CC-486 and Venetoclax for Acute Myeloid Leukemia
This is an open label, dose escalation Phase I single institution pilot study for relapsed and refractory AML patients using CC-486 (oral azacitidine) with venetoclax. At the completion of dose escalation and after establishment of the MTD or recommended dose of CC-486 with venetoclax, an expansion phase will commence, using venetoclax with the MTD of CC-486 in relapsed/refractory patients.
• Subject must have confirmation of non-APL AML by WHO criteria46 and have undergone at least one line of therapy (dose escalation and dose expansion cohorts).
• Transplant eligible patients can participate in the study and they are allowed to proceed with stem cell transplantation at any time during the study.
• Subject must have a projected life expectancy of at least 12 weeks.
• Subject must have an Eastern Cooperative Oncology Group (ECOG) Performance status of ≤ 2.
• Subject must have adequate renal function as demonstrated by a calculated creatinine clearance ≥ 30 mL/min; determined via urine collection for 24-hour creatinine clearance or by the Cockcroft Gault formula.
• Subject must have adequate liver function as demonstrated by:
∙ aspartate aminotransferase (AST) ≤ 3.0 × ULN\*
‣ alanine aminotransferase (ALT) ≤ 3.0 × ULN\*
‣ bilirubin ≤ 1.5 × ULN, unless due to Gilbert's syndrome\* \* Unless considered due to leukemic organ involvement
• Non-sterile male subjects must use contraceptive methods with partner(s) at least prior to beginning study drug administration and continuing up to 90 days after the last dose of study drug. Male subjects must agree to refrain from sperm donation from initial study drug administration until 90 days after the last dose of study drug. No contraception is required if male subjects are surgically sterile (vasectomy with medical assessment confirming surgical success) or if the male subject has a female partner who is postmenopausal or permanently sterile (bilateral oophorectomy, bilateral salpingectomy or hysterectomy).
• Female subjects must be either:
∙ Postmenopausal; defined as Age \> 60 years with no menses for 12 or more months without an alternative medical cause; OR
‣ Permanently surgically sterile (bilateral oophorectomy, bilateral salpingectomy or hysterectomy); OR
‣ If subject is of childbearing potential, use of contraception is required while on study treatment and for 6 months after the last dose.
• Subject must voluntarily sign and date an informed consent, approved by an Institutional Review Board (IRB), prior to the initiation of any research directed screening or procedures.
⁃ Subject is informed that consumption of the following fruits is prohibited 3 days prior to the initiation of study treatment and throughout participation: grapefruit, grapefruit products, Seville oranges (including marmalade containing Seville oranges) or Star fruit.