Overview

Safety of SP-420 in the Treatment of Transfusional Iron Overload

Status:
Recruiting
Trial end date:
2024-03-01
Target enrollment:
0
Participant gender:
All
Summary
This study enrolls patients with myelodysplastic syndrome (MDS) and myelofibrosis (MFS), with transfusional iron overload and treats them with the investigational iron chelator, SP-420. SP-420 may be better tolerated and safer than commercially available iron chelators. Iron chelation therapy (ICT) has been shown to improve outcomes in iron overload, but adherence is poor due to problems related to ease of administration, tolerability, and safety.
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
The University of Texas Health Science Center at San Antonio
Collaborator:
Abfero Pharmaceuticals, Inc
Criteria
Inclusion Criteria:

1. Age ≥18

2. Diagnosis of MDS or MF with transfusional iron overload

3. Patients with MDS, will include only those with MDS Revised international prognostic
scoring system (IPSS-R) risk group of intermediate, high, or very high.

4. Patients with MF, will include only those with Dynamic International Prognostic
Scoring System-Plus (DIPSS=Plus) risk category of intermediate-1, intermediate-2, and
high risk.

5. Not appropriate for other iron chelation therapy, per physician

6. Received 10 or more units of packed red blood cells in the preceding 24 months and
remains red cell transfusion dependent

7. ECOG ≤ 3

8. ALT ≤ 3 times the upper limit of the normal range

9. Estimate glomerular filtration rate calculated using Cockroft Gault of ≥ 60
mL/min/1.73m2

10. Serum ferritin ≥1000 ng/ml

11. Willing to comply with all study procedures and be available for the duration of the
study

12. Able to take oral medication and be willing to adhere to study medication for 28 days

13. Female patient must be post-menopausal (no menses for > 12 consecutive months) or
surgically sterile (i.e., bilateral oophorectomy, hysterectomy, or tubal
sterilization; must agree to completely abstain for heterosexual intercourse; or, if
sexually active, must agree to use 1 of the following methods for birth control from
the date she signs the consent form until 30 days after final dose of the study drug.

- Progesterone implant

- Intrauterine device

- Combination of 2 highly effective birth control methods (e.g., diaphragm/or
cervical cap with spermicide plus a condom, hormonal contraception plus a barrier
method, partner with vasectomy conducted >60 days before screening visit plus a
hormone or barrier method

14. Male patients must agree to use 1 of the following methods for birth control from the
date he signs the consent form until 30 days after final dose of the study drug: be
surgically sterile by vasectomy conducted > 60 days before screening visit plus use a
barrier method, or, must agree to completely abstain from heterosexual intercourse, or
must agree to use a combination of 2 highly effective birth control methods (e.g.,
diaphragm/or cervical cap with spermicide plus a condom, hormonal contraception plus a
barrier method), or have a post-menopausal partner plus barrier method.

Exclusion Criteria:

1. History of kidney disease including the renal Fanconi syndrome

2. Proteinuria on urine dipstick greater than trace positive

3. Pregnant, intending to become pregnant during the study, or breastfeeding

4. Receiving another investigational drug within 30 days or 3 half-lives of the
discontinued investigational agent, whichever is greater, of signing consent

5. History of significant hepatic impairment, defined by Child-Pugh class C

6. Active hepatitis B or C disease, evidenced by positive viral PCR

7. Symptomatic heart failure

8. Receiving active cytotoxic chemotherapy or radiation therapy for a second malignancy
(hormonal therapy or topical therapy for squamous cell/basal cell cutaneous tumors are
allowed). Treatment of the underlying hematologic malignancy with azacytidine,
decitabine, venetoclax, lenalidomide, or ruxolitinib is permitted. Treatment with the
supportive care agents luspatercept or erythropoietin agonists is permitted.

9. Concurrent treatment with Exjade/Jadenu (deferasirox), Desferal (deferoxamine), or
Ferriprox (deferiprone) are not permitted. Patients are allowed to stop these
chelators and participate in this trial 14 days after discontinuation of the other
chelator.