A Prospective, Multicenter, and Exploratory Study of CMGV in the Treatment of Recurrent Adult AML and MDS-EB-2/Elder AML

Launched by RUIJIN HOSPITAL · Mar 19, 2024

Keywords

ClinConnect Summary

This clinical trial is investigating a new treatment combination for adults with recurrent acute myeloid leukemia (AML) and a specific type of myelodysplastic syndrome (MDS). The treatment being studied includes a combination of medications called mitoxantrone hydrochloride liposomes, cytarabine, and G-CSF, along with a drug named Venetoclax. The main goals of the trial are to see how effective this treatment is and to check for any potential side effects.

To participate in this study, patients need to be between 18 and 75 years old and have a confirmed diagnosis of either recurrent AML or MDS. They should also be generally healthy enough to tolerate the treatment and expected to live for at least three more months. Participants can expect to receive the new treatment and will be monitored closely for how well it works and any side effects they might experience. It’s important for interested patients to discuss their eligibility and any questions with their doctor before enrolling in the study.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • The patient fully understands this study, voluntarily participates and signs an informed consent form (ICF);
• • Age: 18-75 years old (including boundary values of 18 and 75);
• * Clinically confirmed adult AML and MDS-IB2 (WHO 2022 standard) patients, AML patients meet any of the following criteria:
• • 1. Treatment related AML
• • 2. Previously had a history of MDS
• • 3. Associated with MDS related genes/chromosomal abnormalities
• • 4. Previously had a history of CMML
• • 5. Age ≥ 60 years old
• • 6. Previous history of prodromal MPN, including ET, PV, and MF, with bone marrow fibrosis ≤ grade 2 (according to the 0-3 grade standard)；
• • For elderly AML or MDS patients, the comprehensive evaluation should be based on the Fit population: ECOG\<3, no major comorbidities, and MMSE and SPPB meet the standards (refer to Appendix 8-11);
• • Expected survival time ≥ 3 months;
• • Liver and kidney function: alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 times the upper limit of normal value (ULN) (≤ 5 times the upper limit of normal value for patients with liver infiltration); Total bilirubin ≤ 1.5 times the upper limit of normal value (≤ 3 times the upper limit of normal value for patients with liver infiltration); Serum creatinine ≤ 1.5 times the upper limit of normal value;
• • The relevant treatment for MDS (excluding blood transfusion) must be completed 2 weeks before the start of the study treatment; In the case of rapidly proliferative diseases, hydroxyurea is allowed to be used until 24 hours before the start of the study treatment. Before starting the research treatment,Toxicity related to previous MDS treatment must be restored to level 2 or below.
• Exclusion Criteria:
• The researchers determined that patients who are not suitable to participate in this study. If a patient meets any of the following criteria, they will not be allowed to enter this study:
• * The subject's previous history of anti-tumor treatment meets one of the following conditions:
• • 1. Individuals who have previously received mitoxantrone or mitoxantrone liposomes;
• • 2. Previously received treatment with doxorubicin or other anthracyclines, with a total cumulative dose of doxorubicin\>360mg/m2 (1mg of doxorubicin is equivalent to 2mg of doxorubicin or 0.5mg of doxorubicin);
• • 3. Within 4 weeks prior to the first use of the study drug or within 5 half-lives of the drug, the patient has received anti-tumor treatment including surgery, chemotherapy, targeted therapy, or participated in other clinical trials and received clinical trial medication;
• * Heart function and disease meet one of the following conditions:
• • 1. Long QTc syndrome or QTc interval\>480ms;
• • 2. Complete left bundle branch block, II or III degree atrioventricular block;
• • 3. Severe and uncontrolled arrhythmias that require medication treatment;
• • 4. The New York College of Cardiology in the United States has a classification of ≥ II;
• • 5. Cardiac ejection fraction (LVEF) below 50%;
• • 6. A history of myocardial infarction, unstable angina, severe unstable ventricular arrhythmias, or any other arrhythmias requiring treatment, a history of clinically severe pericardial disease, or evidence of acute ischemic or active conduction system abnormalities on electrocardiogram within the 6 months prior to recruitment.
• • Patients who have previously or currently suffered from other malignant tumors (except for effectively controlled non melanoma skin basal cell carcinoma, breast/cervical carcinoma in situ, and other malignant tumors that have not been treated for more than 6 months and have been effectively controlled, as well as patients who have received long-term non chemotherapy treatments such as hormone therapy);
• • Uncontrollable systemic diseases (such as infection during the promotion period, uncontrollable hypertension, diabetes, etc.);
• • Central nervous system leukemia;
• • Secondary AML patients with bone marrow fibrosis ≥ grade 3;
• • CML patients with sudden changes;
• • Accompanied by a well prognosis chromosome karyotype t (8; 21) (q22; q22.1) RUNX1:: RUNX1T1, inv (16) (p13.1 q22) CBFB: MYH11, as well as acute promyelocytic leukemia;
• • Human immunodeficiency virus (HIV) infected individuals (HIV antibody positive);
• • Active infection of hepatitis B and hepatitis C (if hepatitis B B surface antigen or core antibody is positive, HBV-DNA will be tested additionally, and if HBV-DNA exceeds 1x103 copies/mL, it will be excluded; if hepatitis C antibody is positive, HCV-RNA will be tested additionally, and if hepatitis C virus RNA exceeds 1x103 copies/mL, it will be excluded);
• • Have a known history of immediate or delayed hypersensitivity reactions to similar drugs and excipients in the study drug;
• • Accompanied by a history of severe neurological or mental illness;
• • The researchers determined that there were patients who were not suitable to participate in this study.