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Clinical Study of Mitoxantrone Hydrochloride Liposome Injection in Subjects With Acute Myeloid Leukemia

Primary Purpose

Relapsed or Refractory Acute Myeloid Leukemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Mitoxantrone liposome
Venetoclax
Sponsored by
Hui Zeng
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory Acute Myeloid Leukemia focused on measuring venetoclax; Mitoxantrone liposomes; Acute myeloid leukemia

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. AML confirmed by bone marrow cytology and pathology;
  2. Meet the diagnostic criteria for relapsed and refractory AML. Diagnostic criteria for relapsed AML: leukemia cells reappeared in peripheral blood after complete remission or blast cells in bone marrow >0.05 (except for other reasons such as bone marrow regeneration after consolidation chemotherapy) or extramedullary leukemia cell infiltration. Diagnostic criteria for refractory AML: naive patients who were ineffective after 2 courses of standard regimens; patients who relapsed within 12 months after consolidation and intensive therapy after CR; patients who relapsed after 12 months but were ineffective after conventional chemotherapy; 2 or more Secondary relapse; persistent extramedullary leukemia;
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2;
  4. Liver and kidney function: Alanine aminotransferase (AST) and aspartate aminotransferase (ALT) ≤2.5 x upper limit of normal (ULN) (≤5 x ULN for patients with liver infiltrates); Total bilirubin ≤1.5 x ULN (≤3 x ULN for patients with liver infiltration); Serum creatinine ≤1.5 x ULN;
  5. Normal cardiac function: left ventricular ejection fraction (LVEF) ≥ 45% assessed by echocardiography or radionuclide active angiography (MUGA);
  6. Pulmonary function: dyspnea ≤ CTC AE grade 1 and SaO2 ≥ 92% in indoor air environment;
  7. The expected survival time is greater than 3 months;
  8. Patients voluntarily participated in this study and signed the informed consent.

Exclusion Criteria:

  1. The subject had previously received any of the following anti-tumor treatments: a)Those who have previously received mitoxantrone or mitoxantrone liposome; b)Previously received doxorubicin or other anthracycline treatment, and the total cumulative dose of doxorubicin is more than 360 mg/m^2 (1 mg doxorubicin converted from other anthracycline drugs is equivalent to 2 mg daunorubicin or 0.5 mg idarubicin); c)Have received anti-tumor treatment (including chemotherapy, targeted therapy, hormone therapy, taking traditional Chinese medicine with anti-tumor activity, etc.) or participated in other clinical trials and received clinical trial drugs within 4 weeks before the first use of the study drugs;
  2. Heart function and disease meet one of the following conditions: a)Long QTc syndrome or QTc interval > 480 ms; b)Complete left bundle branch block, grade II or III atrioventricular block; c)Serious and uncontrolled arrhythmias requiring drug treatment; d)New York Heart Association grade ≥ II; e)A history of myocardial infarction, unstable angina pectoris, severe unstable ventricular arrhythmia or any other arrhythmia requiring treatment, a history of clinically serious pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before recruitment.
  3. Identify patients with central nervous system invasion;
  4. Other malignancies, except for effectively controlled non melanoma skin basal cell carcinoma, breast / cervical carcinoma in situ, and other malignancies that have been effectively controlled without treatment in the past five years;
  5. Non controlled systemic diseases (such as active infection, non controlled hypertension, diabetes, etc.);
  6. Human immunodeficiency virus (HIV) infection (HIV antibody positive);
  7. Active hepatitis B and C infection (hepatitis B test: if there is a positive hepatitis B surface antigen or core antibody, add HBV DNA, and the hepatitis B virus DNA exceeds 1x10^3 copies/mL to exclude; hepatitis C: if the hepatitis C antibody is positive, further test HCV RNA, hepatitis C Viral RNA exceeding 1x10^3 copies/mL was excluded);
  8. Hypersensitivity to any study drug or its components;
  9. Pregnant women, lactating women, patients who refused to take effective contraceptive measures during the study;
  10. Serious neurological or psychiatric history;
  11. Unsuitable subjects for this study determined by the investigator.

Sites / Locations

  • First Affiliated Hospital of Jinan UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Venetoclax-Mitoxantrone liposome

Arm Description

Phase I Mitoxantrone liposome Level 1: 24mg/m^2, ivgtt, d1; Level 2: 30mg/m^2, ivgtt, d1; Level 3: 36mg/m^2, ivgtt, d1; Venetoclax: 100mg po d1, 200mg po d2, 400mg po d3-28. Every 4 weeks is a cycle, a total of 2 cycles, the first cycle to observe DLT. Phase II Mitoxantrone liposome: RP2D Venetoclax: 100mg po d1, 200mg po d2, 400mg po d3-28. 28 days is a cycle, and a maximum of 6 cycles can be carried out. If the patient achieves CR, CRi or PR, if the patient can tolerate it, it will be used for 6 cycles; if the patient is suitable for transplantation, it can also enter the transplantation path; If the patient was evaluated as NR (no response) after 2 cycles, he could withdraw from the study.

Outcomes

Primary Outcome Measures

Phase I: MTD of mitoxantrone liposomes
To evaluate the tolerability of mitoxantrone liposomes combination regime
Phase II: Composite complete remission rate (CRc)
To evaluate the efficacy of anti-leukemia

Secondary Outcome Measures

Phase I: Composite complete remission rate (CRc)
To evaluate the efficacy of anti-leukemia
Phase I: Objective response rate (ORR)
To evaluate the efficacy of anti-leukemia
Phase I: Relapse free survival (RFS)
To evaluate the efficacy of anti-leukemia
Phase I: Overall survival (OS)
To evaluate the efficacy of anti-leukemia
Phase I: Safety: Hematologic and non-hematologic toxicities (NCI CTCAE v5.0)
To identify the incidence of AE and SAE in clinical trial
Phase II: Objective response rate (ORR)
To evaluate the efficacy of anti-leukemia
Phase II: Relapse free survival (RFS)
To evaluate the efficacy of anti-leukemia
Phase II: Overall survival (OS)
To evaluate the efficacy of anti-leukemia
Phase II: Safety: Hematologic and non-hematologic toxicities (NCI CTCAE v5.0)
To identify the incidence of AE and SAE in clinical trial

Full Information

First Posted
August 12, 2022
Last Updated
August 28, 2022
Sponsor
Hui Zeng
Collaborators
CSPC Ouyi Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05522192
Brief Title
Clinical Study of Mitoxantrone Hydrochloride Liposome Injection in Subjects With Acute Myeloid Leukemia
Official Title
Clinical Study of Venetoclax Combined With Mitoxantrone Liposome in the Treatment of Relapsed or Refractory Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 21, 2022 (Actual)
Primary Completion Date
November 2025 (Anticipated)
Study Completion Date
May 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Hui Zeng
Collaborators
CSPC Ouyi Pharmaceutical Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is an open-label, single-arm, phase I/II clinical study. Phase I is a multi-center, dose-escalation study, aiming to explore the maximum tolerated dose (MTD) of venetoclax combined with mitoxantrone liposome in the treatment of relapsed or refractory acute myeloid leukemia (AML), and determine the recommended dose for phase II (RP2D); Phase II is a multi-center, exploratory study, aiming to explore efficacy of venetoclax combined with mitoxantrone liposome in the treatment of relapsed and refractory AML patients, and to explore the differences in the efficacy of this combination therapy with different gene mutations.
Detailed Description
This study is an open-label, single-arm, phase I/II clinical study. Phase I is a multi-center, dose-escalation study. Following the "3+3" principle, it plans to recruit 9-18 patients with clinically diagnosed relapsed or refractory AML who will be treated with venetoclax and mitoxantrone liposome, in order to explore the MTD of mitoxantrone liposome, and determine the RP2D. Mitoxantrone liposome began to explore the dose from 24 mg/m^2, and every 4 weeks (28 days) was a cycle. Three dose groups of 24, 30 and 36 mg/m^2 were preseted; The trial phase includes screening period (within 28 days), treatment period (planned 2 cycles), follow-up period (RFS and OS follow-up, planned 1 year). Phase II is a multi-center, exploratory study, aiming to explore efficacy of venetoclax combined with mitoxantrone liposome in the treatment of relapsed or refractory AML patients, and to explore the differences in the efficacy of this combination therapy with different gene mutations. After Phase I reaches MTD and the dose of Phase II is determined, Phase II clinical trials will be carried out. The phase II trial phase includes screening period (within 28 days) , treatment period (planned 6 cycles ) and a follow-up period (RFS and OS follow-up, planned for 1 year).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory Acute Myeloid Leukemia
Keywords
venetoclax; Mitoxantrone liposomes; Acute myeloid leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
70 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Venetoclax-Mitoxantrone liposome
Arm Type
Experimental
Arm Description
Phase I Mitoxantrone liposome Level 1: 24mg/m^2, ivgtt, d1; Level 2: 30mg/m^2, ivgtt, d1; Level 3: 36mg/m^2, ivgtt, d1; Venetoclax: 100mg po d1, 200mg po d2, 400mg po d3-28. Every 4 weeks is a cycle, a total of 2 cycles, the first cycle to observe DLT. Phase II Mitoxantrone liposome: RP2D Venetoclax: 100mg po d1, 200mg po d2, 400mg po d3-28. 28 days is a cycle, and a maximum of 6 cycles can be carried out. If the patient achieves CR, CRi or PR, if the patient can tolerate it, it will be used for 6 cycles; if the patient is suitable for transplantation, it can also enter the transplantation path; If the patient was evaluated as NR (no response) after 2 cycles, he could withdraw from the study.
Intervention Type
Drug
Intervention Name(s)
Mitoxantrone liposome
Other Intervention Name(s)
Mitoxantrone Hydrochloride Liposome Injection
Intervention Description
Phase I: 24mg/m2, 30 mg/m2, 36mg/m2, IV, d1; Phase II: RP2D.
Intervention Type
Drug
Intervention Name(s)
Venetoclax
Other Intervention Name(s)
Venclexta
Intervention Description
Phase I/II: 100mg po d1,200mg po d2,400mg po d3-28.
Primary Outcome Measure Information:
Title
Phase I: MTD of mitoxantrone liposomes
Description
To evaluate the tolerability of mitoxantrone liposomes combination regime
Time Frame
At the end of Cycle 1 (each cycle is 28 days)
Title
Phase II: Composite complete remission rate (CRc)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
At the end of Cycle 2 (each cycle is 28 days)
Secondary Outcome Measure Information:
Title
Phase I: Composite complete remission rate (CRc)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
At the end of Cycle 2 (each cycle is 28 days)
Title
Phase I: Objective response rate (ORR)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
At the end of Cycle 2 (each cycle is 28 days)
Title
Phase I: Relapse free survival (RFS)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
Up to 2 years
Title
Phase I: Overall survival (OS)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
Up to 2 years
Title
Phase I: Safety: Hematologic and non-hematologic toxicities (NCI CTCAE v5.0)
Description
To identify the incidence of AE and SAE in clinical trial
Time Frame
From the initiation of the first dose to 28 days after the last dose
Title
Phase II: Objective response rate (ORR)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
At the end of Cycle 2 (each cycle is 28 days)
Title
Phase II: Relapse free survival (RFS)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
Up to 4 years
Title
Phase II: Overall survival (OS)
Description
To evaluate the efficacy of anti-leukemia
Time Frame
Up to 4 years
Title
Phase II: Safety: Hematologic and non-hematologic toxicities (NCI CTCAE v5.0)
Description
To identify the incidence of AE and SAE in clinical trial
Time Frame
From the initiation of the first dose to 28 days after the last dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: AML confirmed by bone marrow cytology and pathology; Meet the diagnostic criteria for relapsed and refractory AML. Diagnostic criteria for relapsed AML: leukemia cells reappeared in peripheral blood after complete remission or blast cells in bone marrow >0.05 (except for other reasons such as bone marrow regeneration after consolidation chemotherapy) or extramedullary leukemia cell infiltration. Diagnostic criteria for refractory AML: naive patients who were ineffective after 2 courses of standard regimens; patients who relapsed within 12 months after consolidation and intensive therapy after CR; patients who relapsed after 12 months but were ineffective after conventional chemotherapy; 2 or more Secondary relapse; persistent extramedullary leukemia; Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2; Liver and kidney function: Alanine aminotransferase (AST) and aspartate aminotransferase (ALT) ≤2.5 x upper limit of normal (ULN) (≤5 x ULN for patients with liver infiltrates); Total bilirubin ≤1.5 x ULN (≤3 x ULN for patients with liver infiltration); Serum creatinine ≤1.5 x ULN; Normal cardiac function: left ventricular ejection fraction (LVEF) ≥ 45% assessed by echocardiography or radionuclide active angiography (MUGA); Pulmonary function: dyspnea ≤ CTC AE grade 1 and SaO2 ≥ 92% in indoor air environment; The expected survival time is greater than 3 months; Patients voluntarily participated in this study and signed the informed consent. Exclusion Criteria: The subject had previously received any of the following anti-tumor treatments: a)Those who have previously received mitoxantrone or mitoxantrone liposome; b)Previously received doxorubicin or other anthracycline treatment, and the total cumulative dose of doxorubicin is more than 360 mg/m^2 (1 mg doxorubicin converted from other anthracycline drugs is equivalent to 2 mg daunorubicin or 0.5 mg idarubicin); c)Have received anti-tumor treatment (including chemotherapy, targeted therapy, hormone therapy, taking traditional Chinese medicine with anti-tumor activity, etc.) or participated in other clinical trials and received clinical trial drugs within 4 weeks before the first use of the study drugs; Heart function and disease meet one of the following conditions: a)Long QTc syndrome or QTc interval > 480 ms; b)Complete left bundle branch block, grade II or III atrioventricular block; c)Serious and uncontrolled arrhythmias requiring drug treatment; d)New York Heart Association grade ≥ II; e)A history of myocardial infarction, unstable angina pectoris, severe unstable ventricular arrhythmia or any other arrhythmia requiring treatment, a history of clinically serious pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before recruitment. Identify patients with central nervous system invasion; Other malignancies, except for effectively controlled non melanoma skin basal cell carcinoma, breast / cervical carcinoma in situ, and other malignancies that have been effectively controlled without treatment in the past five years; Non controlled systemic diseases (such as active infection, non controlled hypertension, diabetes, etc.); Human immunodeficiency virus (HIV) infection (HIV antibody positive); Active hepatitis B and C infection (hepatitis B test: if there is a positive hepatitis B surface antigen or core antibody, add HBV DNA, and the hepatitis B virus DNA exceeds 1x10^3 copies/mL to exclude; hepatitis C: if the hepatitis C antibody is positive, further test HCV RNA, hepatitis C Viral RNA exceeding 1x10^3 copies/mL was excluded); Hypersensitivity to any study drug or its components; Pregnant women, lactating women, patients who refused to take effective contraceptive measures during the study; Serious neurological or psychiatric history; Unsuitable subjects for this study determined by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hui Zeng, M.D
Phone
+86-18002201919
Email
xyzengh@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Huien Zhan, M.M.
Phone
+86-19926098944
Email
zhanhuien@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hui Zeng, M.D
Organizational Affiliation
First Affiliated Hospital of Jinan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
First Affiliated Hospital of Jinan University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510632
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hui Zeng, MD

12. IPD Sharing Statement

Learn more about this trial

Clinical Study of Mitoxantrone Hydrochloride Liposome Injection in Subjects With Acute Myeloid Leukemia

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