Immuno-Targeted Therapy Plus Low-Dose Chemotherapy for Newly Diagnosed Adult Ph-Negative B-ALL: A Prospective Umbrella Trial (Ph- ALL-2026)
A Prospective Umbrella Clinical Trial of Immuno-Targeted Agents Combined With Low-Dose Chemotherapy for Newly Diagnosed Adult Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia
This is a prospective, open-label, single-arm, umbrella phase 2 clinical trial enrolling 32 adult patients with newly diagnosed Philadelphia chromosome-negative (Ph-) B-cell acute lymphoblastic leukemia (B-ALL). All patients receive a frontline treatment backbone consisting of low-dose chemotherapy combined with immuno-targeted agents and a BCL2 inhibitor. Subsequent treatment pathways are guided by MRD response, disease characteristics, and clinical decision-making, including antibody-based immunotherapy, CAR-T cell therapy, or hematopoietic stem cell transplantation. All patients continue protocol-defined maintenance therapy after consolidation.
The primary endpoint is the complete remission rate with negative flow cytometric MRD after induction therapy. MRD is monitored longitudinally by flow cytometry, quantitative PCR, and immune repertoire sequencing. Safety is evaluated according to NCI CTCAE version 5.0.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Ying Wang, MD, PhD
- Numero di telefono: +86 22-23608095
- Email: wangying1@ihcams.ac.cn
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Newly diagnosed adult (≥18 years) patients with Ph-negative B-cell acute lymphoblastic leukemia according to WHO 2022 criteria.
- CD22-positive expression on tumor cells (CD22 ≥20%).
- Expected survival ≥3 months.
- Sexually active men and women of childbearing potential must agree to use effective contraception.
- Ability to understand and voluntarily sign informed consent, and willingness to comply with study requirements. Informed consent must be signed by the patient or a legal next of kin prior to initiation of any study-specific procedures.
Exclusion Criteria:
- Burkitt lymphoma/leukemia.
- Acute leukemia of ambiguous lineage.
- Pregnant women.
- Severe, uncontrolled active infections.
- History of chronic liver disease (e.g., liver cirrhosis) or prior veno-occlusive disease (VOD) / sinusoidal obstruction syndrome (SOS).
- History of clinically significant ventricular arrhythmias, unexplained syncope (not vasovagal), or sinus node dysfunction or high-grade atrioventricular (AV) block with chronic bradycardia, unless a permanent pacemaker has been implanted.
- Uncontrolled active hepatitis B or hepatitis C infection, or known HIV seropositivity. HIV testing may be required according to local regulations or standards.
- Psychiatric disorders that may impair the subject's ability to complete treatment or provide informed consent.
- Any other conditions deemed by the investigator to render the subject unsuitable for participation in the study.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione sequenziale
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
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Sperimentale: Immuno-Targeted Therapy Plus Low-Dose Chemotherapy
Adult patients with newly diagnosed Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia (Ph- B-ALL) receive frontline treatment with immuno-targeted agents, a BCL2 inhibitor, and low-dose chemotherapy.
Induction therapy includes inotuzumab ozogamicin, venetoclax, vincristine, cyclophosphamide, and dexamethasone.
Subsequent treatment is adapted according to measurable residual disease (MRD) response, antigen expression profile, and clinical condition, and may include blinatumomab-based immunotherapy, venetoclax-containing chemotherapy, CD19-directed CAR-T cell therapy, or hematopoietic stem cell transplantation.
All patients proceed to protocol-defined maintenance therapy.
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Anti-CD22 antibody-drug conjugate (ADC) administered intravenously during induction and consolidation therapy.
BCL-2 inhibitor administered orally daily during induction and consolidation cycles to enhance leukemic cell apoptosis.
CD19/CD3 bispecific T-cell engager (BiTE) administered as continuous intravenous infusion during consolidation therapy.
Autologous CD19 CAR-T cell therapy administered as a single intravenous infusion as optional consolidation therapy for eligible patients.
A vinca alkaloid that inhibits microtubule formation by binding to tubulin, resulting in mitotic arrest and inhibition of proliferation of rapidly dividing leukemic cells.
An alkylating agent that forms DNA cross-links, leading to inhibition of DNA replication and transcription and subsequent apoptosis of rapidly proliferating hematopoietic cells.
A synthetic glucocorticoid that induces lymphoid cell apoptosis and exerts anti-inflammatory and immunosuppressive effects, contributing to reduction of leukemic burden.
A folate antimetabolite that inhibits dihydrofolate reductase, resulting in impaired DNA synthesis and cell replication, particularly in rapidly dividing lymphoid cells.
A pyrimidine nucleoside analog that inhibits DNA polymerase, leading to termination of DNA chain elongation and inhibition of leukemic cell proliferation.
A glucocorticoid that induces apoptosis in lymphoid cells and provides anti-inflammatory and immunosuppressive effects as part of multi-agent leukemia therapy.
A purine analog antimetabolite that interferes with purine nucleotide synthesis and incorporates into DNA and RNA, inhibiting nucleic acid synthesis and cell proliferation.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Flow Cytometric MRD-Negative Complete Remission Rate
Lasso di tempo: At the end of induction therapy (approximately 1 month after treatment initiation)
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Proportion of patients achieving complete remission (CR) with negative measurable residual disease (MRD) assessed by multiparameter flow cytometry after completion of induction therapy.
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At the end of induction therapy (approximately 1 month after treatment initiation)
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Next-Generation Sequencing (NGS)-MRD Negative Remission Rate
Lasso di tempo: Within 3 months after treatment initiation
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Proportion of patients achieving MRD-negative remission assessed by immune repertoire sequencing.
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Within 3 months after treatment initiation
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Best MRD Clearance Rate
Lasso di tempo: Within 3 months after treatment initiation
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Proportion of patients achieving the deepest MRD response during the first 3 months of treatment as assessed by flow cytometry, quantitative PCR, or immune repertoire sequencing.
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Within 3 months after treatment initiation
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Overall Survival (OS)
Lasso di tempo: Up to 5 years
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Time from study enrollment to death from any cause.
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Up to 5 years
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Disease-Free Survival (DFS)
Lasso di tempo: Up to 5 years
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Time from achievement of complete remission to relapse or death from any cause.
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Up to 5 years
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Relapse-Free Survival (RFS)
Lasso di tempo: Up to 5 years
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Time from achievement of MRD-negative remission to hematologic relapse or death.
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Up to 5 years
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30-Day Mortality
Lasso di tempo: 30 days
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Proportion of patients who die from any cause within 30 days after treatment initiation.
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30 days
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60-Day Mortality
Lasso di tempo: 60 days
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Proportion of patients who die from any cause within 60 days after treatment initiation.
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60 days
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Incidence of Adverse Events
Lasso di tempo: From treatment initiation through completion of study treatment, up to 5 years
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Frequency, severity, and type of adverse events graded according to the National Cancer
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From treatment initiation through completion of study treatment, up to 5 years
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Collaboratori e investigatori
Sponsor
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Aminoacidi, peptidi e proteine
- Proteine
- Composti di zolfo
- Prodotti chimici organici
- Composti eterociclici, 1-anello
- Composti eterociclici
- Composti eterociclici, 2 anelli
- Composti eterociclici, anello fuso
- Acidi nucleici, nucleotidi e nucleosidi
- Idrocarburi
- Carboidrati
- Alcaloidi
- Composti policiclici
- Glicosidi
- Indoli
- Anticorpi, monoclonali, umanizzati
- Anticorpi, monoclonali
- Anticorpi
- Immunoglobuline
- Immunoproteine
- Proteine del sangue
- Globuline sieriche
- Globuline
- Purine
- Citidina
- Nucleosidi di pirimidina
- Pirimidine
- Incinta
- In gravidanza
- Steroidi
- Composti anelli fusi
- Steroidi, fluorurati
- Senape di fosforamide
- Composti di senape di azoto
- Composti di senape
- Idrocarburi, alogenati
- Fosforamidi
- Composti organofosfori
- Nucleosidi
- Pterins
- Pteridine
- Incintadienetrioli
- Incintadienediols
- Vinca Alkaloids
- Alcaloidi di triptamina di secologia
- Alcaloidi indolo
- Indolizidine
- Indolizine
- Arabinonucleosidi
- Aminopterino
- Aminoglicosidi
- Composti solfidrilici
- Calicheamicins
- Inotuzumab ozogamicina
- Desametasone
- Metotrexato
- Prednisone
- Ciclofosfamide
- Citarabina
- Vincristina
- Mercaptopurina
- Venetoclax
- Blinatumomab
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- IIT2026063
- IIT2026063-EC-1 (Altro identificatore: Ethics Committee of Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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