Phase 2
Completed N=94
A Study Evaluating Venetoclax in Combination With Low-Dose Cytarabine in Treatment-Naïve Participants With Acute Myelogenous Leukemia
Source: ClinicalTrials.gov NCT02287233 ↗Enrolled (actual)
94
Serious AEs
91.3%
Results posted
Aug 2022
Primary outcomePrimary: Phase 1: Number of Participants With Dose-limiting Toxicities — 0; 1 Participants
Summary
This study consists of two parts: A Phase 1 dose-escalation part that will evaluate the safety and pharmacokinetic profile of venetoclax in combination with low-dose cytarabine (LDAC), define the maximum tolerated dose (MTD), and generate data to support a recommended Phase 2 dose (RPTD) in treatment-naïve participants with acute myelogenous leukemia (AML); and a Phase 2 part that will evaluate if the RPTD has sufficient efficacy and acceptable toxicity to warrant further development of the combination therapy.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Phase 1: Number of Participants With Dose-limiting Toxicities |
0; 1 | — |
| PRIMARY Phase 1: Maximum Observed Plasma Concentration (Cmax) of Venetoclax |
2.04; 2.26; 2.92; 2.36 | — |
| PRIMARY Phase 1: Time to Maximum Observed Plasma Concentration (Tmax) of Venetoclax |
4.0; 8.0; 7.0; 6.6 | — |
| PRIMARY Phase 1: Area Under the Plasma Concentration-Time Curve Over Time From 0 to 24 Hours (AUC0-24) of Venetoclax |
33.3; 33.4; 51.8; 35.4 | — |
| PRIMARY Phase 1: Maximum Observed Plasma Concentration (Cmax) of Cytarabine |
175; 174; 166; 175 | — |
| PRIMARY Phase 1: Time to Maximum Observed Plasma Concentration (Tmax) of Cytarabine |
0.3; 0.3; 0.3; 0.3 | — |
| PRIMARY Phase 1: Area Under the Plasma Concentration-Time Curve Over Time From 0 to Last Measurable Concentration (AUCt) of Cytarabine |
194; 204; 231; 202 | — |
| PRIMARY Overall Response Rate |
54.9 | — |
| PRIMARY Number of Participants With Treatment-emergent Adverse Events (TEAEs) |
8; 10; 74; 8; 10; 72 | — |
| SECONDARY Complete Remission Rate |
25.6 | — |
| SECONDARY Complete Remission Plus CR With Incomplete Blood Count Recovery (CRi) Rate |
53.7 | — |
| SECONDARY CR Plus CRi Rate by Initiation of Cycle 2 |
28.0 | — |
| SECONDARY Time to First Response of CR + CRi |
1.4 | — |
| SECONDARY Time to Best Response of CR + CRi |
2.8 | — |
| SECONDARY Complete Remission With Partial Hematologic Recovery (CRh) Rate |
20.7 | — |
| SECONDARY CR Plus CRh Rate |
46.3 | — |
| SECONDARY CR Plus CRh Rate by Initiation of Cycle 2 |
30.5 | — |
| SECONDARY Time to First Response of CR Plus CRh |
1.0 | — |
| SECONDARY Time to Best Response of CR Plus CRh |
2.6 | — |
| SECONDARY Best Response Based on IWG Criteria |
21; 23; 1; 6; 19; 4 | — |
| SECONDARY Duration of Complete Response |
14.8 | — |
| SECONDARY Duration of CR Plus CRi |
9.8 | — |
| SECONDARY Duration of CRi |
4.7 | — |
| SECONDARY Duration of CR Plus CRh |
11.0 | — |
| SECONDARY Overall Survival (OS) |
9.7 | — |
| SECONDARY Post Baseline Transfusion Independence Rate |
45.1; 47.6; 58.5 | — |
| SECONDARY Post Baseline Transfusion Independence Rate Among Participants Transfusion-dependent at Baseline |
45.0; 45.3; 60.9 | — |
| SECONDARY Duration of Post Baseline Transfusion Independence |
150; 123; 155.5 | — |
Eligibility Criteria
Inclusion Criteria
- Participant must be greater than or equal to 65 years of age in Phase 1 and 2. Participants enrolled in Cohort C must be either:
- greater than or equal to 75 years of age; OR
- greater than or equal to 60 to 74 years will be eligible if the participants has at least one of the following co-morbidities, which make the participant unfit for intensive chemotherapy:
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 2 - 3;
- Cardiac history of congestive heart failure (CHF) requiring treatment or ejection fraction less than or equal to 50% or chronic stable angina;
- Diffusion capacity of carbon monoxide (DLCO) less than or equal to 65% or forced expiratory volume in one second (FEV1) less than or equal to 65%;
- Creatinine clearance greater than or equal to 30 mL/min to less than 45 ml/min (calculated by Cockcroft-Gault formula)
- Moderate hepatic impairment with total bilirubin greater than 1.5 to less than or equal to 3.0 × upper limit of normal (ULN)
- Any other comorbidity that the physician judges to be incompatible with intensive chemotherapy must be reviewed and approved by the study medical monitor before study enrollment
- Participant must have a projected life expectancy of at least 12 weeks.
- Participant must have histological confirmation of AML and be ineligible for treatment with a standard cytarabine and anthracycline induction regimen due to co-morbidity or other factors.
- Participant must have received no prior treatment for AML with the exception of hydroxyurea, allowed through the first cycle of study treatment. Note: Participant may have been treated for prior Myelodysplastic Syndrome.
- Participant must have an ECOG performance status:
- of 0 to 2 for participants greater than equal to 75 years of age
- of 0 to 3 for participants greater than equal to 60 to 74 years of age, if 0 - 1 another co-morbidity is required to make participant eligible.
- Participant must have adequate renal function as demonstrated by a creatinine clearance greater than or equal to 30 mL/min; determined via urine collection for 24-hour creatinine clearance or by the Cockcroft Gault formula.
- Participant must have adequate liver function as demonstrated by:
- aspartate aminotransferase (AST) less than or equal to 2.5 × ULN
- alanine aminotransferase (ALT) less than or equal to 2.5 × ULN
- bilirubin less than or equal to 1.5 × ULN for all participants age 75 and older
- Participants who are less than 75 years of age must have a bilirubin of less than 3.0 × ULN.
Note: Participants with Gilbert's Syndrome may have a bilirubin greater than 1.5 × ULN per discussion between the investigator and AbbVie medical monitor.
- Male participants must agree to refrain from unprotected sex and sperm donation from initial study drug administration until 180 days after the last dose of study drug.
- Participant must voluntarily sign and date an informed consent, approved by an Independent Ethics Committee (IEC)/Institutional Review Board (IRB), prior to the initiation of any screening or study-specific procedures.
- If female, participant must be either:
- Postmenopausal defined as no menses for 12 or more months without an alternative medical cause OR
- Permanently surgical sterile (bilateral oophorectomy, bilateral salpingectomy or hysterectomy)
Exclusion Criteria
- Participant has received treatment with cytarabine for a pre-existing myeloid disorder.
- Participant has acute promyelocytic leukemia (French-American-British Class M3 AML).
- Participant has known active central nervous system (CNS) involvement with AML.
- Participant has tested positive for human immunodeficiency virus (HIV).
- Participant has received the following within 7 days prior to the initiation of study treatment:
- Strong and moderate CYP3A inducers such as rifampin, carbamazepine, phenytoin, and St. John's wort.
- Participant has consumed grapefruit, grapefruit products, Seville oranges (including marmalade containing Sev
Data sourced from ClinicalTrials.gov (NCT02287233). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.