Combination treatment for newly diagnosed chronic myeloid leukemia
Phase II Study Assessing Safety and Clinical Activity of the Combination of ASTX727 With Dasatinib in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase (CML-CP)
This study is testing a combination of two medications to see if they can help people with newly diagnosed chronic myeloid leukemia achieve a good response to treatment after six months.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Enrollment | 70 (estimated) |
| Sex | All |
| Sponsor | M.D. Anderson Cancer Center Academic / other |
| Drugs / interventions | dasatinib, Chemotherapy |
| Locations | 1 site (Houston, Texas) |
| Trial ID | NCT05007873 on ClinicalTrials.gov |
What this trial studies
This phase II trial evaluates the effectiveness of ASTX727 and dasatinib in patients with newly diagnosed Philadelphia chromosome or BCR-ABL positive chronic myeloid leukemia in chronic phase. The study aims to determine the proportion of patients achieving molecular response 4 (MR4) after 6 months of treatment. Participants will receive dasatinib daily and, starting from the fourth cycle, will also take ASTX727 for a total duration of up to 3 years, with ongoing maintenance therapy for up to 12 years. The trial will also assess safety and various response rates over time.
Who should consider this trial
Good fit: Ideal candidates include individuals diagnosed with Philadelphia chromosome or BCR-ABL positive chronic myeloid leukemia within the last 12 months and who have received minimal prior therapy.
Not a fit: Patients with advanced stages of chronic myeloid leukemia or those who have received extensive prior treatment may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could significantly improve outcomes for patients with chronic myeloid leukemia by achieving deeper molecular responses.
How similar studies have performed: Other studies have shown promising results with similar treatment approaches, indicating potential for success in this trial.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
* Diagnosis of Philadelphia chromosome (Ph)-positive or BCR-ABL positive CML in early chronic phase CML (i.e., time from diagnosis ≤12 months). Except for hydroxyurea and/or 1 to 2 doses of cytarabine patients must have received no or minimal prior therapy, defined as \< 1 month (30 days) of prior Food and Drug Administration (FDA) approved tyrosine kinase inhibitor (TKI)
* Clonal evolution defined as the presence of additional chromosomal abnormalities other than the Ph chromosome has historically been included as a criterion for accelerated phase. However, patients with clonal evolution as the only criterion of accelerated phase have a significantly better prognosis, and when present at diagnosis may not impact the prognosis at all. Thus, patients with clonal evolution at diagnosis (early disease) and no other criteria for accelerated phase will be eligible for this study.
* Eastern Cooperative Oncology Group (ECOG) performance of 0-2
* Adequate end organ function, defined as the following: total bilirubin \<1.5x ULN (unless secondary to Gilbert's disease, in which case should be \< 2.5x ULN), SGPT \<3x ULN, creatinine clearance ≥ 30mL/min calculated using modified Crokcroft-Gault.
* Patients must sign an informed consent indicating they are aware of the investigational nature of this study, in keeping with the policies of the hospital.
* Males must be surgically or biologically sterile or agree to use an adequate method of contraception during the study until 3 months after the last treatment.
Exclusion Criteria:
* New York Heart Association (NYHA) cardiac class 3-4 heart disease
* Cardiac Symptoms: Patients meeting the following criteria are not eligible unless cleared by Cardiology:
* Uncontrolled angina within 3 months
* Diagnosed or suspected congenital long QT syndrome
* Any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsades de pointes).
* Prolonged corrected QT (QTc) interval on pre-entry electrocardiogram (\> 460 msec)
* History of significant bleeding disorder unrelated to cancer, including unless cleared by hematologist or hemato-oncologist
* Diagnosed congenital bleeding disorders (e.g., von Willebrand's disease)
* Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies)
* Patients with active, uncontrolled psychiatric disorders include: psychosis, major depression, and bipolar disorders
* Subject is known to be positive for human immunodeficiency virus (HIV) (HIV testing is not required)
* Evidence of other clinically significant uncontrolled condition(s) including, but not limited to:
* Uncontrolled and/or active systemic infection (viral, bacterial or fungal)
* Chronic hepatitis B virus (HBV) or hepatitis C (HCV) requiring treatment. Note: subjects with serologic evidence of prior vaccination to HBV (i.e. hepatitis B surface \[HBs\] antigen negative-, anti-HBs antibody positive and anti-hepatitis B core \[HBc\] antibody negative) or positive anti-HBc antibody from intravenous immunoglobulins (IVIG) may participate
* Women of pregnancy potential must practice an effective method of birth control during the course of the study, in a manner such that risk of failure is minimized. Prior to study enrollment, women of childbearing potential (WOCBP) must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Women must continue birth control for the duration of the trial and at least 3 months after the last dose of study drug.
Pregnant or breast-feeding women are excluded.
All WOCBP must have a negative pregnancy test prior to first receiving investigational product. If the pregnancy test is positive, the patient must not receive study drug and must not be enrolled in the study
* Patients in late chronic phase (i.e., time from diagnosis to treatment \> 12 months), accelerated (except as noted in inclusion criteria 4.1) or blast phase are excluded. The definitions of CML phases are as follows:
* Early chronic phase: time from diagnosis to therapy ≤ 12 months
* Late chronic phase: time from diagnosis to therapy \> 12 months
* Blastic phase: presence of 30% blasts or more in the peripheral blood or bone marrow
* Accelerated phase CML: presence of any of the following features:
* Peripheral or marrow blasts 15% or more
* Peripheral or marrow basophils 20% or more
* Thrombocytopenia \< 100 x 10\^9/L unrelated to therapy
* Documented extramedullary blastic disease outside liver or spleen
Where this trial is running
Houston, Texas
- M D Anderson Cancer Center — Houston, Texas, United States (Recruiting)
Study contacts
- Principal investigator: Elias Jabbour — M.D. Anderson Cancer Center
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.