No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
Prior Safety Data
This treatment has already been tested in at least one earlier human trial.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Age
18 and older
Sex
Any
Trial phase
Phase 1/2
Study type
Interventional
Purpose
Treatment
Participants needed
62 (estimated)
Sponsor
University of Washington · Other
Who this trial is looking for
This trial is looking for adults with acute myeloid leukemia or high-grade myeloid neoplasms. Participants will receive a treatment that combines venetoclax and a chemotherapy regimen called CLAG-M.
Are You a Good Fit for This Trial?
You may be able to join if
I have been diagnosed with acute myeloid leukemia or a high-grade myeloid neoplasm.
I am at least 18 years old.
I do not have any serious liver or kidney problems.
I understand the study and can provide written consent.
I have a specific level of white blood cells before starting the treatment.
I have a negative pregnancy test if I can become pregnant.
I can use effective birth control if required.
You may not be able to join if
I have acute promyelocytic leukemia or chronic myeloid leukemia.
I have active involvement of my central nervous system by leukemia.
I have an illness that might not let me live for at least a year.
I have a serious active infection, unless it's controlled by treatment.
I am pregnant or breastfeeding.
I have a known allergy to any study drug.
I am HIV positive.
I cannot stop taking certain medications before the study starts.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer three quick questions written from this study's own rules to see if you may qualify. No account needed to find out.
This phase I/II trial finds the best dose, side effects and how well giving venetoclax in combination with cladribine, cytarabine, granulocyte colony-stimulating factor, and mitoxantrone (CLAG-M) in treating patients with acute myeloid leukemia and high-grade myeloid neoplasms. Venetoclax may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Chemotherapy…
This phase I/II trial finds the best dose, side effects and how well giving venetoclax in combination with cladribine, cytarabine, granulocyte colony-stimulating factor, and mitoxantrone (CLAG-M) in treating patients with acute myeloid leukemia and high-grade myeloid neoplasms. Venetoclax may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Chemotherapy drugs, such as cladribine, cytarabine, and mitoxantrone, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving venetoclax with CLAG-M may kill more cancer cells.
Trial Locations
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Status
Eligibility Criteria
Inclusion Criteria:
* Diagnosis of acute myeloid leukemia (per the World Health Organization \[WHO\] 2016 classification) or high-grade myeloid neoplasm (\>= 10% myeloid blasts in peripheral blood or marrow as assessed by morphology or multiparameter flow cytometry at initial presentation). Patient…
Inclusion Criteria:
* Diagnosis of acute myeloid leukemia (per the World Health Organization \[WHO\] 2016 classification) or high-grade myeloid neoplasm (\>= 10% myeloid blasts in peripheral blood or marrow as assessed by morphology or multiparameter flow cytometry at initial presentation). Patients with biphenotypic or mixed phenotype acute leukemia are eligible.
* PHASE I:
* Newly diagnosed patients presenting for trial entry must have adverse risk disease as per the European LeukemiaNet 2017 guidelines
* Relapsed/refractory patients presenting for trial entry must require first or subsequent salvage therapy and have detectable blasts in peripheral blood or \>= 5% blasts in bone marrow, as assessed by morphology or multiparameter flow cytometry; or extramedullary myeloid sarcoma, per European LeukemiaNet 2017 guidelines.
* These patients are only allowed in the phase 1 portion of the trial
* PHASE II:
* Newly diagnosed patients presenting for trial entry must have adverse risk disease as per the European LeukemiaNet 2022 guidelines
* Prior treatment for low-grade myeloid neoplasms (\< 10% myeloid blasts in peripheral blood or marrow) is allowed (e.g. Azacitidine/decitabine, lenalidomide, growth factors). Prior treatment treated for antecedent high-grade myeloid neoplasms (≥ 10% myeloid blasts in peripheral blood or marrow) is not allowed
* Age \>= 18 years
* Aspartate transaminase (AST) and alanine transaminase (ALT) =\< 3.0 X upper limit of normal (ULN)
* Bilirubin =\< 1.5 x ULN (unless bilirubin rise is due to Gilbert's syndrome or of non-hepatic origin)
* Subject must have adequate renal function as demonstrated by a creatinine clearance \>= 30 mL/min; calculated by the Cockcroft Gault formula or measured by 24 hours urine collection
* Left ventricular ejection fraction (LVEF) \>= 45%, assessed by multigated acquisition (MUGA) or echocardiogram (ECHO) within 3 months prior to study day 0 or after most recent anthracycline administration if appropriate and no clinical evidence of congestive heart failure
* Eastern Cooperative Oncology Group (ECOG) =\< 2
* Treatment-related mortality (TRM) score \< 13.1
* Female subjects of childbearing potential must have negative results for pregnancy test. Female subjects of childbearing potential and male subjects with female partners of childbearing potential must agree to use an effective method of birth control from the time of signing the consent form until at least 3 months after the last dose of study drug
* Ability to understand and the willingness to sign a written informed consent document
* White blood cell count in peripheral blood must be \< 25,000/ul prior to initiation of study therapy (CLAG-M plus venetoclax). Cytoreduction with hydroxyurea and/or cytarabine (e.g., 500 mg/m\^2 per dose) is allowed to decrease the risk of tumor lysis syndrome
Exclusion Criteria:
* Acute promyelocytic leukemia or chronic myeloid leukemia in blast crisis
* Known active central nervous system (CNS) involvement with acute myeloid leukemia (AML)
* Concomitant illness associated with a likely survival of \< 1 year
* Active systemic infection, unless disease is under treatment with antimicrobials and considered controlled or stable; patients with fever thought to be likely secondary to leukemia are eligible. Patients with chronic hepatitis B virus (HBV) or hepatitis C (HCV) requiring treatment would be excluded. Note: subjects with serologic evidence of prior vaccination to HBV (i.e. hepatitis B surface \[HBs\] antigen negative-, anti-HBs antibody positive and anti-hepatitis B core \[HBc\] antibody negative) or positive anti-HBc antibody from intravenous immunoglobulins (IVIG) may participate
* Known hypersensitivity to any study drug
* Pregnancy or lactation because of the unknown risks of this combination
* Concurrent treatment with any other investigational agent
* Subject is known to be positive for human immunodeficiency virus (HIV)
* Subjects who cannot discontinue concomitant CYP3A inhibitors, except for voriconazole, prior to cycle 1 day 1 (C1D1)
* Treatment with any of the following within 7 days prior to the first dose of venetoclax
* Steroid therapy for anti-neoplastic intent
* Administration or consumption of any of the following within 3 days prior to the first dose of venetoclax:
* Grapefruit or grapefruit products
* Seville oranges (including marmalade containing Seville oranges)
* Star fruit
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