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- Ensaio Clínico NCT07643103
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.
Visão geral do estudo
Status
Intervenção / Tratamento
- Medicamento: Inotuzumab Ozogamicin (IO)
- Medicamento: Venetoclax
- Medicamento: Blinatumomab
- Biológico: CD19-directed chimeric antigen receptor (CAR-T) T cells
- Medicamento: Vincristine
- Medicamento: Cyclophosphamide
- Medicamento: Dexamethasone
- Medicamento: Methotrexate
- Medicamento: Cytarabine (Ara-C)
- Medicamento: Prednisone
- Medicamento: Mercaptopurine 50 mg
Tipo de estudo
Inscrição (Estimado)
Estágio
- Fase 2
Contactos e Locais
Contato de estudo
- Nome: Ying Wang, MD, PhD
- Número de telefone: +86 22-23608095
- E-mail: wangying1@ihcams.ac.cn
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: N / D
- Modelo Intervencional: Atribuição sequencial
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: 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.
|
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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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Flow Cytometric MRD-Negative Complete Remission Rate
Prazo: 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.
|
At the end of induction therapy (approximately 1 month after treatment initiation)
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Next-Generation Sequencing (NGS)-MRD Negative Remission Rate
Prazo: Within 3 months after treatment initiation
|
Proportion of patients achieving MRD-negative remission assessed by immune repertoire sequencing.
|
Within 3 months after treatment initiation
|
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Best MRD Clearance Rate
Prazo: Within 3 months after treatment initiation
|
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.
|
Within 3 months after treatment initiation
|
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Overall Survival (OS)
Prazo: Up to 5 years
|
Time from study enrollment to death from any cause.
|
Up to 5 years
|
|
Disease-Free Survival (DFS)
Prazo: Up to 5 years
|
Time from achievement of complete remission to relapse or death from any cause.
|
Up to 5 years
|
|
Relapse-Free Survival (RFS)
Prazo: Up to 5 years
|
Time from achievement of MRD-negative remission to hematologic relapse or death.
|
Up to 5 years
|
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30-Day Mortality
Prazo: 30 days
|
Proportion of patients who die from any cause within 30 days after treatment initiation.
|
30 days
|
|
60-Day Mortality
Prazo: 60 days
|
Proportion of patients who die from any cause within 60 days after treatment initiation.
|
60 days
|
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Incidence of Adverse Events
Prazo: From treatment initiation through completion of study treatment, up to 5 years
|
Frequency, severity, and type of adverse events graded according to the National Cancer
|
From treatment initiation through completion of study treatment, up to 5 years
|
Colaboradores e Investigadores
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
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
- Aminoácidos, peptídeos e proteínas
- Proteínas
- Compostos de enxofre
- Produtos químicos orgânicos
- Compostos heterocíclicos, 1 anel
- Compostos heterocíclicos
- Compostos heterocíclicos, 2 anel
- Compostos heterocíclicos, anel fundido
- Ácidos nucleicos, nucleotídeos e nucleosídeos
- Hidrocarbonetos
- Carboidratos
- Alcalóides
- Compostos policíclicos
- Glicosídeos
- Indoles
- Anticorpos, monoclonais, humanizados
- Anticorpos, monoclonais
- Anticorpos
- Imunoglobulinas
- Imunoproteínas
- Proteínas sanguíneas
- Globulinas de soro
- Globulins
- Purinas
- Citidina
- Nucleosídeos de pirimidina
- Pirimidinas
- Pregada
- Pregnas
- Esteróides
- Compostos de anel fundido
- Esteróides, fluorados
- Mustarazas de fosforamida
- Compostos de mostarda de nitrogênio
- Compostos de mostarda
- Hidrocarbonetos, halogenados
- Fosforamidas
- Compostos organofosforos
- Nucleosídeos
- Pterins
- Pteridinas
- Pregadienetriols
- PregadaDiols
- Alcalóides de Vinca
- Alcalóides de triptamina de secologanin
- Alcalóides indol
- Indolizidinas
- Indolizinas
- Arabinonucleosides
- Aminopterina
- Aminoglicosídeos
- Compostos sulfhidryl
- Calicheamicins
- Inotuzumabe Ozogamicina
- Dexametasona
- Metotrexato
- Prednisona
- Ciclofosfamida
- Citarabina
- Vincristina
- Mercaptopurina
- Venetoclax
- blinatumomab
Outros números de identificação do estudo
- IIT2026063
- IIT2026063-EC-1 (Outro identificador: Ethics Committee of Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Informações sobre medicamentos e dispositivos, documentos de estudo
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Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .
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The University of Hong KongNovartis; Queen Mary Hospital, Hong KongAinda não está recrutandoTransplante de Células Tronco Hematopoiéticas, Alogênico | Ph+ Leucemia Linfoblástica Aguda (Ph+ALL) | Transformação blastic de leucemia mielóide crônica | Leucemia Linfoblástica Aguda de Células B Positiva para o Cromossoma Filadélfia (Ph+ B-ALL)Hong Kong
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EDDC (Experimental Drug Development Centre), A*STAR...Chiltern International Inc.RetiradoPh+ Leucemia Linfoblástica Aguda (Ph+ALL) | Ph- Leucemia Linfoblástica Aguda (Ph-ALL) | Fase Acelerada da Leucemia Mielóide Crônica (CML-AP, Ph+) | Crise Blástica de Leucemia Mielóide Crônica (CML-BC, Ph+)Estados Unidos, Cingapura
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TakedaRescindidoLeucemia Linfoblástica Aguda com Cromossomo Filadélfia Positivo Pediátrico (Ph+ALL) | Leucemia Aguda de Fenótipo Misto Ph+ (MPAL) | ALL semelhante ao cromossomo Filadélfia (LL semelhante ao Ph)Estados Unidos, França, China, Espanha, México, Reino Unido, Portugal, Argentina, Austrália, Brasil, Tcheca, Holanda, Polônia, Coréia do Sul, Itália
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Institute of Hematology & Blood Diseases Hospital...Ainda não está recrutandoInibidor de Tirosina Quinase | TCTH | Ph+ Leucemia Linfoblástica Aguda (Ph+ALL)
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Seoul St. Mary's HospitalBristol-Myers SquibbDesconhecidoLeucemia Mielóide Crônica ou Ph Positivo ALLRepublica da Coréia
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Merck Sharp & Dohme LLCRescindidoFase Blast Cromossomos Filadélfia Positivos (Ph+) Leucemia Mielóide Crônica (LMC) | Leucemia Linfocítica Aguda (ALL) Cromossomo Filadélfia Positivo (Ph+)
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Stanford UniversityNational Cancer Institute (NCI)ConcluídoLeucemia Linfoblástica Aguda do Adulto de Células B (ALL) | Leucemia Linfoblástica Aguda (LLA) Adulto Ph-positivo | Leucemia Linfoblástica Aguda Recorrente em Adultos (ALL) | Leucemia Linfoblástica Aguda (LLA) de Células T do AdultoEstados Unidos
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TakedaAtivo, não recrutandoLeucemia Linfoblástica Aguda Positiva do Cromossomo Filadélfia (Ph+ALL)Estados Unidos, China, Brasil, Espanha, Austrália, Canadá, Japão, Itália, Argentina, México, Áustria, Taiwan, Finlândia, Polônia, Coréia do Sul, Bulgária, França, Grécia, Rússia, Turquia (Türkiye)
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Versailles HospitalAtivo, não recrutandoLeucemia Linfoblástica Aguda (ALL) - Cromossomo Filadélfia (Ph)-Precursor de células B CD22+ negativo (BCP)França
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Ariad PharmaceuticalsUnited BioSource, LLCRescindidoLeucemia Mielóide, Fase Crônica, Fase Acelerada, Fase Blástica, Ph+ALLEstados Unidos
Ensaios clínicos em Inotuzumab Ozogamicin (IO)
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Ruijin HospitalAtivo, não recrutandoLeucemia Linfoblástica Aguda | Leucemias Linfoblásticas Agudas (ALL) | Venetoclax | Ozogamicina inotuzumabChina
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WellSpan HealthUniversity of PennsylvaniaConcluído
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Second Affiliated Hospital, School of Medicine,...The First Affiliated Hospital with Nanjing Medical University; Shanghai Zhongshan... e outros colaboradoresRecrutamentoParada Cardíaca Fora do HospitalChina
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Vidacare CorporationConcluídoAcesso vascular | Acesso Vascular IntraósseoEstados Unidos
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Sultan Qaboos UniversityChristian Medical College, Vellore, IndiaDesconhecido
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Implandata Ophthalmic Products GmbHConcluídoGlaucoma primário de ângulo abertoAlemanha
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Wake Forest University Health SciencesConcluídoParagem cardíacaEstados Unidos
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Vidacare CorporationConcluídoPacientes que necessitam de acesso vascular urgenteEstados Unidos
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Implandata Ophthalmic Products GmbHConcluídoGlaucoma Congênito | Síndrome de Stevens-Johnson | Doença do Enxerto x Hospedeiro | Aniridia congênita | Queimaduras QuímicasAlemanha