Adaptive Treatment for Acute Myeloid Leukemia Based on D14 MRD Results (AVS)
AML, MRD
About this trial
This is an interventional treatment trial for AML focused on measuring untreated AML, MRD results, selinexor
Eligibility Criteria
Inclusion Criteria: Known and written informed consent voluntarily Age ≥ 18 years Newly diagnosed AML patients (per WHO 2022 classification criteria for AML diagnosis), who are not suitable for intensive chemotherapy: 75 years or Aged 18 to 74 years with at least one of the following comorbidities: Eastern Cooperative Oncology Group (ECOG) performance status score of 2 or 3 or 4; Cardiac history of Congestive Heart Failure (CHF) requiring treatment or Ejection Fraction <= 50% or chronic stable angina; Diffusing capacity of the Lung for Carbon Monoxide (DLCO) <= 65% or Forced Expiratory Volume in 1 second (FEV1) <= 65%; Creatinine clearance >= 30 mL/min to < 45 ml/min; Moderate hepatic impairment with total bilirubin > 1.5 to <= 3.0 × Upper Limit of Normal (ULN); Any other comorbidity that the physician judges to be incompatible with intensive chemotherapy . Liver function meets the following criteria: aspartate aminotransferase (AST) ≤ 3.0×ULN*; alanine aminotransferase (ALT) ≤3.0×ULN*; Bilirubin≤1.5×ULN*; For subjects <75 years old, the bilirubin level can be ≤3.0×ULN; Unless due to leukemic organ involvement. Renal function meets the following criteria: creatinine clearance ≥ 30 mL/min (Cockroft-Gault formula) Life expectancy ≥ 4 weeks Exclusion Criteria: History of any malignancies prior to study entry with exception noted in the protocol. Participant has known HIV infection, active hepatitis B virus (HBV) and/or hepatitis C virus (HCV) . Participant has known active central nervous system (CNS) involvement with AML. Must not have received prior anti-AML treatment except for hydroxyurea
Sites / Locations
- Beizhan Hospital
- Pla Navy Feature Medical Center
- Shanghai Ruijin Hospital
- Shanghai Tong Ren hospitalRecruiting
Arms of the Study
Arm 1
Experimental
Treatment regimen based on C1D14 MRD
Untreated acute myeloid leukemia who are ineligible for intensive chemotherapy will be given azacitidine 75mg/m2, d1-7 and venetoclax 100mg on day 1 and 200mg on day 2, 400mg on day 3-28. Based on MRD results on C1D14, MRD negative patients will go on azacitidine and venetoclax regimen and for patients with MRD positive, selinexor 60mg on D15 and D22 will be added. Patients can receive transplants at any time once they achieved complete remission and other patients will continue to receive treatment until disease progression or unacceptable toxic effects.