Tomivosertib in Relapsed or Refractory Acute Myeloid Leukemia (AML)

NCT05744739 | Active Not Recruiting Phase 1 DMC FDA Drug

• 4 other identifiers: NU 22H08NCI-2023-00767STU00218776P30CA060553
• Study Type: interventional
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

Phase 1 of the study will open first with a (Bayesian optimal interval BOIN) dose finding design. The starting dose of tomivosertib is 100mgdaily (doses 24 ± 2 hours apart), PO, self-administered with meals. The dose finding follows a BOIN design, with the 100mg BID dose level with a meal being the highest dose. There is one dose level below (dose level -1 = 100mg QD without a meal) that will be given if the de-escalation condition is met during dose finding. Upon completion of the phase 1 dose finding portion of the study, the recommended starting dose of tomivosertib for the subsequent combination with the other agents will be determined, as described in Section 4.3 and Section 8.0. Tomivosertib will be dosed continuously on days 1-28 of each 28-day cycle at the dose level assigned for that cohort.

Conditions

Acute Myeloid Leukemia

Outcome Measures

Primary Outcomes (1)

• Determine the dose of maximum pharmacologic activity (MPA) of tomivosertib

  The 'MPA' is defined as the minimum dose of tomivosertib tested in the phase 1 dose-finding portion of the trial that the isotonic estimate of dose-limiting toxicities (DLTs) is below or equal to the target DLT rate of 20% in phase 1 and biologic activity is observed. Whichever dose level is declared the MPA must have at least 6 patients treated at that level.

  From the initiation of trial therapy (cycle 1 day 1), and throughout the first cycle of treatment for a total of 28 days

Secondary Outcomes (8)

• Frequency of adverse events

  Up to 18 months

• Overall response rate

  Up to 18 months

• Complete remission rate (CRR)

  Up to 18 months

• Duration of response (DOR)

  Time between the day of first documented response to trial therapy (CR, CRp, and CRi or PR), whichever is first recorded, and subsequent disease progression, assessed up to 18 months

• Progression free survival (PFS)

  Time between the initiation of trial therapy and the day of first documented disease progression or death from any cause, assessed up to 18 months

Other Outcomes (4)

• Measure MCL1 expression before and after cycle 1 treatment

  Baseline and after Cycle 1 treatment

• Assess the steady-state pharmacokinetics of tomivosertib

  Up to 18 months

• Correlate eIF4E phosphorylation before and after cycle 1 treatment with treatment response.

  Baseline and after Cycle 1 treatment

Study Arms (1)

Treatment (tomivosertib)

EXPERIMENTAL

Tomivosertib will be dosed continuously on days 1-28 of each 28-day cycle.

Procedure: Biospecimen Collection; Drug: Tomivosertib

Interventions

Biospecimen Collection PROCEDURE

Undergo blood sample collection

Also known as: Biological Sample Collection, Biospecimen Collected, Specimen Collection

Treatment (tomivosertib)

Tomivosertib DRUG

Given PO

Also known as: EFT-508, eFT508, Spiro(cyclohexane-1,3'(2'H)-imidazo(1,5-a)pyridine)-1',5'-dione, 6'-((6-Amino-4-pyrimidinyl)amino)-8'-methyl-

Treatment (tomivosertib)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients age \>= 18 years
• Patients with relapsed/refractory AML (based on the International Consensus Classification of Myeloid Neoplasms and Acute Leukemias
• Previous treatment must consist of:
• At least 1 cycle of therapy with an anthracycline and standard dose cytarabine containing regimen; OR
• At least one cycle of a high- or intermediate-dose cytarabine containing regimen; OR
• At least 4 cycles of hypomethylating agent (HMA) as single agent or 2 cycles of HMA and venetoclax; OR
• Allogeneic stem cell transplant (SCT) for either AML or high-risk MDS and have recovered from all transplant-related toxicities, are off all immunosuppression for at least 6 weeks, and have no evidence of acute or chronic graft-versus-host disease GvHD); OR
• Relapsed or refractory disease without established alternative therapy.
• For patients with a known history of human immunodeficiency virus (HIV), infected patients on effective anti-retroviral therapy must have a viral load undetectable for 6 months prior to registration.
• For patients with a known history of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.
• Patients with a known history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.
• Patients must agree to serial bone marrow aspirate/biopsies
• The effects of tomivosertib on the developing human fetus are unknown. For these reasons, patients of child-bearing potential (POCBP) must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) and refrain from donating eggs from the time of informed consent, for the duration of study treatment, and for 30 days following completion of study therapy. Should a patient become pregnant or suspect they are pregnant while they or their partner are participating in this study, they should inform their treating physician immediately.
• People with sperm-producing reproductive capacity treated or enrolled on this protocol must also agree to use adequate contraception (or abstinence or vasectomy) and refrain from donating sperm from the time of informed consent, for the duration of study therapy, and 30 days after completion of study therapy.
• NOTE: A POCBP is any person with an egg-producing reproductive tract (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:

You may not qualify if:

• Patients who are receiving any other investigational agents
• Previous chemotherapy including biologic/targeted therapy or immunological agents for AML within 14 days prior to start of tomivosertib..
• Patients who have a prior or concurrent malignancy that may interfere with study treatment or safety. NOTE: Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen (i.e., cancers under observation that do not require treatment, resectable skin cancer, low risk prostate cancer, DCIS, LCIS, etc.) are eligible per lead PI discretion. Patients with prior MDS or MPN are eligible.
• Patients who have conditions that would interfere with drug absorption
• Patients who have conditions that would interfere with their ability to swallow oral medications
• Patients who have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to tomivosertib, azacitidine, and/or venetoclax
• Patients who have an uncontrolled intercurrent illness including, but not limited to any of the following, are not eligible:
• Uncontrolled systemic infection (defined as ongoing signs/symptoms related to the infection without improvement despite appropriate antibiotics, antiviral therapy, antifungal therapy and/or other treatment)
• Unstable angina pectoris
• Cardiac ventricular arrhythmia, except for patients that can be successfully treated with rate control or anti-arrhythmic agents
• Psychiatric illness/social situations that would limit compliance with study requirements
• Any other illness or condition that the treating investigator feels would interfere with study compliance or would compromise the patient's safety or study endpoints
• Patients who are pregnant or nursing.

Sponsors & Collaborators

• Northwestern University: lead
• National Cancer Institute (NCI): collaborator
• EFFECTOR Therapeutics, Inc.: collaborator

Study Sites (1)

Northwestern University

Chicago, Illinois, 60611, United States

Location

MeSH Terms

Conditions

Leukemia, Myeloid, Acute

Interventions

Specimen Handling; tomivosertib

Condition Hierarchy (Ancestors)

Leukemia, Myeloid; Leukemia; Neoplasms by Histologic Type; Neoplasms; Hematologic Diseases; Hemic and Lymphatic Diseases

Intervention Hierarchy (Ancestors)

Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Investigative Techniques

Study Officials

• Shira N Dinner

  Northwestern University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 16, 2023
• First Posted: February 27, 2023
• Study Start: September 29, 2023
• Primary Completion: August 20, 2024
• Study Completion (Estimated): April 23, 2030
• Last Updated: October 21, 2025

Record last verified: 2025-10

Locations

US (1)