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NCT Number: NCT06372717

A Study to Investigate APL-4098 Alone and in Combination in Adults With AML or MDS

This is an open-label, Phase 1 study to determine the safety, tolerability, and efficacy of APL-4098 alone, and in combination with azacitidine, and in combination with azacitidine plus venetoclax for the treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS)/AML and MDS-excess blasts (EB).

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 18 years or older
  • Confirmed diagnosis of relapsed refractory acute myeloid leukemia (R/R AML), myelodysplastic syndrome (MDS)/ AML, or MDS-excess blasts (MDS-EB) with the following characteristics: - R/R AML (primary or secondary, including treatment-related), participant is intolerant to, or considered ineligible for available therapies known to provide clinical benefit.
  • WBC count ≤ 25,000/microliter
  • ECOG Performance Status of ≤ 2
  • Weight ≥ 40kg
  • Female participants of childbearing potential must have negative serum pregnancy test at screening; must not plan to become pregnant or have ova harvested or breastfeed while on study; must be willing to use specific contraception or avoid intercourse
  • Male participants must be willing to use specific contraception and not plan to impregnant a female partner or donate sperm while on study
  • Participant must be willing and able to provide written informed consent and to comply with the requirements of the trial

Exclusion criteria

  • Certain prior therapies such as: received an allogeneic stem cell transplant within 6 months of screening, received an autologous stem cell transplant within 3 months of screening, received any anti-cancer treatments within 2 weeks of Cycle 1 Day 1, prior radiation therapy within 4 weeks of screening
  • Certain medical conditions such as: other malignancies, myocardial infarction within 6 months of screening, symptomatic congestive heart failure, uncontrolled active infection, history of arterial thrombosis within 6 months of screening
  • Diagnostic assessments: Left ventricular ejection fraction < 45%, Fridericia's corrected QT interval > 470msec, Aspartate aminotransferase and/or alanine aminotransferase > 3 x upper limit of normal (ULN), total bilirubin > 1.5 x ULN, calculated or measured creatinine clearance < 45 mL/minute (multiply by 0.85 if female)
  • Infectious disease: HIV positive, active hepatitis B and/or C

Treatment and study plan

APL-4098

Drug

APL-4098 is administered orally in 28-day cycles

Azacitidine and APL-4098

Drug

Azacitidine is administered at the standard dose on Day 1 - Day 7 of each 28-day cycle; APL-4098 is administered orally.

Azacitidine and Venetoclax and APL-4098

Drug

Azacitidine is administered at the standard dose on Day 1 - Day 7 of each 28-day cycle; Venetoclax is administered orally; APL-4098 is administered orally.

Primary outcomes

  1. Incidence of Treatment Emergent Adverse Events [Safety]

    Time frame: Through study completion, approximately one year

    Evaluation of safety parameters including treatment emergent adverse events as detected by hematology, chemistry, coagulation safety labs, physical exams, vital signs, Electrocardiogram results

  2. Incidence of Dose Limiting Toxicities [Tolerability]

    Time frame: Cycle 1 Day 1 to Cycle 2 Day 1 (a cycle is 28 days)

    Evaluation of tolerability parameters including dose limiting toxicities as detected by hematology, chemistry, coagulation safety labs, physical exams, vital signs, and Electrocardiogram results

  3. Determine Recommended Phase 2 Dose (RP2D)/Recommended dose range (RDR) levels of APL-4098 alone, in combination with azacitidine, and in combination with azacitidine plus venetoclax.

    Time frame: Approximately one year

  4. Assess the Pharmacokinetics of APL-4098

    Time frame: On Days 1, 2, 8, and 15 of Cycle 1, and on Day 1 of Cycle 2 (each cycle is 28 days)

    Evaluate PK parameters: Maximum plasma concentration (Cmax)

  5. Assess the Pharmacokinetics of APL-4098

    Time frame: On Days 1, 2, 8, and 15 of Cycle 1, and on Day 1 of Cycle 2 (each cycle is 28 days)

    Evaluate PK parameters: area under the curve (AUC)

  6. Assess the Pharmacokinetics of APL-4098

    Time frame: On Days 1, 2, 8, and 15 of Cycle 1, and on Day 1 of Cycle 2 (each cycle is 28 days)

    Evaluate PK parameters: Time to peak concentration (Tmax)

Secondary outcomes

  1. Assess response to disease with APL-4098 alone, in combination with azacitidine, and in combination with azacitidine plus venetoclax.

    Time frame: Response is assessed at Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 7 Day 1 (each cycle is 28 days long), then every three cycles thereafter (assessed for up to 2 years)

    R/R AML and MDS/AML participants: response is assessed per European LeukemiaNet (ELN) 2022 criteria MDS-EB participants: response is assessed per revised International Working Group 2023 response criteria

Study contacts

Contact information is provided by the study sponsor or research team.

Apollo Therapeutics

CONTACT

[email protected]

781-479-2267

Sponsors and collaborators

Lead sponsor

Apollo Therapeutics Ltd

Industry

Registry information

Official study title

A Phase 1 Study to Assess the Safety and Antitumor Activity of APL-4098 Alone and in Combination With Azacitidine and in Combination With Azacitidine Plus Venetoclax in Adults With Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome/AML (MDS/AML) or Myelodysplastic Syndrome With Excess Blasts (MDS-EB)

Important dates

Study start
2024
Primary completion
2027
Study completion
2027
First posted
Apr 18, 2024
Registry last updated
Jun 1, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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