The design of a phase I, open label, dose finding study was chosen in order to establish
a safe and tolerated dose of single agent ABL001 in Chronic myeloid leukemia (CML) and
Philadelphia chromosome positive Acute lymphoblastic leukemia (Ph+ ALL) patients who are
relapsed or refractory to or are intolerant of Tyrosine kinase inhibitors (TKIs), and of
ABL001+Nilotinib, ABL001+Imatinib and ABL001+Dasatinib in Ph positive CML patients who
are relapsed or refractory to TKIs.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT02081378.
This first-in-human trial with ABL001 was a dose escalation study whose primary purpose
was to estimate the maximum tolerated dose (MTD) and/or recommended dose for expansion
(RDE) of single agent ABL001 in CML or Ph+ ALL patients, and in combination with either
Nilotinib or Imatinib or Dasatinib in Ph positive CML patients. The safety, tolerability
and pharmacokinetic (PK) profile of ABL001 and ABL001+Nilotinib, ABL001+Imatinib and
ABL001+Dasatinib were assessed together with an evaluation of pharmacodynamic (PD)
changes in peripheral blood mononuclear cells (PBMC) and bone marrow aspirates and all
data could contribute to the assessment of the RDE.
An understanding of the MTD/RDE, safety profile, PK/PD relationship, and preliminary
evidence of anti-CML and ALL activity wias used to inform future development in adults
with CML and Ph+ ALL. By virtue of its distinct pharmacological profile and by
preclinical pharmacological studies demonstrating an additive effect, a combination of
ABL001 and a tyrosine-kinase inhibitor (TKI) has the potential to achieve a deeper
molecular response in a higher proportion of CML patients as compared to single agent TKI
therapy. Such a combination has the added advantage of targeting the ABL kinase domain at
two distinct locations, theoretically preventing single point mutation-associated
treatment resistance. The prediction is that a nilotinib+ABL001, imatinib+ABL001 and/or
dasatinib+ABL001 combination will increase the percentage of patients who achieve a
complete molecular response (CMR) and decrease the time to CMR, thereby increasing the
possibility of achieving sustained treatment-free remissions in these patients. In
addition, some patients could be intolerant of therapy with TKIs or could develop
mutations that promote resistance to TKI therapy. In these patients, ABL001 could provide
a novel therapeutic option.
Lead OrganizationNovartis Pharmaceuticals Corporation