A Study Evaluating Venetoclax in Combination With Low-Dose Cytarabine in Treatment-Naïve Subjects With Acute Myelogenous Leukemia (AML)
Status: | Active, not recruiting |
---|---|
Conditions: | Blood Cancer, Blood Cancer, Hematology |
Therapuetic Areas: | Hematology, Oncology |
Healthy: | No |
Age Range: | 60 - 99 |
Updated: | 3/8/2019 |
Start Date: | December 30, 2014 |
End Date: | May 12, 2021 |
A Phase 1/2 Study of Venetoclax in Combination With Low-Dose Cytarabine in Treatment-Naïve Subjects With Acute Myelogenous Leukemia Who Are Greater Than or Equal to 60 Years of Age and Who Are Not Eligible for Standard Anthracycline-Based Induction Therapy
This study consists of two portions: The first portion- Phase 1, or dose-escalation portion,
that will evaluate the safety and pharmacokinetic profile of venetoclax in combination with
low-dose cytarabine (LDC), define the maximum tolerated dose (MTD), and generate data to
support a recommended Phase 2 dose (RPTD) in treatment-naïve subjects with Acute Myelogenous
Leukemia (AML). Second portion, initial Phase 2 that will evaluate if the RPTD has sufficient
efficacy and acceptable toxicity to warrant further development of the combination therapy.
Subsequently, Phase 2 Cohort C, will evaluate the overall response rate (ORR) for subjects
allowed additional supportive medications (strong CYP3A inhibitors) if medically indicated.
that will evaluate the safety and pharmacokinetic profile of venetoclax in combination with
low-dose cytarabine (LDC), define the maximum tolerated dose (MTD), and generate data to
support a recommended Phase 2 dose (RPTD) in treatment-naïve subjects with Acute Myelogenous
Leukemia (AML). Second portion, initial Phase 2 that will evaluate if the RPTD has sufficient
efficacy and acceptable toxicity to warrant further development of the combination therapy.
Subsequently, Phase 2 Cohort C, will evaluate the overall response rate (ORR) for subjects
allowed additional supportive medications (strong CYP3A inhibitors) if medically indicated.
Inclusion Criteria:
- Subject must be greater than or equal to 65 years of age in Phase 1 and 2. Subjects
enrolled in Cohort C must be either:
- greater than or equal to 75 years of age; OR
- greater than or equal to 60 to 74 years will be eligible if the subjects has at
least one of the following co-morbidities, which make the subject unfit for
intensive chemotherapy:
- ECOG Performance Status of 2 - 3;
- Cardiac history of CHF requiring treatment or Ejection Fraction less than or equal to
50% or chronic stable angina;
- DLCO less than or equal to 65% or FEV1 less than or equal to 65%;
- Creatinine clearance greater than or equal to 30 mL/min to less than 45 ml/min
(calculated by Cockcroft-Gault formula)
- Moderate hepatic impairment with total bilirubin greater than 1.5 to less than or
equal to 3.0 × ULN
- Any other comorbidity that the physician judges to be incompatible with intensive
chemotherapy must be reviewed and approved by the study medical monitor before study
enrollment
- Subject must have a projected life expectancy of at least 12 weeks.
- Subject must have histological confirmation of AML and be ineligible for treatment
with a standard cytarabine and anthracycline induction regimen due to co-morbidity or
other factors.
- Subject must have received no prior treatment for AML with the exception of
hydroxyurea, allowed through the first cycle of study treatment. Note: Subject may
have been treated for prior Myelodysplastic Syndrome.
- Subject must have an Eastern Cooperative Oncology Group (ECOG) performance status;
- of 0 to 2 for subjects greater than equal to 75 years of age
- of 0 to 3 for subjects greater than equal to 60 to 74 years of age, if 0 - 1
another co-morbidity is required to make subject eligible.
- Subject must have adequate renal function as demonstrated by a creatinine clearance
greater than or equal to 30 mL/min; determined via urine collection for 24-hour
creatinine clearance or by the Cockcroft Gault formula.
Note: Investigators should consider measuring a 24-hour creatinine clearance for subjects
who are morbidly obese, have fluctuating renal function, or who in the investigator's
clinical judgment may yield a more accurate clearance when measured than when calculated.
- Subject must have adequate liver function as demonstrated by:
- aspartate aminotransferase (AST) less than or equal to 2.5 × upper limit of
normal (ULN)*
- alanine aminotransferase (ALT) less than or equal to 2.5 × ULN*
- bilirubin less than or equal to 1.5 × ULN for all subjects age 75 and older*
Subjects who are less than 75 years of age must have a bilirubin of less than 3.0
× ULN * Unless considered due to leukemic organ involvement. Note: Subjects with
Gilbert's Syndrome may have a bilirubin greater than 1.5 × ULN per discussion
between the investigator and AbbVie medical monitor.
- Male subjects must agree to refrain from unprotected sex and sperm donation from
initial study drug administration until 180 days after the last dose of study drug.
- Subject must voluntarily sign and date an informed consent, approved by an Independent
Ethics Committee (IEC)/Institutional Review Board (IRB), prior to the initiation of
any screening or study-specific procedures.
- If female, subject must be either:
- Postmenopausal defined as no menses for 12 or more months without an alternative
medical cause OR
- Permanently surgical sterile (bilateral oophorectomy, bilateral salpingectomy or
hysterectomy)
Exclusion Criteria:
- Participant has received treatment with cytarabine for a pre-existing myeloid
disorder.
- Participant has acute promyelocytic leukemia (French-American-British Class M3 AML).
- Participant has known active central nervous system (CNS) involvement with AML.
- Participant has tested positive for human immunodeficiency virus (HIV).
- Participant has received the following within 7 days prior to the initiation of study
treatment: strong and moderate CYP3A inducers such as rifampin, carbamazepine,
phenytoin, and St. John's wort.
- Participant has consumed grapefruit, grapefruit products, Seville oranges (including
marmalade containing Seville oranges) or Starfruit within 3 days prior to the
initiation of study treatment.
- Participant has a cardiovascular disability status of New York Heart Association Class
greater than 2.
- Participant has a significant history of renal, neurologic, psychiatric,
endocrinologic, metabolic, immunologic, hepatic, cardiovascular disease, or any other
medical condition that in the opinion of the investigator would adversely affect
his/her participating in this study.
- Participant has chronic respiratory disease that requires continuous oxygen use.
- Participant has a malabsorption syndrome or other condition that precludes enteral
route of administration.
- Participant exhibits evidence of other clinically significant uncontrolled
condition(s) including, but not limited to: uncontrolled systemic infection requiring
IV therapy (viral, bacterial or fungal).
- Participant has a history of other malignancies prior to study entry, with the
exception of: adequately treated in situ carcinoma of the breast or cervix uteri;
basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin; or
previous malignancy confined and surgically resected (or treated with other
modalities) with curative intent.
- Participant has a white blood cell count greater than 25 × 10^9/L. Hydroxyurea is
permitted to meet this criterion.
- Participant is a candidate for a bone marrow or stem cell transplant within 12 weeks
after study enrollment.
- Subject has a history of myeloproliferative neoplasm (MPN) including polycythemia
vera, myelofibrosis, essential thrombocythemia, or chronic myelogenous leukemia.
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