A Phase 1/1b Open-Label, Dose Escalation, First-in- Human Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Preliminary Anti-leukemic Activity of the Orally Available CDC-Like Kinase (CLK) Inhibitor, BH-30236, in Adults With Relapsed or Refractory Acute Myelogenous Leukemia (R/R AML) or Higher-Risk Myelodysplastic Syndrome (HR-MDS)
Summary
Study BH-30236-01 is a first-in-human (FIH), Phase 1/1b, open-label, dose escalation and expansion study in participants with relapsed/refractory acute myelogenous leukemia (R/R AML) or higher-risk myelodysplastic syndrome (HR-MDS). Phase 1, Part 1 Dose Escalation - Monotherapy will evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary efficacy of BH-30236 administered orally. Approximately 50 participants may be enrolled in Phase 1, Part 1 Dose Escalation - Monotherapy. Phase 1, Part 2 Dose Escalation - Combination with Venetoclax will evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary efficacy of BH-30236 administered as a combination therapy with venetoclax. Approximately 48 participants may be enrolled in Phase 1, Part 2 Dose Escalation - Combination with Venetoclax. Phase 1b (Dose Expansion) will follow Phase 1 to further understand the relationships among dose, exposure, toxicity, tolerability, and clinical activity. Up to 72 participants may be enrolled in Phase 1b of the study as a monotherapy or in combination with venetoclax.
Detailed description
This is a Phase 1/1b, multi-center, open-label, dose escalation, first-in-human study to evaluate the safety, tolerability, PK, PD, and preliminary anti-leukemic activity of the CLK inhibitor, BH-30236 as a monotherapy or in combination with venetoclax, in adult participants with R/R AML or HR-MDS. The study consists of three parts: Phase 1, Part 1 Dose Escalation - Monotherapy, Phase 1, Part 2 Dose Escalation - Combination with Venetoclax, and Phase 1b Dose Expansion. Phase 1, Part 1 Dose Escalation - Monotherapy is anticipated to enroll approximately 50 participants to evaluate the safety, tolerability, PK, PD, and preliminary anti-leukemic activity of BH-30236, as well as determine the MTD and/or the preliminary recommended dose(s) for expansion (RDEs). Phase 1, Part 2 Dose Escalation - Combination with Venetoclax is anticipated to enroll approximately 48 participants to evaluate the safety, tolerability, PK, PD, and preliminary anti-leukemic activity of BH-30236, as well as determine the MTD and/or the preliminary recommended dose(s) for expansion (RDEs). Phase 1 will follow a Bayesian optimal interval (BOIN) design dose escalation, where participants will receive ascending doses of BH-30236 to determine the recommended RDEs. Phase 1b Dose Expansion will enroll approximately 72 participants to evaluate the safety, tolerability, and preliminary anti-leukemic activity of BH-30236 as a monotherapy or in combination with venetoclax at selected RDEs determined in Phase 1 Dose Escalation.
Arms & interventions
- DrugBH-30236
BH-30236 will be provided as either a 5 mg, 15 mg or 30 mg tablet. Participants will take BH-30236 tablets orally depending on their dose level assignment.
- DrugVenetoclax
Venetoclax will be provided as 10 mg, 50 mg or 100 mg tablets. Participants will take venetoclax orally per label instructions.
Outcome measures
Primary
Dose Escalation: Frequency of dose limiting toxicities (DLTs)
DLTs are dose-limiting toxicities as defined in the study protocol.
Time frame: Dose-limiting toxicities are collected during the first treatment cycle (28 days)
Dose Escalation and Expansion: Safety evaluation of BH-30236: Number of participants with treatment-related adverse events as assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0
Frequency, severity and relationship to study drug of AEs and SAEs
Time frame: From first dose until 28 days after last dose of BH-30236
Dose Expansion: Composite Complete Remission (CR) Rate
Composite CR rate disease assessment in accordance with the following guidelines: European Leukemia Network (ELN) 2022 for acute myelogenous leukemia (AML) and International Working Group (IWG) 2023 for myelodysplastic syndrome (MDS).
Time frame: From first dose of BH-30236 until disease progression (up to approximately 1 year)
Secondary
Dose Escalation and Expansion: Maximum observed blood concentration (Cmax) of BH-30236.
Time frame: Evaluation performed in Cycle 1 (cycle duration is 28 days).
Dose Escalation: Area under the blood concentration time curve (AUC) of BH-30236.
Time frame: Evaluation performed in Cycle 1 (cycle duration is 28 days).
Dose Escalation and Expansion: Concentration before dose at steady state (Ctrough).
Time frame: Evaluation performed in all treatment cycles up to one year (cycle duration is 28 days).
Dose Escalation and Expansion: Objective Response Rate (ORR)
Time frame: From first dose of BH-30236 until disease progression (up to approximately 1 year)
Dose Escalation and Expansion: Duration of Response (DoR)
Time frame: Time from first documented response until disease progression or death (approximately 1 year).
Dose Escalation and Expansion: Time to remission (TTR)
Time frame: From first dose of BH-30236 until complete remission, disease progression or death (approximately 1 year).
Dose Escalation and Expansion: Relapse-free Survival (RFS)
Time frame: From first dose of BH-30236 until disease progression, death, or initiation of a new anti-leukemic therapy (approximately 1 year).
Dose Escalation and Expansion: Measurable Residual Disease (MRD)
Time frame: From time of first dose until discontinuation of BH-30236 (approximately 1 year).
Dose Escalation and Expansion: Measurement of the change in RNA alternative splicing markers on BH-30236 treatment
Time frame: From time of first dose until discontinuation of BH-30236 (approximately 1 year).
Dose Escalation and Expansion: Complete remission (CR) / complete remission with partial hematologic recovery (CRh) rate for AML and complete remission/partial remission (CR/PR) rate for HR-MDS
Time frame: Time from first documented response until disease progression or death (approximately 1 year)
Eligibility criteria
Study locations (13)
City of Hope Medical Center
Duarte, California, 91010
University of California Los Angeles
Los Angeles, California, 90095
Stanford Cancer Center
Palo Alto, California, 94304
Sylvester Comprehensive Cancer Center
Miami, Florida, 33136
Moffitt Cancer Center
Tampa, Florida, 33612
Northwestern Medicine - Northwestern Memorial Hospital Galter Pavilion
Chicago, Illinois, 60611
Roswell Park Cancer Institute
Buffalo, New York, 14263
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
The Ohio State University Wexner Medical Center - James Cancer Hosp
Columbus, Ohio, 43210
Sarah Cannon Research Institute
Nashville, Tennessee, 37203
The University of Texas M.D. Anderson Cancer Center
Houston, Texas, 77030
Fred Hutchinson Cancer Center
Seattle, Washington, 98109
University of Wisconsin Clinical Science Center
Madison, Wisconsin, 53792