Acute Myeloid Leukemias
Conditions
Keywords
SNDX-5613, Lysine-specific Methyltransferase 2A, KMT2A/MLL, Nucleophosmin 1, NPM1, Nucleoporin 98, NUP98, AML, revumenib
Brief summary
The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics, and clinical activity of revumenib in combination with intensive chemotherapy in participants with newly diagnosed acute myeloid leukemia (AML) harboring alterations in KMT2A, NPM1, or NUP98 genes.
Detailed description
The Dose Escalation portion of this study will identify the maximum tolerated dose, or if different, the recommended Phase 2 dose of revumenib to be used in combination with intensive chemotherapy and in maintenance monotherapy following intensive chemotherapy in participants with newly diagnosed AML harboring alterations in KMT2A, NPM1, or NUP98 genes. In the Dose Expansion portion of the study, safety and preliminary efficacy of revumenib may be explored in expansion cohorts at tolerated dose levels. In both Dose Escalation and Dose Expansion, the treatment period will consist of an induction phase (up to 2 cycles), a consolidation phase (up to 4 cycles and could include hematopoietic stem cell transplant for participants who are transplant eligible and have an available donor), and a maintenance monotherapy phase with revumenib. The cycle duration will be 28 days.
Interventions
DRUGRevumenib
Participants will receive revumenib orally during Induction, Consolidation, and Maintenance until meeting criteria for discontinuation.
Induction: Participants will receive an intravenous (IV), 2-drug combination of cytarabine and either daunorubicin or idarubicin.
DRUGHiDAC
Consolidation: Participants will receive HiDAC IV.
Sponsors
Syndax Pharmaceuticals
Study design
Allocation
NA
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Established, pathologically confirmed diagnosis of AML by World Health Organization 2022 criteria. * Newly diagnosed and previously untreated AML and eligible to receive intensive chemotherapy. * KMT2Ar, NPM1m, or NUP98r mutations identified by local laboratory prior to the first dose of revumenib. * Eastern Cooperative Oncology Group performance status ≤2 and ≤1 if \>65 years old. * Adequate liver, kidney, and cardiac function.
Exclusion criteria
* Diagnosis of acute promyelocytic leukemia. * Clinically active central nervous system leukemia (blasts detected in cerebrospinal fluid, radiographic or clinical signs and symptoms). * Fridericia's corrected QT interval (QTcF) \>450 milliseconds (average of triplicate), diagnosis or suspicion of Long QT syndrome or family history of Long QT syndrome. * Any gastrointestinal issue of the upper gastrointestinal tract that might affect oral drug absorption or ingestion. * Cirrhosis with a Child-Pugh score of B or C. * Any of the following within the 6 months prior to study entry: myocardial infarction, uncontrolled/unstable angina, congestive heart failure (New York Heart Association Classification Class ≥II), life-threatening, uncontrolled arrhythmia, cerebrovascular accident, or transient ischemic attack. * Hepatitis B, Hepatitis C, or HIV-positive with detectable viral load. * Documented active, uncontrolled infection. * Uncontrolled disseminated intravascular coagulation. * Lactating/breast feeding or pregnant. * Use of prohibited concomitant chemotherapy, radiation therapy, or immunotherapy. * Use of strong CYP3A4 inducers or inhibitors (except for Itraconazole, Ketoconazole, Posaconazole, or Voriconazole).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Dose Escalation: Number of Participants with Dose-limiting Toxicities | Up to Day 42 |
| Number of Participants with Treatment-emergent Adverse Events (TEAEs) | Day 1 through 30 days after final dose (up to approximately 3 years) |
Secondary
| Measure | Time frame |
|---|---|
| Maximum Plasma Concentration (Cmax) of Revumenib and its Major Metabolite | Predose through Day 15 |
| Area Under the Plasma Concentration Versus Time Curve From Time 0 to t (AUC0-t) of Revumenib and its Major Metabolite | Predose through Day 15 |
Countries
Australia, Canada, Netherlands, Spain, United Kingdom, United States
Outcome results
None listed