RAD001 + PKC412 for Acute Myeloid Leukemia

Not currently recruiting at 2 trial locations
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test the safety of using two drugs, RAD001 (an mTOR inhibitor) and PKC412 (a kinase inhibitor), together to treat certain blood cancers, such as acute myeloid leukemia (AML). The trial examines how effectively these drugs work together to block growth signals in cancer cells, slowing or stopping their spread. Individuals with AML or similar blood disorders who have not responded to standard treatments might be suitable candidates for this trial. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this new combination therapy.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify if you need to stop taking your current medications. However, you cannot participate if you are on chronic treatment with systemic steroids or another immunosuppressive agent.

Is there any evidence suggesting that the combination of RAD001 and PKC412 is likely to be safe for humans?

Research has shown that using RAD001 and PKC412 together to treat acute myeloid leukemia (AML) raises some safety concerns. In earlier studies, PKC412, also known as midostaurin, caused side effects, with about 65% of patients experiencing mild to moderate stomach problems. A few cases of serious lung issues were fatal.

RAD001, also called everolimus, helps slow the growth of cancer cells. While specific safety information on using RAD001 and PKC412 together is limited, both drugs have been studied in other cancer treatments, providing some understanding of their safety. As this is a Phase 1 trial, the main goal is to determine the safest dose, so current safety information might be limited. This trial aims to assess how well patients tolerate these drugs when used together.12345

Why do researchers think this study treatment might be promising?

Researchers are excited about the combination of RAD001 and PKC412 for Acute Myeloid Leukemia (AML) because it targets the disease in a unique way. Unlike traditional chemotherapy, which attacks rapidly dividing cells, PKC412 specifically inhibits a protein called FLT3 that is often mutated in AML, potentially leading to more targeted treatment with fewer side effects. Meanwhile, RAD001 works by inhibiting mTOR, a pathway that cancer cells use to grow and survive. By combining these two drugs, the treatment aims to attack the cancer from multiple angles, potentially improving outcomes for patients with AML who have limited options with standard therapies.

What evidence suggests that the combination of RAD001 and PKC412 might be an effective treatment for Acute Myeloid Leukemia?

Research has shown that a drug called PKC412, or midostaurin, helps patients with acute myeloid leukemia (AML) live longer. In one study, patients taking midostaurin had better survival rates than those who did not. Another drug, RAD001, targets a protein called MTOR, which is often overactive in cancer cells, helping to slow or stop their growth. This trial tests the combination of RAD001 and PKC412, as it might block cancer growth in two different ways. Early results suggest that these drugs may work well together to treat AML more effectively.13678

Who Is on the Research Team?

Richard M. Stone, MD - Dana-Farber ...

Richard Stone, MD

Principal Investigator

Dana-Farber Cancer Institute

Are You a Good Fit for This Trial?

This trial is for adults with relapsed or refractory AML, MDS, or CMML who can't have standard therapy. They should be in relatively stable health (ECOG ≤2), not pregnant, using double barrier contraception if of childbearing potential, and without recent transplants or other cancers within 5 years.

Inclusion Criteria

I can take care of myself but cannot do heavy physical work.
INR < 1.3 (or < 3 on anticoagulants)
I don't expect to need treatment to reduce my blood cell count within a month, except for hydroxyurea.
See 6 more

Exclusion Criteria

I have been diagnosed with acute promyelocytic leukemia.
I had a bone marrow or stem cell transplant less than 2 months ago.
I do not have severe health or mental conditions that could stop me from completing the study.
See 14 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive RAD001 and PKC412 in a dose-escalation study to determine the maximum tolerated dose

28 days per cycle
Multiple visits for evaluations and procedures

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • PKC412
  • RAD001
Trial Overview The study tests RAD001 combined with PKC412 to find the safest high dose against certain blood cancers. RAD001 targets a protein pathway that's overactive in cancer cells while PKC412 blocks an enzyme linked to AML cell growth.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Only one arm on this study.Experimental Treatment2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Richard Stone, MD

Lead Sponsor

Trials
2
Recruited
50+

Novartis

Industry Sponsor

Trials
1,646
Recruited
2,778,000+
Vasant Narasimhan profile image

Vasant Narasimhan

Novartis

Chief Executive Officer since 2018

MD from Harvard Medical School, Bachelor's in Biological Sciences from University of Chicago, Master's in Public Policy from John F. Kennedy School of Government

Shreeram Aradhye profile image

Shreeram Aradhye

Novartis

Chief Medical Officer since 2022

MD from Yale University, MSc in Clinical Epidemiology from University of Pennsylvania

Beth Israel Deaconess Medical Center

Collaborator

Trials
872
Recruited
12,930,000+

Massachusetts General Hospital

Collaborator

Trials
3,066
Recruited
13,430,000+

Brigham and Women's Hospital

Collaborator

Trials
1,694
Recruited
14,790,000+

Published Research Related to This Trial

Midostaurin (PKC412) combined with standard chemotherapy (daunorubicin) shows a synergistic effect in inhibiting intracellular signaling in FLT3-mutated acute myeloid leukemia (AML) cells, which may enhance treatment efficacy.
In contrast, cytarabine appears to antagonize the effects of PKC412, leading to increased FLT3 receptor expression and potentially complicating treatment outcomes, highlighting the need for further research into optimal combination therapies.
Multiplexed single-cell mass cytometry reveals distinct inhibitory effects on intracellular phosphoproteins by midostaurin in combination with chemotherapy in AML cells.Rörby, E., Adolfsson, J., Hultin, E., et al.[2021]

Citations

RAD001 + PKC412 for Acute Myeloid LeukemiaThe purpose of this research study is to determine the safety of the combination of RAD001 and PKC412 as a cancer treatment, and to establish the highest ...
Midostaurin In Acute Myeloid Leukemia: An Evidence- ...The RATIFY trial demonstrated a significant improvement in the 4-year overall survival in patients who received midostaurin compared to placebo ...
FLT3 Mutations in Acute Myeloid Leukemia: Key Concepts ...A phase II trial of crenolanib plus chemotherapy in newly diagnosed FLT3-mutated AML demonstrated a high CR rate of 85%; notably, 70% of ...
Improving consolidation therapy in acute myeloid leukemiaAfter intensive induction therapy, 60% to 80% of younger (≤60 years) and 40% to 60% of older (>60 years) patients with acute myeloid leukemia (AML).
Novartis drug PKC412 (midostaurin) receives ...The median OS for patients in the PKC412 (midostaurin) treatment group was 74.7 months (95% confidence interval [CI]: 31.7, not attained), versus 25.6 months ( ...
The study to evaluate the safety, efficacy, and ... - MedPathThe study to evaluate the safety, efficacy, and pharmacokinetics of twice daily midostaurin (PKC412) combined with standard chemotherapy and as a single ...
Survival outcomes with midostaurin in patients with FLT3 ...We summarize the survival outcomes in patients with FLT3 mutated AML treated with midostaurin from a retrospective cohort within the AML-12 ...
FLT3 inhibitors in acute myeloid leukemia: Current status ...Sorafenib monotherapy at 200 mg to 400 mg twice daily, as tolerated, decreased marrow blasts in 12 of 13 patients with relapsed or refractory AML with FLT3-ITD ...
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