A Multi-center, Randomized Clinical Trial of Chidamide Combined With Azacytidine and the HAG Regimen in the Treatment of Relapsed/Refractory Acute Myeloid Leukemia Patients
试验速览
- 阶段
- 2 期
- 状态
- 进行中(未招募)
- 发起方
- 入组人数
- 21
- 试验地点
- 1
- 主要终点
- Complete remission without minimal residual disease (CR with MRD-)
研究概览
简要总结
This study is to investigate the therapeutic efficacy and side effect of chidamide, azacitidine combined with priming HAG regimen for relapsed or refractroy acute myeloid leukemia
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 69 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged ≥ 18 and ≤ 70 years
- •Patients diagnosed with AML according to 2016 WHO myeloid malignant disease diagnosis standard (Non-APL)
- •Patients with AML must meet one of the following criteria, A or B:
- •A: Refractory AML disease was defined as follows: (1) failure to attain CR following exposure to at least 2 courses of standard or intensive induction therapy; or (2) bone marrow leukemia cell decline index (BMCDI) < 50% and > 20% after 1 course of standard or intensive induction therapy. B: Relapsed AML disease was defined as follows: (1) reappearance of leukemic blasts in the peripheral blood after CR; or (2) detection of ≥ 5% blasts in the BM not attributable to another cause (e.g., BM regeneration after consolidation therapy); or (3) extramedullary relapse.
- •ECOG performance status score less than 3
- •Expected survival time ˃ 3 months
- •Patients without serious heart, lung, liver, or kidney disease
- •Ability to understand and voluntarily provide informed consent
排除标准
- •Patients who are allergic to the study drug or drugs with similar chemical structures
- •Pregnant or lactating women, and women of childbearing age who do not want to practice effective methods of contraception
- •Active infection
- •Active bleeding
- •Patients with new thrombosis, embolism, cerebral hemorrhage, or other diseases or a medical history within one year before enrollment
- •Patients with mental disorders or other conditions whereby informed consent cannot be obtained and where the requirements of the study treatment and procedures cannot be met
- •Liver function abnormalities (total bilirubin > 1.5 times the upper limit of the normal range, ALT/AST > 2.5 times the upper limit of the normal range or patients with liver involvement whose ALT/AST > 1.5 times the upper limit of the normal range), or renal anomalies (serum creatinine > 1.5 times the upper limit of the normal value)
- •Patients with a history of clinically significant QTc interval prolongation (male > 450 ms; female > 470 ms), ventricular heart tachycardia and atrial fibrillation, II-degree heart block, myocardial infarction attack within one year before enrollment, and congestive heart failure, and patients with coronary heart disease who have clinical symptoms and requiring drug treatment
- •Surgery on the main organs within the past six weeks
- •Drug abuse or long-term alcohol abuse that would affect the evaluation results
- •Patients who have received organ transplants (excepting bone marrow transplantation)
- •Patients not suitable for the study according to the investigator's assessment
研究组 & 干预措施
Chidamide+AZA+HHT+AraC+G-CSF group
The patients are randomized into the group. Patients whose last induction failure regimen is a demethylated agent combined with priming regimen enter the experimental group directly.
干预措施: CAHAG regimen (Drug)
Placebo+AZA+HHT+AraC+G-CSF group
The patients are randomized into the group.
干预措施: Placebo regimen (Drug)
结局指标
主要结局
Complete remission without minimal residual disease (CR with MRD-)
时间窗: At the end of Cycle 1 (each cycle is 28 days)
If studied pretreatment, CR with negativity for a genetic marker by RT-qPCR, or CR with negativity by MFC
Overall response rate (ORR)
时间窗: At the end of Cycle 1 (each cycle is 28 days)
The overall response (completed remission without minimal residual disease, completed remission with incomplete blood count recovery, morphologic leukemia-free state and partial remission) rate achieved after one or two courses(28 days) induction therapy by CAHAG regimen.
Complete remission with incomplete hematologic recovery (CRi)
时间窗: At the end of Cycle 1 (each cycle is 28 days)
All CR criteria except for residual neutropenia (,1.0\*10E9/L \[1000/uL\]) or thrombocytopenia (\<100\*10E9/L \[100 000/uL\])
Partial remission (PR)
时间窗: At the end of Cycle 1 (each cycle is 28 days)
All hematologic criteria of CR; decrease of bone marrow blast percentage to 5% to 25%; and decrease of pretreatment bone marrow blast percentage by at least 50%.
Morphologic leukemia-free state (MLFS)
时间窗: At the end of Cycle 1 (each cycle is 28 days)
Bone marrow blasts ,5%; absence of blasts with Auer rods; absence of extramedullary disease; no hematologic recovery required
次要结局
- Duration of Response (DOR)(1 year)
- Overall Survival (OS)(1 year)
- Progression-Free Survival (PFS)(1 year)
研究者
Sheng-Li Xue, MD
accociate professor
The First Affiliated Hospital of Soochow University
