A Study to Investigate the Safety and Tolerability of Ziftomenib in Combination with Venetoclax/Azacitidine, Venetoclax, or 7+3 in Patients with AML

Purpose

This Phase 1 study will assess the safety, tolerability, and preliminary antileukemic activity of ziftomenib in combination with venetoclax and azacitidine (ven/aza), ven, and 7+3 for two different molecularly-defined arms, NPM1-m and KMT2A-r.

Conditions

  • Acute Myeloid Leukemia
  • Mixed Lineage Acute Leukemia
  • Mixed Lineage Leukemia Gene Mutation
  • Mixed Phenotype Acute Leukemia
  • Refractory AML
  • AML with Mutated NPM1
  • Acute Myeloid Leukemia Recurrent
  • Acute Myeloid Leukemia, in Relapse
  • NPM1 Mutation
  • KMT2Ar
  • Myeloid Sarcoma

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Patients must have a documented NPM1 mutation or KMT2A rearrangement and have either newly diagnosed or relapsed/refractory AML - Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 - Adequate liver, renal, and cardiac function according to protocol defined criteria - A female of childbearing potential must agree to use adequate contraception from the time of screening through 180 days following the last dose of study intervention. A male of childbearing potential must agree to use abstinence or adequate contraception from the time of screening through 90 days following the last dose of study intervention

Exclusion Criteria

  • Diagnosis of either acute promyelocytic leukemia or blast chronic myelomonocytic leukemia - Known history of BCR-ABL alteration - Advanced malignant hepatic tumor [for patients receiving ven/aza combination] - Administration of live attenuated vaccines within 14 days prior to, during, or after treatment until B-cell recovery - Active central nervous system (CNS) involvement by AML. - Clinical signs/symptoms of leukostasis or WBC > 25,000 / microliter. Hydroxyurea and/or leukapheresis are permitted to meet this criterion - Not recovered to Grade ≤1 (NCI-CTCAE v5.0) from all nonhematological toxicities except for alopecia - Known clinically active human immunodeficiency virus, active hepatitis B or active hepatitis C infection - For newly diagnosed cohorts: received prior chemotherapy for leukemia, except hydroxyurea and/or leukapheresis to control leukocytosis, prior treatment with all-transretinoic acid for initially suspected acute promyelocytic leukemia, or non-HMA therapy for prior myelodysplastic syndrome - For relapsed/refractory cohorts: received chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational < 14 days prior to the first dose of ziftomenib or within 5 drug half-lives prior to the first dose of study drug - Uncontrolled intercurrent illness including, but not limited to, cardiac illness as defined in the protocol - Mean corrected QT interval corrected for heart rate by Fredericia's formula (QTcF) >480 ms on triplicate ECGs - Uncontrolled infection - Women who are pregnant or lactating - An active malignancy and currently receiving chemotherapy for that malignancy or disease that is uncontrolled/progressing

Study Design

Phase
Phase 1
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Dose Escalation: Ziftomenib/Venetoclax/Azacitidine in R/R NPM1-m (A-1)
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Venetoclax
    Oral Administration
  • Drug: Azacitidine
    Subcutaneous or Intravenous Administration
Experimental
Dose Escalation: Ziftomenib/7+3 in 1L NPM1-m (A-2)
Ziftomenib/7+3 in newly diagnosed NPM1-m AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Daunorubicin
    Intravenous Administration
  • Drug: Cytarabine
    Intravenous Administration
Experimental
Dose Escalation: Ziftomenib/Venetoclax/Azacitidine in R/R KMT2A-r (B-1)
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory KMT2A-r AML patients who have failed at least one prior line of therapy
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Venetoclax
    Oral Administration
  • Drug: Azacitidine
    Subcutaneous or Intravenous Administration
Experimental
Dose Escalation: Ziftomenib/7+3 in 1L KMT2A-r (B-2)
Ziftomenib/7+3 in newly diagnosed KMT2A-r AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Daunorubicin
    Intravenous Administration
  • Drug: Cytarabine
    Intravenous Administration
Experimental
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in R/R NPM1-m (A-1)
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Venetoclax
    Oral Administration
  • Drug: Azacitidine
    Subcutaneous or Intravenous Administration
Experimental
Dose Validation/Expansion: Ziftomenib/7+3 in 1L NPM1-m (A-2)
Ziftomenib/7+3 in newly diagnosed NPM1-m AML patients who are candidates for intensive chemotherapy and meet the protocol definition of high-risk disease
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Daunorubicin
    Intravenous Administration
  • Drug: Cytarabine
    Intravenous Administration
Experimental
Dose Validation/Expansion: Ziftomenib/Venetoclax in R/R NPM1-m (A-3)
Ziftomenib/Venetoclax in relapsed/refractory NPM1-m AML patients who have failed at least one prior line of therapy
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Venetoclax
    Oral Administration
Experimental
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in 1L NPM1-m (A-4)
Ziftomenib/Venetoclax/Azacitidine in newly diagnosed NPM1-m AML patients
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Venetoclax
    Oral Administration
  • Drug: Azacitidine
    Subcutaneous or Intravenous Administration
Experimental
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in R/R KMT2A-r (B-1)
Ziftomenib/Venetoclax/Azacitidine in relapsed/refractory KMT2A-r AML patients who have failed at least one prior line of therapy
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Venetoclax
    Oral Administration
  • Drug: Azacitidine
    Subcutaneous or Intravenous Administration
Experimental
Dose Validation/Expansion: Ziftomenib/7+3 in 1L KMT2A-r (B-2)
Ziftomenib/7+3 in newly diagnosed KMT2A-r AML patients who are candidates for intensive chemotherapy
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Daunorubicin
    Intravenous Administration
  • Drug: Cytarabine
    Intravenous Administration
Experimental
Dose Validation/Expansion: Ziftomenib/Venetoclax/Azacitidine in 1L KMT2A-r (B-3)
Ziftomenib/Venetoclax/Azacitidine in newly diagnosed KMT2A-r AML patients
  • Drug: Ziftomenib
    Oral Administration
  • Drug: Venetoclax
    Oral Administration
  • Drug: Azacitidine
    Subcutaneous or Intravenous Administration

Recruiting Locations

The University of Kansas Cancer Center
Fairway, Kansas 66205
Contact:
Thania Medrano
tmedrano@kumc.edu

More Details

Status
Recruiting
Sponsor
Kura Oncology, Inc.

Study Contact

Clinical Operations
858 500 8800
KO-MEN-007@kuraoncology.com