阿沙替利单抗联合地西他滨/维奈托克治疗TP53突变急性髓系白血病
2026年3月31日 更新者:Northside Hospital, Inc.
阿沙替利单抗联合地西他滨/维奈托克治疗TP53突变/缺失AML患者
Axatilimab联合地西他滨/维奈托克治疗TP53突变/缺失的AML患者
研究概览
研究类型
介入性
注册 (估计的)
32
阶段
- 阶段1
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习联系方式
- 姓名:Caitlin Guzowski
- 电话号码:404-851-8523
- 邮箱:caitlin.guzowski@northside.com
研究联系人备份
- 姓名:Scott R Solomon, MD
- 电话号码:404-255-1930
- 邮箱:ssolomon@bmtga.com
学习地点
-
-
Georgia
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Atlanta、Georgia、美国、30342
- Northside Hospital, Inc.
-
接触:
- Caitlin Guzowski
- 电话号码:404-851-8523
- 邮箱:caitlin.guzowski@northside.com
-
-
参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
不
描述
入选标准:
- MDS/AML或伴有TP53突变或缺失的AML,定义为:
- 大于或等于10%且(满足以下任一条件):
- 存在TP53突变
- 通过FISH检测存在TP53缺失
- 诊断性骨髓的IHC染色TP53阳性
- 未经治疗或首次挽救治疗(原发性难治或首次复发)
排除标准:
- KPS评分<60
- 活动性未受控制的感染
- HIV感染史或活动性HBV或HBC感染
- 当前活动性第二恶性肿瘤
- 计算CrCl<40mL/min
- AST和/或ALT和/或直接胆红素>3倍正常值上限
- 心脏射血分数<40%或未受控制的心律失常史
- 急性或慢性胰腺炎史,肌炎史
- 已知中枢神经系统白血病浸润
- 治疗开始前3个月内接受过造血干细胞移植和/或存在与移植相关的2级及以上持续非血液学毒性
- 需要免疫抑制治疗的活动性急性或慢性GVHD
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的:阿沙替利单抗+地西他滨+维奈托克
|
20毫克/平方米/天 × 5天(诱导与巩固治疗)
400mg/d x14天(诱导期);400mg/d x7天(巩固期)
剂量递增,在每个周期的第1天和第15天给药
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
第二阶段剂量水平确定
大体时间:1年
|
通过根据CTCAE v.5记录不良事件,确定axatilimab联合地西他滨和维奈托克时的推荐二期剂量(RP2D)。
|
1年
|
|
微小残留病灶阴性完全缓解的评估
大体时间:2个月
|
通过进行骨髓活检和诱导后疾病反应评估,估计在接受1-2个周期地西他滨和维奈托克诱导化疗后达到MRD阴性完全缓解率
|
2个月
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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反应率、总生存期评估
大体时间:1年
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通过评估诱导治疗后及巩固治疗期间每3个月进行的骨髓活检,以估算完全缓解率
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1年
|
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治疗方案安全性评估
大体时间:1年
|
通过根据CTCAE v5.0记录所有不良事件,评估axatilimab与地西他滨和venetoclax联合用药的安全性和耐受性
|
1年
|
|
无进展生存期估算
大体时间:1年
|
通过评估诱导治疗后及巩固治疗期间每3个月进行的骨髓活检来估算无进展生存率
|
1年
|
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总体生存期估计
大体时间:1年
|
通过联系完成治疗1年后的患者来估算总体生存率以获取生存数据
|
1年
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Wolff D, Cutler C, Lee SJ, Pusic I, Bittencourt H, White J, Hamadani M, Arai S, Salhotra A, Perez-Simon JA, Alousi A, Choe H, Kwon M, Bermudez A, Kim I, Socie G, Chhabra S, Radojcic V, O'Toole T, Tian C, Ordentlich P, DeFilipp Z, Kitko CL; AGAVE-201 Investigators. Axatilimab in Recurrent or Refractory Chronic Graft-versus-Host Disease. N Engl J Med. 2024 Sep 19;391(11):1002-1014. doi: 10.1056/NEJMoa2401537.
- Kitko CL, Arora M, DeFilipp Z, Zaid MA, Di Stasi A, Radojcic V, Betts CB, Coussens LM, Meyers ML, Qamoos H, Ordentlich P, Kumar V, Quaranto C, Schmitt A, Gu Y, Blazar BR, Wang TP, Salhotra A, Pusic I, Jagasia M, Lee SJ. Axatilimab for Chronic Graft-Versus-Host Disease After Failure of at Least Two Prior Systemic Therapies: Results of a Phase I/II Study. J Clin Oncol. 2023 Apr 1;41(10):1864-1875. doi: 10.1200/JCO.22.00958. Epub 2022 Dec 2.
- Alexander KA, Flynn R, Lineburg KE, Kuns RD, Teal BE, Olver SD, Lor M, Raffelt NC, Koyama M, Leveque L, Le Texier L, Melino M, Markey KA, Varelias A, Engwerda C, Serody JS, Janela B, Ginhoux F, Clouston AD, Blazar BR, Hill GR, MacDonald KP. CSF-1-dependant donor-derived macrophages mediate chronic graft-versus-host disease. J Clin Invest. 2014 Oct;124(10):4266-80. doi: 10.1172/JCI75935. Epub 2014 Aug 26.
- Lemmon MA, Schlessinger J. Cell signaling by receptor tyrosine kinases. Cell. 2010 Jun 25;141(7):1117-34. doi: 10.1016/j.cell.2010.06.011.
- Rosnet O, Birnbaum D. Hematopoietic receptors of class III receptor-type tyrosine kinases. Crit Rev Oncog. 1993;4(6):595-613.
- Xu L, Xie X, Li X, Duan W, Qiu L, Liu H, Luo Y. Inflammatory level under different p53 mutation status and the regulation role of curcumin in tumor microenvironment. Immunobiology. 2022 Mar;227(2):152177. doi: 10.1016/j.imbio.2022.152177. Epub 2022 Jan 7.
- Blagih J, Zani F, Chakravarty P, Hennequart M, Pilley S, Hobor S, Hock AK, Walton JB, Morton JP, Gronroos E, Mason S, Yang M, McNeish I, Swanton C, Blyth K, Vousden KH. Cancer-Specific Loss of p53 Leads to a Modulation of Myeloid and T Cell Responses. Cell Rep. 2020 Jan 14;30(2):481-496.e6. doi: 10.1016/j.celrep.2019.12.028.
- Vadakekolathu J, Lai C, Reeder S, Church SE, Hood T, Lourdusamy A, Rettig MP, Aldoss I, Advani AS, Godwin J, Wieduwilt MJ, Arellano M, Muth J, Yau TO, Ravandi F, Sweet K, Altmann H, Foulds GA, Stolzel F, Middeke JM, Ciciarello M, Curti A, Valk PJM, Lowenberg B, Gojo I, Bornhauser M, DiPersio JF, Davidson-Moncada JK, Rutella S. TP53 abnormalities correlate with immune infiltration and associate with response to flotetuzumab immunotherapy in AML. Blood Adv. 2020 Oct 27;4(20):5011-5024. doi: 10.1182/bloodadvances.2020002512.
- Mussai F, De Santo C, Abu-Dayyeh I, Booth S, Quek L, McEwen-Smith RM, Qureshi A, Dazzi F, Vyas P, Cerundolo V. Acute myeloid leukemia creates an arginase-dependent immunosuppressive microenvironment. Blood. 2013 Aug 1;122(5):749-58. doi: 10.1182/blood-2013-01-480129. Epub 2013 Jun 3.
- Sierra-Filardi E, Nieto C, Dominguez-Soto A, Barroso R, Sanchez-Mateos P, Puig-Kroger A, Lopez-Bravo M, Joven J, Ardavin C, Rodriguez-Fernandez JL, Sanchez-Torres C, Mellado M, Corbi AL. CCL2 shapes macrophage polarization by GM-CSF and M-CSF: identification of CCL2/CCR2-dependent gene expression profile. J Immunol. 2014 Apr 15;192(8):3858-67. doi: 10.4049/jimmunol.1302821. Epub 2014 Mar 17.
- Hartwig T, Montinaro A, von Karstedt S, Sevko A, Surinova S, Chakravarthy A, Taraborrelli L, Draber P, Lafont E, Arce Vargas F, El-Bahrawy MA, Quezada SA, Walczak H. The TRAIL-Induced Cancer Secretome Promotes a Tumor-Supportive Immune Microenvironment via CCR2. Mol Cell. 2017 Feb 16;65(4):730-742.e5. doi: 10.1016/j.molcel.2017.01.021.
- Qian BZ, Li J, Zhang H, Kitamura T, Zhang J, Campion LR, Kaiser EA, Snyder LA, Pollard JW. CCL2 recruits inflammatory monocytes to facilitate breast-tumour metastasis. Nature. 2011 Jun 8;475(7355):222-5. doi: 10.1038/nature10138.
- Corzo CA, Condamine T, Lu L, Cotter MJ, Youn JI, Cheng P, Cho HI, Celis E, Quiceno DG, Padhya T, McCaffrey TV, McCaffrey JC, Gabrilovich DI. HIF-1alpha regulates function and differentiation of myeloid-derived suppressor cells in the tumor microenvironment. J Exp Med. 2010 Oct 25;207(11):2439-53. doi: 10.1084/jem.20100587. Epub 2010 Sep 27.
- Stromnes IM, Greenberg PD, Hingorani SR. Molecular pathways: myeloid complicity in cancer. Clin Cancer Res. 2014 Oct 15;20(20):5157-70. doi: 10.1158/1078-0432.CCR-13-0866. Epub 2014 Jul 21.
- Sallman DA, McLemore AF, Aldrich AL, Komrokji RS, McGraw KL, Dhawan A, Geyer S, Hou HA, Eksioglu EA, Sullivan A, Warren S, MacBeth KJ, Meggendorfer M, Haferlach T, Boettcher S, Ebert BL, Al Ali NH, Lancet JE, Cleveland JL, Padron E, List AF. TP53 mutations in myelodysplastic syndromes and secondary AML confer an immunosuppressive phenotype. Blood. 2020 Dec 10;136(24):2812-2823. doi: 10.1182/blood.2020006158.
- Tohumeken S, Baur R, Bottcher M, Stoll A, Loschinski R, Panagiotidis K, Braun M, Saul D, Volkl S, Baur AS, Bruns H, Mackensen A, Jitschin R, Mougiakakos D. Palmitoylated Proteins on AML-Derived Extracellular Vesicles Promote Myeloid-Derived Suppressor Cell Differentiation via TLR2/Akt/mTOR Signaling. Cancer Res. 2020 Sep 1;80(17):3663-3676. doi: 10.1158/0008-5472.CAN-20-0024. Epub 2020 Jun 30.
- Pyzer AR, Stroopinsky D, Rajabi H, Washington A, Tagde A, Coll M, Fung J, Bryant MP, Cole L, Palmer K, Somaiya P, Karp Leaf R, Nahas M, Apel A, Jain S, McMasters M, Mendez L, Levine J, Joyce R, Arnason J, Pandolfi PP, Kufe D, Rosenblatt J, Avigan D. MUC1-mediated induction of myeloid-derived suppressor cells in patients with acute myeloid leukemia. Blood. 2017 Mar 30;129(13):1791-1801. doi: 10.1182/blood-2016-07-730614. Epub 2017 Jan 26.
- Wang H, Tao Q, Wang Z, Zhang Q, Xiao H, Zhou M, Dong Y, Zhai Z. Circulating Monocytic Myeloid-Derived Suppressor Cells Are Elevated and Associated with Poor Prognosis in Acute Myeloid Leukemia. J Immunol Res. 2020 Dec 21;2020:7363084. doi: 10.1155/2020/7363084. eCollection 2020.
- Sun H, Li Y, Zhang ZF, Ju Y, Li L, Zhang BC, Liu B. Increase in myeloid-derived suppressor cells (MDSCs) associated with minimal residual disease (MRD) detection in adult acute myeloid leukemia. Int J Hematol. 2015 Nov;102(5):579-86. doi: 10.1007/s12185-015-1865-2. Epub 2015 Sep 10.
- Ren X, Tao Q, Wang H, Zhang Q, Zhou M, Liu L, Zhai Z. Monocytic Myeloid-Derived Suppressor Cells But Not Monocytes Predict Poor Prognosis of Acute Myeloid Leukemia. Turk J Haematol. 2022 Dec 1;39(4):230-236. doi: 10.4274/tjh.galenos.2022.2022.0137. Epub 2022 Aug 15.
- Peterlin P, Debord C, Eveillard M, Garnier A, Le Bourgeois A, Guillaume T, Jullien M, Bene MC, Chevallier P. Peripheral levels of monocytic myeloid-derived suppressive cells before and after first induction predict relapse and survivals in AML patients. J Cell Mol Med. 2022 Nov;26(21):5486-5492. doi: 10.1111/jcmm.17576. Epub 2022 Oct 13.
- Hamilton TA, Zhao C, Pavicic PG Jr, Datta S. Myeloid colony-stimulating factors as regulators of macrophage polarization. Front Immunol. 2014 Nov 21;5:554. doi: 10.3389/fimmu.2014.00554. eCollection 2014.
- Edwards DK 5th, Watanabe-Smith K, Rofelty A, Damnernsawad A, Laderas T, Lamble A, Lind EF, Kaempf A, Mori M, Rosenberg M, d'Almeida A, Long N, Agarwal A, Sweeney DT, Loriaux M, McWeeney SK, Tyner JW. CSF1R inhibitors exhibit antitumor activity in acute myeloid leukemia by blocking paracrine signals from support cells. Blood. 2019 Feb 7;133(6):588-599. doi: 10.1182/blood-2018-03-838946. Epub 2018 Nov 13.
- Yang X, Feng W, Wang R, Yang F, Wang L, Chen S, Ru Y, Cheng T, Zheng G. Repolarizing heterogeneous leukemia-associated macrophages with more M1 characteristics eliminates their pro-leukemic effects. Oncoimmunology. 2017 Dec 26;7(4):e1412910. doi: 10.1080/2162402X.2017.1412910. eCollection 2018.
- Xu ZJ, Gu Y, Wang CZ, Jin Y, Wen XM, Ma JC, Tang LJ, Mao ZW, Qian J, Lin J. The M2 macrophage marker CD206: a novel prognostic indicator for acute myeloid leukemia. Oncoimmunology. 2019 Nov 3;9(1):1683347. doi: 10.1080/2162402X.2019.1683347. eCollection 2020.
- Smirnova T, Spertini C, Spertini O. CSF1R Inhibition Combined with GM-CSF Reprograms Macrophages and Disrupts Protumoral Interplays with AML Cells. Cancers (Basel). 2021 Oct 21;13(21):5289. doi: 10.3390/cancers13215289.
- Brauneck F, Fischer B, Witt M, Muschhammer J, Oelrich J, da Costa Avelar PH, Tsoka S, Bullinger L, Seubert E, Smit DJ, Bokemeyer C, Ackermann C, Wellbrock J, Haag F, Fiedler W. TIGIT blockade repolarizes AML-associated TIGIT+ M2 macrophages to an M1 phenotype and increases CD47-mediated phagocytosis. J Immunother Cancer. 2022 Dec;10(12):e004794. doi: 10.1136/jitc-2022-004794.
- Miari KE, Guzman ML, Wheadon H, Williams MTS. Macrophages in Acute Myeloid Leukaemia: Significant Players in Therapy Resistance and Patient Outcomes. Front Cell Dev Biol. 2021 Jun 24;9:692800. doi: 10.3389/fcell.2021.692800. eCollection 2021.
- Mesaros O, Onciul M, Matei E, Joldes C, Jimbu L, Neaga A, Serban O, Zdrenghea M, Nanut AM. Macrophages as Potential Therapeutic Targets in Acute Myeloid Leukemia. Biomedicines. 2024 Oct 11;12(10):2306. doi: 10.3390/biomedicines12102306.
- Cencini E, Fabbri A, Sicuranza A, Gozzetti A, Bocchia M. The Role of Tumor-Associated Macrophages in Hematologic Malignancies. Cancers (Basel). 2021 Jul 18;13(14):3597. doi: 10.3390/cancers13143597.
- Maiti A, Rausch CR, Cortes JE, Pemmaraju N, Daver NG, Ravandi F, Garcia-Manero G, Borthakur G, Naqvi K, Ohanian M, Short NJ, Alvarado Y, Kadia TM, Takahashi K, Yilmaz M, Jain N, Kornblau S, Montalban Bravo G, Sasaki K, Andreeff M, Bose P, Ferrajoli A, Issa GC, Jabbour EJ, Masarova L, Thompson PA, Wang S, Konoplev S, Pierce SA, Ning J, Qiao W, Welch JS, Kantarjian HM, DiNardo CD, Konopleva MY. Outcomes of relapsed or refractory acute myeloid leukemia after frontline hypomethylating agent and venetoclax regimens. Haematologica. 2021 Mar 1;106(3):894-898. doi: 10.3324/haematol.2020.252569. No abstract available.
- Kim K, Maiti A, Loghavi S, Pourebrahim R, Kadia TM, Rausch CR, Furudate K, Daver NG, Alvarado Y, Ohanian M, Sasaki K, Short NJ, Takahashi K, Yilmaz M, Tang G, Ravandi F, Kantarjian HM, DiNardo CD, Konopleva MY. Outcomes of TP53-mutant acute myeloid leukemia with decitabine and venetoclax. Cancer. 2021 Oct 15;127(20):3772-3781. doi: 10.1002/cncr.33689. Epub 2021 Jul 13.
- Dohner H, Pratz KW, DiNardo CD, Wei AH, Jonas BA, Pullarkat VA, Thirman MJ, Recher C, Schuh AC, Babu S, Li X, Ku G, Liu Z, Sun Y, Potluri J, Dail M, Chyla B, Pollyea DA. Genetic risk stratification and outcomes among treatment-naive patients with AML treated with venetoclax and azacitidine. Blood. 2024 Nov 21;144(21):2211-2222. doi: 10.1182/blood.2024024944.
- Zhao D, Zarif M, Zhou Q, Capo-Chichi JM, Schuh A, Minden MD, Atenafu EG, Kumar R, Chang H. TP53 Mutations in AML Patients Are Associated with Dismal Clinical Outcome Irrespective of Frontline Induction Regimen and Allogeneic Hematopoietic Cell Transplantation. Cancers (Basel). 2023 Jun 16;15(12):3210. doi: 10.3390/cancers15123210.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (估计的)
2026年8月1日
初级完成 (估计的)
2029年8月1日
研究完成 (估计的)
2030年8月1日
研究注册日期
首次提交
2026年3月25日
首先提交符合 QC 标准的
2026年3月31日
首次发布 (实际的)
2026年4月6日
研究记录更新
最后更新发布 (实际的)
2026年4月6日
上次提交的符合 QC 标准的更新
2026年3月31日
最后验证
2026年3月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.