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RecruitingInterventionalPhase 1

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)

NCT ID: NCT06501196Sponsor: BlossomHill TherapeuticsLast updated: 2025-09-24

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

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion criteria: * ≥18 years. * Diagnosis of relapsed/refractory acute myelogenous leukemia (R/R) AML or higher-risk myelodysplastic syndrome (HR-MDS) with ≥5% bone marrow blast at time of inclusion. * Prior treatment history must include 1-5 prior lines of therapy. * ECOG performance status ≤2. * Adequate organ function evidenced by the following laboratory values: * Hepatic: Transaminase levels aspartate aminotransferase \[AST\]/ alanine transaminase \[ALT\] ≤ 2.5 × upper limit of normal (ULN). In cases of liver involvement by AML or MDS, AST and ALT \< 5.0 × ULN is acceptable. Total bilirubin ≤ 1.5 × ULN in the absence of documented Gilbert's disease. * Renal: Measured or calculated creatinine clearance ≥ 60 mL/min (Cockcroft-Gault formula) The above are a summary, other inclusion criteria details may apply. Exclusion Criteria: * Diagnosis of acute promyelocytic leukemia or chronic myeloid leukemia with blast crisis. * Prior allogeneic HSCT within 3 months or donor lymphocyte infusion within 30 days of start of therapy; * Active and uncontrolled infections. * Unresolved AEs greater than Grade from prior therapies. * History of other active malignancy (with certain exceptions) * Prior treatment with a CLK inhibitor. * Any acute or chronic graft versus host disease requiring systemic therapy within 4 weeks prior to study drug administration with the exception of topical steroids or the equivalent of 20 mg of prednisone or less. The above is a summary, other exclusion criteria details may apply.

Study locations (13)

City of Hope Medical Center

Duarte, California, 91010

Recruiting

University of California Los Angeles

Los Angeles, California, 90095

Recruiting

Stanford Cancer Center

Palo Alto, California, 94304

Recruiting

Sylvester Comprehensive Cancer Center

Miami, Florida, 33136

Recruiting

Moffitt Cancer Center

Tampa, Florida, 33612

Recruiting

Northwestern Medicine - Northwestern Memorial Hospital Galter Pavilion

Chicago, Illinois, 60611

Recruiting

Roswell Park Cancer Institute

Buffalo, New York, 14263

Recruiting

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Recruiting
Study Coordinator · Contact

The Ohio State University Wexner Medical Center - James Cancer Hosp

Columbus, Ohio, 43210

Recruiting

Sarah Cannon Research Institute

Nashville, Tennessee, 37203

Recruiting
Study Coordinator · Contact

The University of Texas M.D. Anderson Cancer Center

Houston, Texas, 77030

Recruiting

Fred Hutchinson Cancer Center

Seattle, Washington, 98109

Recruiting

University of Wisconsin Clinical Science Center

Madison, Wisconsin, 53792

Recruiting