- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04975919
Venetoclax in Combination With Decitabine and Cedazuridine for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia
A Phase II Study of Venetoclax in Combination With 10-day Oral Decitabine in Relapsed/Refractory Acute Myeloid Leukemia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVE:
I. To determine the overall response rate (complete remission [CR], complete remission with incomplete count recovery [CRi], MLFS and partial response [PR]) of 10-days decitabine and cedazuridine (oral decitabine) and venetoclax in patients with refractory/relapsed acute myeloid leukemia (AML).
SECONDARY OBJECTIVES:
I. To determine the duration of response, event-free survival (EFS), and overall survival (OS) of patients with refractory/relapsed AML treated with this combination.
II. To determine the number of patients who achieve a hematologic improvement (HI) in platelets, hemoglobin, or ANC and the number of patients who achieve > 50% reduction in blasts on therapy with venetoclax/10-day oral decitabine.
III. To determine the safety of venetoclax in combination with 10-day oral decitabine in patients with refractory/ relapsed AML.
IV. To determine the number of patients who transition towards stem cell transplantation upon achieving response with the combination venetoclax/10-day oral decitabine regimen.
V. To determine the incidence of infectious complications per cycle with venetoclax in combination with 10-day oral decitabine.
EXPLORATORY OBJECTIVE:
I. To investigate global gene expression profiles, cytometry by time of flight (CyTOF), BH3 profiling and other potential prognostic markers to explore predictors of antitumor activity and/or resistance to treatment.
OUTLINE:
Patients receive decitabine and cedazuridine orally (PO) once daily (QD) on days 1-10. Patients who achieve CR/CRi during consolidation/maintenance may receive decitabine and cedazuridine PO QD on days 1-5. Patients also receive venetoclax PO QD on days 1-28 of cycle 1 and days 1-21 of subsequent cycles. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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-
Texas
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Houston, Texas, United States, 77030
- M D Anderson Cancer Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients with a diagnosis of relapsed or refractory AML (or biphenotypic or bilineage leukemia including a myeloid component). Patients with isolated extramedullary AML are eligible
- Age >= 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2
- Creatinine < 2 unless related to the disease
- Direct bilirubin < 2 x upper limit of normal (ULN) unless increase is due to Gilbert's disease or leukemic involvement
- Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) < 3 x ULN unless considered due to leukemic involvement
- In the absence of rapidly proliferative disease, the interval from prior treatment to time of initiation will be at least 7 days for cytotoxic or non-cytotoxic (immunotherapy) agents. Oral hydroxyurea and/or cytarabine (up to 2 g/m^2) for patients with rapidly proliferative disease is allowed before the start of study therapy, as needed, for clinical benefit and after discussion with the principal investigator (PI). Concurrent therapy for central nervous system (CNS) prophylaxis or continuation of therapy for controlled CNS disease is permitted
- Male subjects must agree to refrain from unprotected sex and sperm donation from initial study drug administration until 90 days after the last dose of study drug
- Willing and able to provide informed consent
Exclusion Criteria:
- Patients with t(15;17) karyotypic abnormality or acute promyelocytic leukemia (French-American-British [FAB] class M3-AML)
- Patients with active graft-versus-host-disease (GVHD) status post stem cell transplant (patients without active GVHD on chronic suppressive immunosuppression and/or phototherapy for chronic skin GVHD are permitted after discussion with the PI)
- Patients with any severe gastrointestinal or metabolic condition which could interfere with the absorption of oral study medications as determined by the investigator
- Patients with symptomatic CNS leukemia or patients with poorly controlled CNS leukemia
- Active and uncontrolled comorbidities including active uncontrolled infection, uncontrolled hypertension despite adequate medical therapy, active and uncontrolled congestive heart failure New York Heart Association (NYHA) class III/IV, clinically significant and uncontrolled arrhythmia as judged by the treating physician
- Known active hepatitis B (HBV) or hepatitis C (HCV) infection or known human immunodeficiency virus (HIV) infection
- Subject has a white blood cell count > 10 x 10^9/L. (Note: Hydroxyurea is permitted to meet this criterion)
- Any other medical, psychological, or social condition that may interfere with study participation or compliance, or compromise patient safety in the opinion of the investigator
Nursing women, women of childbearing potential (WOCBP) with positive urine or serum pregnancy test, or women of childbearing potential who are not willing to maintain adequate contraception
- Appropriate highly effective method(s) of contraception include oral or injectable hormonal birth control, intrauterine device (IUD), and double barrier methods (for example a condom in combination with a spermicide)
Study Plan
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: Treatment (decitabine and cedazuridine, venetoclax)
Patients receive decitabine and cedazuridine PO QD on days 1-10.
Patients who achieve CR/CRi during consolidation/maintenance may receive decitabine and cedazuridine PO QD on days 1-5.
Patients also receive venetoclax PO QD on days 1-28 of cycle 1 and days 1-21 of subsequent cycles.
Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
|
Given PO
Other Names:
Given PO
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall response rate (ORR)
Time Frame: Within 4 cycles of treatment (each cycle is 28 days)
|
Defined as the proportion of patients who had complete remission (CR), complete remission with incomplete count recovery (CRi), partial response (PR) or MLFS.
Will estimate the ORR for the combination treatment, along with the Bayesian 95% credible interval.
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Within 4 cycles of treatment (each cycle is 28 days)
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Incidence of adverse events
Time Frame: Up to 2 years
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The overall incidence and severity of all adverse events using Common Toxicity Criteria version 5.0.
Safety data will be summarized using frequency and percentage, by category and severity.
|
Up to 2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of achieving HI
Time Frame: Up to 2 years
|
Will estimate for the combination treatment, along with the Bayesian 95% credible interval.
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Up to 2 years
|
Number of patients who transition towards stem cell transplantation
Time Frame: Up to 2 years
|
Will estimate for the combination treatment, along with the Bayesian 95% credible interval.
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Up to 2 years
|
Incidence of infectious complications
Time Frame: Up to 2 years
|
Will estimate for the combination treatment, along with the Bayesian 95% credible interval.
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Up to 2 years
|
Event-free survival (EFS)
Time Frame: Time interval between treatment start until disease progression, relapse/refractory, or death due to any cause, assessed up to 2 years
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The Kaplan-Meier method will be used to estimate the survival probabilities of time-to-event variables such as EFS.
Log-rank tests will be used to compare among subgroups of patients in terms of the time-to-event variables.
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Time interval between treatment start until disease progression, relapse/refractory, or death due to any cause, assessed up to 2 years
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Overall survival (OS)
Time Frame: Time interval between treatment start until death due to any cause, assessed up to 2 years
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The Kaplan-Meier method will be used to estimate the survival probabilities of time-to-event variables such as OS.
Log-rank tests will be used to compare among subgroups of patients in terms of the time-to-event variables.
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Time interval between treatment start until death due to any cause, assessed up to 2 years
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Duration of response
Time Frame: Time from response till progression, relapse/refractory, or death, assessed up to 2 years
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Time from response till progression, relapse/refractory, or death, assessed up to 2 years
|
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Gene expression profiles
Time Frame: Up to 2 years
|
Will examine the association between gene expression profiles and prognostic markers and overall response and/or resistance will be assessed through logistic regression analyses.
Paired t-test or Wilcoxon signed rank test will be used to assess the marker change over time.
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Up to 2 years
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Abhishek Maiti, M.D. Anderson Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Disease Attributes
- Hematologic Diseases
- Leukemia, Lymphoid
- Leukemia
- Leukemia, Myeloid
- Leukemia, Myeloid, Acute
- Recurrence
- Leukemia, Biphenotypic, Acute
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Decitabine
- Venetoclax
- Decitabine and cedazuridine drug combination
Other Study ID Numbers
- 2021-0248 (Other Identifier: M D Anderson Cancer Center)
- NCI-2021-05744 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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