A Master Protocol for Biomarker-Based Treatment of AML (The Beat AML Trial)
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 入组人数
- 3,000
- 试验地点
- 50
- 主要终点
- Proportion of patients for whom molecular, immunophenotypic, and/or biochemical studies are completed in < 7 calendar days for assignment of treatment
研究概览
简要总结
This screening and multi-sub-study Phase 1b/2/3 trial will establish a method for genomic screening followed by assigning and accruing simultaneously to a multi-study "Master Protocol (BAML-16-001-M1)." The specific subtype of acute myeloid leukemia will determine which sub-study, within this protocol, a participant will be assigned to evaluate investigational therapies or combinations with the ultimate goal of advancing new targeted therapies for approval. The study also includes marker negative sub-studies which will include all screened patients not eligible for any of the biomarker-driven sub-studies. Patients with myeloid malignancies [e.g. myelodysplastic syndrome (MDS) or other diseases], will be allowed to enroll to Master protocol if there is an available sub-study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
Exceptions: substudies S25/HO181 and S26/HO177 are double-blind (participant and care provider are masked) and are randomized.
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults, age ≥60 yrs at diagnosis unless in a specific known cytogenetic & genomic group for which treatment in Group A, B, or C is allowed by the substudy where age 18+ is allowed. Patients <60 yrs who are screened but do not fall w/in the cytogenetic & genomic open substudies would still be followed on the M1 Master Protocol (MP) & not considered screen fails
- •Patients must be able to understand & provide written informed consent
- •Group A: Patients must have previously untreated AML according to WHO classification w/ no prior treatment other than hydroxyurea. Patients w/ myeloid malignancies [eg, myelodysplastic syndrome (MDS) or other disease], will be allowed to enroll to this group. For previously untreated subjects w/ ≥20% blasts in bone marrow or blood only: Prior therapy for MDS, myeloproliferative syndromes (MPD), or aplastic anemia is permitted. For select group, patients who cannot wait or choose not to wait for results of genomic testing, will be allowed to enroll to select substudies that allow enrollment & treatment of all patients regardless of their genomic mutations or cytogenetics. For this group, genomic samples will be collected to be analyzed retrospectively after patients' enrollment
- •Group B: Patients must have relapsed or refractory AML according to WHO classification. For study purposes, refractory AML is defined as failure to ever achieve a complete response (CR) or recurrence of AML w/in 6 months of achieving CR; relapsed AML is defined as all others w/ disease after prior remission. For select genomic aberrations specified in substudies, patients ≥18 yrs may be allowed to enroll in this portion of the study. Patients w/ relapsed or refractory myeloid malignancies (eg, MDS or other diseases) will be allowed to enroll to this group
- •Group C: For select sites not part of Beat AML core sites. These sites will only participate in select substudies. Patients in this group will enroll under the Beat AML M1 MP w/ the intent to enroll into these select substudies & following screening on Beat M1 MP, they will come off M1 MP
排除标准
- •Acute promyelocytic leukemia (APL)
- •Clinically active CNS involvement by AML. A patient may be considered eligible if CNS leukemia is showing response to treatment at study entry & should continue to receive intrathecal therapy as clinical indicated. Patients who require or are undergoing craniospinal irradiation of disease control are not eligible for participation
- •Signs of leukostasis requiring urgent therapy
- •Disseminated intravascular coagulopathy (DIC) w/ active bleeding or signs of thrombosis
- •Patients w/ psychological, familial, social, or geographic factors that otherwise preclude them from giving informed consent, following the protocol (including failure to collect genomics samples for screening), or complying w/ study treatment & follow-up
- •Any other significant medical condition, including psychiatric illness or lab abnormality, that would preclude patient participation in the trial or would confound interpretation of trial results
- •Age ≥60 yrs at diagnosis w/ untreated AML according to International Consensus Classification (ICC) 2022 & have NPM1 mutated or KMT2A rearrangement disease & are not candidates for or do not wish to pursue intensive chemotherapy
- •Patients must be able to understand & provide written informed consent
- •Eastern Cooperative Oncology Group (ECOG) score of 0, 1, or 2
- •Aspartate aminotransferase (AST) <5 x upper limit of normal (ULN), alanine aminotransferase (ALT) <5 x ULN, & total bilirubin <2 x ULN (except for patients w/ known or suspected Gilbert's syndrome & w/ direct bilirubin w/in normal range) for the local lab
- •Adequate renal function as defined by calculated creatinine clearance ≥60 mL/min for the local lab
- •Females must be non-childbearing, postmenopausal, surgically sterile or meet certain criteria if of childbearing potential. Males must adhere to criteria if w/ females of childbearing potential
- •Patients must have previously untreated AML w/ no prior treatment other than hydroxyurea. No chemotherapy for AML outside of hydroxyurea for treatment of leukostasis or ATRA for initially suspected APL (that is ruled out) is allowed as well as 1 dose of intrathecal chemotherapy for suspected CNS involvement (that is ruled out) is allowed. Prior therapy for MDS allowed except for hypomethylating agents
- •If patient has co-morbid illness or malignancy, life expectancy attributed to this must be >2 yrs
- •Isolated myeloid sarcoma (must have blood or marrow involvement w/ AML)
- •APL (FAB M3)
- •Favorable risk cytogenetics (Core Binding Factor AML)
- •Active CNS involvement by AML
- •Signs of leukostasis requiring urgent therapy
- •WBC ≥25,000/μl (WBC <25,000/μl to begin therapy, Hydroxyurea may be used to obtain this level)
- •Willing & able to receive intensive chemotherapy
- •DIC w/ active bleeding or signs of thrombosis
- •Patients w/ psychological, familial, social, or geographic factors that otherwise preclude them from giving informed consent, following the protocol, or complying w/ study treatment & follow-up
- •Any significant medical condition, including psychiatric illness or lab abnormality, that would preclude the patient participating in the trial or would confound trial result interpretation
- •Known active HIV, active hepatitis B or C infections
- •Uncontrolled intercurrent illness including, but not limited to, symptomatic congestive heart failure (CHF), unstable angina pectoris, serious cardiac arrhythmia, myocardial infarction (MI) as presentation of AML, New York Heart Association (NYHA) Class III or IV heart failure, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Patients w/ medical comorbidities that will preclude safety evaluation of the combination should not be enrolled
- •Patients w/ uncontrolled infection shall not be enrolled until infection is treated & brought under control
- •Patients who have received an investigational agent (for any indication) w/in 5 half-lives of the agent & until toxicity from this has resolved to ≤ grade 1; if half-life of the agent is unknown, patients must wait 4 wks prior to first dose of study treatment.
- •Patients w/ QTcF >450 ms (males), >468 (females); patients w/ right, left, or partial bundle branch blocks (BBB) or pacemaker that may confound interpretation of this reading excluded provided they lack history of primary arrhythmic events & are cleared by cardiology for enrollment in the trial. Any factors that increase risk of QTc prolongation or risk of arrhythmic event such as congenital long QT syndrome or family history of long QT syndrome
- •≥60 yrs at AML diagnosis
- •ECOG score of 0, 1, or 2
- •AST <2.5 x ULN, ALT <2.5 x ULN, & total bilirubin <1.5 x ULN (except for patients w/ known Gilbert's syndrome) for the local lab. If due to disease, higher values may be approved after discussion w/ medical monitor
- •Adequate renal function as defined by calculated creatinine clearance >40 mL/min per the local lab
- •Patients must be able to understand & provide written informed consent
- •Females must be non-childbearing, postmenopausal, surgically sterile or meet certain criteria if of childbearing potential
- •Males must adhere to criteria if w/ females of childbearing potential
- •No prior chemotherapy for leukemia (hydroxyurea to control leukocytosis & ATRA for initially suspected APL allowed). Prior therapy for MDS or myeloproliferative neoplasm (MPN) allowed (except for hypomethylating agents)
- •If patient has co-morbid illness or malignancy, life expectancy attributed to this must be >2 yrs
- •Patients able & willing to receive intensive chemotherapy for underlying AML
- •Isolated myeloid sarcoma (must have blood or marrow involvement w/ AML)
- •Known active CNS involvement by AML
- •Clinical signs/symptoms of leukostasis requiring urgent therapy
- •Known active HIV, active hepatitis B or C infections
- •DIC w/ active bleeding or signs of thrombosis
- •Patients who have received an investigational agent (for any indication) w/in 5 half-lives of the agent; if half-life of the agent is unknown, patients must wait 1 wk prior to first dose of study treatment
- •Systemic antineoplastic therapy (for any indication) w/in 5 half-lives or radiation therapy w/in 1 wk prior to starting protocol except for hydroxyurea, which is allowed to control WBC counts
- •Patients w/ psychological, familial, social, or geographic factors, any other significant medical condition, or a lab abnormality that otherwise precludes them from giving informed consent, following the protocol, or complying w/ study treatment & follow-up, or would confound trial result interpretation
- •Uncontrolled intercurrent illness including, but not limited to, symptomatic CHF, unstable angina pectoris, serious cardiac arrhythmia, MI w/in 6 months prior to enrollment (Troponin leak alone not included if no residual dysfunction) NYHA Class III or IV heart failure, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Patients w/ medical comorbidities that will preclude safety evaluation of the combination should not be enrolled
- •Patients w/ uncontrolled infection shall not be enrolled until infection is treated & brought under control
- •Patients who require treatment w/ concomitant drugs that are strong inducers of cytochrome P450 (CYP) 3A
- 另有 73 项未显示
研究组 & 干预措施
BAML-16-001-S17
**Active, not Recruiting** This is an open-label Phase 1b dose escalation followed by dose expansion clinical trial to determine the safety and recommended dose of SNDX-5613 combined with azacitidine and venetoclax in newly diagnosed, untreated AML patients age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy and who have NPM1 mutated or KMT2A-rearranged disease.
干预措施: Laboratory Biomarker Analysis (Other)
BAML-16-001-S17
**Active, not Recruiting** This is an open-label Phase 1b dose escalation followed by dose expansion clinical trial to determine the safety and recommended dose of SNDX-5613 combined with azacitidine and venetoclax in newly diagnosed, untreated AML patients age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy and who have NPM1 mutated or KMT2A-rearranged disease.
干预措施: Azacitidine (BAML-16-001-S17) (Drug)
BAML-16-001-S17
**Active, not Recruiting** This is an open-label Phase 1b dose escalation followed by dose expansion clinical trial to determine the safety and recommended dose of SNDX-5613 combined with azacitidine and venetoclax in newly diagnosed, untreated AML patients age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy and who have NPM1 mutated or KMT2A-rearranged disease.
干预措施: Venetoclax (BAML-16-001-S17) (Drug)
BAML-16-001-S3 (Closed)
This is a phase 2 clinical trial to assess the feasibility and efficacy of a stepwise approach to the treatment of IDH2-mutant AML. On day 1 of the trial, all enrolled participants will be initiated on therapy with the IDH2 inhibitor AG-221 for IDH2 R140 and R172-mutant patients. The dosing will be based on phase 1 experience of AG-221, which has established 100 mg daily as a safe and tolerated dose, with preliminary suggestion of efficacy. These will be administered continuously in 28 day cycles. Hydroxyurea will be allowed for the purposes of cytoreduction.
干预措施: Azacitidine (BAML-16-001-S3) (Drug)
BAML-16-001-S6 (Closed)
The study is an open-label phase 2 study of entospletinib in younger and older AML patients with NPM1+/FLT3ITD-AML. It includes patients age ≥18 years who are able and willing to receive 7 + 3 intensive chemotherapy. Entospletinib is administered daily with IV daunorubicin (days 1-3 for Cycle 1) and cytarabine (days 1-7 for Cycle 1). If a second induction is required, it is given with IV daunorubicin (days 1-2 for Cycle 2) and cytarabine (days 1-5 for Cycle 2).
干预措施: Entospletinib (BAML-16-001-S6) (Drug)
BAML-16-001-S10 (Closed)
This is a phase 1b/2 clinical trial to assess the safety and efficacy of the combination of AZD5153 and venetoclax. In a phase 1b component, safety and tolerability of the combination will be assessed in relapsed/refractory AML patients ≥ 18 years of age. Following determination of the recommended Phase 2 dose (RP2D), newly diagnosed, marker negative patients age ≥ 60 will be enrolled in the phase 2 component; these patients will be treated at the previously identified RP2D for the combination. The RP2D will be the highest dose level with ≤ 1 out of 6 patients with dose limiting toxicity and defined as the maximum tolerated dose.
干预措施: Venetoclax (BAML-16-001-S10) (Drug)
BAML-16-001-S17
**Active, not Recruiting** This is an open-label Phase 1b dose escalation followed by dose expansion clinical trial to determine the safety and recommended dose of SNDX-5613 combined with azacitidine and venetoclax in newly diagnosed, untreated AML patients age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy and who have NPM1 mutated or KMT2A-rearranged disease.
干预措施: SNDX-5613 (BAML-16-001-S17) (Drug)
BAML-16-001-S24
**Recruiting** This is a multi-center open-label Phase 1b safety run-in study followed by a Phase 2 study of ficlatuzumab given in combination with venetoclax azacitidine, in newly diagnosed untreated acute myeloid leukemia age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy.
干预措施: ficlatuzumab (BAML-16-001-S24) (Drug)
BAML-16-001-S24
**Recruiting** This is a multi-center open-label Phase 1b safety run-in study followed by a Phase 2 study of ficlatuzumab given in combination with venetoclax azacitidine, in newly diagnosed untreated acute myeloid leukemia age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy.
干预措施: Azacitidine (BAML-16-001-S24) (Drug)
BAML-16-001-S24
**Recruiting** This is a multi-center open-label Phase 1b safety run-in study followed by a Phase 2 study of ficlatuzumab given in combination with venetoclax azacitidine, in newly diagnosed untreated acute myeloid leukemia age ≥ 60 years who are not candidates or do not wish to pursue intensive induction therapy.
干预措施: Venetoclax (BAML-16-001-S24) (Drug)
BAML-16-001-S1 (Closed)
This is an open-label Phase 1b/2 clinical study of Samalizumab given in addition to standard induction chemotherapy/consolidation, followed by Samalizumab maintenance, in newly diagnosed acute myeloid leukemia. Patients that are marker negative, as defined based on the Beat AML Master Protocol assignment or with CBF karyotype/interphase cytogenetics/molecular testing defined by presence of t(8;21)(q22;q22) or the molecular equivalent RUNX1/RUNX1T1 fusion transcript or inv(16)(p13q22) or t(16;16)(p13;q22) or the molecular equivalent CBFB/MYH11 fusion transcript based on the Beat AML will receive Samalizumab in combination with induction therapy followed by Samalizumab maintenance.
干预措施: Samalizumab (BAML-16-001-S1) (Biological)
BAML-16-001-S1 (Closed)
This is an open-label Phase 1b/2 clinical study of Samalizumab given in addition to standard induction chemotherapy/consolidation, followed by Samalizumab maintenance, in newly diagnosed acute myeloid leukemia. Patients that are marker negative, as defined based on the Beat AML Master Protocol assignment or with CBF karyotype/interphase cytogenetics/molecular testing defined by presence of t(8;21)(q22;q22) or the molecular equivalent RUNX1/RUNX1T1 fusion transcript or inv(16)(p13q22) or t(16;16)(p13;q22) or the molecular equivalent CBFB/MYH11 fusion transcript based on the Beat AML will receive Samalizumab in combination with induction therapy followed by Samalizumab maintenance.
干预措施: Daunorubicin (BAML-16-001-S1) (Drug)
BAML-16-001-S1 (Closed)
This is an open-label Phase 1b/2 clinical study of Samalizumab given in addition to standard induction chemotherapy/consolidation, followed by Samalizumab maintenance, in newly diagnosed acute myeloid leukemia. Patients that are marker negative, as defined based on the Beat AML Master Protocol assignment or with CBF karyotype/interphase cytogenetics/molecular testing defined by presence of t(8;21)(q22;q22) or the molecular equivalent RUNX1/RUNX1T1 fusion transcript or inv(16)(p13q22) or t(16;16)(p13;q22) or the molecular equivalent CBFB/MYH11 fusion transcript based on the Beat AML will receive Samalizumab in combination with induction therapy followed by Samalizumab maintenance.
干预措施: Cytarabine (BAML-16-001-S1) (Drug)
BAML-16-001-S2 (Closed)
This is an open-label Phase 1b/2 clinical study of BI 836858 given in combination with azacitidine, followed by BI 836858 plus azacitidine maintenance, in newly diagnosed acute myeloid leukemia. The target population is assigned by the Beat AML Master Protocol (the "umbrella" study). Eligible patients will have previously untreated acute myeloid leukemia, age greater than or equal to 60, with any 1 of the following: mutated TET2, IDH1, IDH2, or WT1, or "marker negative" as defined by the overall Beat AML umbrella protocol.
干预措施: BI 836858 (BAML-16-001-S2) (Biological)
BAML-16-001-S2 (Closed)
This is an open-label Phase 1b/2 clinical study of BI 836858 given in combination with azacitidine, followed by BI 836858 plus azacitidine maintenance, in newly diagnosed acute myeloid leukemia. The target population is assigned by the Beat AML Master Protocol (the "umbrella" study). Eligible patients will have previously untreated acute myeloid leukemia, age greater than or equal to 60, with any 1 of the following: mutated TET2, IDH1, IDH2, or WT1, or "marker negative" as defined by the overall Beat AML umbrella protocol.
干预措施: Azacitidine (BAML-16-001-S2) (Drug)
BAML-16-001-S3 (Closed)
This is a phase 2 clinical trial to assess the feasibility and efficacy of a stepwise approach to the treatment of IDH2-mutant AML. On day 1 of the trial, all enrolled participants will be initiated on therapy with the IDH2 inhibitor AG-221 for IDH2 R140 and R172-mutant patients. The dosing will be based on phase 1 experience of AG-221, which has established 100 mg daily as a safe and tolerated dose, with preliminary suggestion of efficacy. These will be administered continuously in 28 day cycles. Hydroxyurea will be allowed for the purposes of cytoreduction.
干预措施: AG-221 (BAML-16-001-S3) (Drug)
BAML-16-001-S4 (Closed)
This is a 2 cohort phase 1b/2 clinical trial to assess the feasibility and efficacy of entospletinib (ENTO) stepwise approach to the treatment of patients with balanced translocations of MLL identified cytogenetically (Cohort 1) and patients with MLL-partial tandem duplications identified molecularly (Cohort 2). All enrolled participants will be initiated on monotherapy with ENTO 400 mg PO BID. This dose will be administered continuously in 28 day cycles.
干预措施: Entospletinib (BAML-16-001-S4) (Drug)
BAML-16-001-S4 (Closed)
This is a 2 cohort phase 1b/2 clinical trial to assess the feasibility and efficacy of entospletinib (ENTO) stepwise approach to the treatment of patients with balanced translocations of MLL identified cytogenetically (Cohort 1) and patients with MLL-partial tandem duplications identified molecularly (Cohort 2). All enrolled participants will be initiated on monotherapy with ENTO 400 mg PO BID. This dose will be administered continuously in 28 day cycles.
干预措施: Azacitidine (BAML-16-001-S4) (Drug)
BAML-16-001-S5 (Closed)
This is a phase 2 clinical trial to assess the feasibility and efficacy of a stepwise approach to the treatment of patients with TP53 mutations (identified molecularly) with/without complex karyotype (Cohort A) or complex karyotype (3 or greater metaphase abnormalities without TP53) (Cohort B). All enrolled participants will be initiated on entospletinib 400 mg orally twice daily. This dose will be administered continuously in 28 day cycles.
干预措施: Entospletinib (BAML-16-001-S5) (Drug)
BAML-16-001-S5 (Closed)
This is a phase 2 clinical trial to assess the feasibility and efficacy of a stepwise approach to the treatment of patients with TP53 mutations (identified molecularly) with/without complex karyotype (Cohort A) or complex karyotype (3 or greater metaphase abnormalities without TP53) (Cohort B). All enrolled participants will be initiated on entospletinib 400 mg orally twice daily. This dose will be administered continuously in 28 day cycles.
干预措施: Decitabine (BAML-16-001-S5) (Drug)
BAML-16-001-S6 (Closed)
The study is an open-label phase 2 study of entospletinib in younger and older AML patients with NPM1+/FLT3ITD-AML. It includes patients age ≥18 years who are able and willing to receive 7 + 3 intensive chemotherapy. Entospletinib is administered daily with IV daunorubicin (days 1-3 for Cycle 1) and cytarabine (days 1-7 for Cycle 1). If a second induction is required, it is given with IV daunorubicin (days 1-2 for Cycle 2) and cytarabine (days 1-5 for Cycle 2).
干预措施: Daunorubicin (BAML-16-001-S6) (Drug)
BAML-16-001-S6 (Closed)
The study is an open-label phase 2 study of entospletinib in younger and older AML patients with NPM1+/FLT3ITD-AML. It includes patients age ≥18 years who are able and willing to receive 7 + 3 intensive chemotherapy. Entospletinib is administered daily with IV daunorubicin (days 1-3 for Cycle 1) and cytarabine (days 1-7 for Cycle 1). If a second induction is required, it is given with IV daunorubicin (days 1-2 for Cycle 2) and cytarabine (days 1-5 for Cycle 2).
干预措施: Cytarabine (BAML-16-001-S6) (Drug)
BAML-16-001-S8 (Closed)
This is an open-label Phase 1b/2 clinical study of gilteritinib monotherapy, gilteritinib in combination with decitabine, or gilteritinib in combination with decitabine and venetoclax in untreated FLT3 mutated AML with high and low variant allele frequency. Initially, the combination of gilteritinib and decitabine was tested (Group 1); however, subsequently the combination of decitabine and venetoclax was shown to be a highly effective therapy for older AML patients, so the triple combination of gilteritinib in combination with decitabine and venetoclax (Group 2) is now being evaluated in this study.
干预措施: Gilteritinib (BAML-16-001-S8 Group 1) (Drug)
BAML-16-001-S8 (Closed)
This is an open-label Phase 1b/2 clinical study of gilteritinib monotherapy, gilteritinib in combination with decitabine, or gilteritinib in combination with decitabine and venetoclax in untreated FLT3 mutated AML with high and low variant allele frequency. Initially, the combination of gilteritinib and decitabine was tested (Group 1); however, subsequently the combination of decitabine and venetoclax was shown to be a highly effective therapy for older AML patients, so the triple combination of gilteritinib in combination with decitabine and venetoclax (Group 2) is now being evaluated in this study.
干预措施: Decitabine (BAML-16-001-S8 Group 1) (Drug)
BAML-16-001-S8 (Closed)
This is an open-label Phase 1b/2 clinical study of gilteritinib monotherapy, gilteritinib in combination with decitabine, or gilteritinib in combination with decitabine and venetoclax in untreated FLT3 mutated AML with high and low variant allele frequency. Initially, the combination of gilteritinib and decitabine was tested (Group 1); however, subsequently the combination of decitabine and venetoclax was shown to be a highly effective therapy for older AML patients, so the triple combination of gilteritinib in combination with decitabine and venetoclax (Group 2) is now being evaluated in this study.
干预措施: Decitabine (BAML-16-001-S8 Group 2) (Drug)
BAML-16-001-S8 (Closed)
This is an open-label Phase 1b/2 clinical study of gilteritinib monotherapy, gilteritinib in combination with decitabine, or gilteritinib in combination with decitabine and venetoclax in untreated FLT3 mutated AML with high and low variant allele frequency. Initially, the combination of gilteritinib and decitabine was tested (Group 1); however, subsequently the combination of decitabine and venetoclax was shown to be a highly effective therapy for older AML patients, so the triple combination of gilteritinib in combination with decitabine and venetoclax (Group 2) is now being evaluated in this study.
干预措施: Venetoclax (BAML-16-001-S8 Group 2) (Drug)
BAML-16-001-S8 (Closed)
This is an open-label Phase 1b/2 clinical study of gilteritinib monotherapy, gilteritinib in combination with decitabine, or gilteritinib in combination with decitabine and venetoclax in untreated FLT3 mutated AML with high and low variant allele frequency. Initially, the combination of gilteritinib and decitabine was tested (Group 1); however, subsequently the combination of decitabine and venetoclax was shown to be a highly effective therapy for older AML patients, so the triple combination of gilteritinib in combination with decitabine and venetoclax (Group 2) is now being evaluated in this study.
干预措施: Gilteritinib (BAML-16-001-S8 Group 2) (Drug)
BAML-16-001-S9 (Closed)
This is an open-label phase 2 clinical trial of a stepwise approach to the treatment of patients with TP53 mutation AML. On day 1, all enrolled participants will be initiated on therapy with pevonedistat (20 mg/m2) day 1, 3 and 5 together with azacitidine (75 mg/m2 days 1-7 or day 1-5 then day 8, 9) every 28 days. During cycle 1, patients with rapidly progressive disease or severe organ dysfunction, not correctable by hydroxyurea cytoreduction will not be eligible to continue. Those patients who achieved a response, defined as complete response or complete response with incomplete blood count recovery, by the end of cycle 4 will continue on pevonedistat and azacitidine until disease progression, unacceptable toxicity, or 12 cycles of therapy. After 12 months of combined therapy, pevonedistat will be continued until progression of disease, unacceptable toxicity, or up to 2 years of total therapy.
干预措施: Pevonedistat (BAML-16-001-S9) (Drug)
BAML-16-001-S9 (Closed)
This is an open-label phase 2 clinical trial of a stepwise approach to the treatment of patients with TP53 mutation AML. On day 1, all enrolled participants will be initiated on therapy with pevonedistat (20 mg/m2) day 1, 3 and 5 together with azacitidine (75 mg/m2 days 1-7 or day 1-5 then day 8, 9) every 28 days. During cycle 1, patients with rapidly progressive disease or severe organ dysfunction, not correctable by hydroxyurea cytoreduction will not be eligible to continue. Those patients who achieved a response, defined as complete response or complete response with incomplete blood count recovery, by the end of cycle 4 will continue on pevonedistat and azacitidine until disease progression, unacceptable toxicity, or 12 cycles of therapy. After 12 months of combined therapy, pevonedistat will be continued until progression of disease, unacceptable toxicity, or up to 2 years of total therapy.
干预措施: Azacitidine (BAML-16-001-S9) (Drug)
BAML-16-001-S10 (Closed)
This is a phase 1b/2 clinical trial to assess the safety and efficacy of the combination of AZD5153 and venetoclax. In a phase 1b component, safety and tolerability of the combination will be assessed in relapsed/refractory AML patients ≥ 18 years of age. Following determination of the recommended Phase 2 dose (RP2D), newly diagnosed, marker negative patients age ≥ 60 will be enrolled in the phase 2 component; these patients will be treated at the previously identified RP2D for the combination. The RP2D will be the highest dose level with ≤ 1 out of 6 patients with dose limiting toxicity and defined as the maximum tolerated dose.
干预措施: AZD5153 (BAML-16-001-S10) (Drug)
BAML-16-001-S14 (Closed)
The study is an open-label Phase 1b/2 clinical study of TP-0903 given in addition to decitabine in patients ≥ 60 years with newly diagnosed, previously untreated AML with TP53 mutations and/or complex karyotype. The Phase 1b portion of this study will use a standard 3 + 3 design with dose escalation based upon dose limiting toxicities. The maximum tolerated dose will be defined as the highest dose where at most 1 patient in 6 experiences dose-limiting toxicity, and this is generally the recommended Phase 2 dose (RP2D). Once the RP2D is determined from Phase 1b, patients will be enrolled at this dose level to initiate the Phase 2 portion of the study.
干预措施: TP-0903 (BAML-16-001-S14) (Drug)
BAML-16-001-S14 (Closed)
The study is an open-label Phase 1b/2 clinical study of TP-0903 given in addition to decitabine in patients ≥ 60 years with newly diagnosed, previously untreated AML with TP53 mutations and/or complex karyotype. The Phase 1b portion of this study will use a standard 3 + 3 design with dose escalation based upon dose limiting toxicities. The maximum tolerated dose will be defined as the highest dose where at most 1 patient in 6 experiences dose-limiting toxicity, and this is generally the recommended Phase 2 dose (RP2D). Once the RP2D is determined from Phase 1b, patients will be enrolled at this dose level to initiate the Phase 2 portion of the study.
干预措施: Decitabine (BAML-16-001-S14) (Drug)
BAML-16-001-S16 (Closed)
This is an open-label phase 2 clinical study to assess the feasibility and efficacy of a combination based approach to the treatment of IDH1 mutant AML. On day 1 of the trial, all enrolled participants will be initiated on therapy with the IDH1 inhibitor AG-120 given daily together with azacitidine (days 1-5 and 8-9 or 7 consecutive days 1-7) in 28 day cycles for IDH1 mutant patients. Those patients who have achieved a response, defined as complete response or complete response with incomplete blood count recovery, by the end of cycle 6, will continue on combination therapy for a total of 12 cycles and then patients will go onto receive monotherapy with AG-120 until disease progression or unacceptable side effects that mandate discontinuation of therapy. Patients who cannot complete 12 cycles of azacitidine may proceed onto monotherapy with AG-120.
干预措施: AG-120 (BAML-16-001-S16) (Drug)
BAML-16-001-S16 (Closed)
This is an open-label phase 2 clinical study to assess the feasibility and efficacy of a combination based approach to the treatment of IDH1 mutant AML. On day 1 of the trial, all enrolled participants will be initiated on therapy with the IDH1 inhibitor AG-120 given daily together with azacitidine (days 1-5 and 8-9 or 7 consecutive days 1-7) in 28 day cycles for IDH1 mutant patients. Those patients who have achieved a response, defined as complete response or complete response with incomplete blood count recovery, by the end of cycle 6, will continue on combination therapy for a total of 12 cycles and then patients will go onto receive monotherapy with AG-120 until disease progression or unacceptable side effects that mandate discontinuation of therapy. Patients who cannot complete 12 cycles of azacitidine may proceed onto monotherapy with AG-120.
干预措施: Azacitidine (BAML-16-001-S16) (Drug)
BAML-16-001-S18 (Closed)
This is an open-label Phase 1b clinical study of AZD5991 + azacitidine in patients aged ≥60 years with newly diagnosed, previously untreated, hypermethylated and marker-negative AML. The phase 1b1 study will adopt a standard 3+3 design with dose escalation based upon dose limiting toxicities. The recommended Phase 2 dose (RP2D) is defined in this study as the highest dose level where less than 2 dose limiting toxicities (DLT) are observed out of 6 patients. Once the RP2D is defined, patients will be enrolled into 2 separate cohorts (hypermethylation and marker negative group) for the phase 1b2 expansion. These 2 groups will both be treated at the RP2D determined from phase 1b1.
干预措施: AZD5991 (BAML-16-001-S18) (Drug)
BAML-16-001-S18 (Closed)
This is an open-label Phase 1b clinical study of AZD5991 + azacitidine in patients aged ≥60 years with newly diagnosed, previously untreated, hypermethylated and marker-negative AML. The phase 1b1 study will adopt a standard 3+3 design with dose escalation based upon dose limiting toxicities. The recommended Phase 2 dose (RP2D) is defined in this study as the highest dose level where less than 2 dose limiting toxicities (DLT) are observed out of 6 patients. Once the RP2D is defined, patients will be enrolled into 2 separate cohorts (hypermethylation and marker negative group) for the phase 1b2 expansion. These 2 groups will both be treated at the RP2D determined from phase 1b1.
干预措施: Azacitidine (BAML-16-001-S18) (Drug)
BAML-16-001-S12, Arm A (Closed)
This is an open label phase 2 randomized study in which eligible AML patients will be randomly assigned (1:1) to receive either the FDA label-approved regimen of 28-day Venetoclax + Azacitidine (Arm A) or the 14-day regimen of Venetoclax + Azacitidine (Arm B). Newly diagnosed acute myeloid leukemia (AML) patients ≥ 60 years will be enrolled.
干预措施: Venetoclax (BAML-16-001-S12 Arm A) (Drug)
BAML-16-001-S12, Arm A (Closed)
This is an open label phase 2 randomized study in which eligible AML patients will be randomly assigned (1:1) to receive either the FDA label-approved regimen of 28-day Venetoclax + Azacitidine (Arm A) or the 14-day regimen of Venetoclax + Azacitidine (Arm B). Newly diagnosed acute myeloid leukemia (AML) patients ≥ 60 years will be enrolled.
干预措施: Azacitidine (BAML-16-001-S12 Arm A) (Drug)
BAML-16-001-S12, Arm B (Closed)
This is an open label phase 2 randomized study in which eligible AML patients will be randomly assigned (1:1) to receive either the FDA label-approved regimen of 28-day Venetoclax + Azacitidine (Arm A) or the 14-day regimen of Venetoclax + Azacitidine (Arm B). Newly diagnosed acute myeloid leukemia (AML) patients ≥ 60 years will be enrolled.
干预措施: Venetoclax (BAML-16-001-S12 Arm B) (Drug)
BAML-16-001-S12, Arm B (Closed)
This is an open label phase 2 randomized study in which eligible AML patients will be randomly assigned (1:1) to receive either the FDA label-approved regimen of 28-day Venetoclax + Azacitidine (Arm A) or the 14-day regimen of Venetoclax + Azacitidine (Arm B). Newly diagnosed acute myeloid leukemia (AML) patients ≥ 60 years will be enrolled.
干预措施: Azacitidine (BAML-16-001-S12 Arm B) (Drug)
BAML-16-001-S21, Group 1 (Closed)
This is a Phase 1, open-label, multicenter, dose escalation, and dose optimization study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of ZE46-0134 in adult patients with relapsed or refractory AML with FLT3-ITD and/or FLT3-TKD mutations for Group 1 and with spliceosome (SF3B1, SRSF2, U2AFI and ZRSR2) mutations for Group 2. Patients with AML that are out-patients or hospitalized due to their AML can be enrolled in the study. The study will be run in 2 parts: Part 1 will be dose escalation and determination of the maximum tolerated dose, and Part 2 will be dose expansion.
干预措施: Laboratory Biomarker Analysis (Other)
BAML-16-001-S21, Group 1 (Closed)
This is a Phase 1, open-label, multicenter, dose escalation, and dose optimization study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of ZE46-0134 in adult patients with relapsed or refractory AML with FLT3-ITD and/or FLT3-TKD mutations for Group 1 and with spliceosome (SF3B1, SRSF2, U2AFI and ZRSR2) mutations for Group 2. Patients with AML that are out-patients or hospitalized due to their AML can be enrolled in the study. The study will be run in 2 parts: Part 1 will be dose escalation and determination of the maximum tolerated dose, and Part 2 will be dose expansion.
干预措施: ZE46-0134 (BAML-16-001-S21 Group 1) (Drug)
BAML-16-001-S21, Group 2 (Closed)
This is a Phase 1, open-label, multicenter, dose escalation, and dose optimization study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of ZE46-0134 in adult patients with relapsed or refractory AML with FLT3-ITD and/or FLT3-TKD mutations for Group 1 and with spliceosome (SF3B1, SRSF2, U2AFI and ZRSR2) mutations for Group 2. Patients with AML that are out-patients or hospitalized due to their AML can be enrolled in the study. The study will be run in 2 parts: Part 1 will be dose escalation and determination of the maximum tolerated dose, and Part 2 will be dose expansion.
干预措施: Laboratory Biomarker Analysis (Other)
BAML-16-001-S21, Group 2 (Closed)
This is a Phase 1, open-label, multicenter, dose escalation, and dose optimization study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of ZE46-0134 in adult patients with relapsed or refractory AML with FLT3-ITD and/or FLT3-TKD mutations for Group 1 and with spliceosome (SF3B1, SRSF2, U2AFI and ZRSR2) mutations for Group 2. Patients with AML that are out-patients or hospitalized due to their AML can be enrolled in the study. The study will be run in 2 parts: Part 1 will be dose escalation and determination of the maximum tolerated dose, and Part 2 will be dose expansion.
干预措施: ZE46-0134 (BAML-16-001-S21 Group 2) (Drug)
S25/HO181 (Arm 1): Std of care treatment plus bleximenib and also maintenance treatment w/bleximenib
**Recruiting** Bleximenib in combination with remission induction and consolidation therapy, followed by bleximenib maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Bleximenib (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 1): Std of care treatment plus bleximenib and also maintenance treatment w/bleximenib
**Recruiting** Bleximenib in combination with remission induction and consolidation therapy, followed by bleximenib maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Cytarabine (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 1): Std of care treatment plus bleximenib and also maintenance treatment w/bleximenib
**Recruiting** Bleximenib in combination with remission induction and consolidation therapy, followed by bleximenib maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Daunorubicin or Idarubicin (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 2): Standard of care treatment plus bleximenib and maintenance treatment w/ a placebo
**Recruiting** Bleximenib in combination with remission induction and consolidation therapy, followed by placebo maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first)
干预措施: Bleximenib (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 2): Standard of care treatment plus bleximenib and maintenance treatment w/ a placebo
**Recruiting** Bleximenib in combination with remission induction and consolidation therapy, followed by placebo maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first)
干预措施: Cytarabine (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 2): Standard of care treatment plus bleximenib and maintenance treatment w/ a placebo
**Recruiting** Bleximenib in combination with remission induction and consolidation therapy, followed by placebo maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first)
干预措施: Daunorubicin or Idarubicin (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 2): Standard of care treatment plus bleximenib and maintenance treatment w/ a placebo
**Recruiting** Bleximenib in combination with remission induction and consolidation therapy, followed by placebo maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first)
干预措施: Placebo (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 3): Standard of care treatment plus a placebo and maintenance treatment w/ a placebo
**Recruiting** Placebo comparator in combination with remission induction and consolidation therapy, followed by placebo maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Cytarabine (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 3): Standard of care treatment plus a placebo and maintenance treatment w/ a placebo
**Recruiting** Placebo comparator in combination with remission induction and consolidation therapy, followed by placebo maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Daunorubicin or Idarubicin (BAML-16-001-S25/HO181) (Drug)
S25/HO181 (Arm 3): Standard of care treatment plus a placebo and maintenance treatment w/ a placebo
**Recruiting** Placebo comparator in combination with remission induction and consolidation therapy, followed by placebo maintenance therapy. Treatment will continue until PD, unacceptable toxicity or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Placebo (BAML-16-001-S25/HO181) (Drug)
BAML-16-001-S26/HO177 (Revumenib-placebo)
**Recruiting**
day 1-28 Placebo
Treatment will be on a continuous 28-day cycle schedule and continued until disease progression, development of unacceptable toxicity, death, withdrawal by subject or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Placebo (BAML-16-001-S26/HO177) (Drug)
BAML-16-001-S26/HO177 (Revumenib)
**Recruiting**
day 1-28 Revumenib
Treatment will be on a continuous 28-day cycle schedule and continued until disease progression, development of unacceptable toxicity, death, withdrawal by subject or other protocol defined criteria for discontinuation (whichever comes first).
干预措施: Revumenib (BAML-16-001-S26/HO177) (Drug)
结局指标
主要结局
Proportion of patients for whom molecular, immunophenotypic, and/or biochemical studies are completed in < 7 calendar days for assignment of treatment
时间窗: 7 days
The feasibility of completing molecular, genetic, immunophenotypic, and biochemical testing for assignment of therapy will be assessed based on the proportion of patients for whom testing is completed within 7 days of the registration sample arriving at the laboratory
Proportion of patients assigned to a novel therapeutic treatment group in 1 of several sub-studies in this Master Protocol, based on the result of the molecular, immunophenotypic, and/or biochemical studies
时间窗: 7 days
The feasibility of assigning patients to a treatment group will be assessed based on the proportion who are eligible for screening in this study who are assigned to treatment either on this study or an industry study relevant to the specific marker group and not unassignable due to insufficient material, laboratory error, or any other factors
Clinical response rate (rate of complete and partial responses) according to International Working Group criteria for treatment outcomes in therapeutic trials in acute myeloid leukemia
时间窗: Up to 5 years
BAML-16-001-M1: Proportion of patients for whom molecular, immunophenotypic, and/or biochemical studies are completed in < 7 calendar days for assignment of treatment
时间窗: 7 days
BAML-16-001-M1: Proportion of patients assigned to a novel therapeutic treatment group in 1 of several sub-studies in this Master Protocol, based on the result of the molecular, immunophenotypic, and/or biochemical studies
时间窗: 7 days
BAML-16-001-M1: Clinical response rate (rate of complete and partial responses) according to European Leukemianet (ELN) criteria for treatment outcomes in substudies in acute myeloid leukemia.
时间窗: Up to 5 years
BAML-16-001-S25/HO181: Event-Free Survival (EFS) in adult patients with newly diagnosed NPM1m or KMT2Ar AML eligible for intensive chemotherapy
时间窗: Up to 4 years and 5 months
To assess if treatment with bleximenib, as compared with placebo, in combination with remission induction chemotherapy, prolongs event-free survival (EFS) measured from the time from randomization to failure to achieve CR after remission induction, hematologic relapse after achieving CR, or death, whichever occurs first.
BAML-16-001-S26/HO177: Overall survival (OS) in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy.
时间窗: 58 months after last patient inclusion
To assess if treatment with revumenib, in combination with azacitidine and venetoclax, prolongs overall survival (OS) measured from the date of randomization to the date of death from any cause; patients not known to have died at last follow-up are censored on the date they were last known to be alive.
BAML-16-001-S26/HO177: Rate of CR in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy
时间窗: 58 months after the first randomized NPM1-mutated AML patient
Defined as the proportion of NPM1-mutated AML patients who achieve CR at any time-point during protocol therapy.
次要结局
- Proportion of patients enrolled on this trial that ultimately will be assigned and go onto an assigned therapy(7 days)
- Dynamic changes in clonal architecture over time in acute myeloid leukemia patients receiving targeted therapies(time of diagnosis, remission (complete response or complete response with incomplete blood count recovery), 1 year of treatment, and relapse)
- Relationships between baseline functional status and response rate or progression-free survival based on graphical comparison (eg, side-by-side boxplots or Kaplan-Meier plots)(Up to 5 years)
- BAML-16-001-M1: Proportion of patients enrolled on this trial that ultimately will be assigned and go onto an assigned therapy(7 days)
- BAML-16-001-M1: Dynamic changes in clonal architecture over time in acute myeloid leukemia patients receiving targeted therapies(Up to 5 years)
- BAML-16-001-M1: Relationships between baseline functional status and response rate or progression-free survival based on graphical comparison (eg, side-by-side boxplots or Kaplan-Meier plots)(Up to 5 years)
- BAML-16-001-S25/HO181: Overall Survival (OS) in adult patients with newly diagnosed NPM1m or KMT2Ar AML eligible for intensive chemotherapy(Up to 7 years and 10 months)
- BAML-16-001-S25/HO181: Rates of CR, CRh, CRi in adult patients with newly diagnosed NPM1m or KMT2Ar AML eligible for intensive chemotherapy(Up to 7 years and 10 months)
- BAML-16-001-S25/HO181: Prolongation of CR (DoCR) in adult patients with newly diagnosed NPM1m or KMT2Ar AML eligible for intensive chemotherapy(Up to 4 years and 5 months)
- BAML-16-001-S25/HO181: Percentage of participants undergoing an allo-SCT in adult patients with newly diagnosed NPM1m or KMT2Ar AML eligible for intensive chemotherapy(Up to 7 years and 10 months)
- BAML-16-001-S26/HO177: Event-free survival (EFS) in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy.(58 months after the first NPM1-mutated AML patient has been randomized)
- BAML-16-001-S26/HO177: Rate of CR/CRh in adult patients with newly diagnosed NPM1mutated AML ineligible for intensive chemotherapy.(58 months after the first randomized NPM1-mutated AML patient)
- BAML-16-001-S26/HO177: Rate of response (CRh and CR/CRi) in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy(58 months after the first randomized NPM1-mutated AML patient)
- BAML-16-001-S26/HO177: Rates of CRMRD-, CR/CRhMRD-, and CR/CRiMRD- assessed by quantitative PCR of bone marrow in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy(58 months after the first randomized NPM1-mutated AML patient)
- BAML-16-001-S26/HO177: Rates of CRMRD-, CR/CRhMRD-, and CR/CRiMRD- assessed by quantitative PCR of peripheral blood in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy(58 months after the first randomized NPM1-mutated AML patient)
- BAML-16-001-S26/HO177: Time to achievement of response (CR, CR/CRh and CR/CRi) in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy(58 months after the first randomized NPM1-mutated AML patient)
- BAML-16-001-S26/HO177: Duration of response (CR, CR/CRh and CR/CRi; DoR) in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy(58 months after the first randomized NPM1-mutated AML patient)
- BAML-16-001-S26/HO177: QoL in adult patients with newly diagnosed NPM1-mutated AML ineligible for intensive chemotherapy(58 months after the first randomized NPM1-mutated AML patient)
