Trial Outcomes & Findings for Testing Nivolumab in Combination With Decitabine and Venetoclax in Patients With Newly Diagnosed TP53 Gene Mutated Acute Myeloid Leukemia (NCT NCT04277442)

NCT ID: NCT04277442

Last Updated: 2025-03-25

Results Overview

Toxicity will be graded and reported according to the revised National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

1 participants

Primary outcome timeframe

Up to day 15 of cycle 1 (each cycle is 28 days)

Results posted on

2025-03-25

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Overall Study
STARTED
1
Overall Study
COMPLETED
0
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Overall Study
Death
1

Baseline Characteristics

Testing Nivolumab in Combination With Decitabine and Venetoclax in Patients With Newly Diagnosed TP53 Gene Mutated Acute Myeloid Leukemia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 Participants
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
1 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Up to day 15 of cycle 1 (each cycle is 28 days)

Toxicity will be graded and reported according to the revised National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.

Outcome measures

Outcome measures
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 Participants
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Incidence of Adverse Events
Diarrhea
1 participants
Incidence of Adverse Events
Mucositis oral
1 participants
Incidence of Adverse Events
Dyspnea
1 participants
Incidence of Adverse Events
Cough
1 participants
Incidence of Adverse Events
Electrocardiogram QT corrected interval prolonged
1 participants
Incidence of Adverse Events
Hematuria
1 participants
Incidence of Adverse Events
Proteinuria
1 participants
Incidence of Adverse Events
Hyponatremia
1 participants
Incidence of Adverse Events
Blood bilirubin increased
1 participants
Incidence of Adverse Events
Alkaline phosphatase increased
1 participants
Incidence of Adverse Events
Alanine aminotransferase increased
1 participants
Incidence of Adverse Events
Aspartate aminotransferase increased
1 participants
Incidence of Adverse Events
Blood lactate dehydrogenase increased
1 participants
Incidence of Adverse Events
INR increased
1 participants
Incidence of Adverse Events
Anemia
1 participants
Incidence of Adverse Events
Urinary tract infection
1 participants
Incidence of Adverse Events
Febrile neutropenia
1 participants
Incidence of Adverse Events
Confusion
1 participants
Incidence of Adverse Events
Bacteremia
1 participants
Incidence of Adverse Events
Epistaxis
1 participants
Incidence of Adverse Events
Nausea
1 participants
Incidence of Adverse Events
Vomiting
1 participants
Incidence of Adverse Events
Hypophosphatemia
1 participants
Incidence of Adverse Events
Hypoalbuminemia
1 participants
Incidence of Adverse Events
Activate partial thromboplastin time prolonged
1 participants
Incidence of Adverse Events
White blood cell decreased
1 participants
Incidence of Adverse Events
Platelet count decreased
1 participants
Incidence of Adverse Events
Neutrophil count decreased
1 participants
Incidence of Adverse Events
Lymphocyte count decreased
1 participants
Incidence of Adverse Events
Hypocalcemia
1 participants
Incidence of Adverse Events
Thromboembolic event
1 participants
Incidence of Adverse Events
Lung infection
1 participants
Incidence of Adverse Events
Hypothermia
1 participants
Incidence of Adverse Events
Thrush
1 participants
Incidence of Adverse Events
Anorexia
1 participants
Incidence of Adverse Events
Neutropenic Fever
1 participants
Incidence of Adverse Events
Fatigue
1 participants
Incidence of Adverse Events
Edema face
1 participants
Incidence of Adverse Events
Chills
1 participants

PRIMARY outcome

Timeframe: Up to day 15 of cycle 1 (each cycle is 28 days)

Feasibility will be met if 10 of 13 patients are able to complete 3 cycles of therapy.

Outcome measures

Outcome measures
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 Participants
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Number of Patients That Are Able to Complete 3 Cycles of Therapy
0 participants

PRIMARY outcome

Timeframe: Up to day 15 of cycle 1 (each cycle is 28 days)

Response will be defined as being able to achieve complete remission, complete remission with incomplete count recovery, or complete remission with incomplete hematological recovery by cycle 3.

Outcome measures

Outcome measures
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 Participants
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Response
0 participants

SECONDARY outcome

Timeframe: Up to 3 years

Population: Data was not collected due to low enrollment

Patients will be carefully monitored for tumor response and symptom relief in addition to safety and tolerability. Data that are collected serially over time will be explored graphically using box plots and/or individual time plots as well as analytically with either repeated measures analysis of variance or Friedman's nonparametric test.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 2 years 5 months

95% confidence intervals will be given.

Outcome measures

Outcome measures
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 Participants
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Progression-free Survival
0 participants

SECONDARY outcome

Timeframe: Up to 2 years 5 months

95% confidence intervals will be given.

Outcome measures

Outcome measures
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 Participants
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Overall Survival
0 participants

SECONDARY outcome

Timeframe: Up to 3 years

Population: Data not collected due to low enrollment

Will assess MRD by measuring the TP53 mutational burden with variant allele frequency before and after response is achieved to see if there is a change. Will also evaluate its association with MRD status at each time point using chi-square test of independence.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 years

Population: Data not collected and analyzed due to low enrollment

Will study the T cell response against both tumor associated antigen and tumor specific antigen. Analyses of the data will be primarily descriptive in nature given the relatively small sample size.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 years

Population: Data not collected or analyzed due to low enrollment

Will study the level of global DNA methylation as well as methylation levels of specific genes involved in immune checkpoint, such as PD-L1, PD-L2, PD-1 and CTLA4. Analyses of the data will be primarily descriptive in nature given the relatively small sample size.

Outcome measures

Outcome data not reported

Adverse Events

Treatment (Nivolumab, Decitabine, Venetoclax)

Serious events: 1 serious events
Other events: 1 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 participants at risk
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
Blood and lymphatic system disorders
Febrile Neutropenia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.

Other adverse events

Other adverse events
Measure
Treatment (Nivolumab, Decitabine, Venetoclax)
n=1 participants at risk
INDUCTION: Patients receive nivolumab IV over 30 minutes on day 15 of cycle 1 and days 1 and 15 of subsequent cycles, decitabine IV over 60 minutes on days 1-10 of induction cycle 1 (and cycles 2 and 3 if needed), and venetoclax PO QD on days 1-21. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients who achieve a CR or CRi receive nivolumab IV over 30 minutes on days 1 and 15, decitabine IV over 60 minutes on days 1-5, and venetoclax PO QD on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Decitabine: Given IV Nivolumab: Given IV Venetoclax: Given PO
General disorders
Fatigue
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
General disorders
Edema Face
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Gastrointestinal disorders
Diarrhea
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Gastrointestinal disorders
Mucositis Oral
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Respiratory, thoracic and mediastinal disorders
Dyspnea
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Respiratory, thoracic and mediastinal disorders
Cough
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Electrocardiogram QT corrected Interval prolonged
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Renal and urinary disorders
Hematuria
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Renal and urinary disorders
Proteinuria
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Metabolism and nutrition disorders
Hyponatremia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Blood bilirubin Increased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Alkaline Phosphatase Increased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Blood lactate dehydrogena se Increased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
NR Increased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Blood and lymphatic system disorders
Anemia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Neutrophil count decreased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Lymphocyte count decreased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Infections and infestations
Urinary tract infection
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Blood and lymphatic system disorders
Febrile Neutropenia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Psychiatric disorders
Confusion
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Infections and infestations
Bacteremia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Respiratory, thoracic and mediastinal disorders
Epistaxis
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Gastrointestinal disorders
Nausea
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Gastrointestinal disorders
Vomiting
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Metabolism and nutrition disorders
Hypophosphatemia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Metabolism and nutrition disorders
Hypoalbuminemia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Alanine aminotransferase increased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Activated partial thromboplastin time prolonged
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
White blood cell decreased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Investigations
Platelet count decreased
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Metabolism and nutrition disorders
Hypocalcemia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Vascular disorders
Thromboembolic
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
General disorders
Chills
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Infections and infestations
Lung Infection
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
General disorders
Hypothermia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Infections and infestations
Thrush
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.
Metabolism and nutrition disorders
Anorexia
100.0%
1/1 • Number of events 1 • Patients were evaluated for Adverse Events from the start of study to study completion using the NCI CTCAE version 5.0 for up to 2 years 5 months.

Additional Information

Dr. Alice Mims

The Ohio State University

Phone: (614) 293-3196

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60