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Tagraxofusp (SL-401) in Patients With CMML or MF

Trial Status: Active

This multi-center, multi-arm trial is evaluating the safety and efficacy of tagraxofusp, a CD123-targeted therapy, in patients with either chronic myelomonocytic leukemia (CMML) or myelofibrosis (MF). There are two CMML cohorts, one enrolling patients with CMML (CMML-1 or CMML-2) who are refractory / resistant or intolerant to hypomethylating agents (HMA), hydroxyurea (HU), or intensive chemotherapy; and one enrolling treatment-naive patients with CMML (CMML-1 or CMML-2) with molecular features associated with poor prognosis. The MF cohort will enroll patients who are resistant / refractory or intolerant to approved JAK therapy (JAK1 / JAK2 or JAK2).

Inclusion Criteria

  • Abbreviated Inclusion Criteria: All Patients (Stages 2 and 3A): 1. The patient is ≥18 years old. 2. The patient has a life expectancy of >6 months. 3. The patient has an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-2. 4. The patient has adequate baseline organ function, including cardiac, renal, and hepatic function: - Left ventricular ejection fraction (LVEF) ≥ institutional lower limit of normal as measured by multigated acquisition scan (MUGA) or 2-dimensional (2-D) echocardiogram (ECHO) within 28 days prior to start of therapy and no clinically significant abnormalities on a 12-lead electrocardiogram (ECG) - Serum creatinine ≤1.5 mg/dL - Serum albumin ≥3.2 g/dL (or ≥32 g/L) in the absence of receipt of (IV) albumin within the previous 72 hours - Bilirubin ≤1.5 mg/dL - Aspartate transaminase (AST) and alanine transaminase (ALT) ≤2.5 times the upper limit of normal (ULN) - Creatine phosphokinase (CPK) ≤2.5 times the ULN - Absolute neutrophil count (ANC) ≥0.5 × 10⁹/L Additional Abbreviated Inclusion Criteria Specific to Patients with MF (Stage 2): 1. Patient meets the 2016 WHO diagnostic criteria for MF and has an IPSS/DIPSS/DIPSS-plus intermediate-2 or high-risk disease. Patients with IPSS/DIPSS/DIPSS-plus low or intermediate-1 risk disease who have at least one of the following symptoms are also eligible: MF-related anemia (Hb <10 g/dL), splenomegaly (palpable size >10 cm), leukocytosis (WBC >25 × 10⁹/L), marked thrombocytosis (platelet count >1000 × 10⁹/L), or constitutional symptoms (weight loss >10%, during prior 6 months or fever [>37.5ºC or drenching night sweats for >6 weeks]), as recommended by the ELN/IWG 2018 criteria. 2. Patient is approved JAK therapy (JAK1/JAK2 or JAK2) resistant/refractory or intolerant, in accordance with the ELN/IWG 2018 criteria, and at least 4 weeks have elapsed between the last dose of any MF-directed drug treatments; excluding HU, and study enrollment (first dose). HU can be continued until 2 weeks prior to study enrollment. 3. Patient is not eligible for an immediate allo-SCT. Additional Abbreviated Inclusion Criteria Specific to Patients with CMML (Stage 3A): 1. Patient has a 2016 WHO-defined diagnosis of CMML (persistent monocytosis ≥1 × 10⁹/L for at least 3 months, with other causes excluded, and monocytes ≥10% of WBC in peripheral blood, no criteria and no previous history of CML, ET, PV, and acute promyelocytic leukemia; if eosinophilic, neither PDGFRA, PDGFRB, FGFR1 rearrangements nor PCM1-JAK2 translocation; <20% blasts in peripheral blood and bone marrow aspirate; >1 following criteria - dysplasia in >1 myeloid lineage, acquired clonal cytogenetic or molecular abnormality in hematopoietic cells). 2. Patient has 2016 WHO-defined CMML-1 (2-4% blasts in peripheral blood and/or 5-9% blasts in bone marrow) and CMML-2 (5-19% blasts in peripheral blood and/or 10-19% blasts in bone marrow, and/or presence of Auer rods). 3. Patient is refractory/resistant/intolerant to HMAs, or HU, or intensive chemotherapy OR patient is classified as high-risk based on the presence of morphological features, as described by the 2016 WHO prognostic system, and the clinical and molecular features described in molecularly-integrated prognostic systems, such as the GFM, MMM, and the CMML specific prognostic model (CPSS-Mol), and thus is not expected to benefit from HMAs. 4. Patient is ineligible for an immediate allo-SCT. Abbreviated Exclusion Criteria: All Patients (Stages 2 and 3A): 1. Persistent clinically significant toxicities Grade ≥2 from previous therapies not readily controlled by supportive measures (excluding alopecia, nausea, and fatigue). 2. Treatment with any disease-related therapy, including radiation therapy or investigational agent, within 14 days of study entry. 3. Allogeneic SCT within 3 months of study entry. 4. Previous treatment with tagraxofusp or known hypersensitivity to any components of the drug product. 5. Active malignancy and/or cancer history (excluding myeloproliferative disorders and concomitant myeloid malignancies as specified in the inclusion criteria) that can confound the assessment of the study endpoints. Patients with a past cancer history (within 2 years of entry) and/or ongoing active malignancy or substantial potential for recurrence must be discussed with the Sponsor before study entry. Patients with the following neoplastic diagnoses are eligible: non-melanoma skin cancer, carcinoma in situ (including superficial bladder cancer), cervical intraepithelial neoplasia, or organ-confined prostate cancer with no evidence of progressive disease. 6. Clinically significant cardiovascular disease, pulmonary disease, or known active or suspected disease involvement of the central nervous system (CNS). 7. Receiving immunosuppressive therapy, with the exception of corticosteroids as specified in the inclusion criteria and tacrolimus, for treatment or prophylaxis of graft-versus-host disease (GVHD). 8. Uncontrolled intercurrent illness. 9. Patient is pregnant or breast feeding. 10. Patient has known human immunodeficiency virus (HIV), Hepatitis B or Hepatitis C. 11. Patient is oxygen-dependent. Additional Exclusion Criteria Specific to Patients with MF and CMML (Stages 2 and 3A) apply.

California

Duarte
City of Hope Comprehensive Cancer Center
Status: ACTIVE
Contact: Haris Ali
Phone: 626-256-4673ext6268
Los Angeles
UCLA / Jonsson Comprehensive Cancer Center
Status: ACTIVE
Contact: Gary John Schiller
Phone: 310-825-5513
Palo Alto
Stanford Cancer Institute Palo Alto
Status: COMPLETED

Kansas

Fairway
University of Kansas Clinical Research Center
Status: ACTIVE
Kansas City
University of Kansas Cancer Center
Status: ACTIVE
Westwood
University of Kansas Hospital-Westwood Cancer Center
Status: ACTIVE

Massachusetts

Boston
Brigham and Women's Hospital
Status: COMPLETED
Dana-Farber Cancer Institute
Status: COMPLETED
Contact: Martha Wadleigh
Massachusetts General Hospital Cancer Center
Status: COMPLETED
Contact: Gabriela Soriano Hobbs

Michigan

Ann Arbor
University of Michigan Comprehensive Cancer Center
Status: CLOSED_TO_ACCRUAL_AND_INTERVENTION
Contact: Moshe Talpaz

Minnesota

Rochester
Mayo Clinic in Rochester
Status: TEMPORARILY_CLOSED_TO_ACCRUAL
Contact: Animesh Dev Pardanani
Phone: 855-776-0015

New Mexico

Albuquerque
University of New Mexico Cancer Center
Status: CLOSED_TO_ACCRUAL_AND_INTERVENTION

New York

Buffalo
Roswell Park Cancer Institute
Status: ACTIVE

Ohio

Cleveland
Case Comprehensive Cancer Center
Status: IN_REVIEW
Contact: Hetty Eileen Carraway
Phone: 410-955-8804

Texas

Houston
M D Anderson Cancer Center
Status: ACTIVE
Contact: Naveen Pemmaraju
Phone: 713-792-4956

Trial Phase Phase II

Trial Type Treatment

Lead Organization
Stemline Therapeutics, Inc.

  • Primary ID STML-401-0314
  • Secondary IDs NCI-2015-00337
  • Clinicaltrials.gov ID NCT02268253