A Study of Venetoclax in Combination With Cobimetinib and Venetoclax in Combination With Idasanutlin in Patients With Relapsed or Refractory Acute Myeloid Leukemia Who Are Not Eligible for Cytotoxic Therapy

NCT ID: NCT02670044

Last Updated: 2022-01-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

88 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-03-09

Study Completion Date

2020-12-10

Brief Summary

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The primary objective for this study is to assess the safety and tolerability as well as preliminary efficacy of venetoclax in combination with cobimetinib, and venetoclax in combination with idasanutlin in patients with relapsed or refractory acute myeloid leukemia (R/R) AML who are not eligible for cytotoxic therapy.

Detailed Description

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Conditions

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Leukemia, Myeloid, Acute

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dose Escalation: Arm A (Venetoclax 400mg + Cobi 40mg)

Participants received Venetoclax 400mg daily on Days 1-28 of each 28 day treatment cycle and Cobimetinib 40mg daily on Days 1-21 of each 28-day treatment cycle.

Group Type EXPERIMENTAL

Cobimetinib

Intervention Type DRUG

Cobimetinib will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Escalation: Arm A (Venetoclax 600mg + Cobi 40mg)

Participants received Venetoclax 600mg daily on Days 1-28 of each 28 day treatment cycle and Cobimetinib 40mg daily on Days 1-21 of each 28-day treatment cycle.

Group Type EXPERIMENTAL

Cobimetinib

Intervention Type DRUG

Cobimetinib will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Escalation: Arm A (Venetoclax 800mg + Cobi 40mg)

Participants received Venetoclax 800mg daily on Days 1-28 of each 28 day treatment cycle and Cobimetinib 40mg daily on Days 1-21 of each 28-day treatment cycle.

Group Type EXPERIMENTAL

Cobimetinib

Intervention Type DRUG

Cobimetinib will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Escalation: Arm A (Venetoclax 400mg + Cobi 60mg)

Participants received Venetoclax 400mg daily on Days 1-28 of each 28 day treatment cycle and Cobimetinib 60mg daily on Days 1-21 of each 28-day treatment cycle.

Group Type EXPERIMENTAL

Cobimetinib

Intervention Type DRUG

Cobimetinib will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Escalation: Arm B (Venetoclax 400mg + Ida 200mg)

Participants received Venetoclax 400mg daily on Days 1-28 of each 28 day treatment cycle and Idasanutlin 200mg daily or twice daily on Days 1-5 of each 28 day treatment cycle.

Group Type EXPERIMENTAL

Idasanutlin

Intervention Type DRUG

Idasanutlin will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Escalation: Arm B (Venetoclax 600mg + Ida 150mg)

Participants received Venetoclax 600mg daily on Days 1-28 of each 28 day treatment cycle and Idasanutlin 150mg daily or twice daily on Days 1-5 of each 28 day treatment cycle.

Group Type EXPERIMENTAL

Idasanutlin

Intervention Type DRUG

Idasanutlin will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Escalation: Arm B (Venetoclax 600mg + Ida 200mg)

Participants received Venetoclax 600mg daily on Days 1-28 of each 28 day treatment cycle and Idasanutlin 200mg daily or twice daily on Days 1-5 of each 28 day treatment cycle.

Group Type EXPERIMENTAL

Idasanutlin

Intervention Type DRUG

Idasanutlin will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Escalation: Arm B (Venetoclax 400mg + Ida 400mg)

Participants received Venetoclax 400mg daily on Days 1-28 of each 28 day treatment cycle and Idasanutlin 400mg daily or twice daily on Days 1-5 of each 28 day treatment cycle.

Group Type EXPERIMENTAL

Idasanutlin

Intervention Type DRUG

Idasanutlin will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Dose Optimisation: Arm B (Ven 600mg (Day 1 to 21) + Ida 150mg)

Participants received Venetoclax 600mg daily on Days 1-21 of each 28 day treatment cycle and Idasanutlin 150mg daily on Days 1-5 of each 28 day treatment cycle.

Group Type EXPERIMENTAL

Idasanutlin

Intervention Type DRUG

Idasanutlin will be administered orally as per schedule in Arm description.

Venetoclax

Intervention Type DRUG

Venetoclax will be administered orally as per schedule in Arm description.

Interventions

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Cobimetinib

Cobimetinib will be administered orally as per schedule in Arm description.

Intervention Type DRUG

Idasanutlin

Idasanutlin will be administered orally as per schedule in Arm description.

Intervention Type DRUG

Venetoclax

Venetoclax will be administered orally as per schedule in Arm description.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histological confirmation of relapsed or refractory AML after prior anti-leukemic therapy by WHO classification
* Ineligible for cytotoxic therapy defined by the following:

a. Age (\>/=) 75 years or b. age 18- 74 years with at least one of the following comorbidities: i. Eastern Cooperative Oncology Group (ECOG) Performance Status of 2 or 3 ii. Cardiac history of congestive heart failure requiring treatment or ejection fraction (\</=) 50% or chronic stable angina iii. Diffusing capacity of the lungs for carbon monoxide (\</=) 65% or forced expiratory volume in the first second of expiration (\</=) 65% iv. Creatinine clearance (\>/=) 30 mL/min to\< 45 mL/min v. any other comorbidity that the physician judges to be incompatible with intensive chemotherapy must be reviewed and approved by the Medical Monitor before screening and study enrollment.
* Life expectancy of at least 12 weeks
* Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
* Adequate liver and renal function

Exclusion Criteria

* Patients with acute promyelocytic leukemia (French-American-British \[FAB\] class M3 AML)
* Known active central nervous system (CNS) involvement with AML at study entry
* ECOG Performance Status (\>/=) 3 in patients who are (\>/=) 75 years old or ECOG Performance Status of 4, regardless of age
* Prior exposure to Bcl-2 inhibitors, murine double minute 2 (MDM2) antagonists or prior exposure to experimental treatment targeting Raf, mitogen-activated protein kinase (MEK), or the mitogen-activated protein kinase (MAPK) RAS/RAF/MEK/ERK MAPK pathway
* Positive for hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg) and known history of HIV, malignancy, active infection and cardiovascular diseases (CVs)
* Received strong cytochrome (CYP) 3A inhibitors, moderate CYP3A inhibitors, strong CYP3A inducers and moderate CYP3A inducers within 7 days prior to initiation of study treatment
* History of symptomatic Clostridium difficile infection within 1 month prior to dosing


Dose Escalation Arm A (Venetoclax and Cobimetinib):

* History or evidence of retinal pathology on ophthalmologic examination that is considered a risk factor for neurosensory retinal detachment/central serous chorioretinopathy (CSCR), retinal vein occlusion (RVO), or neovascular macular degeneration
* Left ventricular ejection fraction (LVEF) below institutional lower limit of normal (LLN) or below 50%, whichever is lower

Arm B (Venetoclax and Idasanutlin):

* Received the following within 7 days prior to the initiation of study treatment: Strong CYP2C8 inhibitors or CYP2C8 substrates, OATP1B1/3 substrates
* Received the following within 14 days prior to the initiation of study treatment: Strong CYP2C8 inducers
* History of liver cirrhosis by radiologic, clinical or laboratory data, or biopsy despite normal liver function tests
* Received treatment with oral or parenteral anticoagulants/anti-platelet agents within 7 days prior to initiation of study treatment.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hoffmann-La Roche

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Trials

Role: STUDY_DIRECTOR

Hoffmann-La Roche

Locations

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USC Norris Cancer Center

Los Angeles, California, United States

Site Status

UC Davis; Comprehensive Cancer Center

Sacramento, California, United States

Site Status

Univ of Calif, San Francisco

San Francisco, California, United States

Site Status

University of Colorado

Aurora, Colorado, United States

Site Status

Dana Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

Weill Cornell Medical College

New York, New York, United States

Site Status

Wake Forest Baptist Medical Center

Winston-Salem, North Carolina, United States

Site Status

MD Anderson Cancer Center

Houston, Texas, United States

Site Status

University of Alberta Hospital

Edmonton, Alberta, Canada

Site Status

Princess Margaret Cancer Center

Toronto, Ontario, Canada

Site Status

Jewish General Hospital

Montreal, Quebec, Canada

Site Status

Hopital Avicenne, Paris

Bobigny, , France

Site Status

Institut Paoli Calmettes

Marseille, , France

Site Status

CHU de Bordeaux

Pessac, , France

Site Status

University of Bologna

Bologna, Emilia-Romagna, Italy

Site Status

Presidio san salvatore muraglia

Pesaro, Emilia-Romagna, Italy

Site Status

Universita di Roma

Roma, Emilia-Romagna, Italy

Site Status

Countries

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United States Canada France Italy

References

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Daver NG, Dail M, Garcia JS, Jonas BA, Yee KWL, Kelly KR, Vey N, Assouline S, Roboz GJ, Paolini S, Pollyea DA, Tafuri A, Brandwein JM, Pigneux A, Powell BL, Fenaux P, Olin RL, Visani G, Martinelli G, Onishi M, Wang J, Huang W, Green C, Ott MG, Hong WJ, Konopleva MY, Andreeff M. Venetoclax and idasanutlin in relapsed/refractory AML: a nonrandomized, open-label phase 1b trial. Blood. 2023 Mar 16;141(11):1265-1276. doi: 10.1182/blood.2022016362.

Reference Type DERIVED
PMID: 36265087 (View on PubMed)

Other Identifiers

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2015-003386-28

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

GH29914

Identifier Type: -

Identifier Source: org_study_id

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