20 Participants Needed

Azacitidine/Decitabine + Venetoclax for Acute Myeloid Leukemia

Recruiting at 3 trial locations
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Brian Jonas
Must be taking: Decitabine, Azacitidine
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you cannot use other investigational agents or certain anticancer therapies close to starting the trial. It's best to discuss your specific medications with the trial team.

What data supports the effectiveness of the drug combination Azacitidine/Decitabine and Venetoclax for treating Acute Myeloid Leukemia?

Research shows that combining venetoclax with azacitidine improves remission rates and survival in older or unfit patients with acute myeloid leukemia compared to azacitidine alone. Additionally, a study found that this combination leads to rapid and deep remission in patients not suitable for standard chemotherapy, with tolerable side effects.12345

Is the combination of Azacitidine/Decitabine and Venetoclax safe for treating acute myeloid leukemia?

The combination of Azacitidine and Venetoclax is generally considered safe for treating acute myeloid leukemia, especially in older patients. Common side effects include bone marrow suppression (reduced blood cell production), infections, nausea, vomiting, and fatigue, but these are often less severe compared to other treatment regimens.12346

How is the drug combination of Azacitidine/Decitabine and Venetoclax unique for treating acute myeloid leukemia?

This drug combination is unique because it is specifically used for older patients or those who cannot undergo standard chemotherapy, and it improves remission rates and survival compared to using Azacitidine alone.12347

What is the purpose of this trial?

This phase II trial evaluates the effect of azacitidine or decitabine and venetoclax in treating patients with acute myeloid leukemia that has not been treated before (treatment naive) or has come back (relapsed). Chemotherapy drugs, such as azacitidine, decitabine, and venetoclax, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.

Research Team

Brian Andrew Jonas, M.D., Ph.D. for UC ...

Brian Jonas, MD

Principal Investigator

University of California, Davis

Eligibility Criteria

Adults diagnosed with acute myeloid leukemia (AML) who have not been treated for AML before or whose AML has returned. They must have previously failed treatment with hypomethylating agents for a related blood disorder and be able to take oral medication. Women of childbearing age must test negative for pregnancy and agree to use contraception, as should men with partners of childbearing potential.

Inclusion Criteria

Total bilirubin =, 1.5 x institution's ULN unless related to AML or Gilbert's syndrome
My diagnosis is AML, confirmed by the latest WHO criteria.
I had a bone marrow transplant for a blood disorder more than 3 months ago.
See 11 more

Exclusion Criteria

I have been diagnosed with acute promyelocytic leukemia.
I am not using, and do not plan to use, any experimental drugs within 14 days before starting venetoclax.
I haven't taken strong or moderate CYP3A inducers in the last week.
See 12 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive azacitidine or decitabine and venetoclax. Azacitidine is administered IV or SC on days 1-7, or decitabine IV on days 1-5, and venetoclax PO daily on days 1-28. Cycles repeat every 28 days.

Up to 1 year

Follow-up

Participants are monitored for safety and effectiveness after treatment, including overall response rate and measurable residual disease status.

Up to 1 year

Treatment Details

Interventions

  • Azacitidine
  • Decitabine
  • Venetoclax
Trial Overview The trial is testing the combination of chemotherapy drugs azacitidine or decitabine with venetoclax in patients with AML that's either new or has come back after previous treatments. The goal is to see how well these drugs work together in stopping cancer cell growth by killing them, halting division, or preventing spread.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Treatment (azacitidine, decitabine, venetoclax)Experimental Treatment3 Interventions
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7 (for patients with prior decitabine use), or decitabine IV on days 1-5 (for patients with prior azacitidine), and venetoclax PO daily on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Azacitidine is already approved in European Union, United States, Canada, Japan for the following indications:

🇪🇺
Approved in European Union as Vidaza for:
  • Acute myeloid leukemia
  • Chronic myelomonocytic leukemia
  • Myelodysplastic syndromes
🇺🇸
Approved in United States as Vidaza for:
  • Myelodysplastic syndromes
  • Chronic myelomonocytic leukemia
🇨🇦
Approved in Canada as Vidaza for:
  • Myelodysplastic syndromes
  • Acute myeloid leukemia
🇯🇵
Approved in Japan as Vidaza for:
  • Myelodysplastic syndromes
  • Acute myeloid leukemia

Find a Clinic Near You

Who Is Running the Clinical Trial?

Brian Jonas

Lead Sponsor

Trials
5
Recruited
80+

AbbVie

Industry Sponsor

Trials
1,079
Recruited
535,000+
Founded
2013
Headquarters
North Chicago, USA
Known For
Immunology treatments
Top Products
Humira (adalimumab), Skyrizi (risankizumab), Rinvoq (upadacitinib)

Dr. Roopal Thakkar

AbbVie

Chief Medical Officer since 2023

MD from Wayne State University School of Medicine

Robert A. Michael profile image

Robert A. Michael

AbbVie

Chief Executive Officer

Bachelor's degree in Finance from the University of Illinois

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Findings from Research

In a phase II study involving 60 older or unfit patients with newly diagnosed acute myeloid leukemia (AML), the combination of venetoclax with cladribine and low-dose cytarabine alternating with venetoclax and 5-azacitidine resulted in a high composite complete response rate of 93%.
The treatment showed promising overall survival and disease-free survival rates, with only one death occurring within 4 weeks, indicating that this regimen is effective and has a favorable safety profile for this patient population.
Phase II Study of Venetoclax Added to Cladribine Plus Low-Dose Cytarabine Alternating With 5-Azacitidine in Older Patients With Newly Diagnosed Acute Myeloid Leukemia.Kadia, TM., Reville, PK., Wang, X., et al.[2023]
In patients with newly diagnosed unfit acute myeloid leukemia (AML), the combination of azacitidine and venetoclax is a standard first-line treatment.
However, patients with TP53-mutated AML and poor-risk cytogenetics do not benefit from adding venetoclax to azacitidine, suggesting that alternative treatment regimens should be considered for these individuals.
TP53 or Not TP53: That Is the Question.Green, SD., Zeidner, JF.[2023]
In a phase 1/2 study involving six Japanese patients aged 60 and older with acute myeloid leukaemia, the combination of venetoclax and azacitidine demonstrated a high response rate, with 83% of patients achieving a response, including three complete remissions.
The treatment was generally well tolerated, with a median overall survival of 15.7 months, although some patients experienced serious adverse events, including grade 3 fungal pneumonia, which required treatment adjustments.
Venetoclax in combination with azacitidine in Japanese patients with acute myeloid leukaemia: phase 1 trial findings.Taniguchi, S., Yamauchi, T., Choi, I., et al.[2021]

References

Phase II Study of Venetoclax Added to Cladribine Plus Low-Dose Cytarabine Alternating With 5-Azacitidine in Older Patients With Newly Diagnosed Acute Myeloid Leukemia. [2023]
TP53 or Not TP53: That Is the Question. [2023]
Venetoclax in combination with azacitidine in Japanese patients with acute myeloid leukaemia: phase 1 trial findings. [2021]
SARS-CoV-2 Infection in Patients Treated with Azacitidine and Venetoclax for Acute Leukemia: A Report of a Case Series Treated in a Single Institution. [2023]
[Efficacy of venetoclax combined azacitidine in newly diagnosed acute myeloid leukemia unfit for standard chemotherapy: a single center experience]. [2023]
[Efficacy and safety of venetoclax combined with azacitidine versus CAG regimen combined with decitabine in elderly patients with relapsed acute myeloid leukemia]. [2022]
Not BCL2 mutation but dominant mutation conversation contributed to acquired venetoclax resistance in acute myeloid leukemia. [2022]
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