RecruitingPhase 3NCT06713837

IMPACT-AML: A Randomized Pragmatic Clinical Trial for Relapsed or Refractory Acute Myeloid Leukemia.

IMPACT-AML: A Randomized Pragmatic Clinical Trial for Relapsed or Refractory Acute Myeloid Leukemia. IMPACT-AML RPCT


Sponsor

Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS

Enrollment

339 participants

Start Date

Feb 27, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

This is a multicenter, randomized, open-label, pragmatic low intervention clinical trial comparing high intensity reinduction chemotherapy with low intensity therapies in 1st or 2nd relapse Acute Myeloid Leukemia. The study is funded by European Commission (HORIZON-MISS-2022-CANCER-01-03, Project ID 101104421)


Eligibility

Min Age: 18 Years

Inclusion Criteria10

  • Non-Acute promyelocytic leukemia (APL) AML defined according World Health Organization (WHO) 2022 (or International Consensus Classification (ICC) 2022) criteria
  • st or 2nd relapse or refractory according to European leukemia Network (ELN) 2022
  • Patient is clinically candidate to both low intensity therapy and high dose chemotherapy in the opinion of the physician
  • Both low intensity therapy and high dose chemotherapy to which patient is candidate are available and can be provided as per local practice
  • No specific treatment protocol can be rationally considered better suited to patient needs.This specifically include, but is not limited to:
  • i) the availability of a drug that is already demonstrated superior to comparator arm and can be considered the only standard of care ii) specific contraindications related to fitness or any medical conditions that deem to avoid one of the two arms of this randomization iii) patient willingness to avoid one of the two arm of this randomization iv) lack of social support that make unfeasible one of the two arm of this randomization
  • Male or Female, aged\>18 years
  • Eastern Cooperative Oncology Group (ECOG) performance status \<4
  • A female participant is eligible to participate if she is not pregnant and not breastfeeding. If Women of childbearing potential (WOCBP), negative serum pregnancy test within 14 days of starting treatment must be obtained. WOCBP must adopt highly effective birth control methods, according to guideline "Recommendation related to contraception and pregnancy testing in clinical trials". Male patient and his female partner who is of childbearing potential must use 2 methods of birth control (a condom as a barrier method of contraception and one of the highly effective birth control methods, according to guideline "Recommendation related to contraception and pregnancy testing in clinical trials". Use of- and compliance to- birth control methods are required beginning at the screening visit and continuing until 6 months following last treatment with study drug.
  • Participant is willing and able to give informed consent for participation in the study

Exclusion Criteria3

  • Known contraindication to the study drug that will be selected by the treating physician within the list of high or low intensity treatment, according to most update version of Summary of Product Characteristics (SmPC) (e.g. hypersensitivity, allergy, organ failure precluding treatment)
  • Participation in another clinical trial with any investigational agents within 14 days or 5 drug half-lives (whatever comes first) prior to randomization
  • Active infections or other clinical conditions that in the opinion of the investigator make the patient ineligible to receive study treatment.

Interventions

DRUGHigh intensity therapies

* High and intermediate dose Cytarabine * Mitoxantrone - Etoposide - Cytarabine (MEC) * fludarabine - cytarabine - idarubicin - G-CSF (FLAG-IDA) * cladribine - high dose cytarabine (2CDA+HDAraC) * mitoxantrone - intermediate dose cytarabine (MiDAC) * fludarabine - amsacrine - cytarabine (FLAMSA) * Mitoxantrone - Intermediate-dose Cytarabine (HAM) * 3+7 (cytarabine and daunorubicine or idarubicine)

DRUGLow intensity therapies

* Venetoclax+hypomethylating agent (decitabine, azacitidine) * Venetoclax+low dose cytarabine * Gilteritinib alone or in combination with low dose hypomethylating agent or low dose cytarabine * 2CDA 5mg/sqm + low dose cytarabine * Glasdegib+low dose cytarabine * Ivosidenib alone or in combination with low dose hypomethylating agent or low dose cytarabine * Single agent Gemtuzumab or Gemtuzumab in combination with alone or in combination with low dose hypomethylating agent or low dose cytarabine


Locations(37)

Policlinico Sant'Orsola

Bologna, BO, Italy

IRCCS Ospedale Policlinico San Martino

Genova, GE, Italy

University Hospital Brno

Brno, Czechia

University Hospital Hradec Králové

Hradec Králové, Czechia

University Hospital Olomouc

Olomouc, Czechia

University Hospital in Ostrava

Ostrava, Czechia

University Hospital in Pilsen

Pilsen, Czechia

Uniklinik RWTH Aachen

Aachen, Germany

University Hospital Greifswald

Greifswald, Germany

Krankenhaus St. Elisabeth und St. Barbara Halle (Saale) GmbH

Halle, Germany

University Hospital Halle

Halle, Germany

University Hospital of Rostock

Rostock, Germany

Heinrich-Braun-Klinikum gGmbH

Zwickau, Germany

IRCCS Ospedale Policlinico San Martino

Genova, GE, Italy

Ospedali Riuniti Villa Sofia - Cervello

Palermo, PA, Italy

Ospedale S.Spirito - ASL Pescara

Pescara, PE, Italy

Ospedale Santa Maria della Misericordia

Perugia, PG, Italy

Ospedale Santa Maria delle Croci

Ravenna, RA, Italy

Policlinico Tor Vergata

Roma, RM, Italy

Policlinico Umberto I

Roma, RM, Italy

AOU Città della Salute e della Scienza di Torino

Torino, TO, Italy

A. O. Ordine Mauriziano

Torino, TO, Italy

ASST degli Spedali Civili

Brescia, Italy

ASST Valle Olonda

Busto Arsizio, Italy

Istituto Oncologico Veneto IRCCS

Castelfranco Veneto, Italy

AOU Careggi

Florence, Italy

IRST Istituto Romagnolo per lo Studio dei Tumori Dino Amadori

Meldola, Italy

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Milan, Italy

ASST Grande Ospedale Metropolitano Niguarda

Milan, Italy

Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli

Napoli, Italy

Azienda Ospedale-Università Padova

Padua, Italy

Ospedale Infermi

Rimini, Italy

Ospedale San Bortolo

Vicenza, Italy

The Hospital of Lithuanian University of Health Sciences Kauno Klinikos

Kaunas, Lithuania

Hospital de Santa Maria

Lisbon, Portugal

Fundeni Clinical Institute

Bucharest, Romania

Instituto de Investigación Sanitaria La Fe

Valencia, Spain

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NCT06713837


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