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APR-246

Phase 2

Acute Myeloid Leukemia or Myelodysplastic Syndromes | Small molecule | Oncology |Aprea Therapeutics, Inc.|Last Updated: Mar 17, 2025

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Trial Design

UNCONTROLLEDDMC
Total Trials1
Total Enrollment33

FDA Designations

No designations recorded

Clinical trial landscape

APR-246 · 5 trials · 6 indications

Phase 2 2Phase 1 3
NCT03931291APR-246 in Combination With Azacitidine for TP53 Mutated AML (Acute Myeloid Leukemia) or MDS (Myelodysplastic Syndromes) Following Allogeneic Stem Cell TransplantAcute Myeloid Leukemia or Myelodysplastic Syndromes
COMPLETED33 Analytics
NCT03268382p53 Activation in Platinum-Resistant High Grade Serous Ovarian Cancer, a Study of PLD With APR-246High-grade Serous Ovarian Cancer
COMPLETED36 Analytics
PHASE2COMPLETED
APR-246 in Combination With Azacitidine for TP53 Mutated AML (Acute Myeloid Leukemia) or MDS (Myelodysplastic Syndromes) Following Allogeneic Stem Cell Transplant
Acute Myeloid Leukemia or Myelodysplastic SyndromesUnlock trial analytics
PHASE2COMPLETED
p53 Activation in Platinum-Resistant High Grade Serous Ovarian Cancer, a Study of PLD With APR-246
High-grade Serous Ovarian CancerUnlock trial analytics

Study Endpoints

Primary Endpoints

To Assess Relapse-free Survival (RFS) in Patients With TP53 Mutated AML or MDS After Undergoing Allogeneic Hematopoietic Stem Cell Transplant (HSCT).
Through study completion, an average of 1 year

Relapse-free survival (RFS) at 12 months or longer if data permits. RFS was defined as the time from HCT to relapse after HCT or death, whichever occurred first.

Overall Response Rate (ORR)
Up to 18 months

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

To Evaluate the Tolerabililty and the Incidence of Treatment-Emergent Adverse Events of Administration of APR 246 in Combination With Venetoclax and Azacitidine in Patients With TP53 Mutant Myeloid Malignancies.
From baseline until event occures, i.e. through study completion, an average of 1 year

1\. Dose-limiting toxicities (DLTs), classified and graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE, version 5.0).

Phase Ib: Dose-limiting Toxicities (DLT) (See Description) of Combined APR-246 and Carboplatin/PLD Regimen
Until the end of the first treatment cycle, i.e., Day 28

DLT: Hematological and non-hematological toxicities according to grade/days stated in the protocol.

Phase Ib and II: Progression Free Survival (PFS)
Up to 24 months

Phase Ib: Progression-free Survival is calculated from date of enrollment to the date of disease progression or death due to any cause, whichever occurs first. Symptomatic deterioration is not considered PD. For a patient without evidence of disease progression or death, Progression-free survival will be censored at the date of last evaluable tumor assessment. Patients with no evaluable tumor assessments will be censored at the date of first study drug administration. Phase II: Progression-free survival (PFS) based on Blinded Independent Central Review (BICR) is the primary endpoint and is defined as the number of days from the date of randomization to the date of objective disease progression or relapse (according to RECIST v1.1 only) or death due to any cause, whichever occurs first. If neither event occurs, PFS is censored at the date of the last evaluable tumor assessment. Symptomatic deterioration is not considered objective disease progression.

Dose-Limiting Toxicity (DLT) is reached and HFD is defined accordingly, OR the dose, which is expected to result in maximum plasma concentration close to, but not exceeding 35 μg/ml in any single patient without showing signs of DLT.
21 days

Secondary Endpoints

Treatment-emergent Adverse Events With Combined APR-246 and PLD Regimen
Treatment emergent adverse events (TEAEs) were defined as AEs that occurred on or after the first dose of study medication up to and including 30 days after last dose. Median number of 28d Cycles=2.5 (Min = 1, Max = 14)
Phase Ib and Phase II: Overall Response Rate (RR)
Up to 24 months
Determination of the toxicity and safety profile of APR-246 based on safety parameters from the entire study period.
continuously during 21 days
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Experimental arm: APR-246 + azacitidineEXPERIMENTALAPR-246 and azacitidine maintenance therapy will continue for a maximum of 12 cycles
APR-246 + PLDEXPERIMENTAL -
APR-246EXPERIMENTALAPR-246 4.5 g/day
Phase Ib. APR-246 (35mg/kg) + Carboplatin/PLD.EXPERIMENTALDose escalation of APR-246.
Phase II: Arm A. APR-246 + Carboplatin/PLD.EXPERIMENTALExperimental
Phase II: Arm B. Carboplatin/PLD.ACTIVE_COMPARATORActive Comparator
Phase Ib. APR-246 (50mg/kg) + Carboplatin/PLD.EXPERIMENTALDose escalation of APR-246.
Phase Ib. APR-246 (67.5mg/kg) + Carboplatin/PLD.EXPERIMENTALDose escalation of APR-246.

Interventions

NameTypeDescription
APR-246DRUGAPR-246 will be administered on Days 1-4, with azacitidine on Days 1-5, of every 28 day cycle. Patients may receive a maximum of 12 cycles.
Pegylated Liposomal Doxorubicin Hydrochloride (PLD)DRUGIntravenous infusion
VenetoclaxDRUGVenetoclax 400 mg once daily
AzacitidineDRUGSubcutaneous injection, or intravenous infusion
Carboplatin and Pegylated Liposomal Doxorubicin Hydrochloride (PLD)DRUGIntravenous infusion.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites7

Inclusion Criteria: 1. Patient must have previously met pre-transplantation eligibility. 2. Patient has received an allogeneic transplant for AML or MDS. 3. Any standard (non-study) conditioning \[MAC (myeloablative conditioning), RIC (reduced intensity conditioning), or NMA (non-myeloablative cond...

Countries:United StatesBelgiumSpainUnited KingdomFranceGermanyNetherlandsSweden
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Frequently asked questions about APR-246

What is APR-246 used for?

APR-246 is an investigational small molecule being studied in oncology. It is being evaluated for use in acute myeloid leukemia, myelodysplastic syndromes, platinum sensitive recurrent high-grade serous ovarian cancer with mutated p53, bladder cancer, and other hematologic neoplasms. It is not approved and remains in clinical development.

What does APR-246 target?

APR-246 targets the p53 tumor suppressor protein. It is designed to reactivate mutant p53, restoring its tumor-suppressing function. This mechanism is being studied in cancers that carry p53 mutations, including high-grade serous ovarian cancer and TP53 mutant myelodysplastic syndromes.

Who makes APR-246?

APR-246 is being developed by Aprea Therapeutics, Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol APRE. The company is conducting clinical trials of APR-246 across multiple oncology indications.

What phase is APR-246 in?

APR-246 has completed clinical trials ranging from Phase 1 to Phase 3. A Phase 2 study in platinum-resistant high-grade serous ovarian cancer has been completed, as has a Phase 3 study in TP53 mutant myelodysplastic syndromes. The drug remains investigational and is not FDA approved.

What clinical trials is APR-246 in?

APR-246 has been studied in several completed trials. NCT00900614 was a Phase 1 safety study in refractory hematologic or prostate cancer. NCT02098343 was a Phase 1b/II study in recurrent ovarian cancer. NCT03268382 was a Phase 2 study in platinum-resistant ovarian cancer. NCT03745716 was a Phase 3 study in TP53 mutant MDS.

Is APR-246 the same as eprenetapopt?

Yes, APR-246 is also known as eprenetapopt. This alternative name is used in some clinical and scientific literature. Both names refer to the same investigational small molecule being developed by Aprea Therapeutics for p53-mutant cancers.