Trial Radar KI
Die klinische Studie NCT06313437 für Akute myeloische Leukämie, AML, Erwachsene, AML mit Genmutationen, AML, Leukämie ist offene rekrutierung. In der Kartenansicht des Klinische Studien Radar und den KI-Entdeckungstools finden Sie alle Details. Oder stellen Sie hier Ihre Fragen.
Eine Studie entspricht den Filterkriterien
Kartenansicht

Revumenib in Combination With 7+3 + Midostaurin in AML Phase 1 22 Gezielte Therapie

Offene Rekrutierung
Die Details der klinischen Studie sind hauptsächlich auf Englisch verfügbar. Trial Radar KI kann jedoch helfen! Klicken Sie einfach auf 'Studie erklären', um die Informationen zur Studie in der ausgewählten Sprache anzuzeigen und zu besprechen.
Die klinische Studie NCT06313437 untersucht Behandlung im Zusammenhang mit Akute myeloische Leukämie, AML, Erwachsene, AML mit Genmutationen, AML, Leukämie. Diese interventionsstudie der Phase 1 hat den Status offene rekrutierung und startete am 6. Dezember 2024. Es ist geplant, 22 Teilnehmer aufzunehmen. Durchgeführt von Richard Stone, MD wird der Abschluss für 2. März 2028 erwartet. Die Daten von ClinicalTrials.gov wurden zuletzt am 25. März 2026 aktualisiert.
Kurzbeschreibung
This research is being conducted to determine a safe and effective dose of revumenib that can be given in combination with standard induction (initial therapy to induce a remission) + FLT3 targeted therapy (midostaurin) and a single cycle of post-remission therapy + FLT3 targeted therapy (midostaurin) to participants with newly diagnosed Nucleophosmin (NPM1) and FMS-like tyrosine kinase 3 (FLT3) mutated Acute Myeloid...Mehr anzeigen
Ausführliche Beschreibung
This is a single arm open label phase I trial of the menin inhibitor, revumenib, in combination with cytarabine and daunorubicin (7+3) chemotherapy and the multikinase inhibitor midostaurin for the frontline treatment of Nucleophosmin (NPM1) and FMS-like tyrosine kinase 3 (FLT3) mutated Acute Myeloid Leukemia (AML).

Investigators are trying to determine the highest dose of revumenib that can be given safely in combi...

Mehr anzeigen
Offizieller Titel

A Phase I Trial of Revumenib in Combination With 7+3 (7 Days of Cytarabine and 3 Days of Daunorubicin) + Midostaurin Induction Chemotherapy for the Frontline Treatment of NPM1 and FLT3 Mutated AML

Erkrankungen
Akute myeloische LeukämieAML, ErwachseneAML mit GenmutationenAMLLeukämie
Weitere Studien-IDs
  • 24-021
NCT-Nummer
Studienbeginn (tatsächlich)
2024-12-06
Zuletzt aktualisiert
2026-03-25
Studienende (vorauss.)
2028-03-02
Geplante Rekrutierung
22
Studientyp
Interventionsstudie
PHASE
Phase 1
Status
Offene Rekrutierung
Stichwörter
Acute Myeloid Leukemia
AML, Adult
AML with Gene Mutations
AML
Leukemia
Primäres Ziel
Behandlung
Zuteilungsmethode
Nicht randomisiert
Interventionsmodell
Sequentiell
Verblindung
Keine (offene Studie)
Studienarme/Interventionen
Teilnehmergruppe/StudienarmIntervention/Behandlung
ExperimentellDose Escalation Revumenib
Standard 3+3 design for a recommended phase 2 dose of Revumenib per dose-limiting toxicity rules. Cycles are 28 days. * Baseline * Induction Cycle: * Days 1-3: Predetermined dose of Daunorubicin 1x daily * Days 1-7: Predetermined dose of Cytarabine * Days 8-21: Predetermined dose of Midostaurin 2x daily * Days 8-28: Predetermined dose of Revumenib 2x daily * End of Induction visit * Follow-up * Reinduction ...Mehr anzeigen
Revumenib
Menin inhibitor, 25 and 113 mg capsules, taken orally per protocol.
Midostaurin
Kinase inhibitor, capsule taken orally per protocol.
Cytarabine
Antineoplastic agent, via intravenous (into the vein) infusion per protocol.
Daunorubicin
Antineoplastic agent, via intravenous (into the vein) infusion per protocol.
ExperimentellDose-Expansion Revumenib
Cycles are 28 days * Baseline visit and assessments * Induction Cycle: * Days 1-3: Predetermined dose of Daunorubicin 1x daily * Days 1-7: Predetermined dose of Cytarabine * Days 8-21: Predetermined dose of Midostaurin 2x daily * Days 8-28: Predetermined dose of Revumenib 2x daily * End of Induction visit * Follow-up * Reinduction Cycle: Therapy will be administered in the hospital * Days 1-2: Predetermi...Mehr anzeigen
Revumenib
Menin inhibitor, 25 and 113 mg capsules, taken orally per protocol.
Midostaurin
Kinase inhibitor, capsule taken orally per protocol.
Cytarabine
Antineoplastic agent, via intravenous (into the vein) infusion per protocol.
Daunorubicin
Antineoplastic agent, via intravenous (into the vein) infusion per protocol.
Hauptergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
Number of Participants Experiencing Dose Limiting Toxicity (DLT)
Detailed DLT consideration outline in protocol section 5.4.
Up to 12 weeks
Maximum Tolerated Dose (MTD)
MTD is determined by the number of patients who experience a DLT. See previous primary outcome measure for the DLT definition. If 0 out of 3 participants experience DLT, next dose level will be proceeded. If \>=1 out of the group suffer DLT, dose escalation will be stopped and 3 additional participants will be entered at the next lowest dose level. If \<=1 out of 6 DLTs, this dose level is considered as MTD.
Up to 12 weeks
Recommended phase II dose (RP2D)
The RP2D is determined by a combination of the MTD (see previous primary outcome measure), pharmacokinetics, pharmacodynamics and response rate to different doses of revumenib in combination with chemotherapy and the FLT3 inhibitor midostaurin.
Up to 12 weeks
Nebenergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
Complete Remission (CR) rate with induction chemotherapy
CR rate is defined as the proportion of participants who achieve a CR as defined by the ELN 2022 response criteria after completion of induction chemotherapy.
Up to 8 weeks
Complete Remission (CR) rate with consolidation chemotherapy
CR rate is defined as the proportion of participants who achieve a CR as defined by the ELN 2022 response criteria after completion of consolidation chemotherapy.
Up to 12 weeks
Flow Measurable Residual Disease Negative (MRD-) rate with induction chemotherapy
Flow MRD rate is defined as the proportion of participants who achieve MRD negativity (MRD-) after completion of induction chemotherapy assessed by MRD sensitive flow cytometry.
Up to 8 weeks
Flow Measurable Residual Disease Negative (MRD-) rate with consolidation chemotherapy
Flow MRD rate is defined as the proportion of participants who achieve MRD negativity (MRD-) after completion of consolidation chemotherapy assessed by MRD sensitive flow cytometry.
Up to 12 weeks
Molecular Measurable Residual Disease Negative (MRD-) rate with induction chemotherapy
Molecular MRD rate is defined as the proportion of participants who achieve MRD negativity (MRD-) after completion of induction chemotherapy as assessed by NPM1 MRD testing as well as FLT3 ITD MRD testing and duplex sequencing.
Up to 8 weeks
Molecular Measurable Residual Disease Negative (MRD-) rate with consolidation chemotherapy
Molecular MRD rate is defined as the proportion of participants who achieve MRD negativity (MRD-) after completion of consolidation chemotherapy as assessed by NPM1 MRD testing as well as FLT3 ITD MRD testing and duplex sequencing.
Up to 12 weeks
Relapse-Free Survival at 1 year (RFS1)
RFS is defined as the length of time after the completion of a particular medical treatment during which a patient remains free of any signs or symptoms of disease relapse or recurrence based on Kaplan-Meier methodology.
Up to 1 year
Overall Survival at 1 year (OS1)
OS1 is the probability estimated using the Kaplan-Meier method; OS is defined as the time from study entry to death, or censored at the date last known alive.
Up to 1 year
Teilnahme-Assistent
Eignungskriterien

Zugelassene Altersgruppen
Erwachsene, Ältere Erwachsene
Mindestalter
18 Years
Zugelassene Geschlechter
Alle
  • Patients with AML who are newly diagnosed according to the WHO 2022 Classification and previously untreated except for hydroxyurea. ATRA pretreatment for suspected APL for less than 5 days is allowed. Eligible patients with AML arising from an antecedent hematologic disease (AHD) including MDS, may have been treated for their prior hematologic disease (except for allogenic transplant).

  • Patients must be ≥ 18 and < 75 years old.

  • Eastern Cooperative Oncology Group (ECOG) Performance status of 0 to 2.

  • Presence of FLT3-ITD and/or TKD mutation(s) AND NPM1 mutation in bone marrow or peripheral blood

  • Dose escalation phase only: Presence of any of the following adverse risk genetic characteristics:

    • 2022 ELN adverse risk genetic features:

      • t(6;9)(p23.3;q34.1)/DEK::NUP214
      • t(v;11q23.3)/KMT2A-rearranged
      • t(9;22)(q34.1;q11.2)/BCR::ABL1
      • t(8;16)(p11.2;p13.3)/KAT6A::CREBBP
      • inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2)/ GATA2, MECOM(EVI1)
      • t(3q26.2;v)/MECOM(EVI1)-rearranged
      • -5 or del(5q); -7; -17/abn(17p)
      • Complex karyotype, monosomal karyotype
      • Mutations in either one of these genes: ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, and/or ZRSR2
      • Mutated TP53
    • NPM1 + FLT3-ITD + DNMT3A mutation

  • LVEF ≥ 50% by MUGA or ECHO at screening.

  • Adequate renal function as demonstrated by a calculated creatinine clearance ≥ 60 mL/min; determined by the Cockcroft Gault formula.

  • Adequate liver function as demonstrated by:

    • aspartate aminotransferase (AST) ≤ 2.5 × ULN*
    • alanine aminotransferase (ALT) ≤ 2.5× ULN*
    • total bilirubin ≤ 1.5 × ULN* * Unless considered due to leukemic organ involvement. Note: Subjects with Gilbert's Syndrome may have a total bilirubin > 1.5 × ULN per discussion with the Sponsor-Investigator
  • Resolution of adverse reactions to prior drug therapy (such as hydroxyurea) to ≤ grade 1

  • Eligible for intensive cytarabine/daunorubicin (7+3) chemotherapy based on the opinion of the treating physician.

  • Male subjects must agree to refrain from unprotected sex and sperm donation from initial study drug administration until 90 days after the last dose of study drug.

  • Females of childbearing potential (i.e., not postmenopausal for at least 1 year or not surgically sterile) must have negative results by a serum or urine pregnancy test performed within 7 days of day 1.

  • Ability to understand and the willingness to sign a written informed consent document. (Providing consents in as many languages as possible is encouraged)

  • Consolidation should occur between 1-4 weeks following count recovery after induction and remission (must be confirmed by labs to document maximal response) is established. Subjects will receive medium intensity cytarabine -based consolidation in combination with midostaurin and revumenib if the following criteria are fulfilled.

    • an induction response < 5% blasts in the bone marrow and ANC >1000 and PLT >75000 for whom documented path report is submitted.
    • sufficiently fit (performance status <3)
    • resolution of any adverse reactions to no greater than grade 1 severity

  • Subject has acute promyelocytic leukemia, inversion (16), t(8;21) AML as described below. Contact Sponsor-Investigator with questions. Inversion 16 and t(8;21): CBF chromosomal abnormalities may be assessed by molecular (PCR), metaphase cytogenetics, or FISH.

  • Subject has known active CNS involvement with AML.

  • Subject has received a strong CYP3A4 inducer (APPENDIX C) within 7 days prior to the initiation of study treatment

  • Strong CYP3A4 inhibitors (APPENDIX C) are contraindicated except strong CYP3A4 inhibitor antifungal azole medications (systemic itraconazole, ketoconazole, posaconazole, voriconazole). For strong CYP3A4 inhibitor antifungal azole medications, the starting dose of revumenib has to be adjusted (Table 1).

  • QTc using Fridericia's correction \[QTcF\]) > 450 msec. Drugs that prolong QTc should be avoided if possible. A list of common QTc prolonging drugs and alternatives that are not QTc prolonging can be found in APPENDIX D.

  • Subject has tested positive for HIV (due to potential drug-drug interaction between antiretroviral medications and Midostaurin/revumenib). Note: HIV testing is not required.

  • Subject is known to be positive for hepatitis B or C infection with the exception of those with an undetectable viral load within 3 months. (Hepatitis B or C testing is not required). Subjects with serologic evidence of prior vaccination to HBV \[i.e., HBs Ag-, and antiHBs+\] are allowed.

  • Subject has consumed grapefruit, grapefruit products, Seville oranges (including marmalade containing Seville oranges) or Star fruit within 3 days prior to the initiation of study treatment.

  • Subject has a cardiovascular disability status of New York Heart Association Class ≥ 2. Class 2 is defined as cardiac disease in which patients are comfortable at rest but ordinary physical activity results in fatigue, palpitations, dyspnea, or anginal pain.

  • Subject 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.

  • Subject has chronic respiratory disease that requires continuous oxygen use.

  • Subject has a malabsorption syndrome or other condition that precludes enteral route of administration.

  • Subject exhibits evidence of other clinically significant uncontrolled condition(s) including, but not limited to uncontrolled systemic infection.

  • Subject has a history of other malignancies prior to study entry, with the exception of:

    • Adequately treated in situ carcinoma of the cervix uteri or carcinoma in situ of breast;
    • Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin;
    • Previous malignancy confined and surgically resected (or treated with other modalities) with curative intent.
    • Prior malignancies treated with (surgery+/- chemotherapy+/- radiation) that have remained disease free for at least two years after completion of therapy
  • Subject treated with any form of chemotherapy, immunotherapy, or investigative agent within 1 month of enrollment.

  • Patients who have had prior exposure to a menin inhibitor.

Richard Stone, MD logoRichard Stone, MD
Syndax Pharmaceuticals logoSyndax Pharmaceuticals
Verantwortliche Partei
Richard Stone, MD, Prüfsponsor, Sponsor-Investigator, Dana-Farber Cancer Institute
Zentrale Studienkontakte
Kontakt: Richard Stone, MD, 617-632-5157, [email protected]
2 Studienstandorte in 1 Ländern

Connecticut

Yale Cancer Center, New Haven, Connecticut, 06150, United States
Maximilian Stahl, MD, Kontakt, [email protected]
Offene Rekrutierung

Massachusetts

Dana-Farber Cancer Institute, Boston, Massachusetts, 02215, United States
Richard Stone, MD, Kontakt, 617-632-5157, [email protected]
Richard Stone, MD, Hauptprüfer
Offene Rekrutierung