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Phase 1 study of Venetoclax/Azacitidine or Venetoclax in combination with Ziftomenib (KO-539) or standard induction Cytarabine/Daunorubicin (7+3) chemotherapy in combination with Ziftomenib for the treatment of patients with Acute Myeloid Leukemia
Cancer Categories
Hematologic (Blood Cancers)
Karmanos Trial ID
2023-014
NCT ID
NCT05735184
Age Group
Adult
Scope
National
Phase
Phase I
Includes initial studies to determine the metabolism and pharmacologic actions of drugs in humans, the side effects associated with increasing doses, and to gain early evidence of effectiveness; may include healthy participants and/or patients.
Phase I
Principal Investigator
Suresh
Balasubramanian, M.D.
Oncology - Hematology, Oncology - Medical
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Objective:
Primary Objectives:
To determine the safety and tolerability of
ziftomenib combined with SOC treatments in adults
with newly diagnosed NPM1-m or KMT2A-r AML
and for ziftomenib combined with SOC treatments
in NPM1-m or KMT2A-r patients with relapsed or
refractory AML
To determine the antileukemic activity of
ziftomenib combined with SOC treatments in adults
with newly diagnosed NPM1-m or KMT2A-r AML
and for ziftomenib combined with SOC treatments
in NPM1-m or KMT2A-r patients with relapsed or
refractory AML
Secondary Objectives:
To evaluate survival, disease control outcomes and
additional markers of antileukemic activity for
ziftomenib combined with SOC treatments in adults
with newly diagnosed NPM1-m or KMT2A-r AML
and for ziftomenib combined with SOC treatments
in NPM1-m or KMT2A-r patients with relapsed or
refractory AML
Characterize the pharmacokinetics of ziftomenib
and metabolites when administered in combination
with SOC treatments in adults with newly
diagnosed NPM1-m or KMT2A-r AML and for
ziftomenib combined with SOC treatments in
NPM1-m or KMT2A-r patients with relapsed or
refractory AML
To evaluate the potential drug interaction of
ziftomenib on venetoclax (i.e., potential inhibition
of CYP3A4 metabolism of venetoclax by
ziftomenib)
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Eligibility
Locations
Applicable Disease Site
Therapies | Drugs | Devices
Eligibility
Eligibility
Inclusion Criteria:
Patients must have a documented NPM1 mutation or KMT2A rearrangement and have either newly diagnosed or relapsed/refractory AML
Those intending treatment with intensive chemotherapy in Arm C should be NPM1-m and FLT3-ITD+ with an allelic ratio ≥0.05 and eligible for FLT3-targeted treatment
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
Adequate liver, renal, and cardiac function according to protocol defined criteria
A female of childbearing potential must agree to use adequate contraception as well as a double barrier method from the time of screening through 180 days following the last dose of study intervention. A male of childbearing potential must agree to use abstinence or use a double barrier method of contraception from the time of screening through 180 days following the last dose of study intervention
Female patients of childbearing potential who receive quizartinib in Arm C should use a highly effective method of contraception during quizartinib treatment and for 7 months after the last dose
Exclusion Criteria:
Diagnosis of either acute promyelocytic leukemia or blast phase chronic myeloid leukemia
Known history of BCR-ABL alteration
Advanced malignant hepatic tumor
Administration of live attenuated vaccines within 14 days prior to, during, or after treatment until B-cell recovery
Active central nervous system (CNS) involvement by AML.
Clinical signs/symptoms of leukostasis or WBC > 25,000 / microliter. Hydroxyurea and/or leukapheresis and/or up to 2 doses of cytarabine if used per institutional SOC for control of leukocytosis are permitted to meet this criterion
Not recovered to Grade ≤1 (NCI-CTCAE v5.0) from all nonhematological toxicities except for alopecia
Known clinically active human immunodeficiency virus, active hepatitis B or active hepatitis C infection
For newly diagnosed cohorts: received prior chemotherapy for leukemia, except hydroxyurea and/or leukapheresis and/or up to 2 doses of cytarabine per institutional standards to control leukocytosis, or prior treatment with all-transretinoic acid for initially suspected acute promyelocytic leukemia
For relapsed/refractory cohorts: received chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational < 14 days prior to the first dose of ziftomenib or within 5 drug half-lives prior to the first dose of study drug
Uncontrolled intercurrent illness including, but not limited to, cardiac illness as defined in the protocol
Mean QT interval corrected for heart rate by Fredericia's formula (QTcF)
Arm A and Arm B: >480 ms on triplicate ECGs
Arm C: >450 ms on triplicate ECGs
Uncontrolled infection
Women who are pregnant or lactating
An active malignancy and currently receiving chemotherapy for that malignancy or disease that is uncontrolled/progressing
Locations
Locations
Karmanos Cancer Institute - Detroit Headquarters
4100 John R
Detroit, MI 48201
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Phone:
1-800-527-6266
Karmanos Cancer Institute at Weisberg Cancer Center - Farmington Hills
31995 Northwestern Hwy
Farmington Hills, MI 48334
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Phone:
1-800-527-6266
Applicable Disease Site
Applicable Disease Site
Myeloid and Monocytic Leukemia
Therapies, Drugs, Devices
Therapies | Drugs | Devices
Therapies
Chemotherapy, Immunotherapy
Drugs
Azacitdine; Cytarabine; Daunorubicin; Quizartinib; Venetoclax; Ziftomenib
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