Clinical trial • Phase II • Oncology

TREOSULFAN for Acute myeloid leukemia|Myelodysplastic syndrome

Phase II trial of TREOSULFAN for Acute myeloid leukemia|Myelodysplastic syndrome.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Acute myeloid leukemia|Myelodysplastic syndrome
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
27-01-2025
First CTIS Authorization Date
05-03-2025

Trial design

Randomised, comparator: melphalan (powder and solvent for solution for infusion), route: intravenous infusion, max total dose: 140 mg/m2. test (intervention) arm: treosulfan (solution for infusion), route: intravenous infusion, max total dose: 30000 mg/m2. auxiliary medicinal product: fludarabine (solution for infusion), route: intravenous infusion, max total dose: 150 mg/m2.-controlled Phase II trial across 17 sites in Germany.

Randomised
Yes
Comparator
Comparator: MELPHALAN (POWDER AND SOLVENT FOR SOLUTION FOR INFUSION), route: INTRAVENOUS INFUSION, max total dose: 140 mg/m2. Test (intervention) arm: TREOSULFAN (SOLUTION FOR INFUSION), route: INTRAVENOUS INFUSION, max total dose: 30000 mg/m2. Auxiliary medicinal product: FLUDARABINE (SOLUTION FOR INFUSION), route: INTRAVENOUS INFUSION, max total dose: 150 mg/m2.
Target Sample Size
220

Eligibility

Recruits 220 Vulnerable population selected (isVulnerablePopulationSelected: true). Requirement: 'Signed informed consent form by patient'. No details provided on assent or parental consent; participants must be age ≥ 18 years..

Pregnancy Exclusion
Pregnant or breastfeeding women
Vulnerable Population
Vulnerable population selected (isVulnerablePopulationSelected: true). Requirement: 'Signed informed consent form by patient'. No details provided on assent or parental consent; participants must be age ≥ 18 years.

Inclusion criteria

  • {"criterion_text":"- Signed informed consent form by patient\n- Men must agree to refrain from unprotected sex and sperm donation from time point of signing the informed consent until 6 months after the last dose of study drug\n- Women must fulfil at least one of the following criteria in order to be eligible for trial inclusion: a) post-menopausal (12 months of natural amenorrhoea or 6 months of amenorrhoea with serum FSH > 40 U/ml) b) postoperative (i.e.6 weeks) after bilateral ovariectomy with or without hysterectomy) c) Women of childbearing potential must have a negative serum pregnancy test performed within 7 days before the first dose of study drug d) continuous and correct application of a contraceptive method with an Pearl Index < 1% per year (e.g. implants, depots, oral contraceptives, intrauterine device – IUD) from time point of signing the informed consent until 6 months after the last dose of study drug e) sexual abstinence from time point of signing the informed consent until 6 months after the last dose of study drug f) Vasectomy of the sexual partner\n- Patient scheduled for allogeneic transplantation within the next 3 weeks\n- Age ≥ 18 years\n- AML or MDS according to WHO with indication for allogeneic HCT: a) AML in first or second complete remission (CR) or complete remission with incomplete hematologic recovery (CRi/CRh) or morphologic leukemia-free state (MLFS) b) MDS according to WHO\n- Increased risk for treatment-related toxicity by myeloablative conditioning according to at least one of the following criteria: a)\tPatients aged ≥ 50 years at transplant and/or b)\tHCT-CI > 2 and/or c)\tAML or MDS scheduled for 2nd allogeneic HCT from different donor with minimum of 12 months after 1st allogeneic HCT\n- Availability of a suitable donor: a) Matched sibling donor (MSD) or b) Matched unrelated donor (MUD, 10/10 HLA) or c) Mismatched unrelated donor (MMUD, single allele or antigen mismatch at HLA-A, -B, -C, or –DRB1 and no concurrent –DQB1 mismatch (9/10) shown by confirmatory typing) or d) haploidentical family donor\n- Planned GvHD prophylaxis with standard PTCy (with 50mg/kg body weight on days +3 and +4)\n- No history of cardiac disease that precludes allogeneic HCT and absence of active symptoms, otherwise, documented left ventricular ejection fraction ≥ 40 %\n- No need for supplementary oxygen on day of randomization"}

Exclusion criteria

  • {"criterion_text":"- Patients with acute promyelocytic leukemia with t(15;17)(q22;q12)\n- Addictions or other illnesses that do not allow the person concerned to assess the nature and extent of the clinical trial and its possible consequences\n- Pregnant or breastfeeding women\n- Having received any unlicensed drug within 30 days or 5 half-lives, whichever is greater, prior to randomization\n- Indications that the subject is unlikely to adhere to the protocol (e.g., lack of compliance)\n- Patients with graft failure after previous allogeneic HCT\n- Patients with scheduled 2nd allogeneic HCT within 12 months after 1st allogeneic HCT\n- Pretreatment with either melphalan or treosulfan within the last 12 months prior to randomization\n- Planned TBI as part of conditioning\n- Severe organ dysfunction defined by either one of the following criteria: a) Serum bilirubin > 1.5 × ULN (if not considered Gilbert-syndrome) or b) ASAT or ASAT > 5 × ULN\n- Uncontrolled infection at the time of randomization\n- Active viral hepatitis unless serology demonstrates clearance of infection. Occult or prior hepatitis B virus (HBV) infection, defined as negative hepatitis B surface antigen and positive total hepatitis core antibodies, may be included if HBV DNA is undetectable, provided that patients are willing to undergo monthly DNA testing. Patients who have protective titers of hepatitis B surface antibody after vaccination or prior cured hepatitis B are eligible. Patients for hepatitis C virus (HCV) antibody are eligible provided PCR if negative for HCV RNA\n- Hypersensitivity known from medical history to one of the drugs used or their ingredients or to drugs with a similar chemical structure"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Overall survival (OS) as time-to-event endpoint","definition_or_measurement_approach":"Time-to-event endpoint (overall survival as time-to-event)"}

Secondary endpoints

  • {"endpoint_text":"- ­non-relapse mortality (NRM)\n- ­Graft-versus-host-free and relapse-free survival (GRFS)\n- ­Cumulative incidences of acute and chronic GvHD (NIH criteria)\n- ­Rates of AEs/SAEs/AESI\n- ­Cumulative incidence of relapse (CIR) and Relapse-free survival (RFS)\n- ­Rate of morphologic and molecular CR/CRh/CRi/MLFS\n- ­Rate of engraftment on day +28 and Rate of complete donor-type chimerism on day +28 and day +56","definition_or_measurement_approach":""}

Recruitment

Planned Sample Size
220
Recruitment Window Months
37
Consent Approach
Signed informed consent form by patient. Subject information and informed consent form documents available (L1_RELEVANT_SIS and ICF main study; biobank; pregnant partner). No age-specific assent/parental consent details provided; participants must be aged ≥ 18 years.

Geography

Total Number Of Sites
17
Total Number Of Participants
220

Germany

Earliest CTIS Part Ii Submission Date
27-02-2025
Latest Decision Or Authorization Date
24-02-2026
Processing Time Days
362
Number Of Sites
17
Number Of Participants
220

Sites

Site Name
Universitaetsklinikum Augsburg
Department Name
II. Medizinische Klinik
Principal Investigator Name
Christoph Schmid
Principal Investigator Email
christoph.schmid@uk-augsburg.de
Contact Person Name
Christoph Schmid
Site Name
Goethe University Frankfurt
Department Name
Medizinische Klinik II, Hämatologie/Onkologie
Principal Investigator Name
Gesine Bug
Principal Investigator Email
g.bug@em.uni-frankfurt.de
Contact Person Name
Gesine Bug
Contact Person Email
g.bug@em.uni-frankfurt.de
Site Name
University Hospital Cologne AöR
Department Name
Department I of Internal Medicine
Principal Investigator Name
Udo Holtick
Principal Investigator Email
udo.holtick@uk-koeln.de
Contact Person Name
Udo Holtick
Contact Person Email
udo.holtick@uk-koeln.de
Site Name
Technische Universitaet Dresden
Department Name
Medizinische Klinik und Poliklinik I
Principal Investigator Name
Désirée Kunadt
Principal Investigator Email
Desiree.Kunadt@ukdd.de
Contact Person Name
Désirée Kunadt
Contact Person Email
Desiree.Kunadt@ukdd.de
Site Name
Universitaetsmedizin Greifswald KöR
Department Name
Innere Medizin C, Hämatologie, Onkologie/Transplantationszentrum
Principal Investigator Name
William Krüger
Principal Investigator Email
william.krueger@med.uni-greifswald.de
Contact Person Name
William Krüger
Site Name
Universitaet Leipzig
Department Name
Klinik und Poliklinik für Hämatologie, Zelltherapie, Hämostaseologie und Infektiologie
Principal Investigator Name
Georg-Nikolaus Franke
Contact Person Name
Georg-Nikolaus Franke
Site Name
Universitaetsklinikum Schleswig-Holstein AöR
Department Name
Department of Internal Mediztin II, Section for Stem Cell Transplantation and Cellular Immunotherapy
Principal Investigator Name
Friedrich Stölzel
Principal Investigator Email
Friedrich.Stoelzel@uksh.de
Contact Person Name
Friedrich Stölzel
Contact Person Email
Friedrich.Stoelzel@uksh.de
Site Name
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz KöR
Department Name
III. Medizinische Klinik und Poliklinik, Hämatologie und Medizinische Onkologie
Principal Investigator Name
Eva Maria Wagner-Drouet
Principal Investigator Email
eva.wagner@unimedizin-mainz.de
Contact Person Name
Eva Maria Wagner-Drouet
Contact Person Email
eva.wagner@unimedizin-mainz.de
Site Name
Universitaet Muenster
Department Name
Medizinische Klinik A, KMT-Zentrum
Principal Investigator Name
Matthias Stelljes
Principal Investigator Email
stelljes@uni-muenster.de
Contact Person Name
Matthias Stelljes
Contact Person Email
stelljes@uni-muenster.de
Site Name
HELIOS Klinikum Berlin-Buch GmbH
Department Name
Hämatologie und Zelltherapie
Principal Investigator Name
Judith Niederland
Principal Investigator Email
judith.niederland@helios-gesundheit.de
Contact Person Name
Judith Niederland
Site Name
Martin-Luther-Universitaet Halle-Wittenberg
Department Name
Universitätsklinik und Poliklinik für Innere Medizin IV
Principal Investigator Name
Judith Schaffrath
Principal Investigator Email
judith.schaffrath@uk-halle.de
Contact Person Name
Judith Schaffrath
Contact Person Email
judith.schaffrath@uk-halle.de
Site Name
Robert Bosch Gesellschaft fuer medizinische Forschung mbH
Department Name
Robert-Bosch-Krankenhaus, Hämatologie, Onkologie und Palliativmedizin
Principal Investigator Name
Martin Kaufmann
Principal Investigator Email
martin.kaufmann@rbk.de
Contact Person Name
Martin Kaufmann
Contact Person Email
martin.kaufmann@rbk.de
Site Name
Universitaetsklinikum Aachen AöR
Department Name
Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation (MK IV)
Principal Investigator Name
Edgar Jost
Principal Investigator Email
ejost@ukaachen.de
Contact Person Name
Edgar Jost
Contact Person Email
ejost@ukaachen.de
Site Name
Universitaetsklinikum Jena KöR
Department Name
Klinik für Innere Medizin II
Principal Investigator Name
Inken Hilgendorf
Principal Investigator Email
inken.hilgendorf@med.uni-jena.de
Contact Person Name
Inken Hilgendorf
Site Name
Klinikum Chemnitz gGmbH
Department Name
Klinik für Innere Medizin III
Principal Investigator Name
Mathias Hänel
Principal Investigator Email
m.haenel@skc.de
Contact Person Name
Mathias Hänel
Contact Person Email
m.haenel@skc.de
Site Name
Rostock University Medical Center
Department Name
Medizinische Klinik III - Hämatologie, Onkologie und Palliativ
Principal Investigator Name
Christian Junghanß
Principal Investigator Email
christian.junghanss@med.uni-rostock.de
Contact Person Name
Christian Junghanß
Site Name
Klinikum Nuernberg
Department Name
Medizinische Klinik 5, Hämatologie Haus 12
Principal Investigator Name
Kerstin Schäfer-Eckart
Contact Person Name
Kerstin Schäfer-Eckart

Sponsor

Primary sponsor

Full Name
Technische Universitat Dresden
Organisation Type
Educational Institution
Country Of Registered Address
Germany

Third parties

  • {"country":"","full_name":"medac GmbH","duties_or_roles":"Source of monetary support","organisation_type":""}

Investigational products

Investigational Product Name
TREOSULFAN
Active Substance
TREOSULFAN
Modality
Small molecule
Routes Of Administration
INTRAVENOUS INFUSION
Route
INTRAVENOUS INFUSION
Maximum Dose
30000 mg/m2
Investigational Product Name
MELPHALAN
Active Substance
MELPHALAN
Modality
Small molecule
Routes Of Administration
INTRAVENOUS INFUSION
Route
INTRAVENOUS INFUSION
Maximum Dose
140 mg/m2
Investigational Product Name
FLUDARABINE
Active Substance
FLUDARABINE
Modality
Small molecule
Routes Of Administration
INTRAVENOUS INFUSION
Route
INTRAVENOUS INFUSION
Maximum Dose
150 mg/m2
Combination Treatment
Yes

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