Combining venetoclax with chemotherapy for treating acute myeloid leukemia
A Phase 1b/2 Study of the BCL-2 Inhibitor Venetoclax in Combination With Standard Intensive AML Induction/Consolidation Therapy With FLAG-IDA in Patients With Newly Diagnosed or Relapsed/Refractory AML
This study is testing if combining a drug called venetoclax with chemotherapy can help people with newly diagnosed or tough-to-treat acute myeloid leukemia feel better and improve their chances of recovery.
Quick facts
| Phase | Phase1; Phase2 |
|---|---|
| Study type | Interventional |
| Enrollment | 116 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | M.D. Anderson Cancer Center Academic / other |
| Drugs / interventions | chemotherapy, fludarabine |
| Locations | 1 site (Houston, Texas) |
| Trial ID | NCT03214562 on ClinicalTrials.gov |
What this trial studies
This clinical trial evaluates the safety and effectiveness of venetoclax in combination with chemotherapy for patients with newly diagnosed or relapsed/refractory acute myeloid leukemia (AML). The study is divided into two phases: the first phase focuses on determining the maximum tolerated dose and side effects of the treatment, while the second phase assesses the overall activity of the combination therapy. Patients will receive venetoclax along with other chemotherapy agents such as fludarabine, cytarabine, and idarubicin over a specified treatment schedule. The trial also aims to identify biomarkers that may predict the effectiveness of venetoclax.
Who should consider this trial
Good fit: Ideal candidates include patients diagnosed with acute myeloid leukemia or high-risk myelodysplastic syndrome who meet specific health criteria.
Not a fit: Patients with severe comorbidities or those who do not meet the eligibility criteria may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could improve outcomes for patients with acute myeloid leukemia by enhancing the effectiveness of chemotherapy.
How similar studies have performed: Other studies have shown promising results with similar combinations of venetoclax and chemotherapy, indicating potential for success.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
* Diagnosis of AML by World Health Organization (WHO) criteria. Patients with high risk myelodysplastic syndrome (MDS) as defined by the presence of \>= 10% blasts are also eligible at the discretion of the principal investigator
* Patients older than 65 who are deemed fit to receive intensive chemotherapy by the treating physician will be eligible after discussion with the principal investigator (PI).
* Eastern Cooperative Oncology Group (ECOG) performance status of =\< 2
* Creatinine clearance \>= 30 mL/min based on the Cockcroft-Gault equation
* Total bilirubin \< 1.5 x upper limit of normal (ULN) unless increase is due to Gilbert's disease or leukemic involvement
* Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) \< 3 x ULN unless considered due to leukemic involvement
* Ability to understand and provide signed informed consent
* Male subjects must agree to refrain from unprotected sex and sperm donation from initial study drug administration until 90 days after the last dose of study drug
* Only patients who are relapsed, refractory, or intolerant of standard AML therapy will be eligible for Part 1 (minimum of 1 prior line of AML-directed therapy)
Exclusion Criteria:
* Patients with t(15;17) karyotypic abnormality or acute promyelocytic leukemia (French-American-British \[FAB\] class M3-AML)
* Patients having received any prior BCL2 inhibitor therapy
* Subject has known active central nervous system (CNS) involvement with AML
* Patients with New York Heart Association (NYHA) class III or IV congestive heart failure or left ventricular ejection fraction (LVEF) \< 40% by echocardiogram or multi-gated acquisition (MUGA) scan
* Patients with a history of myocardial infarction within the last 6 months or unstable / uncontrolled angina pectoris or history of severe and/or uncontrolled ventricular arrhythmias
* Patients with known infection with human immunodeficiency virus (HIV) or active hepatitis B or C
* Patients with known dysphagia, short-gut syndrome, or other conditions that would affect the ingestion or gastrointestinal absorption of drugs administered orally
* Subject has any other significant medical or psychiatric history that in the opinion of the investigator would adversely affect participation in this study
* Subject has a white blood cell count \> 25 x 10{9}/L. (Note: hydroxyurea 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 method(s) of contraception include oral or injectable hormonal birth control, intrauterine device (IUD), and double barrier methods (for example a condom in combination with a spermicide)
Where this trial is running
Houston, Texas
- M D Anderson Cancer Center — Houston, Texas, United States (Recruiting)
Study contacts
- Principal investigator: Courtney DiNardo — M.D. Anderson Cancer Center
- Study coordinator: DiNardo, MD
- Email: cdinardo@mdanderson.org
- Phone: (713) 794-1141
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.