Targeted Therapies for Acute Myeloid Leukemia
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to find better treatments for acute myeloid leukemia (AML) by testing new drugs and drug combinations tailored to specific genetic profiles of the disease. Researchers place participants in different study groups based on their leukemia's genetic makeup to determine which treatments work best. Ideal participants are adults with newly diagnosed or relapsed AML who have not received significant prior treatment for the disease. As a Phase 1 trial, this research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive potentially groundbreaking therapies.
Will I have to stop taking my current medications?
The trial information does not specify if you need to stop taking your current medications. However, it mentions that prior treatment with certain medications is allowed, so it's best to discuss your specific medications with the trial team.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research has shown that many treatments for acute myeloid leukemia (AML) have been tested with varying levels of safety and tolerance. Here is a summary of key findings:
1. **AG-120 (Ivosidenib)**: FDA-approved for some AML patients, this drug is generally well-tolerated. Common side effects include nausea and fatigue, which are often manageable.
2. **AG-221 (Enasidenib)**: Past studies have shown this drug to be well-tolerated, with common side effects like nausea and diarrhea. It is not approved for children but shows promise in adults.
3. **Azacitidine**: Used for several blood disorders, this treatment has a known safety profile. Common side effects include low blood counts and fatigue, with no unexpected safety concerns.
4. **AZD5153**: In early testing stages, this drug's safety is still being evaluated. More information will become available as studies continue.
5. **AZD5991**: Initial studies suggest this drug is well-tolerated alone or with other treatments. Reported side effects include nausea and fatigue.
6. **BI 836858**: Studied in combination with other treatments, this drug has shown to be safe. Side effects can include low blood counts, common in many cancer treatments.
7. **Cytarabine and Daunorubicin**: These standard chemotherapy drugs for AML are known for their safety and side effects, which often include low blood counts and infection risk.
8. **Entospletinib**: Generally well-tolerated in studies, with mild side effects like nausea.
9. **Gilteritinib**: Approved for certain AML cases, this drug has a well-established safety profile, though side effects like fever and fatigue are common.
10. **Pevonedistat**: Early studies show it is safe, with side effects similar to other cancer treatments.
11. **SNDX-5613**: FDA-approved for certain types of leukemia, indicating a favorable safety profile.
12. **TP-0903**: Early data suggest it is a feasible treatment with a manageable safety profile.
13. **Venetoclax**: FDA-approved for certain leukemia types, it is generally well-tolerated, though side effects like low blood cell counts and infection can occur.
Overall, these treatments show promise in terms of safety, with mostly known and manageable side effects. Each drug has a unique profile, so discussing options with a healthcare provider will help determine the best fit for individual needs.12345Why are researchers excited about this trial's treatments?
Researchers are excited about these treatments for acute myeloid leukemia (AML) because they target specific genetic mutations and pathways that are not addressed by traditional chemotherapies like daunorubicin and cytarabine. For instance, AG-120 targets the IDH1 mutation, which is a new approach compared to the standard treatments. Gilteritinib is designed to block the FLT3 mutation, which is often associated with aggressive forms of AML. Additionally, combinations like AZD5153 with venetoclax offer a novel mechanism by inhibiting proteins involved in cancer cell survival, potentially providing more effective treatment options for patients with relapsed or refractory AML. These innovations offer hope for better-targeted therapies with the potential for improved outcomes.
What evidence suggests that this trial's treatments could be effective for acute myeloid leukemia?
Research has shown that several new treatments hold promise for acute myeloid leukemia (AML). In this trial, participants with an IDH1 mutation may receive a combination of AG-120 and azacitidine, which led to complete remission in 51% of cases and improved survival rates in previous studies. For those with IDH2 mutations, AG-221 is another treatment option, and studies have suggested it offers better survival compared to standard treatments, with an average survival time of 9.26 months. Participants with FLT3 mutations may receive Gilteritinib, which significantly improved survival rates compared to chemotherapy, with 54% of patients responding well in past research. Pevonedistat, when used with azacitidine, is being tested for its positive results in patients whose AML has returned. Venetoclax, often combined with azacitidine, is approved for AML and effectively improves response rates. These treatments target specific genetic changes in AML, providing personalized options for patients in this trial.678910
Who Is on the Research Team?
John C Byrd, MD
Principal Investigator
Beat AML
Are You a Good Fit for This Trial?
This trial is for adults with acute myeloid leukemia (AML). Group A includes those who haven't been treated before, except possibly with hydroxyurea. People over 60 or certain younger adults with specific genetic markers can join. Group B is for those whose AML has returned or didn't respond to treatment. You can't join if you have brain involvement by AML, active bleeding disorders, isolated myeloid sarcoma without blood/marrow involvement, a type of leukemia called acute promyelocytic leukemia, or other serious medical conditions.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are assigned to sub-studies based on genomic screening to evaluate investigational therapies or combinations
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- AG-120
- AG-221
- Azacitidine
- AZD5153
- AZD5991
- BI 836858
- Cytarabine
- Daunorubicin
- Entospletinib
- Gilteritinib
- Laboratory Biomarker Analysis
- Pevonedistat
- SNDX-5613
- TP-0903
- Venetoclax
Trial Overview
The study tests different treatments based on patients' specific genetic types of AML. It's part of a larger 'Master Protocol' that assigns people to sub-studies testing various drugs and combinations like SNDX-5613, Gilteritinib, Venetoclax and others alongside standard therapies such as Azacitidine and Cytarabine.
How Is the Trial Designed?
This is an open-label phase 2 clinical trial of a stepwise approach to the treatment of patients with TP53 mutation AML. On day 1, all enrolled participants will be initiated on therapy with pevonedistat (20 mg/m2) day 1, 3 and 5 together with azacitidine (75 mg/m2 days 1-7 or day 1-5 then day 8, 9) every 28 days. During cycle 1, patients with rapidly progressive disease or severe organ dysfunction, not correctable by hydroxyurea cytoreduction will not be eligible to continue. Those patients who achieved a response, defined as complete response or complete response with incomplete blood count recovery, by the end of cycle 4 will continue on pevonedistat and azacitidine until disease progression, unacceptable toxicity, or 12 cycles of therapy. After 12 months of combined therapy, pevonedistat will be continued until progression of disease, unacceptable toxicity, or up to 2 years of total therapy.
This is an open-label Phase 1b/2 clinical study of gilteritinib monotherapy, gilteritinib in combination with decitabine, or gilteritinib in combination with decitabine and venetoclax in untreated FLT3 mutated AML with high and low variant allele frequency. Initially, the combination of gilteritinib and decitabine was tested (Group 1); however, subsequently the combination of decitabine and venetoclax was shown to be a highly effective therapy for older AML patients, so the triple combination of gilteritinib in combination with decitabine and venetoclax (Group 2) is now being evaluated in this study.
The study is an open-label phase 2 study of entospletinib in younger and older AML patients with NPM1+/FLT3ITD-AML. It includes patients age ≥18 years who are able and willing to receive 7 + 3 intensive chemotherapy. Entospletinib is administered daily with IV daunorubicin (days 1-3 for Cycle 1) and cytarabine (days 1-7 for Cycle 1). If a second induction is required, it is given with IV daunorubicin (days 1-2 for Cycle 2) and cytarabine (days 1-5 for Cycle 2).
This is a phase 2 clinical trial to assess the feasibility and efficacy of a stepwise approach to the treatment of patients with TP53 mutations (identified molecularly) with/without complex karyotype (Cohort A) or complex karyotype (3 or greater metaphase abnormalities without TP53) (Cohort B). All enrolled participants will be initiated on entospletinib 400 mg orally twice daily. This dose will be administered continuously in 28 day cycles.
This is a 2 cohort phase 1b/2 clinical trial to assess the feasibility and efficacy of entospletinib (ENTO) stepwise approach to the treatment of patients with balanced translocations of MLL identified cytogenetically (Cohort 1) and patients with MLL-partial tandem duplications identified molecularly (Cohort 2). All enrolled participants will be initiated on monotherapy with ENTO 400 mg PO BID. This dose will be administered continuously in 28 day cycles.
This is a phase 2 clinical trial to assess the feasibility and efficacy of a stepwise approach to the treatment of IDH2-mutant AML. On day 1 of the trial, all enrolled participants will be initiated on therapy with the IDH2 inhibitor AG-221 for IDH2 R140 and R172-mutant patients. The dosing will be based on phase 1 experience of AG-221, which has established 100 mg daily as a safe and tolerated dose, with preliminary suggestion of efficacy. These will be administered continuously in 28 day cycles. Hydroxyurea will be allowed for the purposes of cytoreduction.
This is a Phase 1, open-label, multicenter, dose escalation, and dose optimization study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of ZE46-0134 in adult patients with relapsed or refractory AML with FLT3-ITD and/or FLT3-TKD mutations. Patients with AML that are out-patients or hospitalized due to their AML can be enrolled in the study. The study will be run in 2 parts: Part 1 will be dose escalation and determination of the maximum tolerated dose, and Part 2 will be dose expansion.
This is an open-label Phase 1b/2 clinical study of BI 836858 given in combination with azacitidine, followed by BI 836858 plus azacitidine maintenance, in newly diagnosed acute myeloid leukemia. The target population is assigned by the Beat AML Master Protocol (the "umbrella" study). Eligible patients will have previously untreated acute myeloid leukemia, age greater than or equal to 60, with any 1 of the following: mutated TET2, IDH1, IDH2, or WT1, or "marker negative" as defined by the overall Beat AML umbrella protocol.
This is an open-label Phase 1b clinical study of AZD5991 + azacitidine in patients aged ≥60 years with newly diagnosed, previously untreated, hypermethylated and marker-negative AML. The phase 1b1 study will adopt a standard 3+3 design with dose escalation based upon dose limiting toxicities. The recommended Phase 2 dose (RP2D) is defined in this study as the highest dose level where less than 2 dose limiting toxicities (DLT) are observed out of 6 patients. Once the RP2D is defined, patients will be enrolled into 2 separate cohorts (hypermethylation and marker negative group) for the phase 1b2 expansion. These 2 groups will both be treated at the RP2D determined from phase 1b1.
This is an open-label Phase 1b dose escalation and expansion clinical trial to determine the safety and recommended dose of SNDX-5613 combined with azacitidine and venetoclax in newly diagnosed, untreated AML patients age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy and who have NPM1 mutated or MLL-rearranged disease. After determination of the recommended dose of SNDX-5613, the study will have an expansion cohort to be treated at the recommended dose in combination with azacitidine and venetoclax in the same patient population.
This is an open-label phase 2 clinical study to assess the feasibility and efficacy of a combination based approach to the treatment of IDH1 mutant AML. On day 1 of the trial, all enrolled participants will be initiated on therapy with the IDH1 inhibitor AG-120 given daily together with azacitidine (days 1-5 and 8-9 or 7 consecutive days 1-7) in 28 day cycles for IDH1 mutant patients. Those patients who have achieved a response, defined as complete response or complete response with incomplete blood count recovery, by the end of cycle 6, will continue on combination therapy for a total of 12 cycles and then patients will go onto receive monotherapy with AG-120 until disease progression or unacceptable side effects that mandate discontinuation of therapy. Patients who cannot complete 12 cycles of azacitidine may proceed onto monotherapy with AG-120.
The study is an open-label Phase 1b/2 clinical study of TP-0903 given in addition to decitabine in patients ≥ 60 years with newly diagnosed, previously untreated AML with TP53 mutations and/or complex karyotype. The Phase 1b portion of this study will use a standard 3 + 3 design with dose escalation based upon dose limiting toxicities. The maximum tolerated dose will be defined as the highest dose where at most 1 patient in 6 experiences dose-limiting toxicity, and this is generally the recommended Phase 2 dose (RP2D). Once the RP2D is determined from Phase 1b, patients will be enrolled at this dose level to initiate the Phase 2 portion of the study.
This is an open label phase 2 randomized study in which eligible AML patients will be randomly assigned (1:1) to receive either the FDA label-approved regimen of 28-day Venetoclax + Azacitidine (Arm A) or the 14-day regimen of Venetoclax + Azacitidine (Arm B). Newly diagnosed acute myeloid leukemia (AML) patients ≥ 60 years will be enrolled.
This is a phase 1b/2 clinical trial to assess the safety and efficacy of the combination of AZD5153 and venetoclax. In a phase 1b component, safety and tolerability of the combination will be assessed in relapsed/refractory AML patients ≥ 18 years of age. Following determination of the recommended Phase 2 dose (RP2D), newly diagnosed, marker negative patients age ≥ 60 will be enrolled in the phase 2 component; these patients will be treated at the previously identified RP2D for the combination. The RP2D will be the highest dose level with ≤ 1 out of 6 patients with dose limiting toxicity and defined as the maximum tolerated dose.
This is an open-label Phase 1b/2 clinical study of Samalizumab given in addition to standard induction chemotherapy/consolidation, followed by Samalizumab maintenance, in newly diagnosed acute myeloid leukemia. Patients that are marker negative, as defined based on the Beat AML Master Protocol assignment or with CBF karyotype/interphase cytogenetics/molecular testing defined by presence of t(8;21)(q22;q22) or the molecular equivalent RUNX1/RUNX1T1 fusion transcript or inv(16)(p13q22) or t(16;16)(p13;q22) or the molecular equivalent CBFB/MYH11 fusion transcript based on the Beat AML will receive Samalizumab in combination with induction therapy followed by Samalizumab maintenance.
This is an open label phase 2 randomized study in which eligible AML patients will be randomly assigned (1:1) to receive either the FDA label-approved regimen of 28-day Venetoclax + Azacitidine (Arm A) or the 14-day regimen of Venetoclax + Azacitidine (Arm B). Newly diagnosed acute myeloid leukemia (AML) patients ≥ 60 years will be enrolled.
AG-120 is already approved in United States for the following indications:
- Acute myeloid leukemia (AML) with a susceptible IDH1 mutation
Find a Clinic Near You
Who Is Running the Clinical Trial?
Beat AML, LLC
Lead Sponsor
Published Research Related to This Trial
Citations
Long-term results from the AGILE study of azacitidine plus ...
Hematologic recovery was faster, more durable, and conversion to transfusion independence (53.8% vs 17.1%; P = .0004) was more common with ivosidenib than with ...
2.
ashpublications.org
ashpublications.org/bloodadvances/article/9/20/5177/546354/Long-term-results-from-the-AGILE-study-ofLong-term results from the AGILE study of azacitidine plus ...
In long-term follow-up, ivosidenib-azacitidine, with a median OS of 29.3 months, sustained survival and hematologic benefits in mutant IDH1 AML.
AML Clinical Trial Results | TIBSOVO® (ivosidenib tablets)
In the clinical study, 51% of people (37 out of 72) on TIBSOVO + azacitidine achieved complete remission (CR) or complete remission with partial hematologic ...
Ivosidenib and Azacitidine in IDH1-Mutated Acute Myeloid ...
Ivosidenib and azacitidine showed significant clinical benefit as compared with placebo and azacitidine in this difficult-to-treat population.
NCT03173248 | Study of AG-120 (Ivosidenib) vs. Placebo ...
Study AG120-C-009 is a global, Phase 3, multicenter, double-blind, randomized, placebo-controlled clinical trial to evaluate the efficacy and safety of ...
TIBSOVO® safety profile in acute myeloid leukemia (AML)
Review common adverse reactions to TIBSOVO® and other important safety information for patients with AML. See Full Prescribing Information & Boxed Warning.
TIBSOVO (ivosidenib tablets - accessdata.fda.gov
TIBSOVO is indicated for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible isocitrate dehydrogenase-1 ...
Updated efficacy and safety data from the AGILE study in ...
Updated efficacy and safety data ... Changes in health-related quality of life in patients with newly diagnosed acute myeloid leukemia receiving ...
9.
investor.agios.com
investor.agios.com/news-releases/news-release-details/agios-presents-updated-data-ivosidenib-phase-1-dose-escalationPress Release Details
Single Agent Ivosidenib Demonstrated CR+CRh Rate of 42.4% and Overall Response Rate (ORR) of 57.6% in Newly Diagnosed AML Patients ...
TIBSOVO® (ivosidenib tablets)
#1 Prescribed FDA-Approved · Acute myeloid leukemia (AML) · MYELODYSPLASTIC SYNDROMES (MDS) · Cholangiocarcinoma (bile duct cancer) · IMPORTANT SAFETY INFORMATION.
Other People Viewed
By Subject
By Trial
Related Searches
Unbiased Results
We believe in providing patients with all the options.
Your Data Stays Your Data
We only share your information with the clinical trials you're trying to access.
Verified Trials Only
All of our trials are run by licensed doctors, researchers, and healthcare companies.