Acute Myeloid Leukemia, AML
Conditions
Brief summary
To evaluate the feasibility, effectiveness and safety of chidamide combined with venetoclax and azacitidine in the treatment of newly diagnosed acute myeloid leukemia (AML) who are not suitable for intensive chemotherapy.
Interventions
DRUGChidamide
30 mg/d orally twice-weekly
DRUGVenetoclax
100 mg d1 200 mg d 2 400 mg d3-d28 Orally
DRUGazacitidine
75 mg/m 2 /d subcutaneous injection or IV d1-d7
Sponsors
Institute of Hematology & Blood Diseases Hospital, China
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* （1）Age ≥18 years old, no gender limit ; * （2）be diagnosed with AML (non-M3) according to WHO 2016 standards; * （3）No previous treatment; * （4）Ineligible for intensive chemotherapy based on the following definitions: ≥75 years of age or 18 to 74 years of age with at least one of the following comorbidities: Eastern Cooperative Oncology Group (ECOG) performance status of 2 or 3 A history of cardiac disease such as congestive heart failure Treatment is required, or ejection fraction ≤ 50%, or chronic stable angina, diffusing capacity of lung for carbon monoxide (DLCO) ≤ 65%, or forced expiratory volume in first second (FEV1) ≤ 65%, creatinine clearance ≥ 30 mL/min to \< 45 mL/min, moderate hepatic impairment, total bilirubin \> 1.5 to ≤ 3.0 × ULN, other comorbidities that are not suitable for intensive chemotherapy in the physician's judgment. * （5）Subjects must have an ECOG performance status score of: 0 to 2 for subjects aged ≥ 75 years or 0 to 3 for subjects aged ≥ 18 to 74 years. * （6）Other comorbidities that are not suitable for intensive chemotherapy in the doctor's judgment; * （7）Expected survival time ≥3 months; * （8）Have the ability to understand and be willing to sign the informed consent form for this study.
Exclusion criteria
* (1) Combined with other malignant tumors * (2) Have ever received treatment with chidamide and / or venetoclax or azacitidine; * (3) The risk is assessed as low risk according to the NCCN 2022 guidelines \[t(8;21)(q22;q22.1);RUNX1-RUNX1T1, inv(16)(p13.1q22) or t(16;16 )(p13.1;q22);CBFB-MYH11 \] ; * (4) The subject is known to have AML central nervous system (CNS) infiltration; * (5) Have undergone cardiac angioplasty or stent placement within 12 months before signing the informed consent form , or have a history of myocardial infarction, unstable angina, or other clinically significant heart disease; * (6 ) Active infections (including bacterial, fungal or viral infections) and organ bleeding that cannot be controlled clinically; * (7) Pregnant or lactating women; * (8) Participated in any other clinical research within 3 months before signing the informed consent form ; * (9 ) The researcher believes that it is not suitable to participate in this study;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite complete remission rate | 2 months | Composite complete remission rate after 2 cycles of treatment \[Complete remission, CR) + complete remission with incomplete blood count (CR with incomplete blood count recovery, CRi); CR + CRi \] |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall response rate (ORR) | 24months | Overall response rate (ORR), including complete remission (Complete remission (CR), complete remission with incomplete blood count (CR with incomplete blood count recovery (CRi), morphological leukemia free state (MLFS), and partial remission (PR) as a percentage of the total number of patients participating in the efficacy analysis. |
| Overall survival (OS) | 24months | Overall survival (OS): defined as the number of days from the date of randomization to the date of death. Subjects who have not died will be censored on the last date they are known to be alive . |
| MRD response rate | 24months | Minimal residual disease (MRD)rate: defined as less than 0.1% remaining blasts per white blood cell, as measured by bone marrow examination. Other thresholds can also be explored and correlated with efficacy results. Subjects who are randomized but not assessed for MRD will be considered MRD response rate non-responders. The proportion of subjects achieving an MRD response (CR + CRi) was calculated. |
Countries
China
Contacts
Primary ContactJianxiang Wang, Medical PhD
Outcome results
None listed