Testing new treatments for high-risk acute myeloid leukemia
Official title: A Randomized Phase II Study Comparing Cytarabine + Daunorubicin (7 + 3) vs (Daunorubicin and Cytarabine) Liposome, Cytarabine + Daunorubicin + Venetoclax, Azacitidine + Venetoclax, and (Daunorubicin and Cytarabine) Liposome + Venetoclax in Patients Aged 59 or Younger Who Are Considered High-Risk (Adverse) Acute Myeloid Leukemia As Determined by MYELOMATCH; A MYELOMATCH SubStudy
Run by National Cancer Institute (NCI) · NCT05554406 · Data updated 2026-11-12
This study is testing new treatment combinations for people with high-risk acute myeloid leukemia to see if they can achieve better remission rates than the standard therapy.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years to 59 Years |
| Sex | All |
| Enrollment | 335 (estimated) |
| Sponsor | National Cancer Institute (NCI) NIH |
| Drugs / interventions | chemotherapy |
| Locations | 227 sites (Birmingham, Alabama and 226 other locations) |
| Status | Recruiting |
| Started | September 25, 2024 |
| Main results expected | March 31, 2027 |
| Study ends | March 31, 2027 |
| Registry record updated | November 9, 2026 |
| Trial ID | NCT05554406 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are newly diagnosed, untreated patients with high-risk acute myeloid leukemia as defined by specific criteria.
✕Probably not a fit
Patients with favorable or intermediate risk disease or those with acute promyelocytic leukemia will not benefit from this study.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This phase II trial evaluates the effectiveness of various experimental regimens compared to the standard treatment of cytarabine and daunorubicin in patients with newly diagnosed, untreated high-risk acute myeloid leukemia (AML). Participants are randomized into five different treatment arms, which include combinations of established drugs and novel agents like venetoclax and azacitidine. The primary goal is to compare the rates of measurable residual disease negative complete remission among the different regimens. Secondary objectives include assessing toxicity, overall survival, and other remission rates. Specimens will also be banked for future studies.
Why it matters
Potential benefit: If successful, this trial could lead to more effective treatment options for patients with high-risk acute myeloid leukemia.
How similar studies have gone: Other studies have shown promise with similar approaches, but this specific combination of treatments is being tested for the first time.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * STEP 1 REGISTRATION: * Participants must have been registered to Master Screening and Re-Assessment Protocol, MYELOMATCH, prior to consenting to this study. Participants must have been assigned to this clinical trial, via MATCHBox, prior to registration to this study. * Note: Pre-enrollment/diagnosis labs must have already been performed under MYELOMATCH * Participants must have newly diagnosed, untreated acute myeloid leukemia (AML) per World Health Organization (WHO) criteria * Participants must have high-risk (adverse) AML per European LeukemiaNet (ELN) 2017 criteria * Participants with therapy-related AML (t-AML), or with AML evolving from an antecedent hematologic disorder (such as myeloproliferative neoplasm), or AML with myelodysplasia-related changes (AML-MRC) are eligible-unless they were previously treated * Acute promyelocytic leukemia is excluded * Participants with favorable or intermediate risk disease per ELN 2017 criteria are excluded * Participants with FLT3 mutations (ITD or TKD) are excluded * Participants with t(9;22) translocation are excluded * A single dose of intrathecal chemotherapy for AML is allowed prior to study entry * Prior anthracycline therapy for any indication is allowed but must not exceed a cumulative lifetime dose of 200 mg/m\^2 daunorubicin or equivalent * Participants must not have received or be currently receiving any prior therapy for acute myeloid leukemia. Hydroxyurea to control the white blood cells (WBC) is allowed prior to registration and initiation of protocol-defined therapy. All trans retinoic acid (ATRA) given until a diagnosis of acute promyelocytic leukemia is ruled out is also allowed. For urgent cytoreduction, cytarabine may be given either as a single dose or in multiple doses not to exceed 2500 mg * Participants must not be receiving or planning to receive any other investigational agents before completing protocol therapy * Participants must be between 18 and 59 years of age * Participants must have Zubrod performance status =\< 3 as determined by a complete medical history and physical exam (H\&P) completed within 7 days prior to registration * Participants must be able to swallow and retain oral medications and have no known gastrointestinal disorders likely to interfere with absorption of oral medications * Participants with a known history of human immunodeficiency virus (HIV)-infection must be on effective anti-retroviral therapy at time of registration and have undetectable HIV viral load on the most recent test results obtained within 6 months prior to registration * Participants with a known history of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load within 28 days prior to registration and be on suppressive therapy, if indicated * Participants with a known history of hepatitis C virus (HCV) infection must have been treated and cured. Participants with active HCV infection who are currently on treatment must have an undetectable HCV viral load within 28 days prior to registration * The following tests must be performed within 14 days prior to registration to establish baseline values: * Complete blood count (CBC)/differential/platelets * Total bilirubin * Lactate dehydrogenase (LDH) * Albumin * Glucose * Fibrinogen * Participants must have adequate kidney function as evidenced by creatinine clearance \>= 30mL/min (by Cockcroft Gault) within 7 days prior to registration * Participants must have adequate liver function as evidenced by aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 x upper limit of normal (ULN) within 7 days prior to registration- unless elevations are considered due to leukemia in the opinion of the treating investigator * Total bilirubin =\< 2.0 x ULN (or 5.0 x ULN if the participant has a history of Gilbert's disease) within 28 days prior to registration * Participants must have adequate cardiac function as determined by echocardiography or MUGA scan with an ejection fraction \>= 50% within 28 days prior to registration * Participants with a prior or concurrent malignancy whose natural history (in the opinion of the treating physician) does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial. No concurrent therapies for such malignancy are allowed with the exception of hormonal therapy * Participants with central nervous system (CNS) disease are eligible for this trial and will be treated according to institutional guidelines with intrathecal chemotherapy for this aspect of their disease. * Participants with known history of Wilson's disease or other known copper-metabolism disorder are excluded * Participants must not be pregnant or nursing. Women/men of reproductive potential must have agreed to use 2 contraception methods. A woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months. In addition to routine contraceptive methods (e.g., hormonal contraceptives \[examples include birth control pills, vaginal rings, or patches\] associated with inhibition of ovulation for at least 1 month prior to taking study drug), "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation. However, if at any point a previously celibate participant chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures. A barrier method should be used during this study along with hormonal contraceptives from initial study drug administration to 30 days after the last dose of study drug as drug-drug interaction with venetoclax is unknown * Participants must have agreed to have specimens submitted for translational medicine (MRD) under MYELOMATCH and specimens must be submitted * Participants must be offered the opportunity to participate in specimen banking * Note: Specimens must be collected and submitted using the Southwest Oncology Group (SWOG) Specimen Tracking System * Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines * For participants with impaired decision-making capabilities, legally authorized representatives may sign and give informed consent on behalf of study participants in accordance with applicable federal, local, and Central Institutional Review Board (CIRB) regulations * As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system
Where it's running
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University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, United States Recruiting -
Mayo Clinic Hospital in Arizona
Phoenix, Arizona, United States Recruiting -
Banner University Medical Center - Tucson
Tucson, Arizona, United States Recruiting -
University of Arizona Cancer Center-North Campus
Tucson, Arizona, United States Recruiting -
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States Recruiting -
Cedars-Sinai Medical Center
Los Angeles, California, United States Recruiting
Show 44 more locations
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Kaiser Permanente-Oakland
Oakland, California, United States Recruiting -
Kaiser Permanente-Roseville
Roseville, California, United States Recruiting -
University of California Davis Comprehensive Cancer Center
Sacramento, California, United States Recruiting -
UCSF Medical Center-Parnassus
San Francisco, California, United States Recruiting -
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, United States Recruiting -
Yale University
New Haven, Connecticut, United States Recruiting -
Mayo Clinic in Florida
Jacksonville, Florida, United States Recruiting -
Miami Cancer Institute
Miami, Florida, United States Recruiting -
Memorial Hospital West
Pembroke Pines, Florida, United States Recruiting -
Phoebe Putney Memorial Hospital
Albany, Georgia, United States Recruiting -
Augusta University Medical Center
Augusta, Georgia, United States Recruiting -
Hawaii Cancer Care Inc - Waterfront Plaza
Honolulu, Hawaii, United States Recruiting -
Straub Clinic and Hospital
Honolulu, Hawaii, United States Recruiting -
Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, United States Recruiting -
Hawaii Cancer Care - Westridge
‘Aiea, Hawaii, United States Recruiting -
Pali Momi Medical Center
‘Aiea, Hawaii, United States Recruiting -
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, United States Recruiting -
Saint Luke's Cancer Institute - Boise
Boise, Idaho, United States Recruiting -
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, United States Recruiting -
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, United States Recruiting -
Saint Luke's Cancer Institute - Fruitland
Fruitland, Idaho, United States Recruiting -
Saint Luke's Cancer Institute - Meridian
Meridian, Idaho, United States Recruiting -
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, United States Recruiting -
Saint Luke's Cancer Institute - Nampa
Nampa, Idaho, United States Recruiting -
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, United States Recruiting -
Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho, United States Recruiting -
OSF Saint Joseph Medical Center
Bloomington, Illinois, United States Recruiting -
Illinois CancerCare-Bloomington
Bloomington, Illinois, United States Recruiting -
Illinois CancerCare-Canton
Canton, Illinois, United States Recruiting -
Illinois CancerCare-Carthage
Carthage, Illinois, United States Recruiting -
Northwestern University
Chicago, Illinois, United States Recruiting -
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, United States Recruiting -
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, United States Recruiting -
Decatur Memorial Hospital
Decatur, Illinois, United States Recruiting -
Illinois CancerCare-Dixon
Dixon, Illinois, United States Recruiting -
Crossroads Cancer Center
Effingham, Illinois, United States Recruiting -
Illinois CancerCare-Eureka
Eureka, Illinois, United States Recruiting -
NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, United States Recruiting -
Illinois CancerCare-Galesburg
Galesburg, Illinois, United States Recruiting -
NorthShore University HealthSystem-Glenbrook Hospital
Glenview, Illinois, United States Recruiting -
NorthShore University HealthSystem-Highland Park Hospital
Highland Park, Illinois, United States Recruiting -
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, United States Recruiting -
Illinois CancerCare-Macomb
Macomb, Illinois, United States Recruiting -
Loyola University Medical Center
Maywood, Illinois, United States Recruiting
+177 more sites. See ClinicalTrials.gov for the full list.
Study contacts
- Principal investigator: Paul J Shami — SWOG Cancer Research Network
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.