RecruitingPhase 1NCT07320235

Imetelstat Combinations in Relapsed AML

IMetelstat and Azacitidine With or Without Venetoclax GIveN in rElapsed Acute Myeloid Leukemia (IMAGINE Trial)


Sponsor

Douglas Tremblay

Enrollment

36 participants

Start Date

Jan 2, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

IMAGINE is a two-part trial to evaluate the safety and preliminary efficacy of imetelstat in combination with azacitidine with or without venetoclax in patients with relapsed or refractory AML. The trial will consist of a safety run-in phase (Part A) employing a 3+3 design to monitor dose-limiting toxicities of imetelstat when administered in combination with a fixed dose of azacitidine. Part B will consist of a phase 1b trial employing a BOIN12 design to determine the optimal biological dose of imetelstat, starting at a lower dose level, in combination with azacitidine and venetoclax. Total of up to 36 participants will be accrued over 54 months at Mount Sinai Hospital. Estimated duration of trial is 114 months including recruitment, screening, treatment, and follow-up.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is testing imetelstat — a drug that targets cancer cell division — in combination with other treatments in people with relapsed or treatment-resistant acute myeloid leukemia (AML), a type of blood cancer. **You may be eligible if...** - You are 18 or older - You have confirmed AML (non-APL type) that has not responded to or has relapsed after at least one prior treatment - No standard treatment is available that may provide benefit - You have a life expectancy of at least 12 weeks - You are in reasonably good physical condition (ECOG 0–3) **You may NOT be eligible if...** - You have active cancer involving the brain or spinal fluid (CNS) - You do not meet organ function requirements (adequate kidney, liver, and bone marrow function) - You are pregnant or breastfeeding (women of childbearing potential must use highly effective contraception) - You are unwilling to use contraception during and for 6 months after treatment (for both men and women) Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGImetelstat

Three 3 dose levels administered on Day 1 of each 28-day cycle for Safety Run-in Phase and optimal dose to be administered on Day 1 of each 28-day cycle

DRUGAzacitidine

75mg/m2 IV or subcutaneous (SQ) once daily for Days 1 (+/- 1 day) through 7 (+/- 1 day) of each 28-day cycle. Azacitidine can be administered locally as long as documentation of administration is provided to the study team.

DRUGVenetoclax

Venetoclax 400mg oral once daily for Days 1 (+/- 1 day) through 14 (+/- 1 day) of each 28-day cycle. Venetoclax reduced dosey should be substituted if concomitant posaconazole, or if other concomitant strong CYP3A4 inhibitor (e.g. voriconazole) or 200mg for moderate CYP3A4 inhibitor (e.g. isavuconazole). For Cycle 1, participants will receive a venetoclax ramp-up dose on day 1, day 2, and days 3-14 of venetoclax,. If the participant is being treated with concomitant posaconazole, or other concomitant strong CYP3A4 inhibitor, or with a concomitant moderate CYP3A4 inhibitor or a pg-p inhibitor, participants will receive a lower ramp-up dose on day 1, day 2, and days 3-14 of venetoclax.


Locations(1)

Icahn School of Medicine at Mount Sinai

New York, New York, United States

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NCT07320235


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