Venetoclax Plus Inotuzumab Reduced-Intensity Induction Sequentially Followed by Blinatumomab in B-ALL (ALL-CD22-Ph)

A Prospective Single-Arm Study of Venetoclax Combined With Inotuzumab Ozogamicin Reduced-Chemotherapy Induction Sequentially Followed by Blinatumomab in Newly Diagnosed CD22-Positive Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia

This prospective, open-label, single-arm study evaluates whether reduced-intensity induction with venetoclax plus inotuzumab ozogamicin (2VIP) followed by one cycle of blinatumomab improves the 8-week NGS-MRD-negative complete remission rate in adolescents and adults (age 14-60 years) with newly diagnosed, untreated, CD22-positive, Philadelphia chromosome-negative B-cell ALL. A Simon two-stage design will enroll up to 43 evaluable patients.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

43

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years to 60 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Newly diagnosed, untreated (except prednisone/hydroxyurea) Ph-negative ALL by morphology and immunophenotype.
  • CD22-positive (≥20% blasts).
  • Age ≥14 and ≤60 years.
  • ECOG ≤2.
  • Effective contraception if of childbearing potential.
  • Organ function: TBIL <1.5×ULN; AST/ALT ≤2.5×ULN; creatinine <2×ULN; myocardial enzymes <2×ULN; amylase ≤1.5×ULN; LVEF >45%.
  • Written informed consent.

Exclusion Criteria:

  • Burkitt lymphoma/leukemia.
  • Acute leukemia of ambiguous lineage.
  • Pregnancy.
  • Uncontrolled active infection.
  • History of pancreatitis.
  • Uncontrolled diabetes (HbA1c >7.5%).
  • Active GI bleeding within 6 months. -
  • Arterial/venous thrombosis within 6 months.
  • Known HIV.
  • Psychiatric disease precluding compliance.
  • Other conditions judged unsuitable by the investigator.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 2VIP induction followed by blinatumomab, then pediatric-inspired chemo

Induction 2VIP: Inotuzumab 1 mg d4 and d11; Vincristine 1.4 mg/m² (max 2 mg) d1,8; Venetoclax ramp 100/200/400 mg d6-14; Prednisone 1 mg/kg/d d1-14. Immunologic consolidation: Blinatumomab 8.75 μg d1-8 then 28 μg d9-28. Subsequent CAMVL / HD-MTX-based early intensification / VDLD delayed intensification / maintenance (female 2.5 y, male 3 y). Optional additional 2VIP or Blinatumomab per protocol

Inotuzumab: 1 mg d4 and d11

Venetoclax ramp 100/200/400 mg d6-14

Vincristine 1.4 mg/m² (max 2 mg) d1,8

Prednisone 1 mg/kg/d d1-14.

Blinatumomab 8.75 μg d1-8 then 28 μg d9-28.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
8-week NGS-MRD-negative complete remission (CR_MRD-) rate
Time Frame: up to 8 weeks

Proportion of evaluable patients achieving CR (or CRi/CRp counted as CR per protocol) with NGS (IG/TR clonotype) MRD negativity at week 8. Time frame: 8 weeks from start of protocol therapy.

up to 8 weeks

Secondary Outcome Measures

Outcome Measure
Time Frame
Overall survival (OS)
Time Frame: Up to 5 years
Up to 5 years
Disease-free survival (DFS)
Time Frame: Up to 5 years
Up to 5 years
Cumulative incidence of relapse
Time Frame: Up to 5 years
Up to 5 years
Event-free survival (EFS)
Time Frame: Up to 5 years
Up to 5 years
Relapse-free survival (RFS)
Time Frame: Up to 5 years
Up to 5 years
2-week NGS-MRD-negative CR rate
Time Frame: up to 2 weeks
up to 2 weeks
12-week flow-cytometry MRD-negative CR rate
Time Frame: up to 12 weeks
up to 12 weeks
Early mortality at 4 weeks and 8 weeks
Time Frame: Up to 4 weeks and 8 weeks
Up to 4 weeks and 8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 30, 2026

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

November 30, 2035

Study Registration Dates

First Submitted

November 2, 2026

First Submitted That Met QC Criteria

November 2, 2026

First Posted (Actual)

November 6, 2026

Study Record Updates

Last Update Posted (Actual)

November 6, 2026

Last Update Submitted That Met QC Criteria

November 2, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • ALL-CD22-Ph-negative-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Pending PI confirmation

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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