A Study of Siremadlin in Combination With Venetoclax Plus Azacitidine in Adult Participants With Acute Myeloid Leukemia (AML) Who Are Ineligible for Chemotherapy.
Acute Myeloid Leukemia
About this trial
This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring Acute myeloid leukemia, AML, Azacitidine, venetoclax, p53, MDM2, siremadlin, HDM201, unfit adult AML participants, newly diagnosed unfit AML, presenting with high-risk clinical features
Eligibility Criteria
Inclusion Criteria:
- Age at the date of signing the informed consent form (ICF): Arm 1 and Arm 2: ≥ 18 years
- Participants diagnosed with AML based on WHO 2016 classification (Arber et al 2016) who are ineligible for standard induction chemotherapy and: Arm 1 : have received at least 2 cycles and not more than 4 cycles of first-line venetoclax plus azacitidine treatment and have not achieved a CR, CRi, CRh or MLFS.
Arm 2 : newly diagnosed AML with adverse genetic risk stratification (according to ELN 2022) (except TP53 mutation positive participants).
Participant must be considered ineligible for standard of care intensive induction chemotherapy defined by the following:
- 75 years of age; OR
- 18 to 74 years of age with at least one of the following co-morbidities: Eastern Cooperative Oncology Group (ECOG) Performance Status of 2 or 3; Cardiac history of congestive heart failure (CHF) requiring treatment or Ejection Fraction ≤ 50% or chronic stable angina; DLCO ≤ 65% or FEV1 ≤ 65%.
Participants must have an ECOG performance status:
0 to 2 for participants ≥ 75 years of age. OR 0 to 3 for participants ≥ 18 to 74 years of age.
- WBC < 25x109/L
- AST and ALT ≤ 3 × ULN
- Estimated Glomerular Filtration Rate (eGFR)≥ 60 mL/min/1.73 m2
Exclusion Criteria:
- Prior exposure to MDM2-inhibitor therapy at any time.
- Participants with TP53 mutation positive.
- Participants with del17p.
- Participants with AML-M3 / APL (Acute promyelocytic leukemia) with PML-RARA (Promyelocytic leukemia/retinoic acid receptor alpha) or with AML secondary to Down's syndrome.
- Participants treated with FLT3 inhibitors
- Participants who require treatment with moderate or strong CYP3A4 inducers within 14 days prior to starting study treatment, or are expected to receive moderate or strong CYP3A4 inducers during the entire study
- Participants who require treatment with substrates of CYP3A4/5 with a narrow therapeutic index.
Other protocol-defined inclusion/exclusion criteria may apply at the end
Sites / Locations
- University of California Los Angeles .Recruiting
- Rocky Mountain Cancer Centers RMCC - AuroraRecruiting
- Dana Farber Cancer Institute Harvard Cancer CenterRecruiting
- Uni of Massachusetts Medical CenterRecruiting
- Roswell Park Cancer InstituteRecruiting
- Cleveland Clinic FoundationRecruiting
- Oregon Health and Science UnivRecruiting
- UPMC Cancer Centers Division Hematology-OncologyRecruiting
- Texas Oncology Sammons Cancer Center Sammons Cancer Center (SC)Recruiting
- University of Texas MD Anderson Cancer CenterRecruiting
- Virginia Cancer Specialists .Recruiting
- Medical College of Wisconsin .Recruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
- Novartis Investigative SiteRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Arm 1: Unfit adult participants with AML who responded sub-optimally to standard of care
Arm 2: Newly diagnosed unfit adult participants with high-risk AML
Unfit adult participants with AML who responded sub-optimally to at least 2 and not more than 4 cycles ( 1 cycle=28 days) of first-line venetoclax plus azacitidine therapy
Unfit adult participants with newly diagnosed AML and with adverse genetic risk stratification (according to ELN 2022)(Except TP53 mutation positive participants).