug. * Subject must be at least 4 weeks from antitumor therapy, major surgery, radiation therapy, or participation in other investigational trials. * Subject has received a strong and/or moderate CYP3A inhibitor or inducer, P-gp inhibitor or CYP2C8 substrate within 14 days prior to the initiation of study treatment. * Subject has received drugs with a potential to cause prolonged QT intervals or torsade de pointes. * Administration or consumption of any of the following within 3 days prior to the first dose of study drug: Grapefruit or grapefruit products; Seville oranges (including marmalade containing Seville oranges); Star fruit. * Subject has known malignancy within 3 years prior to the first dose of study drug, with the exception of: Adequately treated basal skin cancers, in situ carcinoma of the cervix uteri or breast, localized squamous cell carcinoma. * Subject has serious and/or uncontrolled systemic diseases, in the opinion of the investigator, the subject is inappropriate for enrollment into this study (serious active infection with grade ≥ 2(based on CTCAE), high blood pressure that cannot be controlled by medication, diabetes, unstable angina, congestive heart failure, Respiratory diseases requiring continuous oxygen intake, severe vascular embolism, uncontrolled massive bleeding or bleeding from vital organs, severe liver, kidney or metabolic diseases, such as cirrhosis, kidney failure, etc.). * Subject has myocardial infarction or stroke within 6 months prior to the first dose of study drug. * Subject has a cardiac history including the following: History of CHF requiring treatment or Ejection Fraction \<50% or a cardiovascular disability status of New York Heart Association. * Subject has uncontrolled and/or active systemic infection (viral, bacterial or fungal). * Subject has difficulty to swallow pills or has conditions that affect drug absorption or pharmacokinetics. * Strong and/or moderate CYP3A inhibitor or inducer and CYP2C8 substrate cannot be discontinued during the study. * Vaccination with live, attenuated vaccines ≤4 weeks prior to initiation of study treatment or anticipation of need for such a vaccine during the study or 4 weeks after the last dose of study drug. * Subject has an autoimmune disease that requires immunosuppressive therapy In the opinion of the investigator, the subject is inappropriate for enrollment into this study.

Primary outcome measure(s)

  • Maximum Tolerated Dose(MTD) — Up to 42 days after initial dose of study drug at the designated cohort dose.
    Standard phase I 3+3 design. The first 3 subjects will be assigned to dose level 1 cohort. If none of the first three subjects experiences DLT, escalation to dose level 2 cohort is permitted. If one of the first three subjects' experiences DLT, a total of six subjects will be required in that dose cohort, and escalation will only be permitted if five of six subjects do not experience DLT. If more than one DLT is observed in the dose level 2 cohort, this will be determined to be the maximally administered dose, and three more subjects will be enrolled in the dose level 1 cohort if only three were previously treated at that dose. Escalation from dose level 2 to level 3 cohort will be with the same method as before. The MTD will be the cohort in which ≤1/6 subjects have dose limiting toxicity at the dose prior to the maximally administered dose. If the dose level 3 cohort has ≤1/6 subjects with a DLT, the MTD will not have been reached.
  • Recommended Phase 2 Dose(RP2D) — Up to 1.5 years
    RP2D will be determined using available safety and pharmacokinetics data upon completion of the dose escalation phase.
  • Incidence of AEs — From first dose of study drug to 28 days after last dose of study drug
    Type, frequency and severity of AEs, relationship of AEs to study treatment
  • Incidence of clinically significant changes in clinical laboratory results — From first dose of study drug to 28 days after last dose of study drug
    Clinically significant changes in hematology, chemistry, coagulation and urinalysis tests results.
  • Cmax of LP-108 — Up to 24 hours post dose
    Maximum plasma concentration (Cmax) of LP-108.
  • Tmax of LP-108 — Up to 24 hours post dose
    Time to maximum plasma concentration (Tmax) of LP-108.
  • t1/2 of LP-108 — Up to 24 hours post dose
    The terminal elimination half-life (t1/2).
  • AUC0-t of LP-108 — Up to 24 hours post dose
    Area under the plasma concentration-time curve (AUC) from 0 to the time of the last measurable concentration of LP-108.
  • CL/F of LP-108 — Up to 24 hours post dose
    Apparent clearance (CL/F) of LP-108.
  • Vd/F of LP-108 — Up to 24 hours post dose
    Apparent volume of distribution of LP-108.

Trial sites (3)

FacilityCityRegionStatus
The First Affiliated Hospital of Nanchang University Nanchang China Recruiting
First Affiliated Hospital of Soochow University Suzhou China Recruiting
Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital Zhengzhou China Recruiting
Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT05641259 on ClinicalTrials.gov ↗ ← All trials in China