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Brief Title: Clinical Trial to Assess the Safety and Tolerability of the Combination of Low-dose Cytarabine or Azacitidine Plus Venetoclax and Quizartinib in Newly Diagnosed AML Patients Aged Equal or More Than 60 Years Old
Official Title: A Phase I-II, Multicentre, Open Label Clinical Trial to Assess the Safety and Tolerability of the Combination of Low-dose Cytarabine or Azacitidine, Plus Venetoclax and Quizartinib in Newly Diagnosed Acute Myeloid Leukemia Patients Aged Equal or More Than 60 Years Old Ineligible for Standard Induction Chemotherapy
Study ID: NCT04687761
Brief Summary: A phase I-II trial based on the combination of three drugs regimen LDAC or Azacitidine + Venetoclax + Quizartinib that in this population could be well tolerated by a sequential type administration. The first objective is to achieve rapid control of the disease, using two different schemes, one based in Azacitidine and the other in LDAC, by dose escalation in phase I of the trial. The second goal is to prevent relapse through a maintenance schedule. Phase II will study the efficacy and safety of the recommended dose for Phase II
Detailed Description: The prognosis of AML in elderly patients remain very poor and without significant advances in last decades. AML is a heterogeneous disease in which many altered molecular pathways could contribute to the disease. Thus, curative approaches have been based on highly eradicating regimens using high-dose chemotherapy. However, the low rate of CRs and the high rate of deaths due to toxicity and relapses in elderly patients should stimulate the development of new regimens that overcome these therapeutic obstacles. In recent years, there are a series of new drugs under development that allow the design of sequential combination therapies in this vulnerable population. These drugs have an acceptable toxicity profile and are apparently effective in monotherapy or even in combination, being able to improve the CR rate in this population. The investigators hypothesize that the combination of two targeted drugs that have different mechanisms of action could be capable of breaking the viability of leukemic cells as well as their proliferative qualities, and therefore prolong survival. In this way, the combined action of a pro-apoptotic agent (Venetoclax) and an antiproliferative agent (Quizartinib) could produce a powerful antileukemic effect, preventing the adaptive escape mechanisms of leukemic cells. The investigators have designed a phase I-II trial based on the combination of three drugs regimen LDAC or Azacitidine + Venetoclax + Quizartinib that in this population could be well tolerated by a sequential type administration. The first objective is to achieve rapid control of the disease, using two different schemes, one based in Azacitidine and the other in LDAC, by dose escalation in phase I of the trial. The second goal is to prevent relapse through a maintenance schedule. Phase II will study the efficacy and safety of the recommended dose for Phase II.
Minimum Age: 60 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Hospital Universitario Príncipe de Asturias, Alcalá De Henares, , Spain
Hospital Clínic, Barcelona, , Spain
Hospital San Pedro de Alcántara, Cáceres, , Spain
Hospital Universitario de Jerez de La Frontera, Jerez De La Frontera, , Spain
Hospital de León (Complejo Asistencial Universitario de León), León, , Spain
Hospital Universitari Arnau de Vilanova de Lleida, Lleida, , Spain
Hospital Universitario Infanta Leonor, Madrid, , Spain
Hospital Universitario La Zarzuela, Madrid, , Spain
Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, , Spain
Hospital de Sant Joan de Deu (Manresa), Manresa, , Spain
Hospital Clinico Universitario Virgen de La Arrixaca, Murcia, , Spain
Hospital Universitari Son Espases, Palma De Mallorca, , Spain
Hospital Universitario Marques de Valdecilla, Santander, , Spain
Hospital Universitari Mutua de Terrassa, Terrassa, , Spain
Hospital Universitario y Politécnico La Fe, Valencia, , Spain
Name: Pau Montesinos, MD
Affiliation: Hospital Universitario La Fe
Role: PRINCIPAL_INVESTIGATOR
Name: Juan Bergua, MD
Affiliation: Hospital San Pedro Alcántara
Role: PRINCIPAL_INVESTIGATOR
Name: Carmen López-Carrero García
Affiliation: Fundación PETHEMA
Role: STUDY_CHAIR