Study on the Efficacy and Safety of VA Regimen Compared to "3+7" Regimen in Newly Diagnosed AML With NPM1 or IDH1/IDH2 Mutations
A Prospective, Multicenter, Randomized Controlled, Open Label, Non-Inferiority Study Comparing the Efficacy and Safety of the VA Regimen (Venetoclax Combined With Azacitidine) With the "3+7" Regimen in the Treatment of Newly Diagnosed AML Patients With NPM1 or IDH1/IDH2 Mutations
This prospective, multicenter, randomized, open-label, non-inferiority clinical study aims to compare the efficacy and safety of VA regimen (venetoclax combined with azacitidine) versus conventional "3+7" chemotherapy regimen in adult patients aged 18 to 65 years with newly diagnosed acute myeloid leukemia (AML) carrying NPM1, IDH1 or IDH2 gene mutations.
The primary goal of this trial is to check whether the VA treatment can reach a non-inferior composite complete remission rate at the end of the induction treatment cycle, which is the key primary endpoint of this research. Several secondary clinical outcomes will also be evaluated in this study, including the rate of minimal residual disease (MRD) negativity after remission, duration of remission, 1-year event-free survival rate and 1-year overall survival rate of enrolled patients. In addition, the safety and treatment-related side effects occurring during the whole induction treatment phase will be systematically collected and compared between two groups as another important secondary assessment.
Eligible enrolled participants will be randomly split into two study groups: patients in experimental group will receive venetoclax plus azacitidine (VA regimen), while patients in control group will receive standard "3+7" induction chemotherapy following conventional clinical protocol. All subjects will complete regular disease assessment, laboratory examinations and scheduled follow-up visits as required by trial design during treatment and post-treatment observation period.
Researchers will collect and analyze all above clinical outcome data from all participants, to verify the non-inferior efficacy and relative safety of VA regimen for this specific subtype of newly diagnosed AML patients.
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: Yang Shen, MD
- Numero di telefono: +86-021-64370045
- Email: sy_clinicaltrial@163.com
Luoghi di studio
-
-
Shanghai Municipality
-
Shanghai, Shanghai Municipality, Cina, 200025
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
-
Contatto:
- Yang Shen, MD
- Numero di telefono: +86-021-64370045
- Email: sy_clinicaltrial@163.com
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Age ≥ 65 years old ≥ 18 years old;
- Diagnosed as acute myeloid leukemia (non APL) (diagnostic criteria refer to the 2022 ELN classification system);
- Initial diagnosis accompanied by NPM1 mutations (A, B, D types and rare types are all acceptable) and/or IDH1/IDH2 mutations;
- Have not received any other induction therapy before (except hydroxyurea);
- Physical fitness status score (ECOG PS) 0-3;
Having sufficient organ function, defined as follows:
- Liver function: serum total bilirubin ≤ 3 x upper limit of normal range (ULN), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) ≤ 3 x ULN, unless considered to be caused by leukemia;
- Renal function: endogenous creatinine clearance rate ≥ 30ml/min;
- Heart function: NYHA classification ≤ 2 points;
- Participants must have the ability to understand and be willing to participate in this study, and sign an informed consent form.
Exclusion Criteria:
- Acute promyelocytic leukemia;
- Merge extramedullary infiltration such as central nervous system leukemia;
- Have a clear history of CMML or MDS, and later progress to AML; Or have a history of malignant tumors;
- There is uncontrolled active infection (including bacterial, fungal, or viral infections);
- Pregnant or lactating women;
- Researchers determine that participants are not suitable to participate in this experiment
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Venetoclax plus Azacitidine (VA regimen)
|
Venetoclax,oral targeted anti-BCL-2 agent and Azacitidine,hypomethylating agent, given via injection for experimental VA arm only
|
|
Comparatore attivo: "3+7" induction chemotherapy
Standard 3+7 induction chemotherapy (Cytarabine continuous infusion for 7 days plus Anthracycline intravenous infusion for 3 days) following routine clinical induction regimen for AML.
|
Cytarabine,continuous intravenous infusion for total 7 days and Daunorubicin,Intravenous anthracycline chemotherapy administered for 3 days,in standard 3+7 induction regimen
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Lasso di tempo |
|---|---|
|
Composite complete remission rate at the end of induction cycle
Lasso di tempo: At the end of 1-2 induction treatment cycles (each cycle is 28 days)
|
At the end of 1-2 induction treatment cycles (each cycle is 28 days)
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Composite Complete Remission
Lasso di tempo: At the end of 1-2 induction treatment cycles (each cycle is 28 days)
|
At the end of 1-2 induction treatment cycles (each cycle is 28 days)
|
|
|
Minimal residual disease (MRD) negative rate after remission
Lasso di tempo: At the end of induction cycle (each cycle is 28 days)
|
At the end of induction cycle (each cycle is 28 days)
|
|
|
Duration of Response (DoR)
Lasso di tempo: From date of confirmed complete response (CR) until documented disease relapse or death from any cause, assessed up to 24 months after randomization
|
From date of confirmed complete response (CR) until documented disease relapse or death from any cause, assessed up to 24 months after randomization
|
|
|
1-year Event-Free Survival (EFS) rate
Lasso di tempo: From date of randomization until first documented treatment failure, relapse, or death from any cause, assessed up to 24 months after randomization; 1-year rate calculated at 12 months post-randomization
|
From date of randomization until first documented treatment failure, relapse, or death from any cause, assessed up to 24 months after randomization; 1-year rate calculated at 12 months post-randomization
|
|
|
1-year Overall Survival (OS) rate
Lasso di tempo: From date of randomization until death from any cause, assessed up to 24 months after randomization; 1-year rate calculated at 12 months post-randomization
|
From date of randomization until death from any cause, assessed up to 24 months after randomization; 1-year rate calculated at 12 months post-randomization
|
|
|
1-year recurrence free survival rate
Lasso di tempo: From date of randomization until first confirmed disease recurrence or death from any cause, assessed up to 24 months after randomization; the 1-year rate will be calculated at the 12-month timepoint after randomization
|
From date of randomization until first confirmed disease recurrence or death from any cause, assessed up to 24 months after randomization; the 1-year rate will be calculated at the 12-month timepoint after randomization
|
|
|
Safety profile during induction therapy
Lasso di tempo: From initiation of induction therapy through the end of the induction treatment period,assessed up to 8 weeks after randomization
|
Evaluate the incidence of grade 3 and grade 4 adverse events classified per CTCAE Version 5.0, the duration of severe adverse events, type, frequency and management of all treatment-emergent adverse events occurring during the induction treatment phase.
|
From initiation of induction therapy through the end of the induction treatment period,assessed up to 8 weeks after randomization
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Lasso di tempo |
|---|---|
|
Correlation between baseline AML gene mutation status detected by next-generation sequencing and anti-leukemic efficacy endpoints (complete remission rate, MRD-negative rate, 1-year recurrence-free survival rate) in VA regimen arm
Lasso di tempo: From date of randomization up to 24 months after randomization, biomarker-efficacy correlation analysis will be performed using clinical data collected within the first 12 months post randomization
|
From date of randomization up to 24 months after randomization, biomarker-efficacy correlation analysis will be performed using clinical data collected within the first 12 months post randomization
|
|
Hospitalization duration during induction therapy
Lasso di tempo: From the date of induction therapy initiation through completion of the first induction cycle (each cycle is 28 days)
|
From the date of induction therapy initiation through completion of the first induction cycle (each cycle is 28 days)
|
|
Transfusion volume during induction therapy
Lasso di tempo: From the date of induction therapy initiation through completion of the first induction cycle (each cycle is 28 days)
|
From the date of induction therapy initiation through completion of the first induction cycle (each cycle is 28 days)
|
|
Medical cost during induction therapy
Lasso di tempo: From the date of induction therapy initiation through completion of the first induction cycle (each cycle is 28 days)
|
From the date of induction therapy initiation through completion of the first induction cycle (each cycle is 28 days)
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Yang Shen, MD, Ruijin Hospital
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
- Neoplasie
- Neoplasie per tipo istologico
- Malattie ematologiche
- Leucemia, mieloide
- Leucemia
- Malattie emiche e linfatiche
- Leucemia, mieloide, acuta
- Prodotti chimici organici
- Composti eterociclici, 1-anello
- Composti eterociclici
- Acidi nucleici, nucleotidi e nucleosidi
- Idrocarburi
- Idrocarburi, ciclici
- Carboidrati
- Idrocarburi policiclici aromatici
- Idrocarburi, aromatici
- Composti policiclici
- Glicosidi
- Citidina
- Nucleosidi di pirimidina
- Pirimidine
- Composti aza
- Nucleosidi
- Ribonucleosidi
- Arabinonucleosidi
- Antracicline
- Naftaceni
- Aminoglicosidi
- Citarabina
- Azacitidina
- Daunorubicina
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- NPM1/IDH-AML01
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 .