A Phase II Multicenter Open-label Trial of Tagraxofusp (Tag) in Combination With Venetoclax and Azacitidine (Ven/Aza) in Adults With Previously Untreated CD123+ Acute Myeloid Leukemia (AML) Who Are Ineligible for Intensive Chemotherapy
Summary
This study will be divided into 2 parts (Part 1 and Part 2). Part 1 will evaluate 2 doses of tagraxofusp (9 and 12 micrograms/kilogram/day \[μg/kg/day\]), used in combination with venetoclax and azacitidine, to determine the dose for Part 2. This determined dose, in combination with venetoclax and azacitidine, will then be further evaluated in Part 2 in 2 cohorts (TP53 mutated and TP53 wild type). Both parts will be conducted in participants with previously untreated CD123+ AML who are ineligible for intensive chemotherapy.
Arms & interventions
- DrugTagraxofusp
Tagraxofusp will be administered by intravenous infusion for 3 consecutive days during each 28-day cycle.
- DrugVenetoclax
Venetoclax will be administered as an oral tablet (400 milligrams \[mg\]) daily, with ramp up in Cycle 1, and should be continued at target dose (400 mg) for the remainder of Cycle 1 and subsequent cycles of 28 days each.
- DrugAzacitidine
Azacitidine will be administered subcutaneously or by intravenous infusion (75 milligrams/square meter) over 7 days of each 28-day cycle, per institutional guidelines/physician choice.
Outcome measures
Primary
Part 1: Determination of Part 2 Selected Dose of Tagraxofusp When Administered in Combination with Venetoclax and Azacitidine
Time frame: Cycles 1-4 (up to 112 days; 28 days/cycle)
Part 2: Number of Participants Achieving a Best Overall Response (BOR) of Complete Remission (CR)
Time frame: Cycles 1-4 (up to 112 days; 28 days/cycle)
Secondary
Parts 1 and 2: Number of Participants Achieving a BOR of CR
Time frame: Cycles 1-6 (up to 168 days; 28 days/cycle)
Parts 1 and 2: Time to First CR
Time frame: Cycles 1-6 (up to 168 days; 28 days/cycle)
Parts 1 and 2: Duration of Response
Time frame: Cycles 1-6 (up to 168 days; 28 days/cycle)
Parts 1 and 2: Number of Participants Achieving a BOR of CR, CR with Incomplete Hematologic Recovery (CRi), or CR with Partial Hematologic Recovery (CRh)
Time frame: Cycles 1-4 (up to 112 days; 28 days/cycle)
Parts 1 and 2: Time to First Composite CR
Time frame: Cycles 1-4 (up to 112 days; 28 days/cycle)
Parts 1 and 2: Number of Participants Achieving a BOR of CR or CRi
Time frame: Cycles 1-6 (up to 168 days; 28 days/cycle)
Parts 1 and 2: Time to first CR/CRi
Time frame: Cycles 1-6 (up to 168 days; 28 days/cycle)
Parts 1 and 2: Event-free Survival (EFS)
Time frame: Up to approximately 6 years
Parts 1 and 2: CR with Minimal Residual Disease (MRD) Negative
Time frame: Cycles 1-6 (up to 168 days; 28 days/cycle)
Parts 1 and 2: Number of Participants Who Bridged to Stem Cell Transplant (SCT) Through Study Treatment
Time frame: Up to approximately 6 years
Part 1: Plasma Concentration of Free Tagraxofusp, Venetoclax, and Azacitidine
Time frame: Predose, up to 8 hours post dose (Days 4, 5, 6, 7, 14; Cycles 1-4; 28 days/cycle)
Part 2: Plasma Concentration of Free Tagraxofusp and Venetoclax
Time frame: Predose, up to 8 hours post dose (Days 4, 5, 6, 7, 14; Cycles 1-4; 28 days/cycle)
Parts 1 and 2: Number of Participants With Serum Anti-drug Antibodies for Tagraxofusp, Venetoclax, and Azacitidine
Time frame: Day 4 of each cycle (each cycle is 28 days) up to the end of study (approximately 6 years)
Parts 1 and 2: Exposure-response of Free Tagraxofusp When Administered in Combination with Venetoclax and Azacitidine
Time frame: Up to approximately 6 years
Parts 1 and 2: Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time frame: Up to approximately 6 years
Parts 1 and 2: Overall Survival
Time frame: Up to approximately 6 years
Parts 1 and 2: Maximum Plasma Concentration (Cmax) of Tagraxofusp and Venetoclax
Time frame: Predose, up to 8 hours post dose (Days 4, 5, 6, 7, 14; Cycles 1-4; 28 days/cycle)
Parts 1 and 2: Time to Reach Cmax (Tmax) of Tagraxofusp and Venetoclax
Time frame: Predose, up to 8 hours post dose (Days 4, 5, 6, 7, 14; Cycles 1-4; 28 days/cycle)
Parts 1 and 2: Area Under the Concentration-time Curve (AUC) of Tagraxofusp and Venetoclax
Time frame: Predose, up to 8 hours post dose (Days 4, 5, 6, 7, 14; Cycles 1-4; 28 days/cycle)
Eligibility criteria
Study locations (24)
University of California, Los Angeles
Los Angeles, California, 90095
Stanford Health Care
Stanford, California, 94305
University of Miami
Miami, Florida, 33136
AdventHealth Cancer Institute
Orlando, Florida, 32804
University of Chicago
Chicago, Illinois, 60637
Dana Farber Cancer Institute (DFCI)
Boston, Massachusetts, 02114
Massachusetts General Hospital
Boston, Massachusetts, 02114
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02215
Henry Ford Health System Brigitte Harris Cancer Pavillion
Detroit, Michigan, 48202
Washington University - Siteman Cancer Center
St Louis, Missouri, 63110
John Theurer Cancer Center - Hackensack Meridian Health
Hackensack, New Jersey, 07601
Rutgers Cancer Institute
New Brunswick, New Jersey, 08901
Roswell Park Cancer Institute
Buffalo, New York, 14203
North Shore University Hospital
Manhasset, New York, 11030
NYU Langone Health
New York, New York, 10016
Columbia University Irving Medical Center
New York, New York, 10032
Novant Health Presbyterian Medical Center
Charlotte, North Carolina, 28204
Novant Health Derrick L Davis Cancer Center
Winston-Salem, North Carolina, 27103
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
Sydney Kimmel (Thomas Jefferson University)
Philadelphia, Pennsylvania, 19107
Sarah Cannon, the Cancer Institute of HCA Healthcare
Nashville, Tennessee, 37203
Tennessee Oncology
Nashville, Tennessee, 37203
Baylor Scott & White Health
Dallas, Texas, 75246
University of Texas MD Anderson Cancer Center
Houston, Texas, 77030