VAC Regimen for AML Patients Who Failed to Response to VA Regimen
A Clinical Study of Chidamide in Combination With Venetoclax and Azacitidine (VAC) for Patients With Acute Myeloid Leukemia Who Did Not Achieve CR/CRi/MLFS (PR or NR) With One Cycle of Venetoclax and Azacitidine (VA).
The First Affiliated Hospital of Soochow University
32 participants
Feb 1, 2024
INTERVENTIONAL
Conditions
Summary
Chidamide in combination with venetoclax and azacitidine (VAC) were expected to improve remission rate of patients following to VA regimen treatment failure.
Eligibility
Inclusion Criteria9
- Patients with AML who are not suitable for intensive chemotherapy according to the WHO diagnosis: age ≥60 years or age \<60 years but fulfil the following criteria;
- Age 18 to 59 years;
- Eastern Cooperative Oncology Group (ECOG) physical status score of 2 or 3;
- Expected survival time ≥3 months;
- Or fulfilment of severe cardiac, pulmonary, hepatic, or renal disease; (A) Presence of a cardiac history of congestive heart failure, or ejection fraction ≤ 50%, or presence of chronic stable angina; (B) Lung carbon monoxide diffusing capacity (DLCO) ≤ 65%, or first forced expiratory volume (FEV1) ≤ 65%; (C) Moderate hepatic impairment with total bilirubin \> 1.5 to ≤ 3.0 x upper limit of normal (ULN); (D) Creatinine clearance ≥ 30 mL/min to \< 45 mL/min;
- Not received radiotherapy, treatment regimens other than the VA regimen, or haematopoietic stem cell transplantation within 4 weeks prior to enrolment;
- Other comorbidities that, in the judgement of the physician, make the administration of intensive chemotherapy unsuitable;
- Ability to understand and willingness to sign the informed consent for this trial;
- The patient refuses intensive chemotherapy and has the willingness to accept non-intensive chemotherapy.
Exclusion Criteria11
- Patients with a history of myeloproliferative neoplasms (MPN), including myelofibrosis, thrombocythemia, polycythaemia vera, chronic granulocytic leukemia (CML) with or without BCR-ABL1 translocation, and AML or acute promyelocytic leukemia (APL) with BCR-ABL1 translocation;
- Patients with FLT3 mutations and who were treated with targeted agents (inclusion is possible if the use of specific targeted agents is discontinued);
- Patients with less than 50% reduction of blasts after VA regimen;
- Patients with active CNS involvement;
- With prior treatment with chidamide;
- Clinically uncontrolled active infections (including bacterial, fungal or viral infections) and organ hemorrhage;
- Pregnant or lactating women;
- Participation in any other clinical trial within 3 months prior to VAC regimen;
- With other malignant tumours;
- With uncontrolled mental disorders;
- Any other condition that, in the opinion of the investigator, makes it inappropriate to participate in this trial.
Interventions
Enrolled patients were given chidamide 10 mg every day on days 1-14, azacitidine 75mg/m2 every day on days 1-7, and oral venetoclax began at 100mg on day 1 and increased stepwise over 3 days to reach the target dose of 400mg (100mg, 200mg, and 400mg) on days 1-28. Dose adjustments for concomitant venetoclax with CYP3A4 inhibitors were made according to the literature.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06220162