Recruiting at 188 sites Phase 3 Acute Myeloid Leukemia

Trial comparing treatments for Acute Myeloid Leukemia

Official title A Study to Compare Standard Chemotherapy to Therapy With CPX-351 and/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations

ClinicalTrials.gov ID: NCT04293562

What this study is testing

What is Asparaginase Erwinia chrysanthemi?

This is an investigational medicine being studied as a potential treatment for acute myeloid leukemia. It is designed to lower levels of the amino acid asparagine in the body, which cancer cells need to grow.

Also referred to as Crisantaspase, Erwinase.

Plain-language explanation of the investigational treatment. It is being studied and is not an approved or proven therapy. The study team can confirm the details.

What it's testing
This study aims to find out if specific drug combinations work better than standard chemotherapy for treating acute myeloid leukemia. It also checks how these treatments affect heart health.
Who it's for
People who have just been diagnosed with acute myeloid leukemia, regardless of whether they have a specific gene change called FLT3.
What's involved
Participants will receive either standard chemotherapy or a combination of newer drugs, including CPX-351 and possibly gilteritinib. They will undergo regular tests to monitor their health and heart function.
Time commitment
The study involves ongoing treatment and monitoring visits for the duration of the therapy, though the exact total time is not specified in the provided text.
  • Phase 3: a large, late-stage study
  • Which group you join is decided by chance.

A plain-language read of the study's public ClinicalTrials.gov listing. The study team confirms the details.

Who can take part

Ages 6 to 21

You may be able to join if

  • All patients must be enrolled on APEC14B1 and consented to Eligibility Screening (Part A) prior to enrollment and treatment on AAML1831.
  • Patients must be at least 6 months of age and less than 22 years of age at the time of study enrollment
  • Patient must be newly diagnosed with de novo AML according to the 2016 World Health Organization (WHO) classification with or without extramedullary...
  • \>= 20% bone marrow blasts (obtained within 14 days prior to enrollment)
  • In cases where extensive fibrosis may result in a dry tap, blast count can be obtained from touch imprints or estimated from an adequate bone marrow...

You likely can't join if

  • Fanconi anemia
  • Shwachman Diamond syndrome
  • Patients with constitutional trisomy 21 or with constitutional mosaicism of trisomy 21
  • Telomere disorders
  • Germline predispositions known, or suspected by the treating physician to increase risk of toxicity with AML therapy
  • Any concurrent malignancy
See the full eligibility criteria
Who can join
  • All patients must be enrolled on APEC14B1 and consented to Eligibility Screening (Part A) prior to enrollment and treatment on AAML1831.
  • Patients must be at least 6 months of age and less than 22 years of age at the time of study enrollment
  • Patient must be newly diagnosed with de novo AML according to the 2016 World Health Organization (WHO) classification with or without extramedullary disease
  • \>= 20% bone marrow blasts (obtained within 14 days prior to enrollment)
  • In cases where extensive fibrosis may result in a dry tap, blast count can be obtained from touch imprints or estimated from an adequate bone marrow core biopsy
  • \< 20% bone marrow blasts with one or more of the genetic abnormalities associated with childhood/young adult AML as provided in the protocol (sample obtained within 14 days prior to enrollment)
  • A complete blood count (CBC) documenting the presence of at least 1,000/uL (i.e., a white blood cell [WBC] count \>= 10,000/uL with \>= 10% blasts or a WBC count of \>= 5,000/uL with \>= 20% blasts) circulating leukemic...
  • ARM C: Patient must be \>= 2 years of age at the time of Late Callback
  • ARM C: Patient must have FLT3/ITD allelic ratio \> 0.1 as reported by Molecular Oncology
  • ARM C: Patient does not have any congenital long QT syndrome or congenital heart block
  • ARM C: Females of reproductive potential must agree to use effective contraception during treatment and for at least 6 months after the last dose of gilteritinib
  • ARM C: Lactating women must agree not to breastfeed during treatment with gilteritinib and for 2 months after the last dose of gilteritinib
  • ARM C: Males of reproductive potential must agree to use effective contraception during treatment and for at least 4 months after the last dose of gilteritinib
  • ARM D: Patient must be \>= 2 years of age at the time of Late Callback
  • ARM D: Patient must have one of the clinically relevant non-ITD FLT3 activating mutations as reported by Foundation Medicine
  • ARM D: Females of reproductive potential must agree to use effective contraception during treatment and for at least 6 months after the last dose of gilteritinib
  • ARM D: Lactating women must agree not to breastfeed during treatment with gilteritinib and for 2 months after the last dose of gilteritinib
  • ARM D: Males of reproductive potential must agree to use effective contraception during treatment and for at least 4 months after the last dose of gilteritinib
  • NEUROPSYCHOLOGICAL TESTING: Patient must be enrolled on Arm A or Arm B. Patients who transfer to Arm C or Arm D are not eligible
  • NEUROPSYCHOLOGICAL TESTING: Patient must be 5 years or older at the time of enrollment
  • NEUROPSYCHOLOGICAL TESTING: English-, French- or Spanish-speaking
  • NEUROPSYCHOLOGICAL TESTING: No known history of neurodevelopmental disorder prior to diagnosis of AML (e.g., Down syndrome, fragile X, William syndrome, mental retardation)
  • NEUROPSYCHOLOGICAL TESTING: No significant visual or motor impairment that would prevent computer use or recognition of visual test stimuli
  • All patients and/or their parents or legal guardians must sign a written informed consent
  • All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
What rules you out
  • Fanconi anemia
  • Shwachman Diamond syndrome
  • Patients with constitutional trisomy 21 or with constitutional mosaicism of trisomy 21
  • Telomere disorders
  • Germline predispositions known, or suspected by the treating physician to increase risk of toxicity with AML therapy
  • Any concurrent malignancy
  • Juvenile myelomonocytic leukemia (JMML)
  • Philadelphia chromosome positive AML
  • Mixed phenotype acute leukemia
  • Acute promyelocytic leukemia
  • Acute myeloid leukemia arising from myelodysplasia
  • Therapy-related myeloid neoplasms
  • Patients with persistent cardiac dysfunction prior to enrollment, defined as ejection fraction (EF) \ = 50%, the patient is eligible to enroll and may receive an anthracycline-containing Induction regimen
  • Hydroxyurea
  • All-trans retinoic acid (ATRA)
  • Corticosteroids (any route)
  • Intrathecal therapy given at diagnosis
  • In particular, strong inducers of CYP3A4 and/or P-glycoprotein (P-gp) should be avoided from the time of enrollment until it is determined whether the patient will receive gilteritinib.
  • Patients \< 8.3 kg at study enrollment are not eligible
  • Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential
  • Lactating females who plan to breastfeed their infants
  • Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation
  • ARM D: Patient does not have any congenital long QT syndrome or congenital heart block

The study team makes the final eligibility decision.

Where it is enrolling

  • Birmingham, Alabama, United States
  • Mobile, Alabama, United States
  • Mesa, Arizona, United States
  • Phoenix, Arizona, United States
  • Tucson, Arizona, United States
  • Little Rock, Arkansas, United States
  • Downey, California, United States
  • Duarte, California, United States
  • Loma Linda, California, United States
  • Long Beach, California, United States
  • Los Angeles, California, United States
  • Madera, California, United States
  • Oakland, California, United States
  • Orange, California, United States
  • Palo Alto, California, United States
  • Sacramento, California, United States
  • San Diego, California, United States
  • San Francisco, California, United States
  • Santa Barbara, California, United States
  • Aurora, Colorado, United States

+ 135 more site(s).

Questions & answers

Do participants get paid in this trial?

This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.

Is it free to join, and do I need insurance?

Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part, but confirm specifics with the study team.

How long does this study last?

The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.

Who can join this trial?

This study is enrolling all sexes, 6 months to 21 years. The study team makes the final eligibility decision.

Where is this trial taking place?

This study is enrolling now at Birmingham, Alabama, United States; Mobile, Alabama, United States; Mesa, Arizona, United States; Phoenix, Arizona, United States; Tucson, Arizona, United States; Little Rock, Arkansas, United States and 149 more locations. Enter your location above to see the nearest enrolling site and check your eligibility.

Explore other conditions

BridgeMD is an information and trial-matching tool that is independent of the study sponsor. Details come from ClinicalTrials.gov. The study team decides eligibility, and your own doctor gives medical advice.