An All-Oral Combination of Ivosidenib, Sonrotoclax, and Chidamide for Newly Diagnosed Acute Myeloid Leukemia With an IDH1 Mutation (ISC) (ISC)

November 8, 2026 updated by: First Affiliated Hospital of Zhejiang University

A Multicenter, Prospective, Exploratory Study Evaluating an All-oral Combination of Ivosidenib, Sonrotoclax, and Chidamide for the Treatment of Newly Diagnosed IDH1-mutated Acute Myeloid Leukemia

This prospective, multicenter, exploratory clinical study is designed to evaluate the efficacy and safety of an all-oral combination of ivosidenib, sonrotoclax, and chidamide in adults with newly diagnosed acute myeloid leukemia (AML) harboring an IDH1 R132 mutation.

Approximately 30 participants aged 18 years or older will be enrolled. Eligible participants must have previously untreated AML with a confirmed IDH1 R132 mutation and adequate heart, liver, and kidney function. Ivosidenib targets the abnormal IDH1 protein, sonrotoclax blocks BCL-2, a protein that helps leukemia cells survive, and chidamide affects gene regulation and may increase the sensitivity of leukemia cells to treatment. The study hypothesis is that combining these three medicines may produce deep and durable remissions with an acceptable safety profile while providing a treatment that can be taken entirely by mouth.

Treatment will be given in 28-day cycles. During induction treatment, all participants will receive oral ivosidenib, sonrotoclax, and chidamide. In the initial exploratory stage, participants will be assigned in a 1:1:1 ratio to one of three induction schedules. The schedules differ in the planned duration of sonrotoclax and chidamide treatment. A bone marrow examination will be performed on Day 10 or Day 14, depending on the assigned schedule, to determine whether sonrotoclax and/or chidamide should be continued through Day 28. Early remission results, adverse events, and overall tolerability will be reviewed to select a recommended induction schedule for the expansion stage.

Participants who achieve a response will receive at least three 28-day cycles of consolidation treatment with the three-drug combination. Treatment duration may be shortened or the next cycle may be delayed if blood cell counts recover slowly or other clinically important side effects occur. After consolidation, measurable residual disease (MRD) will be assessed. MRD refers to the small number of leukemia cells that may remain after treatment even when remission has been achieved. Participants who become negative for IDH1 MRD will proceed to maintenance treatment with oral ivosidenib for up to 2 years. Participants with persistent IDH1 MRD may receive additional consolidation treatment, and allogeneic hematopoietic stem cell transplantation may be considered according to the protocol and clinical assessment.

The primary outcome is the 1-year event-free survival rate, defined by whether participants remain alive without relapse or disease progression. Secondary outcomes include the composite complete remission rate after induction treatment, MRD clearance and the time to MRD clearance, relapse-free survival, overall survival, and exploratory biological markers. Safety will be evaluated by recording adverse events and monitoring blood counts, bone marrow findings, liver and kidney function, electrocardiograms, and other clinically indicated tests. Participants will be followed regularly during treatment and follow-up.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 2

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

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

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

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients with newly diagnosed AML. Diagnosis based on the 2022 WHO classification.
  • Age >=18 years.
  • Presence of an IDH1 R132 mutation (R132H, R132C, R132G, R132S, or R132L) confirmed by real-time quantitative PCR or NGS.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-3 (see Appendix 1).
  • Echocardiographic LVEF >=45%; QTc interval <450 ms (males) or <470 ms (females).
  • Renal function: creatinine clearance >=50 mL/min (calculated using the Cockcroft-Gault formula or measured via 24-hour urine collection).
  • Liver function: aspartate aminotransferase (AST) <=3× ULN*; alanine aminotransferase (ALT) <=3× ULN*; total bilirubin <=1.5× ULN* (*unless attributed to leukemic infiltration).
  • Male patients, women of childbearing potential (women are considered non-childbearing only if postmenopausal for at least 12 months), and their partners voluntarily agree to use contraceptive measures deemed effective by the investigator during treatment and for at least 12 months after the last dose of the study drug.
  • Patient or guardian agrees to participate in the clinical trial and signs the informed consent form.

Exclusion Criteria:

  • Acute promyelocytic leukemia (APL/M3); core-binding factor AML (CBF-AML) with t(8;21), inv(16), or t(16;16).
  • Patients previously treated with anthracyclines, or those with prior treatment involving IDH1 inhibitors, BCL-2 inhibitors (e.g., venetoclax), or HDAC inhibitors (e.g., chidamide).
  • Patients with AML known to involve the central nervous system (CNS).
  • Subjects known to be infected with HIV (HIV testing will be performed at screening in accordance with local guidelines or institutional standards).
  • Subjects with active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection (defined as testing positive for the virus and having abnormal liver function).
  • Subjects who have received treatment with strong or moderate CYP3A inducers/inhibitors within 5 half-lives (or within 7 days) prior to the start of study treatment.
  • Subjects with a New York Heart Association (NYHA) functional classification > Class II. Class II is defined as heart disease where the patient has no symptoms at rest but experiences fatigue, palpitations, dyspnea, or angina during ordinary physical activity.
  • Subjects with chronic respiratory disease requiring continuous supplemental oxygen.
  • Patients unable to take oral medication or those with malabsorption syndrome.
  • Presence of uncontrolled systemic infection (viral, bacterial, or fungal).
  • Inability to sign the informed consent form.

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

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Arm

Ivosidenib, Chidamide, Sonrotoclax
Drug: Ivosidenib, Sonrotoclax, Chidamide

Cohort 1: Ivosidenib 500 mg qd po d1-28; Chidamide 10 mg qd po d1-28; Sonrotoclax 40 mg d1, 80 mg d2, 160 mg d3, 320 mg d4-10 po. On d10, Sonrotoclax is adjusted according to bone marrow findings: if blasts <5%, stop from d11; otherwise, continue 320 mg qd po to d28. Cohort 2: Ivosidenib 500 mg qd po d1-28; Chidamide 10 mg qd po d1-28; Sonrotoclax 40 mg d1, 80 mg d2, 160 mg d3, 320 mg d4-14 po. On d14, Sonrotoclax is adjusted: if blasts <5%, stop from d15; otherwise, continue 320 mg qd po to d28. Cohort 3: Ivosidenib 500 mg qd po d1-28; Chidamide 10 mg qd po d1-14; Sonrotoclax 40 mg d1, 80 mg d2, 160 mg d3, 320 mg d4-14 po. On d14, Chidamide and Sonrotoclax are adjusted: if blasts <5%, stop both from d15; otherwise, continue both to d28. The recommended induction schedule will be selected based on CRc, adverse events, and overall tolerability for the expansion stage.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
1-Year Event-Free Survival Rate (EFS)
Time Frame: From treatment initiation through 1 year.

Event-free survival is defined as the time from the date of initiation of study treatment to the earliest occurrence of documented relapse after remission, disease progression, or death from any cause. The 1-year EFS rate will be estimated using the Kaplan-Meier method. Participants without an event will be censored at the date of their last disease assessment.
From treatment initiation through 1 year.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Composite Complete Remission Rate After Two Cycles (CRc=CR+CRi)
Time Frame: At the end of Cycle 2（each cycle is 28 days）

After completion of two induction treatment cycles, CR and CRi will be assessed according to bone marrow morphology, peripheral blood cell counts, and the response criteria specified in the protocol. CRc is defined as CR plus CRi.
At the end of Cycle 2（each cycle is 28 days）
Minimal Residual Disease (MRD) Negativity Rate
Time Frame: At the end of each Cycle（each cycle is 28 days），up to 2 years

MRD will be dynamically assessed using multiparameter flow cytometry, quantitative PCR, and/or NGS. Flow cytometric MRD negativity is defined as <0.01%, while molecular MRD negativity is determined according to the corresponding assay result.
At the end of each Cycle（each cycle is 28 days），up to 2 years
Relapse-Free Survival (RFS)
Time Frame: up to 2 years

RFS is defined as the time from the first achievement of CR or CRi to disease relapse or death from any cause. Patients without an event are censored at the date of the last disease assessment. RFS will be analyzed using the Kaplan-Meier method.
up to 2 years
Overall Survival (OS)
Time Frame: up to 5 years

OS is defined as the time from treatment initiation to death from any cause. Patients who remain alive at the end of the study are censored at the last date known to be alive. OS will be analyzed using the Kaplan-Meier method.
up to 5 years
Incidence of Adverse Events and Serious Adverse Events
Time Frame: From day 1 of treatment to 28 days after the last dose

Adverse events and serious adverse events will be recorded according to their incidence, severity, relationship to the study drugs, and outcomes, and will be graded according to CTCAE Version 5.0.
From day 1 of treatment to 28 days after the last dose

Collaborators and Investigators

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

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
First Affiliated Hospital of Zhejiang University

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)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 15, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 14, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 14, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 13, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 13, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2026CIIT NO158

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because this is an investigator-initiated exploratory study with a small sample size, and the data include sensitive clinical and genomic information. De-identified aggregate study results may be reported in publications or scientific presentations.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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