A Study of Venetoclax in Combination With Low Dose Cytarabine Versus Low Dose Cytarabine Alone in Treatment Naive Patients With Acute Myeloid Leukemia Who Are Ineligible for Intensive Chemotherapy
A Randomized, Double-Blind, Placebo Controlled Phase 3 Study of Venetoclax Co-Administered With Low Dose Cytarabine Versus Low Dose Cytarabine in Treatment Naïve Patients With Acute Myeloid Leukemia Who Are Ineligible for Intensive Chemotherapy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Acute myeloid leukemia (AML) is an aggressive and rare cancer of myeloid cells (a white blood cell responsible for fighting infections). Successful treatment of AML is dependent on what subtype of AML the patient has, and the age of the patient when diagnosed.
Venetoclax is an experimental drug that kills cancer cells by blocking a protein (part of a cell) that allows cancer cells to stay alive. This study is designed to see if adding venetoclax to cytarabine works better than cytarabine on its own.
This is a Phase 3, randomized, double-blind (treatment unknown to patients and doctors), placebo-controlled, multicenter study in patients with AML who are 18 or more years old and have not been treated before. Patients who take part in this study should not be suitable for intensive induction chemotherapy (usual starting treatment). Abbvie is funding this study which will take place at approximately 125 hospitals globally. In this study, 2/3 of patients will receive venetoclax every day with cytarabine and the remaining 1/3 will receive placebo (dummy) tablets with cytarabine.
Participants will continue to have study visits and receive treatment for as long as they are having a clinical benefit. The effect of the treatment on AML will be checked by taking blood, bone marrow, scans, measuring side effects and by completing health questionnaires. Blood and bone marrow tests will be completed to see why some people respond better than others.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Expanded Access
Expanded Access
Available
- Available: Expanded access is currently available for this investigational treatment, and patients who are not participants in the clinical study may be able to gain access to the drug, biologic, or medical device being studied.
- No longer available: Expanded access was available for this intervention previously but is not currently available and will not be available in the future.
- Temporarily not available: Expanded access is not currently available for this intervention but is expected to be available in the future.
- Approved for marketing: The intervention has been approved by the U.S. Food and Drug Administration for use by the public.
Contacts and Locations
Study Locations
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Buenos Aires, Argentina, 1431
- Cemic /Id# 159676
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Córdoba, Argentina, 5000
- Sanatorio Allende /ID# 159675
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New South Wales
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Waratah, New South Wales, Australia, 2298
- Calvary Mater Newcastle /ID# 160123
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Westmead, New South Wales, Australia, 2145
- Westmead Hospital /ID# 160121
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Victoria
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Melbourne, Victoria, Australia, 3004
- Alfred Hospital /ID# 160125
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Melbourne, Victoria, Australia, 3128
- Box Hill Hospital /ID# 162920
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Antwerpen
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Edegem, Antwerpen, Belgium, 2650
- Universitair Ziekenhuis Antwerpen /ID# 159566
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Brussels Capital
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Woluwe-Saint-Lambert, Brussels Capital, Belgium, 1200
- Cliniques Universitaires Saint Luc /ID# 159567
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Porto Alegre, Brazil, 90470-150
- Hospital do Cancer Mae de Deus /ID# 163416
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São Paulo, Brazil, 08270-070
- Casa de Saúde Santa Marcelina /ID# 163413
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Santa Catarina
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Florianópolis, Santa Catarina, Brazil, 88034-000
- Centro de Pesquisas Oncologicas /ID# 163567
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São Paulo
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Barretos, São Paulo, Brazil, 14784-400
- Hospital de Cancer de Barretos /ID# 163568
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Alberta
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Edmonton, Alberta, Canada, T6G 2G3
- University of Alberta Hospital /ID# 159646
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Quebec
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Greenfield Park, Quebec, Canada, J4V 2H1
- CISSS de la Monteregie /ID# 159782
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Montreal, Quebec, Canada, H1T 2M4
- Hospital Maisonneuve-Rosemont /ID# 159780
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Montreal, Quebec, Canada, H4J 1C5
- Hopital Sacre Coeur Montreal /ID# 160982
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Jinan, China, 250014
- Qilu Hospital of Shandong Univ /ID# 167507
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Wuhan, China, 430022
- Union Hospital Tongji Medical College Huazhong University of Science and Technol /ID# 167515
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Zhengzhou, Henan, China, 450008
- Henan Cancer Hospital /ID# 167327
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Fujian
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Fuzhou, Fujian, China, 350001
- Fujian Medical Univ Union Hosp /ID# 167321
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Guangdong
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Guangzhou, Guangdong, China, 510515
- Nanfang Hospital of Southern Medical University /ID# 170147
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Jiangsu
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Nanjing, Jiangsu, China, 210029
- Jiangsu Province People's Hospital /ID# 167511
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Jilin
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Changchun, Jilin, China, 130021
- The First Hosp of Jilin Univ /ID# 167512
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Shanghai Municipality
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Shanghai, Shanghai Municipality, China, 200025
- Ruijin Hospital, Shanghai Jiaotong /ID# 167325
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Sichuan
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Chengdu, Sichuan, China, 610041
- West China Hospital /ID# 167514
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Tianjin Municipality
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Tianjin, Tianjin Municipality, China, 300020
- Blood disease hosp of Chinese Academy of Med Sciences(Institute of Hematology) /ID# 167509
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Zhejiang
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Hangzhou, Zhejiang, China, 310003
- The First Affiliated Hospital,College of Medicine, Zhejiang University /ID# 167324
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Brno, Czechia, 625 00
- Fakultni Nemocnice Brno /ID# 159247
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Ostrava, Czechia, 708 52
- Univ Hosp Ostrava-Poruba /ID# 159246
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Prague, Czechia, 100 34
- Fakult Nem Kralovske Vinohrady /ID# 159248
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Bayonne, France, 64100
- Centre Hospitalier de la Cote /ID# 159697
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Pessac, France, 33600
- CHU Bordeaux /ID# 159704
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Vandœuvre-lès-Nancy, France, 54511
- CHU De Nancy /ID# 159700
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Rhone
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Pierre-Bénite, Rhone, France, 69495
- Centre Hospitalier Lyon Sud /ID# 159705
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Sarthe
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Le Mans, Sarthe, France, 72037
- Centre Hospitalier Le Mans /ID# 159702
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Berlin, Germany, 10967
- Vivantes Klinikum Am Urban /ID# 159569
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Hamburg, Germany, 20246
- Universitaetsklinikum Hamburg /ID# 161760
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Baden-Wurttemberg
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Villingen-Schwenningen, Baden-Wurttemberg, Germany, 78052
- Schwarzwald-Baar-Klinikum /ID# 159571
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Alexandroupoli, Greece, 68100
- Gen Univ Hosp Alexandroupolis /ID# 157868
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Athens, Greece, 10676
- General Hospital of Athens Evaggelismos and Ophthalmiatrio of Athens Polyclinic /ID# 157869
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Pátrai, Greece, 26504
- University Gen Hosp of Patra /ID# 157871
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Thessaloniki, Greece, 57010
- General Hospital of Thessaloniki George Papanikolaou /ID# 157867
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Attica
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Athens, Attica, Greece, 115 27
- General Hospital of Athens Laiko /ID# 157870
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Budapest, Hungary, 1083
- Semmelweis Egyetem I. Belklini /ID# 158180
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Debrecen, Hungary, 4032
- Debreceni Egyetem Klinikai Koz /ID# 158178
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Győr, Hungary, 9023
- Petz Aladar Megyei Oktato Korh /ID# 161739
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Kaposvár, Hungary, 7400
- Kaposi Mor Oktato Korhaz /ID# 158175
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Kecskemét, Hungary, 6000
- Bacs-Kiskun Megyei Korhaz /ID# 160973
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Budapest
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Budapest IX, Budapest, Hungary, 1097
- Dél-pesti Centrumkórház- Országos Hematológiai és Infektológiai Intézet /ID# 159127
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Pecs
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Pécs, Pecs, Hungary, 7624
- Pecsi Tudomanyegyetem /ID# 163161
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Dublin, Ireland, D09 XR63
- Beaumont Hospital /ID# 162733
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Galway, Ireland, H91 YR71
- University Hospital Galway /ID# 162734
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Limerick, Ireland, V94F858
- University Hospital Limerick /ID# 162735
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Dublin
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Dublin, Dublin, Ireland, D08 E9P6
- St. James's Hospital /ID# 162730
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Akita, Japan, 100041
- Akita University Hospital /ID# 160602
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Hidaka, Japan, 350-1241
- Saitama Med Univ Int Med Ctr /ID# 161308
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Nagoya, Japan, 460-0001
- NHO Nagoya Medical Center /ID# 159768
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Shimotsuga, Japan, 321-0293
- Dokkyo Medical University Hosp /ID# 159650
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Tokyo, Japan, 113-8431
- Juntendo University Hospital /ID# 159781
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Fukui
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Yoshida-gun, Fukui, Japan, 910-1193
- University of Fukui Hospital /ID# 159770
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Fukuoka
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Fukuoka, Fukuoka, Japan, 812-8582
- Kyushu University Hospital /ID# 159688
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Gunma
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Maebashi, Gunma, Japan, 371-0821
- Gunmaken Saiseikai Maebashi Hospital /ID# 160597
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Ibaraki
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Higashi Ibaraki-gun, Ibaraki, Japan, 3113193
- National Hospital Organization Mito Medical Center /ID# 162988
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Kyoto
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Kyoto, Kyoto, Japan, 602-8566
- Kyoto Prefect Univ Med /ID# 160101
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Miyagi
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Sendai, Miyagi, Japan, 980-8574
- Tohoku University Hospital /ID# 161151
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Nagasaki
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Nagasaki, Nagasaki, Japan, 852-8501
- Nagasaki University Hospital /ID# 160233
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Osaka
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Osaka, Osaka, Japan, 545-0051
- Osaka City University Hospital /ID# 159722
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Osakasayama-shi, Osaka, Japan, 589-8511
- Kinki University -Osakasayama Campus /ID# 160777
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Tokyo
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Bunkyo-ku, Tokyo, Japan, 113-8677
- Tokyo Metropolitan Komagome Hospital /ID# 160759
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Komae-shi, Tokyo, Japan, 201-8601
- Tokyo Jikei Daisan Hospital /ID# 159769
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Shinagawa-ku, Tokyo, Japan, 141-8625
- NTT Medical Center Tokyo /ID# 160678
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Yamagata
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Yamagata, Yamagata, Japan, 990-9585
- Yamagata University Hospital /ID# 161223
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Mexico City
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Mexico City, Mexico City, Mexico, 14080
- Instituto Nacional de Cancerol /ID# 159269
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Michoacán
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Morelia, Michoacán, Mexico, 58260
- Centro de Invest Clin Chapulte /ID# 162625
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Nuevo León
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Monterrey, Nuevo León, Mexico, 64320
- Hosp. Univ. Dr. Jose E. Gonz /ID# 159268
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Auckland, New Zealand, 0622
- North Shore Hospital /ID# 160132
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Auckland, New Zealand, 2025
- Middlemore Clinical Trials /ID# 160131
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Grålum, Norway, 1714
- Sykehuset Ostfold Kalnes /ID# 165632
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Hordaland
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Bergen, Hordaland, Norway, 5021
- Haukeland University Hospital /ID# 165630
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San Juan, Puerto Rico, 00921-3201
- VA Caribbean Healthcare System /ID# 158999
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Moscow, Russia, 125284
- City Clinical Hospital Botkina /ID# 164086
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Saint Petersburg, Russia, 197341
- Almazov North-West Federal Med /ID# 162170
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Saint Petersburg, Russia, 198205
- Saint Petersburg State Institu /ID# 162171
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Samara, Russia, 443099
- Samara State Medical Universit /ID# 164173
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Saratov, Russia, 41002
- saratov state medical /ID# 163130
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Yaroslavl, Russia, 150062
- Yaroslavl Regional Clinic Hosp /ID# 162172
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Kemerovo Oblast
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Kemerovo, Kemerovo Oblast, Russia, 650066
- Kemerovo Regional Clinical Hospital n.a. S.V. Belyaev /ID# 162991
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Nizhny Novgorod Oblast
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Nizhny Novgorod, Nizhny Novgorod Oblast, Russia, 603126
- Nizhniy Novgorod regional clinical hospital named N. A. Semashko /ID# 163186
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Ryazan Oblast
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Ryazan, Ryazan Oblast, Russia, 390039
- State Institution of Health of the Ryazan Regional Clinical Hospital /ID# 163126
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Gauteng
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Pretoria, Gauteng, South Africa, 0001
- Netcare Pretoria East Hospital /ID# 157373
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Pretoria, Gauteng, South Africa, 0001
- Tshwane District Hospital /ID# 157361
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Seoul, South Korea, 03080
- Seoul National University Hospital /ID# 162253
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Busan Gwang Yeogsi
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Busan, Busan Gwang Yeogsi, South Korea, 602-739
- Pusan National University Hosp /ID# 158725
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Daejeon Gwang Yeogsi
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Junggu, Daejeon Gwang Yeogsi, South Korea, 35015
- Chungnam National University Hospital /ID# 158726
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Seoul Teugbyeolsi
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Seoul, Seoul Teugbyeolsi, South Korea, 06591
- Cath Univ Seoul St Mary's Hosp /ID# 158724
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Madrid, Spain, 28031
- Hospital Infanta Leonor /ID# 161180
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Valenciana
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Valencia, Valenciana, Spain, 46026
- Hospital Universitario y Politecnico La Fe /ID# 161181
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Kaohsiung City, Taiwan, 80708
- Kaohsiung Medical University /ID# 161693
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Taipei
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Taipei City, Taipei, Taiwan, 10002
- National Taiwan Univ Hosp /ID# 162781
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Taipei City, Taipei, Taiwan, 11490
- Tri-Service General Hospital /ID# 161683
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Birmingham, United Kingdom, B9 5SS
- Heartlands Hospital /ID# 163534
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Cardiff, United Kingdom, CF14 4EN
- University Hospital of Wales /ID# 162726
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Harrow, United Kingdom, HA1 3UJ
- Northwick Park Hospital /ID# 162727
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Florida
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Tampa, Florida, United States, 33612
- H. Lee Moffit Cancer Center /ID# 164273
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Kentucky
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Louisville, Kentucky, United States, 40202-3700
- Norton Cancer Institute /ID# 158998
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15232
- Univ of Pittsburgh Med Ctr /ID# 158997
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Texas
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Houston, Texas, United States, 77030
- Univ TX, MD Anderson /ID# 159678
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Washington
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Seattle, Washington, United States, 98104
- Swedish Medical Center /ID# 161280
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Wisconsin
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La Crosse, Wisconsin, United States, 54601
- Gundersen Health System /ID# 164272
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Participant must have histological confirmation of acute myeloid leukemia (AML) by World Health Organization criteria, be ineligible for intensive induction chemotherapy and either be:
- ≥ 75 years of age OR
≥ 18 to 74 years of age and fulfill at least one criteria associated with lack of fitness for intensive induction chemotherapy:
- Eastern Cooperative Oncology Group (ECOG) performance status of 2 - 3
- Cardiac history of congestive heart failure (CHF) requiring treatment or ejection fraction ≤ 50% or chronic stable angina
- Diffusing capacity of the lung for carbon monoxide (DLCO) ≤ 65% or forced expiratory volume in 1 second (FEV1) ≤ 65%
- Creatinine clearance ≥ 30 mL/min to < 45 ml/min
- Moderate hepatic impairment with total bilirubin > 1.5 to ≤ 3.0 × upper limit of normal (ULN)
- Other comorbidity that the physician judges to be incompatible with conventional intensive chemotherapy which must be reviewed and approved by the study medical monitor before study enrollment
Participant must have an ECOG performance status:
- of 0 to 2 for subjects ≥ 75 years of age OR
- of 0 to 3 for subjects between 18 to 74 years of age
- Participant must have a projected life expectancy of at least 12 weeks.
- Participant must have adequate renal function as demonstrated by a creatinine clearance ≥ 30 mL/min; calculated by the Cockcroft Gault formula or measured by 24-hour urine collection.
Participant must have adequate liver function as demonstrated by:
- aspartate aminotransferase (AST) ≤ 3.0 × ULN*
- alanine aminotransferase (ALT) ≤ 3.0 × ULN*
bilirubin ≤ 1.5 × ULN*
- Subjects who are < 75 years of age may have bilirubin of ≤ 3.0 × ULN
(*Unless considered to be due to leukemic organ involvement.)
Female participants must be either postmenopausal defined as:
- Age > 55 years with no menses for 12 or more months without an alternative medical cause.
- Age ≤ 55 years with no menses for 12 or more months without an alternative medical cause AND a follicle-stimulating hormone (FSH) level > 40 IU/L.
OR
- Permanently surgical sterile (bilateral oophorectomy, bilateral salpingectomy or hysterectomy).
OR
- A woman of childbearing potential (WOCBP) practicing at least one protocol specified method of birth control starting at Study Day 1 through at least 180 days after the last dose of study drug.
- Male participants who are sexually active, must agree, from Study Day 1 through at least 180 days after the last dose of study drug, to practice protocol specified methods of contraception. Male subjects must agree to refrain from sperm donation from initial study drug administration through at least 180 days after the last dose of study drug.
Females of childbearing potential must have negative results for pregnancy test performed:
- At Screening with a serum sample obtained within 14 days prior to the first study drug administration, and
- Prior to dosing with urine sample obtained on Cycle 1 Day 1, if it has been > 7 days since obtaining the serum pregnancy test results.
- Subjects with borderline pregnancy tests at Screening must have a serum pregnancy test ≥ 3 days later to document continued lack of a positive result.
- Participant must voluntarily sign and date an informed consent form, approved by an Independent Ethics Committee (IEC)/Institutional Review Board (IRB), prior to the initiation of any screening or study-specific procedures.
Exclusion Criteria:
- Participant has received any prior treatment for AML with the exception of hydroxyurea, allowed through the first cycle of study treatment. Note: Prior treatment for myelodysplastic syndrome is allowed except for use of cytarabine.
- Participant had an antecedent myeloproliferative neoplasm (MPN) including myelofibrosis, essential thrombocytosis, polycythemia vera, or chronic myelogenous leukemia (CML) with or without BCR-ABL 1 translocation and AML with BCR-ABL 1 translocation.
- Participants that have acute promyelocytic leukemia (APL).
- Participant has known central nervous system (CNS) involvement with AML.
- Participant has known human immunodeficiency virus (HIV) infection (due to potential drug-drug interactions between antiretroviral medications and venetoclax). HIV testing will be performed at Screening, if required per local guidelines or institutional standards.
- Participant is known to be positive for hepatitis B virus (HBV), or hepatitis C virus (HCV) infection. Inactive hepatitis carrier status or low viral hepatitis titer on antivirals (non-exclusionary medications) are not excluded.
Participant has received strong or moderate cytochrome P450 3A4 (CYP3A) inducers 7 days prior to the initiation of study treatment.
- Chinese subjects are excluded from receiving strong and/or moderate CYP3A inhibitors 7 days prior to the initiation of study treatment through the end of intensive pharmacokinetic (PK) collection (24 hours post dose on Cycle 1 Day 10).
- Participant has consumed grapefruit, grapefruit products, Seville oranges (including marmalade containing Seville oranges) or star fruit within 3 days prior to the initiation of study treatment.
- Participant has cardiovascular disability status of New York Heart Association Class > 2. Class 2 is defined as cardiac disease which subjects are comfortable at rest but ordinary physical activity results in fatigue, palpitations, dyspnea, or angina pain. Class 3 is defined as cardiac disease which subjects are comfortable at rest but less than ordinary activity causes fatigue, palpitation, or dyspnea. Class 4 is defined as cardiac disease which subjects have an inability to carry on any physical activity without discomfort, symptoms of heart failure at rest, and if any physical activity is undertaken then discomfort increases.
- Participant has chronic respiratory disease that requires continuous oxygen, or significant history of renal, neurologic, psychiatric, endocrinologic, metabolic, immunologic, hepatic, cardiovascular disease, any other medical condition or known hypersensitivity to any of the study medications including excipients of LDAC that in the opinion of the investigator would adversely affect his/her participating in this study.
- Participant has a malabsorption syndrome or other condition that precludes enteral route of administration.
- Participant exhibits evidence of other clinically significant uncontrolled systemic infection requiring therapy (viral, bacterial or fungal).
Participant has a history of other malignancies prior to study entry, with the exception of:
- Adequately treated in situ carcinoma of the cervix uteri or carcinoma in situ of breast;
- Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin;
- Previous malignancy confined and surgically resected (or treated with other modalities) with curative intent.
- Participant has a white blood cell count > 25 × 10^9/L. (Note: hydroxyurea administration or leukapheresis is permitted to meet this criterion).
- Previous treatment with venetoclax and/or current participation in any other research study with investigational products.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Venetoclax + Low Dose Cytarabine (LDAC)
Venetoclax 600 mg orally every day (QD) plus LDAC 20 mg/m² subcutaneously on Days 1 to 10 of each 28-day cycle.
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tablet
Other Names:
Subcutaneous injection
Other Names:
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Placebo Comparator: Placebo + LDAC
Matching placebo to venetoclax orally QD plus LDAC 20 mg/m² subcutaneously on Days 1 to 10 of each 28-day cycle.
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tablet
Subcutaneous injection
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Overall Survival (OS)
Time Frame: From randomization until the primary analysis cut-off date of February 15 2019; the median follow-up time was 12.0 months (range: 0.2-17.0) in the placebo arm and 12.0 months (range: 0.1-17.6) in the venetoclax arm.
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Overall survival is defined as the time from the date of randomization to the date of death.
Participants who had not died were censored at the date they were last known to be alive on or before the cutoff date.
Overall survival was analyzed using Kaplan-Meier methodology.
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From randomization until the primary analysis cut-off date of February 15 2019; the median follow-up time was 12.0 months (range: 0.2-17.0) in the placebo arm and 12.0 months (range: 0.1-17.6) in the venetoclax arm.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percentage of Participants With Complete Remission or Complete Remission With Incomplete Blood Count Recovery (CR + CRi)
Time Frame: Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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The composite complete remission rate is defined as the percentage of participants with complete remission (CR) or complete remission with incomplete blood count recovery (CRi) at any time during the study as assessed by the investigator. Response was based on physical examination, bone marrow results and hematology values according to the revised guidelines by the International Working Group (IWG) for AML: CR: No morphologic evidence of AML and absolute neutrophil count (ANC) ≥ 10³/μL (1,000/μL), platelets ≥ 10⁵/μL (100,000/μL), red blood cell (RBC) transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRi: All criteria as CR except for residual neutropenia < 10³/μL or thrombocytopenia < 10⁵/μL. If all criteria for CR are met except RBC transfusion independence, the CRi criteria are met. Participants who had no IWG disease assessments were considered to be non-responders. |
Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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Percentage of Participants With Complete Remission or Complete Remission With Partial Hematologic Recovery (CR + CRh)
Time Frame: Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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The percentage of participants who achieved a complete remission (CR) or complete remission with partial hematologic recovery (CRh) at any time point during the study assessed by the investigator. CR is defined according to the revised guidelines by the IWG for AML as no morphologic evidence of AML, ANC count ≥ 10³/μL, platelets ≥ 10⁵/μL, RBC transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRh is a derived response based on bone marrow blast and hematology lab values, achieved when the following criteria are met:
Participants with no disease assessments were considered to be non-responders. |
Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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Percentage of Participants With Complete Remission or Complete Remission With Incomplete Blood Count Recovery (CR + CRi) by Initiation of Cycle 2
Time Frame: Cycle 1, 28 days
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The composite complete remission rate is defined as the percentage of participants with complete remission (CR) or complete remission with incomplete blood count recovery (CRi) before initiation of Cycle 2, assessed by the investigator. Response was based on physical examination, bone marrow results and hematology values according to the revised guidelines by the IWG for AML: CR: No morphologic evidence of AML and absolute neutrophil count ≥ 10³/μL, platelets ≥ 10⁵/μL, red cell transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRi: All criteria as CR except for residual neutropenia < 10³/μL or thrombocytopenia < 10⁵/μL. If all criteria for CR are met except for RBC transfusion independence, CRi criteria are met. Participants who had no IWG disease assessments were considered to be non-responders. |
Cycle 1, 28 days
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Percentage of Participants With Complete Remission and Complete Remission With Partial Hematologic Recovery (CR + CRh) by Initiation of Cycle 2
Time Frame: Cycle 1, 28 days
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The percentage of participants who achieved a complete remission (CR) or complete remission with partial hematologic recovery (CRh) before initiation of Cycle 2 assessed by the investigator. CR is defined according to the revised guidelines by the IWG for AML as no morphologic evidence of AML, ANC count ≥ 10³/μL, platelets ≥ 10⁵/μL, RBC transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRh is a derived response based on bone marrow blast and hematology lab values, achieved when when the following criteria are met:
Participants with no disease assessments were considered to be non-responders. |
Cycle 1, 28 days
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Percentage of Participants With Complete Remission
Time Frame: Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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The complete remission rate is defined as the percentage of participants with complete remission (CR) at any time during the study as assessed by the investigator. Response was based on physical examination, bone marrow results and hematology values according to the revised guidelines by the International Working Group (IWG) for AML. CR is defined as no morphologic evidence of AML and absolute neutrophil count ≥ 10³/μL, platelets ≥ 10⁵/μL, red blood cell transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. Participants who had no IWG disease assessments were considered to be non-responders. |
Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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Change From Baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form (SF) 7a
Time Frame: Baseline and Day 1 of Cycles 3, 5, 7, and 9
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PROMIS Fatigue SF 7a is a seven-item questionnaire that assesses the impact and experience of fatigue over the past 7 days.
All questions employ the following five response options: 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, and 5 = Always.
The PROMIS Fatigue 7a score is calculated as a T-score, which is a standardized score with a mean of 50 (based on the average for the United States general population) and a standard deviation (SD) of 10.
Higher scores indicate higher levels of fatigue.
A decrease in score (negative change from Baseline) indicates improvement in fatigue; the minimum important difference used in this study was 3 points.
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Baseline and Day 1 of Cycles 3, 5, 7, and 9
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Change From Baseline in Global Health Status / Quality of Life
Time Frame: Baseline and Day 1 of Cycles 3, 5, 7, and 9
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The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) consists of a Global Health Status/Quality of Life (GHS/QoL) scale, a Financial Difficulties scale, 5 functional scales (Cognitive, Social, Physical, Emotional, and Role Functioning), and 8 symptom scales/items (Fatigue, Insomnia, Appetite Loss, Pain, Constipation, Diarrhea, Dyspnea, and Nausea and Vomiting). The GHS/QoL scale includes 2 questions in which participants were asked to rate their overall health and overall quality of life during the past week on a scale from 1 (very poor) to 7 (excellent). The 2 scores were averaged and transformed to a scale from 0 to 100, where a high score represents a high QoL. A positive change from baseline indicates better quality of life. |
Baseline and Day 1 of Cycles 3, 5, 7, and 9
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Event-free Survival (EFS)
Time Frame: From randomization until the primary analysis cut-off date of February 15, 2019; the median follow-up time was 12.0 months (range: 0.2-17.0) in the placebo arm and 12.0 months (range: 0.1-17.6) in the venetoclax arm.
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Event-free survival is defined as the time from randomization to the date of progressive disease (PD), confirmed morphologic relapse from CR or CRi, treatment failure (failure to achieve CR, CRi or morphologic leukemia free state (MLFS) after at least 6 cycles of study treatment), or death from any cause, assessed by the investigator according to the modified IWG criteria. PD:
Participants with no events prior to the cut-off date were censored at their last assessment date; participants with no events prior to post-treatment therapy initiated before the cut-off date were censored on the start date of post-treatment therapy. |
From randomization until the primary analysis cut-off date of February 15, 2019; the median follow-up time was 12.0 months (range: 0.2-17.0) in the placebo arm and 12.0 months (range: 0.1-17.6) in the venetoclax arm.
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Percentage of Participants With Post Baseline Red Blood Cell (RBC) Transfusion Independence
Time Frame: From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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The post baseline red blood cell (RBC) transfusion independence rate was calculated as the percentage of participants who achieved RBC transfusion independence post baseline.
RBC transfusion independence is defined as a period of at least 56 consecutive days with no RBC transfusion after the first dose of study drug and on or before the last dose of study drug plus 30 days, or disease progression, or confirmed morphological relapse, or death, or the data cut-off date, whichever occurred earlier.
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From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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Percentage of Participants With Post Baseline Platelet Transfusion Independence
Time Frame: From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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The post baseline platelet transfusion independence rate was calculated as the percentage of participants who achieved platelet transfusion independence post Baseline.
Platelet transfusion independence is defined as a period of at least 56 consecutive days with no platelet transfusion after the first dose of study drug and on or before the last dose of study drug plus 30 days, or disease progression, or confirmed morphological relapse, or death, or the data cut--off date, whichever occurred earlier.
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From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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Percentage of Participants With RBC Transfusion Independence Among Those Who Were Transfusion Dependent at Baseline
Time Frame: From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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The rate of conversion was calculated as the percentage of participants who were post-baseline RBC transfusion independent among participants who had an RBC transfusion within 8 weeks prior to the first dose of study drug (i.e. were transfusion dependent at Baseline).
RBC transfusion independence is defined as a period of at least 56 days with no RBC transfusion after the first dose of study drug and on or before the last dose of study drug plus 30 days, or disease progression, or confirmed morphological relapse, or death, or the data cut-off date, whichever occurred earlier.
|
From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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Percentage of Participants With Platelet Transfusion Independence Among Those Who Were Transfusion Dependent at Baseline
Time Frame: From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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The rate of conversion was calculated as the percentage of participants who were post-baseline platelet transfusion independent among participants who had a platelet transfusion within 8 weeks prior to the first dose of study drug (i.e. were transfusion dependent at Baseline).
Platelet transfusion independence is defined as a period of at least 56 days with no platelet transfusion after the first dose of study drug and on or before the last dose of study drug plus 30 days, or disease progression, or confirmed morphological relapse, or death, or the data cut-off date, whichever occurred earlier.
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From first dose of study drug until 30 days after last dose up to the data cut-off date of 15 February 2019; Median time on treatment was 1.7 months (range: 0.1-14.2) in the placebo arm and 3.9 months (range: 0.0-17.1) in the venetoclax arm.
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Percentage of Participants With Complete Remission or Complete Remission With Incomplete Blood Count Recovery (CR + CRi) and Minimal Residual Disease (MRD) Response
Time Frame: Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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The percentage of participants with complete remission or complete remission with incomplete blood count recovery AND minimal residual disease (MRD) as assessed by the investigator. Response was based on the modified IWG response criteria for AML: CR: No morphologic evidence of AML and ANC ≥ 10³/μL, platelets ≥ 10⁵/μL, red blood cell (RBC) transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRi: All criteria as CR except for residual neutropenia < 10³/μL or thrombocytopenia < 10⁵/μL. If all criteria for CR are met except RBC transfusion independence, CRi criteria are met. MRD response (at lowest-point MRD value) was defined as having less than 10-³ residual blasts per leukocyte measured in the bone marrow, per European LeukemiaNet (ELN) recommendations. Participants who had no disease or MRD assessments were considered to be non-responders. |
Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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Percentage of Participants With Complete Remission or Complete Remission With Partial Hematologic Recovery (CR + CRh) and Minimal Residual Disease (MRD) Response
Time Frame: Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
|
The percentage of participants with complete remission or complete remission with partial hematologic recovery (CRh) AND MRD response as assessed by the investigator. CR is defined according to the modified IWG response criteria for AML as no morphologic evidence of AML, ANC ≥ 10³/μL, platelets ≥ 10⁵/μL, RBC transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRh is achieved when the following criteria are met:
MRD response (at lowest-point MRD value) was defined as less than 10-³ residual blasts per leukocyte measured in the bone marrow, per ELN recommendations. Participants who had no disease or MRD assessments were considered to be non-responders. |
Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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Overall Survival (OS) by Mutation Subgroups
Time Frame: From randomization until the primary analysis cut-off date of February 15, 2019; the median follow-up time was 12.0 months (range: 0.2-17.0) in the placebo arm and 12.0 months (range: 0.1-17.6) in the venetoclax arm.
|
Overall survival is defined as the time from the date of randomization to the date of death. Participants who had not died were censored at the date they were last known to be alive on or before the cutoff date. Overall survival was analyzed using Kaplan-Meier methodology. Overall survival was analyzed in participants with the following molecular markers:
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From randomization until the primary analysis cut-off date of February 15, 2019; the median follow-up time was 12.0 months (range: 0.2-17.0) in the placebo arm and 12.0 months (range: 0.1-17.6) in the venetoclax arm.
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Percentage of Participants With Complete Remission or Complete Remission With Incomplete Blood Count Recovery (CR + CRi) by Mutation Subgroup
Time Frame: Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
|
Response was based on physical examination, bone marrow results and hematology values according to the revised guidelines by the IWG for AML: CR: No morphologic evidence of AML and ANC ≥ 10³/μL, platelets ≥ 10⁵/μL, RBC transfusion independence, and bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRi: All criteria as CR except for residual neutropenia < 10³/μL or thrombocytopenia < 10⁵/μL. If all criteria for CR are met except RBC transfusion independence, CRi criteria is met. Participants who had no IWG disease assessments were considered to be non-responders. Response was analyzed in participants with the following mutations:
|
Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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Percentage of Participants With Complete Remission or Complete Remission With Partial Hematologic Recovery (CR + CRh) by Mutation Subgroup
Time Frame: Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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The percentage of participants who achieved a complete remission or complete remission with partial hematologic recovery assessed by the investigator for participants with the following mutations:
CR is defined according to the modified IWG criteria for AML as no morphologic evidence of AML, ANC ≥ 10³/μL, platelets ≥ 10⁵/μL, RBC transfusion independence, bone marrow with < 5% blasts, absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease. CRh is achieved when the following criteria are met:
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Response was assessed at the end of Cycle 1 and every 3 cycles thereafter to the end of treatment. Median treatment duration at the 15 February 2019 cut-off date was 1.7 months (range: 0.1-14.2) and 3.9 months (range: 0.0-17.1) in each group respectively.
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: ABBVIE INC., AbbVie
Publications and helpful links
General Publications
- Badawi M, Chen X, Marroum P, Suleiman AA, Mensing S, Koenigsdorfer A, Schiele JT, Palenski T, Samineni D, Hoffman D, Menon R, Salem AH. Bioavailability Evaluation of Venetoclax Lower-Strength Tablets and Oral Powder Formulations to Establish Interchangeability with the 100 mg Tablet. Clin Drug Investig. 2022 Aug;42(8):657-668. doi: 10.1007/s40261-022-01172-4. Epub 2022 Jul 13.
- Wei AH, Montesinos P, Ivanov V, DiNardo CD, Novak J, Laribi K, Kim I, Stevens DA, Fiedler W, Pagoni M, Samoilova O, Hu Y, Anagnostopoulos A, Bergeron J, Hou JZ, Murthy V, Yamauchi T, McDonald A, Chyla B, Gopalakrishnan S, Jiang Q, Mendes W, Hayslip J, Panayiotidis P. Venetoclax plus LDAC for newly diagnosed AML ineligible for intensive chemotherapy: a phase 3 randomized placebo-controlled trial. Blood. 2020 Jun 11;135(24):2137-2145. doi: 10.1182/blood.2020004856.
- Wei AH, Panayiotidis P, Montesinos P, Laribi K, Ivanov V, Kim I, Novak J, Stevens DA, Fiedler W, Pagoni M, Bergeron J, Ting SB, Hou JZ, Anagnostopoulos A, McDonald A, Murthy V, Yamauchi T, Wang J, Chyla B, Sun Y, Jiang Q, Mendes W, Hayslip J, DiNardo CD. 6-month follow-up of VIALE-C demonstrates improved and durable efficacy in patients with untreated AML ineligible for intensive chemotherapy (141/150). Blood Cancer J. 2021 Oct 1;11(10):163. doi: 10.1038/s41408-021-00555-8.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Histologic Type
- Hematologic Diseases
- Leukemia, Myeloid
- Hemic and Lymphatic Diseases
- Leukemia
- Leukemia, Myeloid, Acute
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Nucleic Acids, Nucleotides, and Nucleosides
- Cytidine
- Pyrimidine Nucleosides
- Pyrimidines
- Nucleosides
- Arabinonucleosides
- Cytarabine
- venetoclax
Other Study ID Numbers
Other Study ID Numbers
- M16-043
- 2016-003900-30 (EudraCT Number)
- 2024-513630-37-00 (Other Identifier: EU CT)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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