Estudo de Fase 1b/2 de Decitabina e Venetoclax em Combinação com o Inibidor IDH1 Mutante Alvo Olutasidenib
To find a recommended combination dose of decitabine and venetoclax that can be given in combination with olutasidenib to participants with AML.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Primary Objectives
- Phase 1b: To determine the safety and tolerability and recommended phase 2 dose (RP2D) of decitabine (either IV or oral decitabine/cedazuridine (ASTX727, Inqovi)) and venetoclax in combination with olutasidenib.
- Phase 2: To determine the composite remission rate (CR, CRh and CRi) of decitabine (IV or oral decitabine/cedazuridine (ASTX727, Inqovi)) and venetoclax in combination with olutasidenib for newly diagnosed (Arm A) or relapsed/refractory (Arm B) participants with IDH1-mutated myeloid malignancy.
Secondary Objectives
- To determine duration of response (DOR), event-free survival (EFS), and overall survival (OS)
- To evaluate occurrence of minimal residual disease (MRD) negative status by multiparameter flow cytometry and molecular evaluation.
- To determine the overall response rate (CR, CRh, CRi, MLFS, and PR)
- To characterize the pharmacokinetic (PK) profiles of venetoclax and olutasidenib in plasma samples (Phase 1b only).
Exploratory Objectives
- To investigate global gene expression profiles, DNA methylation profiles, BH3 profiling and other potential prognostic markers to explore predictors of antitumor activity and/or resistance to treatment.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Fase 2
- Fase 1
Contactos e Locais
Contato de estudo
- Nome: Courtney DiNardo, MD
- Número de telefone: (713) 794-1141
- E-mail: cdinardo@mdanderson.org
Locais de estudo
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Florida
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Miami, Florida, Estados Unidos, 33136
- Recrutamento
- University of Miami
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Investigador principal:
- Justin Watts, MD
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Contato:
- Justin Watts, MD
- Número de telefone: 305-243-8986
- E-mail: jxw401@med.miami.edu
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Kansas
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Westwood, Kansas, Estados Unidos, 66205
- Recrutamento
- The University of Kansas Medical Center
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Contato:
- Yacoub Abdulraheem, MD
- E-mail: ayacoub@kumc.edu
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Investigador principal:
- Yacoub Abdulraheem, MD
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Massachusetts
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Boston, Massachusetts, Estados Unidos, 02215
- Recrutamento
- Dana-Farber Cancer Institute
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Investigador principal:
- Jacqueline Garcia, MD
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Contato:
- Jacqueline Garcia, MD
- Número de telefone: 617-632-6349
- E-mail: jacqueline_garcia@dfci.harvard.edu
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New York
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Buffalo, New York, Estados Unidos, 14263
- Recrutamento
- Roswell Park
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Investigador principal:
- Eunice Wang, MD
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Contato:
- Eunice Wang, MD
- E-mail: eunice.wang@roswellpark.org
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Texas
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Houston, Texas, Estados Unidos, 77030
- Recrutamento
- MD Anderson Cancer Center
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Contato:
- Courtney DiNardo, MD
- Número de telefone: 713-794-1141
- E-mail: cdinardo@mdanderson.org
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Investigador principal:
- Courtney DiNardo, MD
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
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Age > 18 years
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Participants must have a documented IDH1 gene mutation
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Participants with a diagnosis of relapsed or refractory AML (including biphenotypic or bilineage leukemia including a myeloid component or isolated extramedullary AML), high-risk MDS by IPSS-R or IPSS-M; OR
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Participants with newly diagnosed AML not eligible or appropriate for intensive chemotherapy are also eligible. (Phase 2 portion only)
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To be considered not eligible for intensive chemotherapy, participants must be defined by the following: Age 75 years or older, or Age 18 to 74 years with at least one of the following comorbidities:
- Severe cardiac disorder (eg, congestive heart failure requiring treatment, ejection fraction ≤50%, or chronic stable angina).
- Severe pulmonary disorder (eg, DLCO ≤65% or forced expiratory volume in 1 second [FEV1] ≤65%).
- Creatinine clearance ≥30 mL/min to <45 mL/min.
- Moderate hepatic impairment with total bilirubin >1.5 to .3.0 x upper limit of normal (ULN)
- ECOG performance status of 2 or 3
- Any other comorbidity that per the investigator renders a patient inappropriate for intensive chemotherapy
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Eastern Cooperative Oncology Group (ECOG) Performance Status </=2 (unless age 18 to 74 years of age with newly diagnosed AML not eligible for intensive chemotherapy as per 5e above)
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Adequate renal function including creatinine < 1.5, unless related to the disease or unless age 18 to 74 years of age with newly diagnosed AML not eligible for intensive chemotherapy as per 5c above.
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Adequate hepatic function (direct bilirubin < 2x upper limit of normal (ULN) unless increase is due to Gilbert fs disease or leukemic involvement, and AST and/or ALT < 3x ULN unless considered due to leukemic involvement, in which case direct bilirubin or AST and/or ALT < 5x ULN will be considered eligible, or unless age 18 to 74 years of age with newly diagnosed AML not eligible for intensive chemotherapy as per 5d above)
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In the absence of rapidly proliferative disease, the interval from prior treatment to time of initiation will be at least 14 days for cytotoxic or non-cytotoxic (immunotherapy agent(s), or an interval of 5 half-lives of the prior therapy. Oral hydroxyurea and/or cytarabine (up to 2 g/m2) for patients with rapidly proliferative disease is allowed before the start of study therapy, as needed, for clinical benefit and after discussion with the PI. Concurrent intrathecal therapy for central nervous system (CNS) prophylaxis or continuation of therapy for controlled CNS disease is permitted.
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Male participants who are sexually active with a women of childbearing potential (WOCBP) and who have not had vasectomies must be willing to use a barrier method of contraception and refrain from sperm donation from initial study drug until 90 days after last dose of study drug.
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Willing and able to provide informed consent.
Exclusion Criteria:
- Participants with t(15;17) karyotypic abnormality or acute promyelocytic leukemia (French-American-British [FAB] class M3-AML).
- Participants with any concurrent uncontrolled clinically significant medical condition including life-threatening severe infection, or psychiatric illness, which could place the participants at unacceptable risk of study treatment.
- Participants with active, uncontrolled leukemia involvement of the CNS
- Participants with active graft-versus-host-disease (GVHD) status post stem cell transplant including active cGVHD requiring topic therapy. Patients must have discontinued calcineurin inhibitors at least 4 weeks prior to start of study treatment.
- Participants with any severe gastrointestinal or metabolic condition which could interfere with the absorption of oral study medications.
- Known active hepatitis B (HBV) or Hepatitis C (HCV) infection or known HIV infection.
- Participant has a white blood cell count > 25 x 10^9/L. (Note: Hydroxyurea and cytarabine is permitted to meet this criterion.)
- Nursing women, women of childbearing potential (WOCBP) with positive urine pregnancy test, or women of childbearing potential who are not willing to maintain adequate contraception.
A) Appropriate highly effective method(s) of contraception include oral or injectable hormonal birth control, IUD, and double barrier methods (for example a condom in combination with a spermicide).
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Não randomizado
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: Part 1
Participants enrolled in Part 1, the dose of venetoclax/decitabine you receive will depend on when you join this study. Up to 3 dose levels will be tested. Up to 6 participants will be enrolled at each dose level. - All participants will receive the same dose level of olutasidenib. |
Given by PO
Outros nomes:
Given by IV
Outros nomes:
Given by PO Given by PO
Outros nomes:
|
|
Experimental: Part 2
Participants enrolled in Part 2, you will receive venetoclax/decitabine at the recommended dose that was found in Part 1. - All participants will receive the same dose level of olutasidenib. |
Given by PO
Outros nomes:
Given by IV
Outros nomes:
Given by PO Given by PO
Outros nomes:
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Safety and adverse events (AEs)
Prazo: Through study completion; an average of 1 year.
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Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0 |
Through study completion; an average of 1 year.
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Courtney DiNardo, MD, M.D. Anderson Cancer Center
Publicações e links úteis
Links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Produtos químicos orgânicos
- Compostos heterocíclicos, 1 anel
- Compostos heterocíclicos
- Ácidos nucleicos, nucleotídeos e nucleosídeos
- Citidina
- Nucleosídeos de pirimidina
- Pirimidinas
- Compostos AZA
- Nucleosídeos
- Ribonucleosídeos
- Azacitidina
- Decitabina
- Venetoclax
- combinação de drogas decitabina e cedazuridina
- Olutasidenib
Outros números de identificação do estudo
- 2024-0180
- NCI-2024-04807 (Outro identificador: NCI-CTRP Clinical Registry)
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