Trials / Active Not Recruiting

Active Not RecruitingNCT03862157

Azacitidine, Venetoclax, and Pevonedistat in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia

A Phase I/II Study of Azacitidine, Venetoclax and Pevonedistat in Adults With Newly Diagnosed Secondary or Therapy-Related AML

Status: Active Not Recruiting
Phase: Phase 1 / Phase 2
Study type: Interventional
Enrollment: 40 (actual)

Sponsor: M.D. Anderson Cancer Center · Academic / Other
Sex: All
Age: 18 Years
Healthy volunteers: Not accepted

Summary

This phase I/II trial studies the best dose of venetoclax when given together with azacitidine and pevonedistat and to see how well it works in treating patients with newly diagnosed acute myeloid leukemia. Drugs used in chemotherapy, such as azacitidine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Venetoclax may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Pevonedistat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving azacitidine, venetoclax, and pevonedistat may work better in treating patients with acute myeloid leukemia.

Detailed description

PRIMARY OBJECTIVES: I. To determine the maximum-tolerated dose (MTD) of venetoclax in combination with azacitidine and pevonedistat in patients with previously untreated secondary acute myeloid leukemia (AML). (Phase I) II. To determine the efficacy of the combination regimen, as defined by the rate of complete response (CR) plus complete response with incomplete bone marrow recovery (CRi) within 6 cycles of treatment. (Phase II \[AML\]) III. To determine the efficacy of the combination regimen, as defined by the rate of CR within 6 cycles of treatment. (Phase II \[myelodysplastic syndrome (MDS) Newly Diagnosed\]) IV. To determine the overall response rate (defined as CR + marrow CR \[mCR\] + partial remission \[PR\] + hematological improvement \[HI\]) within 6 cycles of treatment. (Phase II \[MDS/chronic myelomonocytic leukemia (CMML) post-hypomethylating agent (HMA) failure\]) SECONDARY OBJECTIVES: I. To determine efficacy outcomes, including CR rate, leukemia response rate (CR + CRi + partial response \[PR\] + morphologic leukemia free state \[MLFS\]), minimal residual disease (MRD) negativity by flow cytometry, duration of response, transformation to AML (in the MDS cohorts), relapse-free survival (RFS), event-free survival (EFS) and overall survival (OS). II. To determine the safety of the combination regimen. OUTLINE: This is a phase I, dose-escalation study of venetoclax followed by a phase II study. Patients receive venetoclax orally (PO) once daily (QD) on days 1-28, azacitidine intravenously (IV) or subcutaneously (SC) on days 1-7, and pevonedistat IV over 60 minutes on days 1, 3, and 5. Treatment repeats every 28 days for up to 24 cycles in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 30 days, and then every 6 months thereafter.

Conditions

Interventions

Type	Name	Description
DRUG	Azacitidine	Given IV or SC
DRUG	Pevonedistat	Given IV
DRUG	Venetoclax	Given PO

Timeline

Start date: 2019-02-27
Primary completion: 2027-01-31
Completion: 2027-01-31
First posted: 2019-03-05
Last updated: 2026-03-11

Locations

1 site across 1 country: United States

Regulatory

FDA-regulated drug study

Source: ClinicalTrials.gov record NCT03862157. Inclusion in this directory is not an endorsement.