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Phase 2 Completed N=94 Treatment

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

OutcomeResultp-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
View full record on ClinicalTrials.gov →

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.

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