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Closed (no longer recruiting)Last updated: 7 February 2024

CAVEAT: This phase I trial is evaluating the investigational drug, venetoclax, in combination with chemotherapy for the treatment of Acute Myeloid Leukaemia (AML)A phase Ib clinical evaluation of Venetoclax in combination with chemotherapy in older patients with Acute Myeloid Leukemia

Clinical summary

Summary

The primary purpose of this trial is to evaluate the safety and efficacy of venetoclax in combination with chemotherapy for the treatment of acute myeloid leukaemia (AML) in elderly patients. Who is it for? You may be eligible to participate in this trial if you are aged 60 or over with monosomal karyotype, or aged 65 or over with any karyotype, and have been diagnosed with AML for which you have received no induction chemotherapy. Study details All participants enrolled in this trial will be administered Venetoclax in combination with modified-dose chemotherapy. The dose provided will depend on the time of enrolment - each sequentially enrolled group of participants will be administered with a slightly higher dose than the previous group, pending a review of the safety of the previous dose. Participants will have an induction treatment consisting of 14 days Venetoclax tablets, 5 days IV Cytarabine and 2 days IV Idarubicin. For participant achieving a response to treatment there will be up to 4 further cycles of 14 days Venetoclax, 2 days Cytarabine and 1 day Idarubicin or until adequate blood count recovery. Participants will be assessed through blood samples taken daily during initial hospitalisation and then at the end of each cycle of treatment, bone marrow samples taken 3 times during induction and then every other cycle as well as a physical exam every cycle in order for researchers to monitor whether the treatment is safe and whether it is effectively treating the AML. It is hoped that the findings of this trial will provide information on the optimal dose of Venetoclax in combination with chemotherapy for the safe and effective treatment of AML in elderly patients.

Conditions

This trial is treating patients with Acute Myeloid Leukaemia

Cancer

Blood Cancers Haematological

Age

People60+

Phase

I

Trial Acronym

CAVEAT

More information

Trial Identifiers

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Trial sponsor

Alfred Health

Scientific Title

A phase Ib clinical evaluation of Venetoclax in combination with chemotherapy in older patients with Acute Myeloid Leukemia

Eligibility

Inclusion

1. De novo, secondary or therapy-related AML (except Acute Promyelocytic Leukaemia) without prior exposure to induction chemotherapy (not including hydroxyurea, low-dose cytarabine eg ~20mg bd, hypomethylating agents or non-chemotherapy-based investigational agents)
2. Age greater than or equal to 65
3. Or Age greater than or equal to 60 and monosomal karyotype
4. ECOG performance status 0-1
5. Adequate hepatic function as defined by bilirubin less than or equal to 1.5 x the upper limit of normal (ULN, excluding Gilbert’s syndrome) and AST & ALT less than or equal to 2.5 x ULN (unless due to leukemic involvement)
6. Adequate renal function as defined by eGFR>50ml/min as assessed by eCCr =(140 – Age) x (Weight in kg) x [1.23 if Male, 1.04 if Female]/Serum Creatinine (micromol/L)
7. WCC less than 25 x 109/L (hydroxyurea allowable to reduce WCC prior to day 1 of study)

Exclusion

 

1. Prior investigational anti-leukemia agents within 14 days of day 1 of study drug; demethylating agents within 14 days of day 1 of study drug; and hydroxyurea within 24 hrs prior to day 1 of study drug.
2. Prior exposure to Venetoclax or other BCL2 inhibitors
3. Prior anthracycline exposure for previous cancer
4. Any serious medical condition which the investigator feels may lead to an unacceptably high risk of treatment related death from 5+2 induction
5. Concurrent malignancy likely to affect treatment safety or study procedures
6. Known HIV infection
7. Uncontrolled viral hepatitis type B or C
8. Males with a female partner of childbearing potential must agree to use at least 2 effective contraceptive methods throughout the study and for 30 days following the date of last dose
9. Cardiac ejection fraction <45%
10. Subject has received the following within 7 days prior to the initiation of study treatment:
*Potent CYP3A inducers such as rifampin, carbamazepine, phenytoin, and St. John's wort;
*Warfarin or requires the use of warfarin (due to potential drug-drug interactions that may potentially increase the exposure of warfarin and complications of this effect).
11. Subject has received the following within 5 days prior to the initiation of study treatment:
* CYP3A inhibitors such as fluconazole, ketoconazole, and clarithromycin.
12. Subject has consumed grapefruit, grapefruit products, Seville oranges (including marmalade containing Seville oranges) or Starfruit within 3 days prior to the initiation of study treatment.
13. Subject has a history of other malignancies prior to study entry, with the exception of:
*Adequately treated in situ carcinoma of the breast or cervix uteri;
*Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin;
*Previous malignancy confined and surgically resected (or treated with other modalities) with curative intent.
*Prior malignancy treated >4 years ago and no evidence of active disease

Exclusion

  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
  • You have previously been treated (or are currently being treated) on a clinical trial.
Message

Clinical trials have complex eligibility criteria.

Ask your doctor if this trial could be right for you.

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