Study of HQP1351 in Subjects With Refractory CML and Ph+ ALL

Recruiting now · Phase 1

Conditions studied: Leukemia, Myeloid, Chronic, Myeloid Leukemia, Chronic Myeloid Leukemia, Philadelphia Positive Acute Lymphoblastic Leukemia, B Cell Precursor Type Acute Leukemia

In brief

A multi-center, open-label, randomized, phase Ib study to evaluate the pharmacokinetics (PK) of HQP1351 and to determine the recommended phase 2 dose (RP2D) of HQP1351 in subjects with CML chronic phase (CP), accelerated phase (AP), or blast phase (BP) or with Ph+ ALL, who have experienced resistance or intolerance to at least two tyrosine kinase inhibitors (TKIs) or in subjects with Ph+ B-cell precursor (BCP) ALL or lymphoid blast phase CML (CML LBP), who have experienced resistance or intolerance to at least one second or later generation TKI.

Key facts

Study ID: NCT04260022
Run by: Ascentage Pharma Group Inc.
People needed: 242
Starts: 2020-01-09
Expected to finish: 2030-03-31
Last updated by the study team: 2025-11-05

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

For HQP1351 monotherapy, patients must have CML in any phase (CP, AP, or BP of any phenotype) or Ph+ ALL, with or without T315I mutation
For Cohort D, patients with Ph+ BCP ALL or CML LBP must be resistant or intolerant to at least one second or later generation TKI, such as dasatinib, nilotinib, bosutinib and ponatinib, despite optimal supportive care
For HQP1351 monotherapy only: Be previously treated with and developed resistance or intolerance to at least two TKIs including ponatinib, imatinib, dasatinib, nilotinib, bosutinib, and asciminib. For patients with a T315I mutation, number of pretreated TKIs is not restricted.
The definition of resistance to first-line TKI treatment refers to European Leukemia Net (ELN) recommendations. The definitions are the same for patients in CP, AP, BP, and Ph+ ALL, and apply also to second-line treatment, when first-line treatment was changed for intolerance. The patients must meet at least one criterion:
Three months after the initiation of therapy: non-complete hematologic response (CHR) and/or Ph+ >95%
Six months after the initiation of therapy: BCR-ABL1>10% and/or Ph+ >35%
Twelve months after the initiation of therapy: BCR-ABL1>1% and/or Ph+ >0%
Then, and at any time after the initiation of therapy: Loss of CHR, or loss of complete cytogenetic response (CCyR), or confirmed loss of major molecular response (MMR) (In 2 consecutive tests, of which one with a BCR-ABL1 transcripts level ≥1%), mutations, clonal chromosome abnormalities in Ph+ cells (CCA/Ph+)
The definition of resistance to second-line TKI treatment
a) For CML CP patients: the patients must meet at least one criterion as follows:
i.) Three months after the initiation of therapy: No CHR or Ph+ >95% or new mutations
ii.) Six months after the initiation of therapy: BCR-ABL1>10% and/or Ph+ >65% and/or new mutations
iii.) Twelve months after the initiation of therapy: BCR-ABL1>1% and/or Ph+ >35% and/or new mutations
iv.) Then, and at any time after the initiation of therapy: Loss of CHR or loss of CCyR, new mutations, confirmed loss of MMR (In 2 consecutive tests, of which one with a BCR-ABL1 transcripts level ≥1%), clonal chromosome abnormalities in Ph+ cells (CCA/Ph+)
b) For CML AP patients: the patients must meet at least one criterion as follows:
i.) Three months after the initiation of therapy: failure to achieve a major hematologic response (MaHR)
ii.) At any time after the initiation of therapy, the loss of a MaHR, confirmed in at least 2 consecutive analyses separated by at least 4 weeks
iii.) At any time after the initiation of therapy, the development of new BCR-ABL kinase domain mutations in the absence of a MaHR
c) For CML BP and Ph+ ALL patients: the patients must meet at least one criterion as follows:
i) One month after the initiation of therapy: failure to achieve a MaHR
ii) At any time after the initiation of therapy, the loss of a MaHR, confirmed in at least 2 consecutive analyses separated by at least 1 week
iii) At any time after the initiation of therapy, the development of new BCR-ABL kinase domain mutations in the absence of a MaHR
Intolerance to TKIs is defined as:
Non-hematological AEs: patients with grade 3 or 4 toxicity during TKIs treatment, or with persistent grade 2 toxicity, unresponsive to optimal management, including dose adjustments in the absence of a CCyR for CP patients or MaHR for AP/BP or Ph+ ALL patients
Hematological AEs: patients with grade 3 or 4 toxicity during TKIs treatment, that is recurrent after unresponsive after optimal management, including dose adjustments in the absence of a CCyR for CP patients or MaHR for AP/BP or Ph+ ALL patients

You may not qualify if…

Received TKI therapy within 5 half-lives or 7 days prior to first dose of HQP1351, whichever is shorter, or any adverse events (AEs) (except alopecia and pigmentation) not recovered to CTCAE v5.0 grade 0-1 due to any other treatments
Received other therapies as follows:
For CP and AP patients, received hydroxyurea or anagrelide within 24 hours prior to the first dose of HQP1351; or, interferon, immunotherapy or cytarabine within 14 days prior to the first dose of HQP1351; or, any other radiotherapy, cytotoxic chemotherapy or investigational therapy within 28 days prior to receiving the first dose of HQP1351
For BP patients, received chemotherapy within 7 days prior to the first dose of HQP1351
For Ph+ ALL patients, received corticosteroids within 24 hours before the first dose of HQP1351, or received chemotherapy within 7 days prior to the first dose of HQP1351
Patients who are currently receiving treatment with a medication that has the potential to interact with HQP1351
Patients who had been treated with HQP1351
Patients requiring immunosuppressive therapy other than short time of steroid
Impairment of gastrointestinal (GI) function or GI disease that may significantly alter absorption of study drugs
Patients with cardiovascular diseases, including uncontrolled high blood pressure (HBP) (that is blood pressure >140/90mmHg.); or, receiving drugs that can cause prolonged QT interval. Patients with well controlled HBP can be considered to be included. ("well controlled HBP" is defined as: HBP can be ≤ 140/90mmHg with antihypertensive treatment). Those requiring 3 or more antihypertensive medications should be discussed with the medical monitor.
Have clinically significant, uncontrolled, or active cardiovascular disease, specifically including, but not restricted to:
Any history of myocardial infarction (MI) within 6 months or unstable angina within 3 months
Any history of cerebrovascular accident within 1 year, or transient ischemic attack (TIA) within 3 months
Any history of peripheral vascular infarction, including visceral infarction within 6 months
Congestive heart failure (CHF) (New York Heart Association [NYHA] class III or IV) within 6 months prior to enrollment, or left ventricular ejection fraction (LVEF) less than lower limit of normal, per local institutional standards, within 6 months prior to enrollment
History of clinically significant (as determined by the treating physician) atrial arrhythmia or any history of ventricular arrhythmia
Venous thromboembolism, including deep venous thrombosis or pulmonary embolism, within 3 months prior to enrollment. Patients who have experienced a venous thromboembolic event should only be eligible if the condition is well controlled with optimal intervention (as determined by the treating physician). Continued prophylactic anticoagulation is acceptable.
Patients with revascularization procedures including cardiac bypass within the 6 months and stenting within the past 3 months should be excluded.
Have history of autologous or allogeneic stem cell transplant, or with active graft-versus-host disease (GVHD), or active immune suppression in recent 6 months prior to informed consent date or active immune suppression in recent 6 months prior to informed consent date
CML CP patients with CCyR
Patients who have a significant bleeding disorder unrelated to CML or Ph+ ALL
Patients who had a major surgery within 4 weeks prior to study entry or have not recovered from side effects of such surgery which the Investigator considers not appropriate for enrollment
Cytologically confirmed central nervous system (CNS) involvement (if asymptomatic, spinal fluid examination is not necessary prior to first treatment)
Patients with another primary malignancy within 1 year of study entry. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection and are considered disease-free at the time of study entry.
Have ongoing or active infection, including known history of immunodeficiency virus (HIV) or HIV antibody positive, hepatitis B virus (HBV) or HBsAg positive, hepatitis C virus (HCV). Patients who have positive HCV antibody must have an undetectable HCV viral load.

Where it is running

University of Alabama at Birmingham — Birmingham, Alabama, United States (enrolling)
City of Hope — Duarte, California, United States (enrolling)
Winship Cancer Institute, Emory University — Atlanta, Georgia, United States (enrolling)
Augusta Cancer Center — Augusta, Georgia, United States (enrolling)
University of Maryland — Baltimore, Maryland, United States (enrolling)
Cleveland Clinic — Cleveland, Ohio, United States (enrolling)
University of Texas MD Anderson Cancer Center — Houston, Texas, United States (enrolling)
Fred Hutchinson Cancer Research Center — Seattle, Washington, United States (enrolling)
Princess Margaret Cancer Centre — Toronto, Ontario, Canada (enrolling)

Full record on ClinicalTrials.gov

Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.