A Multi-phase, Pharmacokinetics, Safety, and Efficacy Study of ASTX030 (Azacitidine and Cedazuridine) as Monotherapy in Subjects With Myeloid Neoplasm or in Combination With Venetoclax in Subjects With AML (AZTOUND Study)
Summary
Study ASTX030-01 is a multi-phase study comprising of Phases 1-3 Monotherapy arms, and Phase 1 and Phase 2 Combination Therapy arms. Phase 1 Monotherapy consists of an open-label Dose Escalation Stage (Stage A) using multiple cohorts at escalating dose levels of oral cedazuridine and azacitidine (only one study drug will be escalated at a time) followed by a Dose Expansion Stage (Stage B). Phase 2 Monotherapy is a randomized, open-label, crossover study to compare oral ASTX030 to subcutaneous (SC) azacitidine. Phase 3 Monotherapy is a randomized open-label crossover study comparing the final fixed dose of oral ASTX030 to SC azacitidine. Phase 1 Combination Therapy is an open-label, multicenter, randomized, exploratory study comparing ASTX030 and SC azacitidine in combination with venetoclax in participants with treatment-naïve AML. Phase 2 Combination Therapy is an open-label, single arm, study evaluating the efficacy, safety, pharmacokinetics (PK), and drug interactions of ASTX030 in combination with venetoclax in participants with treatment-naïve AML. The duration of this multi-phase study is approximately 8 years.
Detailed description
The Phase 1 and Phase 2 Monotherapy arms have completed enrollment. The Phase 3 Monotherapy, Phase 1 Combination Therapy, and Phase 2 Combination Therapy arms are open for enrollment.
Arms & interventions
- DrugAzacitidine
Tablets/Capsules for oral administration and powder for reconstitution to aqueous suspension for SC administration.
- DrugASTX030 (cedazuridine + azacitidine)
FDC Capsules for oral administration.
- DrugAzacitidine
Powder for reconstitution to aqueous suspension for SC administration.
- DrugASTX030 (cedazuridine + azacitidine)
Tablets/Capsules for oral administration.
- DrugCedazuridine
Tablets for oral administration.
- DrugVenetoclax
Oral tablets.
Outcome measures
Primary
Phase 1, 2 and 3 Monotherapy: Total Cycle Area Under the Curve (AUC) From 0 to 24 Hours (AUC0-24) Exposures
Ratio of azacitidine total cycle AUC0-24 exposures after oral ASTX030 over SC azacitidine.
Time frame: Predose and at multiple timepoints post-dose up to 24 hours
Phase 1 Combination Therapy: Number of Participants with Treatment-emergent Adverse Events (TEAEs)
Time frame: Up to 24 months
Phase 1 and 2 Combination Therapy: Complete Response (CR) Rate as Assessed by the Investigator
Time frame: Up to 36 months
Phase 1 Combination Therapy: AUC0-24 of Venetoclax With ASTX030
Time frame: Pre-dose and at multiple timepoints post-dose up to 24 hours on Day 7 (with ASTX030] of Cycle 1
Phase 1 Combination Therapy: AUC0-24 of Venetoclax Without ASTX030
Time frame: Pre-dose and at multiple timepoints post-dose up to 24 hours on Day 14 (without ASTX030) of Cycle 1
Phase 1 Combination Therapy: Maximum Plasma Concentration (Cmax) of Venetoclax With ASTX030
Time frame: Pre-dose and at multiple timepoints post-dose up to 24 hours on Day 7 (with ASTX030] of Cycle 1
Phase 1 Combination Therapy: Cmax of Venetoclax Without ASTX030
Time frame: Pre-dose and at multiple timepoints post-dose up to 24 hours on Day 14 (without ASTX030) of Cycle 1
Secondary
Phase 1, 2 and 3 Monotherapy: Number of Participants with Treatment-emergent Adverse Events (TEAEs)
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: Change in Deoxyribonucleic Acid (DNA) Methylation
Time frame: Baseline in Phase 1 to the end of Cycle 2 in Phase 3 (28 days per cycle)
Phase 1, 2 and 3 Monotherapy: Best CR Rate in Participants with MDS, CMML, or MDS/Myeloproliferative Neoplasms (MPN)
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: AML-free Survival for Participants with MDS, CMML, or MDS/MPN
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: Duration of Response
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: Overall Survival
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: Time to Response
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: Red Blood Cell (RBC) Transfusion Independence (TI)
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: Platelet Transfusion Independence (TI)
Time frame: Up to 36 months
Phase 1, 2 and 3 Monotherapy: AUC of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Days 1, 2 and 7 of Cycle 1 and Cycle 2 (cycle length=28 days)
Phase 1, 2 and 3 Monotherapy: Cmax of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Days 1, 2 and 7 of Cycle 1 and Cycle 2 (cycle length=28 days)
Phase 1, 2 and 3 Monotherapy: Time to Reach Cmax (Tmax) of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Days 1, 2 and 7 of Cycle 1 and Cycle 2 (cycle length=28 days)
Phase 1B, Food Effect Cohort: AUC of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycle 2 (cycle length=28 days)
Phase 1B Monotherapy, Food Effect Cohort: Cmax of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycle 2 (cycle length=28 days)
Phase 1B Monotherapy, Food Effect Cohort: Tmax of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycle 2 (cycle length=28 days)
Phase 1 and 2 Combination Therapy: AUC0-24 of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose up to 24 hours on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 and 2 Combination Therapy: Cmax of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 and 2 Combination Therapy: Tmax of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 and 2 Combination Therapy: AUC0-9 of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose up to 9 hours on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 and 2 Combination Therapy: AUC0-inf of Azacitidine, Cedazuridine and Cedazuridine-epimer
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 Combination Therapy: AUC of SC Azacitidine and Venetoclax
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 Combination Therapy: AUC of Venetoclax, Azacitidine, and Cedazuridine
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 Combination Therapy: Cmax of SC Azacitidine and Venetoclax
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 Combination Therapy: Cmax of Venetoclax, Azacitidine, and Cedazuridine
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 Combination Therapy: Tmax of Venetoclax, Azacitidine, and Cedazuridine
Time frame: Predose and at multiple timepoints post-dose on Day 7 of Cycles 1 and 2 (cycle length = 28 days)
Phase 1 and 2 Combination Therapy: CR and Complete Response with Partial Hematologic Recovery (CRh) Rate
Time frame: Up to 36 months
Phase 1 and 2 Combination Therapy: CR and Complete Response with Incomplete Hematologic Recovery (CRi) Rate
Time frame: Up to 36 months
Phase 1 and 2 Combination Therapy: Time to CR and CRh
Time frame: Up to 36 months
Phase 2 Combination Therapy: AUC0-24 of Venetoclax With and Without ASTX030
Time frame: Pre-dose and at multiple timepoints post-dose up to 24 hours on Day 7 (with ASTX030] and Day 14 (without ASTX030) of Cycle 1
Phase 2 Combination Therapy: Cmax of Venetoclax With and Without ASTX030
Time frame: Time Frame: Pre-dose and at multiple timepoints post-dose up to 24 hours on Day 7 (with ASTX030] and Day 14 (without ASTX030) of Cycle 1
Phase 2 Combination Therapy: Number of Participants with TEAEs
Time frame: Up to 36 months
Phase 2 Combination Therapy: Overall Survival (OS)
Time frame: Up to 36 months
Phase 2 Combination Therapy: Event Free Survival (EFS)
Time frame: Up to 36 months
Phase 2 Combination Therapy: Duration of CR and CRi or CRh
Time frame: Up to 36 months
Eligibility criteria
Study locations (24)
Keck School of Medicine of USC
Los Angeles, California, 90089
UC Irvine Health - Chao Family Comprehensive Cancer Center
Orange, California, 92868
Yale University
New Haven, Connecticut, 06510
University of Miami - Sylvester Comprehensive Cancer Center
Miami, Florida, 33136
University of Emory - Winship Cancer Institute
Atlanta, Georgia, 30322
Dana-Farber Cancer Institute
Boston, Massachusetts, 02114
John Theurer Cancer Center / Hackensack University
Hackensack, New Jersey, 07601
Roswell Park Comprehensive Cancer Center
Buffalo, New York, 14263
New York University Langone Hospital - Long Island
Mineola, New York, 11501
Perlmutter Cancer Center - 34th Street
New York, New York, 10016
Icahn School of Medicine at Mount Sinai
New York, New York, 10029
Weill Cornell Medical Center
New York, New York, 10065
Montefiore Medical Center
The Bronx, New York, 10467
Duke University
Durham, North Carolina, 27705
Ohio State University Comprehensive Cancer Center (OSUCCC) - The James Cancer Hospital and Solove Research Institute
Columbus, Ohio, 43210
Oregon Health and Science University
Portland, Oregon, 97239
Oregon Oncology Specialists
Salem, Oregon, 97301
Hollings Cancer Center
Charleston, South Carolina, 29425
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
Baylor Research Institute dba Baylor Scott & White Research Institute
Dallas, Texas, 75204
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
MD Anderson Cancer Center
Houston, Texas, 77030
Seattle Cancer Care Alliance
Seattle, Washington, 98109
Froedtert & Medical College of Wisconsin
Milwaukee, Wisconsin, 53226