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Venetoclax Combining Chidamide and Azacitidine (VCA) in the Treatment of R/R AML

Primary Purpose

Leukemia, Myeloid, Acute, Relapsed Adult AML, Refractory Leukemia

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
venetoclax combining chidamide and azacitidine (VCA)
Sponsored by
The First Affiliated Hospital of Xiamen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Myeloid, Acute focused on measuring refractory/relapsed acute myelogenous leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥18
  • Relapsed and refractory patients with acute myeloid leukemia via morphology and immunology
  • ECOG:0-2
  • Life expectancy ≥ 3 months
  • Adequate laboratory parameters during the screening period as evidenced by the following:

    1. Creatinine clearance≥30 mL/min and serum Creatinine ≤ 160µmol/L
    2. ALT and AST ≤ 3 × upper limit of normal (ULN)
    3. Able to understand and sign an informed consent form (ICF).

Exclusion Criteria:

  • Diagnosis of acute promyelocytic leukemia (APL)
  • Central nervous system leukemia
  • Uncontrolled or significant cardiovascular disease, including any of the following:

    1. Bradycardia of less than 50 beats per minute, unless the subject has a pacemaker; Diagnosis of or suspicion of long QT syndrome (including family history of long QT syndrome);
    2. Systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg; History of clinically relevant ventricular arrhythmias (eg, ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes);
    3. History of second (Mobitz II) or third degree heart block (subjects with pacemakers are eligible if they have no history of fainting or clinically relevant arrhythmias while using the pacemaker);
    4. History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to Screening;
    5. History of New York Heart Association Class 3 or 4 heart failure;
    6. Complete left bundle branch block;
    7. Known history of left ventricular ejection fraction (LVEF) ≤45% or less than the institutional lower limit of normal;
  • Active acute or chronic systemic fungal, bacterial, or viral infection not well controlled by antifungal, antibacterial or antiviral therapy;
  • Suffered from other non-myeloid malignancies within 2 years, except adequately treated non-melanoma skin cancer, curatively treated in-situ disease, or other solid tumors curatively treated with no evidence of disease
  • Females who are pregnant or breastfeeding;
  • Mental disorders that hinder research participation
  • Previous solid organ transplantation (SCT treatment is allowed in advance, but if the patient has GVHD or is still receiving immunosuppression/GVHD treatment, it is not allowed)
  • Any other situation where the investigator believes that the patient should not participate in this trial

Sites / Locations

  • Bing XuRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

venetoclax combining chidamide and azacitidine (VCA)

Arm Description

28 days per cycle × at least 2 cycles; 1) chidamide 30mg biw × 2weeks;2) venetoclax 200mg/d × 2 weeks 3) azacitidine 100mg/d d1-7

Outcomes

Primary Outcome Measures

Complete remission (CR) rate
CR was <5% marrow blasts by morphology

Secondary Outcome Measures

1 year leukemia free survival (LFS)
Leukemia-free survival (LFS) is defined as survival without evidence of relapse from treatment initiation
1year overall survival (OS)
Overall survival(OS)is defined as the time from treatment initiation to death from any cause.
Adverse events
Adverse event is defined as any untoward medical occurrence associated with treatment
objective response rate (ORR)
ORR is defined as CR, CRi and PR. Partial remission (PR) is defined as a decrease of at least 50% in the percentage of blasts to 5 to 25% in the bone marrow aspirate and the normalization of blood counts.

Full Information

First Posted
March 8, 2022
Last Updated
August 1, 2022
Sponsor
The First Affiliated Hospital of Xiamen University
Collaborators
Fujian Provincial Hospital, Fujian Cancer Hospital, Zhangzhou manicipal hospital of Fujian Province, Jieyang People's Hospital, Dongguan People's Hospital, Huizhou Municipal Central Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05305859
Brief Title
Venetoclax Combining Chidamide and Azacitidine (VCA) in the Treatment of R/R AML
Official Title
A Multi-center, Prospective, Single-arm Study of Venetoclax Combining Chidamide and Azacitidine (VCA) in the Treatment of Refractory/Relapsed Acute Myelogenous Leukemia (R/R AML)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 1, 2022 (Actual)
Primary Completion Date
January 31, 2024 (Anticipated)
Study Completion Date
January 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The First Affiliated Hospital of Xiamen University
Collaborators
Fujian Provincial Hospital, Fujian Cancer Hospital, Zhangzhou manicipal hospital of Fujian Province, Jieyang People's Hospital, Dongguan People's Hospital, Huizhou Municipal Central Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and efficacy of Venetoclax Combining Chidamide and Azacitidine (VCA) in the Treatment of relapsed and/or refractory AML
Detailed Description
Patients with relapsed and/or refractory AML have inferior outcomes. The regimen of Venetoclax and Azacitidine has been widely used in the treatment of RR AML and has proved to achieve CR rate of 30% ~ 40%. However, the median duration of response (DOR) of this regimen is about one year. Chidamide is a histone deacetylase (HDAC) inhibitor and preclinical data showed adding low-dose Chidamide to venetoclax could significantly promoted apoptosis of leukemia cell lines. Meanwhile, the Venetoclax Combining Chidamide and Azacitidine (VCA) regimen was applied to 2 patients with refractory AML. This regimen was well tolerated and both patients achieved CR after one cycle. Thus, we register this clinical trial and evaluate the safety and efficacy of VCA regimen.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Myeloid, Acute, Relapsed Adult AML, Refractory Leukemia
Keywords
refractory/relapsed acute myelogenous leukemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
venetoclax combining chidamide and azacitidine (VCA)
Arm Type
Experimental
Arm Description
28 days per cycle × at least 2 cycles; 1) chidamide 30mg biw × 2weeks;2) venetoclax 200mg/d × 2 weeks 3) azacitidine 100mg/d d1-7
Intervention Type
Drug
Intervention Name(s)
venetoclax combining chidamide and azacitidine (VCA)
Other Intervention Name(s)
VCA
Intervention Description
information already included in arm/group descriptions
Primary Outcome Measure Information:
Title
Complete remission (CR) rate
Description
CR was <5% marrow blasts by morphology
Time Frame
2 months
Secondary Outcome Measure Information:
Title
1 year leukemia free survival (LFS)
Description
Leukemia-free survival (LFS) is defined as survival without evidence of relapse from treatment initiation
Time Frame
1 year from treatment initiation
Title
1year overall survival (OS)
Description
Overall survival(OS)is defined as the time from treatment initiation to death from any cause.
Time Frame
1 year from treatment initiation
Title
Adverse events
Description
Adverse event is defined as any untoward medical occurrence associated with treatment
Time Frame
2 months
Title
objective response rate (ORR)
Description
ORR is defined as CR, CRi and PR. Partial remission (PR) is defined as a decrease of at least 50% in the percentage of blasts to 5 to 25% in the bone marrow aspirate and the normalization of blood counts.
Time Frame
2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 Relapsed and refractory patients with acute myeloid leukemia via morphology and immunology ECOG:0-2 Life expectancy ≥ 3 months Adequate laboratory parameters during the screening period as evidenced by the following: Creatinine clearance≥30 mL/min and serum Creatinine ≤ 160µmol/L ALT and AST ≤ 3 × upper limit of normal (ULN) Able to understand and sign an informed consent form (ICF). Exclusion Criteria: Diagnosis of acute promyelocytic leukemia (APL) Central nervous system leukemia Uncontrolled or significant cardiovascular disease, including any of the following: Bradycardia of less than 50 beats per minute, unless the subject has a pacemaker; Diagnosis of or suspicion of long QT syndrome (including family history of long QT syndrome); Systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg; History of clinically relevant ventricular arrhythmias (eg, ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes); History of second (Mobitz II) or third degree heart block (subjects with pacemakers are eligible if they have no history of fainting or clinically relevant arrhythmias while using the pacemaker); History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to Screening; History of New York Heart Association Class 3 or 4 heart failure; Complete left bundle branch block; Known history of left ventricular ejection fraction (LVEF) ≤45% or less than the institutional lower limit of normal; Active acute or chronic systemic fungal, bacterial, or viral infection not well controlled by antifungal, antibacterial or antiviral therapy; Suffered from other non-myeloid malignancies within 2 years, except adequately treated non-melanoma skin cancer, curatively treated in-situ disease, or other solid tumors curatively treated with no evidence of disease Females who are pregnant or breastfeeding; Mental disorders that hinder research participation Previous solid organ transplantation (SCT treatment is allowed in advance, but if the patient has GVHD or is still receiving immunosuppression/GVHD treatment, it is not allowed) Any other situation where the investigator believes that the patient should not participate in this trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Bing Xu, M.D.
Phone
+865922137255
Email
xubingzhangjian@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bing Xu
Organizational Affiliation
The First Affiliated Hospital of Xiamen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bing Xu
City
Xiamen
State/Province
Fujian
ZIP/Postal Code
361003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bing Xu
First Name & Middle Initial & Last Name & Degree
Bing Xu

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Venetoclax Combining Chidamide and Azacitidine (VCA) in the Treatment of R/R AML

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