Clinical trial • Phase II • Oncology|Haematology

Cytarabine; Daunorubicin for Myelodysplastic syndrome (higher-risk)|Oligoblastic acute myeloid leukaemia (AML)

Phase II trial of Cytarabine; Daunorubicin for Myelodysplastic syndrome (higher-risk)|Oligoblastic acute myeloid leukaemia (AML).

Overview

Trial Therapeutic Area
Oncology|Haematology
Trial Disease
Myelodysplastic syndrome (higher-risk)|Oligoblastic acute myeloid leukaemia (AML)
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
19-09-2024
First CTIS Authorization Date
20-10-2024

Trial design

Conventional care regimens (CCR) as comparator: Daunorubicin hydrochloride (intravenous; maxDailyDoseAmount 60 mg/m2), Cytarabine (intravenous; maxDailyDoseAmount 1500 mg/m2), Azacitidine (subcutaneous; maxDailyDoseAmount 75 mg/m2) — specific regimen/schedule not detailed in the available data.-controlled Phase II trial across 26 sites in Austria, Germany.

Comparator
Conventional care regimens (CCR) as comparator: Daunorubicin hydrochloride (intravenous; maxDailyDoseAmount 60 mg/m2), Cytarabine (intravenous; maxDailyDoseAmount 1500 mg/m2), Azacitidine (subcutaneous; maxDailyDoseAmount 75 mg/m2) — specific regimen/schedule not detailed in the available data.
Target Sample Size
150

Eligibility

Recruits 150 Vulnerable population is selected. Trial enrols adults only (18-75) and requires signed informed consent. Participants with any condition preventing obtaining informed consent are excluded. Subject information and informed consent forms for adults are available (German); optional biobanking consent and pregnancy-related partner/participant ICFs are documented. No paediatric assent procedures (paediatrics excluded)..

Pregnancy Exclusion
Female patients who are pregnant or lactating.
Vulnerable Population
Vulnerable population is selected. Trial enrols adults only (18-75) and requires signed informed consent. Participants with any condition preventing obtaining informed consent are excluded. Subject information and informed consent forms for adults are available (German); optional biobanking consent and pregnancy-related partner/participant ICFs are documented. No paediatric assent procedures (paediatrics excluded).

Inclusion criteria

  • {"criterion_text":"- Adult patients (irrespective of sex), 18-75 years of age\n- Contraception: - Female subjects of childbearing potential† must agree to use a medically acceptable method of contraception for at least 2 months prior to the first dose of CPX-351 and consent of female patients to use a medically acceptable method of contraception throughout the entire study period and for 6 months following the last dose of CPX-351; Male patients must be willing to refrain from sperm donation for 6 months following the last dose of CPX-351 and must use adequate contraception throughout the entire study period and for 6 months following the last dose of CPX-351\n- Diagnosis of high risk MDS including oligoblastic non-proliferative (WBC <13 Gpt/l) AML up to 29% of bone marrow blasts\n- Bone marrow blasts ≥ 5% (central morphology Düsseldorf)\n- IPSS score intermediate or high\n- alloHCT intended within the next 6 months\n- ECOG performance status of 0 or 1\n- Signed informed consent\n- Laboratory values fulfilling all of the following: Serum creatinine < 2.0 mg/dL; Serum total bilirubin < 2.0 mg/dL; Serum alanine aminotransferase or aspartate aminotransferase < 3 times the ULN\n- Cardiac ejection fraction (LVEF) ≥ 50% by echocardiography"}

Exclusion criteria

  • {"criterion_text":"- Patients with history of myeloproliferative neoplasms (MPN) (defined as a history of essential thrombocytosis or polycythemia vera, or idiopathic myelofibrosis prior to the diagnosis of AML) or combined MDS/MPN are not eligible.\n- WHO-2016 defined AML entities: AML with t(15;17), PMLRARA; AML with t(8;21), RUNX1-RUNX1T1, AML with inv(16)/t(16;16), CBFβ-MYH11; AML with BCR-ABL1, AML with biallelic CEBPA mutation; AML with mutated FLT3 or NPM1.\n- Clinical evidence of active CNS leukaemia.\n- Patients with a “currently active” second malignancy other than non-melanoma skin cancers. Patients are not considered to have a “currently active” malignancy if they have completed therapy more than 2 years ago and are disease free.\n- Any major surgery or radiation therapy within four weeks prior screening.\n- Patients with prior treatment of either CPX-351, hypomethylating agents, cytarabine or intensive chemotherapy for high-risk MDS or AML.\n- Patients with prior cumulative anthracycline exposure of greater than 368 mg/m2 daunorubicin (or equivalent).\n- Recent (< 30 days) or planned live vaccinations during the clinical trial.\n- Any serious medical condition, laboratory abnormality or psychiatric illness that would prevent obtaining informed consent.\n- Creatinine clearance < 30 ml/min.\n- Active or uncontrolled infection. Patients with an infection receiving treatment (antibiotic, antifungal or antiviral treatment) may be entered into the study but must be afebrile and hemodynamically stable for ≥ 72 hrs.\n- Current evidence of invasive fungal infection (blood or tissue culture); patients with recent fungal infection must have a subsequent negative cultures to be eligible; known HIV (new testing not required) or evidence of active hepatitis B or C infection (with rising transaminase values).\n- Hypersensitivity to cytarabine, daunorubicin or liposomal products.\n- History of Wilson’s disease or other copper-metabolism disorder, unless the therapy outweighs the risks.\n- Female patients who are pregnant or lactating."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- EFS with a data cut off date of September 2025","definition_or_measurement_approach":"Event-free survival (EFS) comparing CPX-351 vs. conventional care regimens (CCR) prior to allogeneic HCT; data cut-off date September 2025"}

Secondary endpoints

  • {"endpoint_text":"- Best and overall response rate according to AML-ELN and MDS-IWG criteria","definition_or_measurement_approach":"Response assessed according to AML-ELN and MDS-IWG criteria"}
  • {"endpoint_text":"- Toxicity as measured by NCI CTCAE v5.0","definition_or_measurement_approach":"Adverse event grading per NCI CTCAE version 5.0"}
  • {"endpoint_text":"- Proportion of patients proceeding to alloHCT","definition_or_measurement_approach":"Proportion of randomized patients who proceed to allogeneic haematopoietic cell transplantation"}
  • {"endpoint_text":"- MRD assessed at all times of BM puncture","definition_or_measurement_approach":"Minimal residual disease (MRD) assessment at each bone marrow puncture timepoint"}
  • {"endpoint_text":"- Quality of life as measured by EORTC-QLQ30 supplemented by information on self-assessed concomitant diseases and demographics upon inclusion and at EOT (i.e. before alloHCT, if applicable)","definition_or_measurement_approach":"Quality of life measured using EORTC QLQ-C30 questionnaire and supplementary self-assessed comorbidity and demographic information at baseline and end of treatment"}
  • {"endpoint_text":"- Key Secondary Endpoint: OS with a data cut-off dates of September 2025 for interim and September 2026 for final","definition_or_measurement_approach":"Overall survival (OS) with interim data cut-off September 2025 and final cut-off September 2026"}

Recruitment

Planned Sample Size
150
Recruitment Window Months
89
Consent Approach
Signed informed consent is required from adult participants (18-75). Subject information and informed consent forms for adults are available (documents titled L1_SIS and ICF adults; German language indicated). Optional biobanking consent and pregnancy/partner-specific ICFs are provided. No paediatric assent procedures (paediatric subjects excluded).

Geography

Total Number Of Sites
26
Total Number Of Participants
150

Austria

Latest Decision Or Authorization Date
20-10-2024
Number Of Sites
1
Number Of Participants
20

Sites

Site Name
Ordensklinikum Linz GmbH
Department Name
Ordensklinikum Linz Elisabethinen GmbH
Contact Person Name
Sigrid Machherndl-Spandl

Germany

Latest Decision Or Authorization Date
24-10-2024
Number Of Sites
25
Number Of Participants
130

Sites

Site Name
Klinikum rechts der Isar der TU Muenchen AöR
Department Name
Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Innere Medizin III
Contact Person Name
Katharina Götze
Contact Person Email
katharina.goetze@mri.tum.de
Site Name
Universitaetsklinikum Aachen AöR
Department Name
Uniklinik RWTH Aachen, Medizinische Klinik IV
Contact Person Name
Martina Margit Crysandt
Contact Person Email
mcrysandt@ukaachen.de
Site Name
Robert Bosch Krankenhaus GmbH
Department Name
Robert-Bosch-Krankenhaus Stuttgart, Abteilung Hämatologie, Onkologie, Studieneinheit ZIM2
Contact Person Name
Martin Kaufmann
Contact Person Email
martin.kaufmann@rbk.de
Site Name
Universitaetsklinikum Ulm AöR
Department Name
Universitätsklinikum Ulm Klinik für Innere Medizin III AMLSG-Sekretariat
Contact Person Name
Hartmut Döhner
Site Name
Universitaetsklinikum Mannheim GmbH
Department Name
Universitätsmedizin Mannheim III. Medizinische Klinik
Contact Person Name
Stefan Klein
Contact Person Email
stefan.klein@umm.de
Site Name
Klinikum Chemnitz gGmbH
Department Name
Klinikum Chemnitz-gGmbH Klinik für Innere Medizin III
Contact Person Name
Mathias Hänel
Contact Person Email
m.haenel@skc.de
Site Name
Universitaetsklinikum Duesseldorf AöR
Department Name
Universitätsklinikum Düsseldorf
Contact Person Name
Ulrich Germing
Contact Person Email
germing@med.uni-duesseldorf.de
Site Name
Universitaetsklinikum Carl Gustav Carus Dresden AöR
Department Name
Universitätsklinikum Carl Gustav Carus Dresden an der TU Dresden, Medizinische Klinik I, Hämatologie
Contact Person Name
Christoph Röllig
Site Name
HELIOS Klinikum Berlin-Buch GmbH
Department Name
Klinik für Hämatologie und Stammzelltransplantation
Contact Person Name
Judith Niederland
Site Name
Universitaetsklinikum Leipzig AöR
Department Name
Hematology and Cell Therapy, University Hospital Leipzig
Contact Person Name
Madlen Jentzsch
Site Name
Goethe University Frankfurt
Department Name
Universitätsklinikum Frankfurt, Medizinische Klinik II
Contact Person Name
Gesine Bug
Contact Person Email
bug@em.uni-frankfurt.de
Site Name
Universitaetsklinikum Halle (Saale) AöR
Department Name
Universitätsklinikum Halle, Klinik und Poliklinik für Innere Medizin IV
Contact Person Name
Christine Dierks
Contact Person Email
christine.dierks@uk-halle.de
Site Name
University Hospital Cologne AöR
Department Name
Universitätsklinikum Köln, Klinik I für Innere Medizin
Contact Person Name
Christof Scheid
Contact Person Email
christoph.scheid@uk-koeln.de
Site Name
Universitaetsklinikum Augsburg
Department Name
Universitätsklinikum Augsburg, II. Medizinische Klinik-Hämatologie, Onkologie
Contact Person Name
Andreas Rank
Contact Person Email
andreas.rank@uk-augsburg.de
Site Name
Charite Universitaetsmedizin Berlin KöR
Department Name
Charité-Universitätsmedizin Berlin, Medizinische Klinik, CBF
Contact Person Name
Jan Krönke
Contact Person Email
jan.kroenke@charite.de
Site Name
Medizinische Hochschule Hannover
Department Name
MHH, Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation
Contact Person Name
Felicitas Thol
Contact Person Email
thol.felicitas@mh-hannover.de
Site Name
Universitaetsklinikum Bonn AöR
Department Name
Universitätsklinikum Bonn (UKB) Med Klinik III, Abt. für Hämatologie, Onkologie, Rheumatologie
Contact Person Name
Tobias Holderried
Contact Person Email
tobias.holderried@ukbonn.de
Site Name
Universitaetsklinikum Jena KöR
Department Name
Universitätsklinikum Jena Klinik für Innere Medizin II
Contact Person Name
Inken Hilgendorf
Site Name
Rostock University Medical Center
Department Name
Universitätsmedizin Rostock Klinik III, Zentrum für Innere Medizin
Contact Person Name
Christian Junghanss
Site Name
Gemeinschaftsklinikum Mittelrhein gGmbH
Department Name
Gemeinschaftsklinikum Mittelrhein gGmbH Ev. Stift St. Martin Klinik für Innere Med, Studienzentrum
Contact Person Name
Dirk Niemann
Contact Person Email
dirk.niemann@gk.de
Site Name
Universitaetsklinikum Tuebingen AöR
Department Name
Universitätsklinikum Tübingen Medizinische Klinik Abteilung Innere Medizin II
Contact Person Name
Wolfgang Bethge
Site Name
Klinikum Nuernberg
Department Name
Klinikum Nürnberg, Klinik für Onkologie und Hämatologie, Einheit für Knochenmarktransplantation
Contact Person Name
Kerstin Schäfer-Eckhart
Contact Person Email
schaefer@klinikum-nuernberg.de
Site Name
Klinikum Frankfurt (Oder) GmbH
Department Name
Klinikum Frankfurt(Oder) GmbH, Medizinische Klinik I
Contact Person Name
Olaf Hopfer
Contact Person Email
innere@klinikumffo.de
Site Name
Universitaetsklinikum Essen AöR
Department Name
Universitätsklinikum Essen, Klinik für Hämatologie und Stammzelltransplantation
Contact Person Name
Thomas Schröder
Contact Person Email
Thomas.Schroeder@uk-essen.de
Site Name
Universitaetsklinikum Heidelberg AöR
Department Name
Universitätsklinikum Heidelberg, Medizinische Klinik und Poliklinik V
Contact Person Name
Tim Sauer

Sponsor

Primary sponsor

Full Name
GWT-Tud GmbH
Organisation Type
Pharmaceutical company
Country Of Registered Address
Germany

Third parties

  • {"country":"Germany","full_name":"Universitaetsklinikum Leipzig AöR","duties_or_roles":"code 4","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Germany","full_name":"National Center For Tumor Diseases (NCT) Heidelberg","duties_or_roles":"code 10","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Germany","full_name":"Universitaetsklinikum Duesseldorf AöR","duties_or_roles":"code 4","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Germany","full_name":"Universitaetsklinikum Leipzig AöR","duties_or_roles":"Biobanking (code 15)","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Germany","full_name":"Clinigen Clinical Supplies Management GmbH","duties_or_roles":"code 14","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"Universitaet Leipzig","duties_or_roles":"code 1, code 6, code 8","organisation_type":"Educational Institution"}

Investigational products

Investigational Product Name
Vyxeos Liposomal 44 mg/100 mg powder for concentrate for solution for infusion.
Active Substance
Cytarabine; Daunorubicin
Modality
Small molecule
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
EU/1/18/1308/001
Maximum Dose
100 U unit(s)
Investigational Product Name
DAUNORUBICIN HYDROCHLORIDE
Active Substance
Daunorubicin hydrochloride
Modality
Small molecule
Routes Of Administration
Intravenous
Route
Intravenous
Maximum Dose
60 mg/m2 milligram(s)/square meter
Investigational Product Name
CYTARABINE
Active Substance
Cytarabine
Modality
Small molecule
Routes Of Administration
Intravenous
Route
Intravenous
Maximum Dose
1500 mg/m2 milligram(s)/square meter
Investigational Product Name
AZACITIDINE
Active Substance
Azacitidine
Modality
Small molecule
Routes Of Administration
Subcutaneous injection
Route
Subcutaneous
Maximum Dose
75 mg/m2 milligram(s)/square meter
Combination Treatment
Yes

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