AzTrials
AzTrials

Acute Myelogenous LeukemiaPhase 2NCT03059615

A Phase 2a, Open-Label, Two Stage Study of Nerofe or Nerofe With Doxorubicin in Subjects With AML or MDS

A Phase 2 study testing Nerofe and Doxorubicin in people with Acute Myelogenous Leukemia and Myelodysplastic Syndromes, run by Immune System Key Ltd at 2 sites in Israel.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
Search all trials

Trial summary

This is a Phase 2a, Open-label, one arm study in which the eligible patients will be treated with IV Nerofe, three times a week in 28 days cycles (up to 12 cycles). Evaluation will include safety procedures, blood level of study drug in certain time points, immune system response and tests checking the mechanism of… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Nerofe and Doxorubicin
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
2 sitesIsrael
Study dates
25 Oct 2018to 26 Jul 2020
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males and females ≥18 years of age.
  • Either:
  • AML patients, who are not candidates for aggressive therapy and/or stem cell transplant (usually the elderly patients), or
  • Low and high prognostic risk MDS patients (according to the IPSS-R classification), resistant or relapsing following at least 1 course of hypo-methylation therapy.
  • Anti-tumor (in this case the anti-MDS or anti-leukemic) effect can be measured according to the IWG criteria (Appendices B, C).
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2
Show all 20Show fewer
  • Acceptable clinical laboratory values at screening, as indicated by:
  • Absolute neutrophil count ≥ 1,000/mm3;
  • Platelets ≥ 50,000/mm3;
  • Hemoglobin ≥ 6.5 g/dl ;
  • Total bilirubin ≤ 1.5 × the upper limit of normal (ULN);
  • AST (SGOT) ≤ 2.5 × the ULN;
  • ALT (SGPT) ≤ 2.5 × the ULN;
  • Serum creatinine ≤ 1.5 mg/dL or a measured creatinine clearance 60 mL/min and above
  • Negative serum β hCG test in women of childbearing potential
  • Women of childbearing potential must agree to use dual contraceptive methods while on study drug and for 3 months afterward.
  • Men who partner with a woman of childbearing potential must agree to use effective, dual contraceptive methods while on study drug and for 3 months afterward.
  • Willing and able to provide written acceptance that during the trial, bone marrow examination should be performed, with cytogenetics. Bone marrow examination will be performed at Screening, Cycle 3, every odd subsequent cycles and End of Dosing Visit (as per PI and Medical Monitor decision).
  • Bone marrow positive for ST2 receptor expression.
  • Willing and able to provide written Informed Consent and comply with the requirements of the study

Who cannot join

  • Any chemotherapy, immunomodulatory drug therapy, anti-neoplastic hormonal therapy 30 days prior to study entry and , immunosuppressive therapy, prednisone > 20 mg/day, or any equivalent corticosteroids during the last six months.
  • Erythroid stimulating agents are allowed until one day prior to treatment initiation with study drug.
  • Presence of an acute toxicity of prior chemotherapy, with the exception of alopecia or peripheral neuropathy, that has not resolved to ≤ Grade 2, as determined by NCI CTCAE v 4.0
  • Receipt of >1 prior regimen of genotoxic therapy.
  • Previous bone marrow transplantation.
  • Life expectancy <12 weeks.
Show all 22Show fewer
  • RBC transfusions for at least 1 week and platelet transfusions for at least 3 days prior to study entry.
  • Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome-related illness (AIDS).
  • Known active hepatitis B or C or other active liver disease
  • Active infection requiring systemic therapy.
  • Unstable Insulin-dependent diabetes mellitus (IDDM), defined by one or more hospitalization (including ER visits) due to high or low blood glucose levels within the last 6 months.
  • History of any of the following within 12 months prior to initiation of study drug: Uncontrolled congestive heart failure (New York Heart Association Classification 3 or 4), unstable angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack, or pulmonary embolism (within the last 6 month).
  • Uncontrolled hypertension and change in treatment regimen within the last month prior to screening.
  • Risk of syncope, in the judgment of the Principle Investigator, according to the patient's history of Syncope.
  • History of ongoing cardiac dysrhythmias requiring drug treatment.
  • Malignancies during the last yearexcept for skin non-melanomatous tumors and thyroid carcinomas..
  • Any known severe multiple allergy or acute allergic reaction.
  • Use of any investigational agents within 4 weeks or 5 half-lives of initiation of study drug.
  • Pregnant or lactating women.
  • Any severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of study results and, in the investigator's opinion, would make the patient inappropriate for entry into this study.
  • For combination therapy only:
  • Impaired cardiac function defined as left ventricular ejection fraction (LVEF) ≤ 55 % as measured by ECHO.

Trial locations and contacts

2 sites in 1 country.

Israel2 sites
  • Rabin Medical Center

    Petah Tikva, 4941492

  • Kaplan Medical Center

    Rehovot, 76100

Other trials in Israel

About this study

Official title: A Phase 2a, Open-Label, Two Stage Study: Stage A: Dose-Range Finder Study to Assess the Safety and Efficacy of Two Doses of Nerofe and Two Doses of Nerofe in Combination With Doxorubicin in Subjects With Acute Myelogenous Leukemia or High Risk Myelodysplastic Syndrome (AML/High Risk MDS). Stage B: Dose Confirmation Study to Assess the Safety and Efficacy of Nerofe or Nerofe in Combination With Doxorubicin in Subjects With AML/ High Risk MDS

This is a Phase 2a, Open-label, one arm study in which the eligible patients will be treated with IV Nerofe, three times a week in 28 days cycles (up to 12 cycles).

Evaluation will include safety procedures, blood level of study drug in certain time points, immune system response and tests checking the mechanism of the drug action.

Read the detailed description

Nerofe is a first-in-class hormone peptide with cancer suppressive properties. It works in three mechanisms of action. The purpose of this research is to study Nerofe's effect in patients diagnosed with AML and MDS.

Being tested
Nerofe, Doxorubicin
Medical subject headings
Leukemia, Myeloid, Acute, Myelodysplastic Syndromes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NerofeDrug

    Nerofe is a first-in-class hormone-peptide with cancer suppressive properties. Nerofe is a derivative of the human hormone-peptide Tumor-Cells Apoptosis Factor (TCApF). It contains 14 amino-acids. Binding Nerofe to the T1/ST2 receptor caused a rapid activation both of Caspase 8 and Bcl-2 mediated downstream in proliferating cancer cells.

  • DoxorubicinDrug

    Doxorubicin is an anthracycline antibiotic with antineoplastic activity. Doxorubicin, isolated from the bacterium Streptomyces peucetius var. caesius, is the hydroxylated congener of daunorubicin. Doxorubicin intercalates between base pairs in the DNA helix, thereby preventing DNA replication and ultimately inhibiting protein synthesis.

Study groups in NCT03059615
Study groupRoleWhat they receive
Nerofe 48mg/m2Experimental48mg/m2 IV Nerofe - three times a week
Receives: Drug: Nerofe
Nerofe 96mg/m2Experimental96mg/m2 IV Nerofe - three times a week
Receives: Drug: Nerofe
Nerofe 48mg/m2 + Doxorubicin 10mg/m2Experimental48mg/m2 IV Nerofe + Doxorubicin 10mg/m2 - once a week
Receives: Drug: Nerofe; Drug: Doxorubicin
Nerofe 96mg/m2 + Doxorubicin 10mg/m2Experimental96mg/m2 IV Nerofe + Doxorubicin 10mg/m2 - once a week
Receives: Drug: Nerofe; Drug: Doxorubicin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Assessing change in IWG Criteria to evaluate response to Nerofe treatment (with or without Doxorubicin) for AML subjects

    Bone Marrow samples and CBC will be done every 2 cycles

    Measured: At end of Cycles 2, 4, 6, 8, 10, 12 (Cycle length 28 Days)

  2. Assessing changes in R-IPSS (Revised International Prognostic Scoring System) Score to evaluate response to Nerofe treatment (with or without Doxorubicin) for MDS patients. A calculation of several variables.

    Bone Marrow samples to measure percentage of blasts (%). Range 0-30% (the higher the percentage the worse outcome).

    Measured: At end of Cycles 2, 4, 6, 8, 10, 12 (Cycle length 28 Days)

  3. Assessing changes in R-IPSS (Revised International Prognostic Scoring System) Score to evaluate response to Nerofe treatment (with or without Doxorubicin) for MDS patients. A calculation of several variables.

    Complete Blood Count (CBC) to measure hemoglobin (g/dL). Range 4-20 (4 worse outcome and 20 best outcome).

    Measured: At end of Cycles 2, 4, 6, 8, 10, 12 (Cycle length 28 Days)

  4. Assessing changes in R-IPSS (Revised International Prognostic Scoring System) Score to evaluate response to Nerofe treatment (with or without Doxorubicin) for MDS patients. A calculation of several variables.

    Complete Blood Count (CBC) to measure absolute neutrophil count (x10^9/L). Range 0-15 (the higher the score the better outcome).

    Measured: At end of Cycles 2, 4, 6, 8, 10, 12 (Cycle length 28 Days)

  5. Assessing changes in R-IPSS (Revised International Prognostic Scoring System) Score to evaluate response to Nerofe treatment (with or without Doxorubicin) for MDS patients. A calculation of several variables.

    Complete Blood Count (CBC) to measure platelets (x10^9/L). Range 0-2000 (the higher the score the better outcome)

    Measured: At end of Cycles 2, 4, 6, 8, 10, 12 (Cycle length 28 Days)

  6. Assessing changes in R-IPSS (Revised International Prognostic Scoring System) Score to evaluate response to Nerofe treatment (with or without Doxorubicin) for MDS patients. A calculation of several variables.

    Measuring cytogenetic abnormalities. Range from very good (0) to very poor (4)

    Measured: At end of Cycles 2, 4, 6, 8, 10, 12 (Cycle length 28 Days)

  7. Safety as determined by frequency, nature and severity of adverse events

    Per CTCAE v4.0

    Measured: 13 months

Secondary outcomes (7)
  1. Pharmacokinetic behavior of Nerofe: Maximum Plasma Concentration (Cmax)

    Done at Cycle 1 and 2: pre-dose, 15 minutes, 1, 2, 4, 6, 8 and 24 hours.

    Measured: At cycles 1 and 2 (Cycle length 28 days)

  2. Pharmacokinetic behavior of Nerofe: Minimum Plasma Concentration (Cmin)

    Done at Cycle 1 and 2: pre-dose, 15 minutes, 1, 2, 4, 6, 8 and 24 hours.

    Measured: At cycles 1 and 2 (Cycle length 28 days)

  3. Pharmacokinetic behavior of Nerofe: Area Under the Curve (AUC)

    Done at Cycle 1 and 2: pre-dose, 15 minutes, 1, 2, 4, 6, 8 and 24 hours.

    Measured: At cycles 1 and 2 (Cycle length 28 days)

  4. Pharmacokinetic behavior of Nerofe: Tmax

    Done at Cycle 1 and 2: pre-dose, 15 minutes, 1, 2, 4, 6, 8 and 24 hours.

    Measured: At cycles 1 and 2 (Cycle length 28 days)

  5. Pharmacodynamic analysis of changes from baseline in levels of circulating cytokines

    At Cycle 1 and 2 on Day 1 and Day 15 and on day 1 of each consecutive cycle (up to 12 cycles)

    Measured: Every cycle (Cycle length 28 days)

  6. Pharmacodynamic analysis of changes from baseline in levels of soluble T1/ST2 receptor

    At Cycle 1 and 2 on Day 1 and Day 15 and on day 1 of each consecutive cycle (up to 12 cycles)

    Measured: Every cycle (Cycle length 28 days)

  7. Pharmacodynamic analysis of changes from baseline in PBMCs' T1/ST2 receptor expression

    At Cycle 1 and 2 on Day 1 and Day 15 and on day 1 of each consecutive cycle (up to 12 cycles)

    Measured: Every cycle (Cycle length 28 days)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Feb 2017
  2. Study start25 Oct 2018
  3. Primary completion26 Jul 2020
  4. Study completion26 Jul 2020

Why it stopped: No recruitment since initiation

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
2 stage study: 1. Dose Range Finder (4 treatment arms) 2. Dose Confirmation (1 chosen treatment arm)
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03059615
Sponsor's protocol ID
ISK-N102
Status last verified
Jul 2020
First submitted
9 Feb 2017
Last updated
31 Jul 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Nerofe and Doxorubicin in people with Acute Myelogenous Leukemia and Myelodysplastic Syndromes, run by Immune System Key Ltd at 2 sites in Israel.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 20 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 31 Jul 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Assessing change in IWG Criteria to evaluate response to Nerofe treatment (with or without Doxorubicin) for AML subjects (time frame: At end of Cycles 2, 4, 6, 8, 10, 12 (Cycle length 28 Days)). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Jul 2020.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in