A Randomized Phase II Study Comparing Cytarabine + Daunorubicin (7 + 3) vs (Daunorubicin and Cytarabine) Liposome, Cytarabine + Daunorubicin + Venetoclax, Azacitidine + Venetoclax, and (Daunorubicin and Cytarabine) Liposome + Venetoclax in Patients Aged 59 or Younger Who Are Considered High-Risk (Adverse) Acute Myeloid Leukemia As Determined by MYELOMATCH; A MYELOMATCH Clinical Trial

Status: Recruiting
Location: See all (188) locations...
Intervention Type: Procedure, Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

This phase II MyeloMATCH treatment trial tests whether the standard approach of cytarabine and daunorubicin in comparison to the following experimental regimens works to shrink cancer in patients with high risk acute myeloid leukemia (AML): 1) daunorubicin and cytarabine liposome alone; 2) cytarabine and daunorubicin with venetoclax; 3) azacitidine and venetoclax; 4) daunorubicin and cytarabine liposome and venetoclax. High-risk refers to traits that have been known to make the AML harder to treat. Cytarabine is in a class of medications called antimetabolites. It works by slowing or stopping the growth of cancer cells in the body. Daunorubicin is in a class of medications called anthracyclines. It also works by slowing or stopping the growth of cancer cells in the body. Azacitidine is in a class of medications called demethylation agents. It works by helping the bone marrow to produce normal blood cells and by killing abnormal cells. Venetoclax is in a class of medications called B-cell lymphoma-2 (BCL-2) inhibitors. It may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. There is evidence that these newer experimental treatment regimens may work better in getting rid of more AML compared to the standard approach of cytarabine and daunorubicin.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 59
Healthy Volunteers: f
View:

• STEP 1 REGISTRATION:

• Participants must have been registered to Master Screening and Re-Assessment Protocol, MYELOMATCH, prior to consenting to this study. Participants must have been assigned to this clinical trial, via MATCHBox, prior to registration to this study.

‣ Note: Pre-enrollment/diagnosis labs must have already been performed under the MYELOMATCH

• Participants must have newly diagnosed, untreated acute myeloid leukemia (AML) per World Health Organization (WHO) criteria

• Participants must have high-risk (adverse) AML per European LeukemiaNet (ELN) 2017 criteria

• Participants with therapy-related AML (t-AML), or with AML evolving from an antecedent hematologic disorder (such as myeloproliferative neoplasm), or AML with myelodysplasia-related changes (AML-MRC) are eligible

• Acute promyelocytic leukemia is excluded

• Participants with favorable or intermediate risk disease are excluded

• Participants with FLT3 mutations (ITD or TKD) are excluded

• Participants with t(9;22) translocation are excluded

• A single dose of intrathecal chemotherapy is allowed prior to study entry

• Prior anthracycline therapy is allowed but must not exceed a cumulative lifetime dose of 200 mg/m\^2 daunorubicin or equivalent. Prior hypomethylating agent (HMA) exposure is allowed, as long as not for AML diagnosis

• Participants must not have received or be currently receiving any prior therapy for acute myeloid leukemia. Hydroxyurea to control the white blood cells (WBC) is allowed prior to registration and initiation of protocol-defined therapy. All trans retinoic acid (ATRA) given until a diagnosis of acute promyelocytic leukemia is ruled out is also allowed.

• Participants must not be receiving or planning to receive any other investigational agents before completing protocol therapy

• Participants must be between 18 and 59 years of age

• Participants must have Zubrod performance status =\< 3 as determined by a history and physical (H\&P) completed within 14 days prior to registration

• Participants must have a complete medical history and physical exam within 7 days prior to registration

• Participants must be able to swallow and retain oral medications and have no known gastrointestinal disorders likely to interfere with absorption of oral medications

• Participants with known human immunodeficiency virus (HIV)-infection must be on effective anti-retroviral therapy at time of registration and have undetectable HIV viral load within 6 months prior to registration

• Participants with evidence of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load within 28 days prior to registration and be on suppressive therapy, if indicated

• Participants with a history of hepatitis C virus (HCV) infection must have been treated and cured. Participants with active HCV infection who are currently on treatment must have an undetectable HCV viral load within 28 days prior to registration

• The following tests must be performed within 14 days prior to registration to establish baseline values:

‣ Complete blood count (CBC)/differential/platelets

⁃ Total bilirubin

⁃ Lactate dehydrogenase (LDH)

⁃ Albumin

⁃ Glucose

⁃ Fibrinogen

• Participants must have adequate kidney function as evidenced by creatinine clearance \>= 30mL/min (by Cockcroft Gault) within 28 days prior to registration

• Participants must have adequate liver function as evidenced by aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3.0 x upper limit of normal (ULN), and total bilirubin =\< 2.0 x ULN (or 5.0 x ULN if the participant has a history of Gilbert's disease) within 28 days prior to registration

• Total bilirubin =\< 2.0 x ULN (or 5.0 x ULN if the participant has a history of Gilbert's disease) within 28 days prior to registration

• Participants must have adequate cardiac function as determined by echocardiography or MUGA scan with an ejection fraction \>= 50% within 28 days prior to registration

• Participants with a prior or concurrent malignancy whose natural history (in the opinion of the treating physician) does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial. No concurrent therapies for such malignancy are allowed with the exception of hormonal therapy

• Participants with known history of Wilson's disease or other known copper-metabolism disorder are excluded

• Participants must not be pregnant or nursing. Women/men of reproductive potential must have agreed to use 2 contraception methods. A woman is considered to be of reproductive potential if she has had menses at any time in the preceding 12 consecutive months. In addition to routine contraceptive methods (e.g., hormonal contraceptives \[examples include birth control pills, vaginal rings, or patches\] associated with inhibition of ovulation for at least 1 month prior to taking study drug), effective contraception also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation. However, if at any point a previously celibate participant chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures. A barrier method should be used during this study along with hormonal contraceptives from initial study drug administration to 30 days after the last dose of study drug as drug-drug interaction with venetoclax is unknown

• Participants must have agreed to have specimens submitted for translational medicine (MRD) under the myeloMATCH MSRP and specimens must be submitted

• Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines

• As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system

Locations
United States
Alabama
University of Alabama at Birmingham Cancer Center
RECRUITING
Birmingham
Arkansas
University of Arkansas for Medical Sciences
RECRUITING
Little Rock
Arizona
Mayo Clinic Hospital in Arizona
RECRUITING
Phoenix
Banner University Medical Center - Tucson
RECRUITING
Tucson
University of Arizona Cancer Center-North Campus
RECRUITING
Tucson
California
Alta Bates Summit Medical Center-Herrick Campus
RECRUITING
Berkeley
Cedars Sinai Medical Center
RECRUITING
Los Angeles
University of California Davis Comprehensive Cancer Center
RECRUITING
Sacramento
UCSF Medical Center-Parnassus
RECRUITING
San Francisco
Mills Health Center
RECRUITING
San Mateo
Connecticut
Yale University
RECRUITING
New Haven
Florida
Mayo Clinic in Florida
RECRUITING
Jacksonville
Georgia
Phoebe Putney Memorial Hospital
RECRUITING
Albany
Augusta University Medical Center
RECRUITING
Augusta
Hawaii
Hawaii Cancer Care - Westridge
RECRUITING
‘aiea
Pali Momi Medical Center
RECRUITING
‘aiea
Hawaii Cancer Care Inc - Waterfront Plaza
RECRUITING
Honolulu
Kapiolani Medical Center for Women and Children
RECRUITING
Honolulu
Straub Clinic and Hospital
RECRUITING
Honolulu
Iowa
University of Iowa/Holden Comprehensive Cancer Center
RECRUITING
Iowa City
Idaho
Saint Alphonsus Cancer Care Center-Boise
RECRUITING
Boise
Saint Luke's Cancer Institute - Boise
RECRUITING
Boise
Saint Alphonsus Cancer Care Center-Caldwell
RECRUITING
Caldwell
Kootenai Health - Coeur d'Alene
RECRUITING
Coeur D'alene
Saint Luke's Cancer Institute - Fruitland
RECRUITING
Fruitland
Saint Luke's Cancer Institute - Meridian
RECRUITING
Meridian
Saint Alphonsus Cancer Care Center-Nampa
RECRUITING
Nampa
Saint Luke's Cancer Institute - Nampa
RECRUITING
Nampa
Kootenai Clinic Cancer Services - Post Falls
RECRUITING
Post Falls
Kootenai Clinic Cancer Services - Sandpoint
RECRUITING
Sandpoint
Illinois
Illinois CancerCare-Bloomington
RECRUITING
Bloomington
OSF Saint Joseph Medical Center
RECRUITING
Bloomington
Illinois CancerCare-Canton
RECRUITING
Canton
Illinois CancerCare-Carthage
RECRUITING
Carthage
Northwestern University
RECRUITING
Chicago
University of Chicago Comprehensive Cancer Center
RECRUITING
Chicago
Cancer Care Specialists of Illinois - Decatur
RECRUITING
Decatur
Decatur Memorial Hospital
RECRUITING
Decatur
Illinois CancerCare-Dixon
RECRUITING
Dixon
Crossroads Cancer Center
RECRUITING
Effingham
Illinois CancerCare-Eureka
RECRUITING
Eureka
NorthShore University HealthSystem-Evanston Hospital
RECRUITING
Evanston
Illinois CancerCare-Galesburg
RECRUITING
Galesburg
NorthShore University HealthSystem-Glenbrook Hospital
RECRUITING
Glenview
NorthShore University HealthSystem-Highland Park Hospital
RECRUITING
Highland Park
Illinois CancerCare-Kewanee Clinic
RECRUITING
Kewanee
Illinois CancerCare-Macomb
RECRUITING
Macomb
Loyola University Medical Center
RECRUITING
Maywood
Cancer Care Center of O'Fallon
RECRUITING
O'fallon
Illinois CancerCare-Ottawa Clinic
RECRUITING
Ottawa
Illinois CancerCare-Pekin
RECRUITING
Pekin
Illinois CancerCare-Peoria
RECRUITING
Peoria
Methodist Medical Center of Illinois
RECRUITING
Peoria
OSF Saint Francis Medical Center
RECRUITING
Peoria
Illinois CancerCare-Peru
RECRUITING
Peru
Illinois CancerCare-Princeton
RECRUITING
Princeton
Southern Illinois University School of Medicine
RECRUITING
Springfield
Springfield Clinic
RECRUITING
Springfield
Springfield Memorial Hospital
RECRUITING
Springfield
Illinois CancerCare - Washington
RECRUITING
Washington
Indiana
Indiana University/Melvin and Bren Simon Cancer Center
RECRUITING
Indianapolis
Kansas
University of Kansas Clinical Research Center
RECRUITING
Fairway
University of Kansas Cancer Center
RECRUITING
Kansas City
University of Kansas Hospital-Indian Creek Campus
RECRUITING
Overland Park
University of Kansas Hospital-Westwood Cancer Center
RECRUITING
Westwood
Kentucky
University of Kentucky/Markey Cancer Center
RECRUITING
Lexington
The James Graham Brown Cancer Center at University of Louisville
RECRUITING
Louisville
UofL Health Medical Center Northeast
RECRUITING
Louisville
Louisiana
LSU Health Baton Rouge-North Clinic
RECRUITING
Baton Rouge
Our Lady of The Lake
RECRUITING
Baton Rouge
Our Lady of the Lake Physician Group
RECRUITING
Baton Rouge
Massachusetts
Dana-Farber Cancer Institute
RECRUITING
Boston
Tufts Medical Center
RECRUITING
Boston
Lahey Hospital and Medical Center
RECRUITING
Burlington
Lahey Medical Center-Peabody
RECRUITING
Peabody
Maryland
Johns Hopkins University/Sidney Kimmel Cancer Center
RECRUITING
Baltimore
Maine
MaineHealth Maine Medical Center - Portland
RECRUITING
Portland
MaineHealth Cancer Care and IV Therapy - South Portland
RECRUITING
South Portland
Michigan
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
RECRUITING
Ann Arbor
Trinity Health IHA Medical Group Hematology Oncology - Brighton
RECRUITING
Brighton
Trinity Health IHA Medical Group Hematology Oncology - Canton
RECRUITING
Canton
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
RECRUITING
Chelsea
Henry Ford Hospital
RECRUITING
Detroit
Wayne State University/Karmanos Cancer Institute
RECRUITING
Detroit
Weisberg Cancer Treatment Center
RECRUITING
Farmington Hills
Cancer Hematology Centers - Flint
RECRUITING
Flint
Genesee Hematology Oncology PC
SUSPENDED
Flint
Genesys Hurley Cancer Institute
RECRUITING
Flint
Hurley Medical Center
RECRUITING
Flint
Trinity Health Saint Mary Mercy Livonia Hospital
RECRUITING
Livonia
Henry Ford Medical Center-Columbus
RECRUITING
Novi
Henry Ford West Bloomfield Hospital
RECRUITING
West Bloomfield
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
RECRUITING
Ypsilanti
Minnesota
Mercy Hospital
RECRUITING
Coon Rapids
Essentia Health - Deer River Clinic
RECRUITING
Deer River
Essentia Health Cancer Center
RECRUITING
Duluth
Fairview Southdale Hospital
RECRUITING
Edina
Essentia Health Hibbing Clinic
RECRUITING
Hibbing
Abbott-Northwestern Hospital
RECRUITING
Minneapolis
Mayo Clinic in Rochester
RECRUITING
Rochester
Park Nicollet Clinic - Saint Louis Park
RECRUITING
Saint Louis Park
Regions Hospital
RECRUITING
Saint Paul
United Hospital
RECRUITING
Saint Paul
Essentia Health Sandstone
RECRUITING
Sandstone
Essentia Health Virginia Clinic
RECRUITING
Virginia
Missouri
Siteman Cancer Center at Saint Peters Hospital
RECRUITING
City Of Saint Peters
Siteman Cancer Center at West County Hospital
RECRUITING
Creve Coeur
Siteman Cancer Center at Christian Hospital
RECRUITING
St Louis
Siteman Cancer Center-South County
RECRUITING
St Louis
Washington University School of Medicine
RECRUITING
St Louis
Mississippi
Baptist Memorial Hospital and Cancer Center-Golden Triangle
RECRUITING
Columbus
Baptist Cancer Center-Grenada
RECRUITING
Grenada
Baptist Memorial Hospital and Cancer Center-Union County
RECRUITING
New Albany
Baptist Memorial Hospital and Cancer Center-Oxford
RECRUITING
Oxford
Baptist Memorial Hospital and Cancer Center-Desoto
RECRUITING
Southhaven
Montana
Community Hospital of Anaconda
RECRUITING
Anaconda
Billings Clinic Cancer Center
RECRUITING
Billings
Bozeman Health Deaconess Hospital
RECRUITING
Bozeman
Benefis Sletten Cancer Institute
RECRUITING
Great Falls
Logan Health Medical Center
RECRUITING
Kalispell
Community Medical Center
RECRUITING
Missoula
North Carolina
Carolinas Medical Center/Levine Cancer Institute
RECRUITING
Charlotte
Duke University Medical Center
RECRUITING
Durham
Wake Forest University Health Sciences
RECRUITING
Winston-salem
Nebraska
Nebraska Medicine-Bellevue
RECRUITING
Bellevue
Nebraska Medicine-Village Pointe
RECRUITING
Omaha
University of Nebraska Medical Center
RECRUITING
Omaha
New Jersey
Cooper Hospital University Medical Center
RECRUITING
Camden
Saint Barnabas Medical Center
RECRUITING
Livingston
Monmouth Medical Center
RECRUITING
Long Branch
Rutgers Cancer Institute of New Jersey
RECRUITING
New Brunswick
The Valley Hospital - Luckow Pavilion
RECRUITING
Paramus
Valley Health System Ridgewood Campus
RECRUITING
Ridgewood
Community Medical Center
RECRUITING
Toms River
New Mexico
University of New Mexico Cancer Center
RECRUITING
Albuquerque
Nevada
OptumCare Cancer Care at Seven Hills
RECRUITING
Henderson
OptumCare Cancer Care at Charleston
RECRUITING
Las Vegas
OptumCare Cancer Care at Fort Apache
RECRUITING
Las Vegas
New York
Roswell Park Cancer Institute
RECRUITING
Buffalo
Northwell Health/Center for Advanced Medicine
RECRUITING
Lake Success
North Shore University Hospital
RECRUITING
Manhasset
Mount Sinai Hospital
RECRUITING
New York
University of Rochester
RECRUITING
Rochester
State University of New York Upstate Medical University
RECRUITING
Syracuse
Montefiore Medical Center - Moses Campus
RECRUITING
The Bronx
Ohio
Ohio State University Comprehensive Cancer Center
RECRUITING
Columbus
Oklahoma
University of Oklahoma Health Sciences Center
RECRUITING
Oklahoma City
Oregon
Saint Alphonsus Cancer Care Center-Ontario
RECRUITING
Ontario
Oregon Health and Science University
RECRUITING
Portland
Providence Portland Medical Center
RECRUITING
Portland
Providence Saint Vincent Medical Center
RECRUITING
Portland
Pennsylvania
Lehigh Valley Hospital-Cedar Crest
RECRUITING
Allentown
Geisinger Medical Center
RECRUITING
Danville
Penn State Milton S Hershey Medical Center
RECRUITING
Hershey
Lewistown Hospital
RECRUITING
Lewistown
Thomas Jefferson University Hospital
RECRUITING
Philadelphia
University of Pennsylvania/Abramson Cancer Center
RECRUITING
Philadelphia
University of Pittsburgh Cancer Institute (UPCI)
RECRUITING
Pittsburgh
Reading Hospital
RECRUITING
West Reading
South Carolina
Prisma Health Cancer Institute - Spartanburg
RECRUITING
Boiling Springs
Prisma Health Cancer Institute - Easley
RECRUITING
Easley
Prisma Health Cancer Institute - Butternut
RECRUITING
Greenville
Prisma Health Cancer Institute - Eastside
RECRUITING
Greenville
Prisma Health Cancer Institute - Faris
RECRUITING
Greenville
Prisma Health Cancer Institute - Greer
RECRUITING
Greer
Prisma Health Cancer Institute - Seneca
RECRUITING
Seneca
Tennessee
Baptist Memorial Hospital and Cancer Center-Collierville
RECRUITING
Collierville
University of Tennessee - Knoxville
RECRUITING
Knoxville
Baptist Memorial Hospital and Cancer Center-Memphis
RECRUITING
Memphis
Utah
Huntsman Cancer Institute/University of Utah
RECRUITING
Salt Lake City
Virginia
University of Virginia Cancer Center
RECRUITING
Charlottesville
Inova Schar Cancer Institute
RECRUITING
Fairfax
Inova Fairfax Hospital
RECRUITING
Falls Church
Vermont
University of Vermont and State Agricultural College
RECRUITING
Burlington
University of Vermont Medical Center
RECRUITING
Burlington
Washington
Swedish Cancer Institute-Edmonds
RECRUITING
Edmonds
Swedish Cancer Institute-Issaquah
RECRUITING
Issaquah
Swedish Medical Center-First Hill
RECRUITING
Seattle
Wisconsin
ThedaCare Regional Cancer Center
RECRUITING
Appleton
Duluth Clinic Ashland
RECRUITING
Ashland
Saint Vincent Hospital Cancer Center at Saint Mary's
RECRUITING
Green Bay
Saint Vincent Hospital Cancer Center Green Bay
RECRUITING
Green Bay
Gundersen Lutheran Medical Center
RECRUITING
La Crosse
Medical College of Wisconsin
RECRUITING
Milwaukee
Other Locations
Canada
Arthur J E Child Comprehensive Cancer Centre
RECRUITING
Calgary
CancerCare Manitoba
RECRUITING
Winnipeg
Puerto Rico
Centro Comprensivo de Cancer de UPR
RECRUITING
San Juan
San Juan City Hospital
RECRUITING
San Juan
Time Frame
Start Date: 2024-09-25
Estimated Completion Date: 2027-03-31
Participants
Target number of participants: 335
Treatments
Active_comparator: Arm I (cytarabine, daunorubicin)
Patients receive cytarabine IV continuously on days 1-7 and daunorubicin IV on days 1-3 per standard approach of each cycle. Cycles repeat every 28 days for 1 cycle in the absence of disease progression or unacceptable toxicity. Patients may receive an additional cycle of cytarabine IV continuously on days 1-5 and daunorubicin IV on days 1-2. Patients undergo ECHO or MUGA scan during screening. Patients also undergo a bone marrow aspiration and collection of blood throughout the trial.
Experimental: Arm II (cytarabine, daunorubicin, venetoclax)
Patients receive cytarabine IV continuously on days 2-8 and daunorubicin IV on days 2-4 with venetoclax PO on days 1-11 of each cycle. Cycles repeat every 28 days for 1 cycle in the absence of disease progression or unacceptable toxicity. Patients may receive an additional cycle of cytarabine IV continuously on days 2-6 and daunorubicin IV on days 2-3 with venetoclax PO on days 1-8. Patients undergo ECHO or MUGA scan during screening. Patients also undergo a bone marrow aspiration and collection of blood throughout the trial.
Experimental: Arm III (azacitidine, venetoclax)
Patients receive azacitidine SC or IV on days 1-7 and venetoclax PO on days 1-28 of each cycle. Cycles repeat every 28 days for 2 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA scan during screening. Patients also undergo a bone marrow aspiration and collection of blood throughout the trial.
Experimental: Arm IV (daunorubicin and cytarabine liposome)
Patients receive daunorubicin and cytarabine liposome IV over 90 minutes on days 1, 3, and 5 of each cycle. Cycles repeat every 28 days for 1 cycle in the absence of disease progression or unacceptable toxicity. Patients may receive an additional cycle of daunorubicin and cytarabine liposome IV over 90 minutes on days 1 and 3. Patients undergo ECHO or MUGA scan during screening. Patients also undergo a bone marrow aspiration and collection of blood throughout the trial.
Experimental: Arm V (daunorubicin and cytarabine liposome, venetoclax)
Patients receive daunorubicin and cytarabine liposome IV over 90 minutes on days 1, 3, and 5 and venetoclax PO on days 1-14 of each cycle. Cycles repeat every 28 days for 1 cycle in the absence of disease progression or unacceptable toxicity. Patients may receive an additional cycle of daunorubicin and cytarabine liposome IV over 90 minutes on days 1 and 3 and venetoclax PO on days 1-7. Patients undergo ECHO or MUGA scan during screening. Patients also undergo a bone marrow aspiration and collection of blood throughout the trial.
Sponsors
Leads: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov

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