Ignite Creation Date:
2025-12-24 @ 9:12 PM
Ignite Modification Date:
2025-12-25 @ 7:01 PM
Study NCT ID:
NCT07172204
Status:
RECRUITING
Last Update Posted:
2025-11-28
First Post:
2025-08-19
Is NOT Gene Therapy:
False
Has Adverse Events:
False
Brief Title:
Alternating Regimen of VA and Low-dose CHA in the Treatment of Unfit Newly Diagnosed AML
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D015470', 'term': 'Leukemia, Myeloid, Acute'}], 'ancestors': [{'id': 'D007951', 'term': 'Leukemia, Myeloid'}, {'id': 'D007938', 'term': 'Leukemia'}, {'id': 'D009370', 'term': 'Neoplasms by Histologic Type'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D006402', 'term': 'Hematologic Diseases'}, {'id': 'D006425', 'term': 'Hemic and Lymphatic Diseases'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE2'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'NA', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'SINGLE_GROUP'}, 'enrollmentInfo': {'type': 'ESTIMATED', 'count': 25}}, 'statusModule': {'overallStatus': 'RECRUITING', 'startDateStruct': {'date': '2025-09-16', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-11', 'completionDateStruct': {'date': '2029-07-31', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-11-21', 'studyFirstSubmitDate': '2025-08-19', 'studyFirstSubmitQcDate': '2025-09-07', 'lastUpdatePostDateStruct': {'date': '2025-11-28', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2025-09-15', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2027-07-31', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Negative rate of minimal residual lesions (MRD)', 'timeFrame': 'At day28 of the second alternating (one alternating is VA plus low-CHA)', 'description': 'Proportion of patients achieving MRD-negative status (≤0.1% leukemic blasts by flow cytometry) after two cycles of alternating VA/CHA therapy'}], 'secondaryOutcomes': [{'measure': 'composite complete remission, CRc', 'timeFrame': 'At day28 of the first alternating and the second alternating (one alternating is VA plus low-CHA)', 'description': 'Proportion achieving CR or CRi per ELN 2022 criteria at each cycle completion'}, {'measure': 'Overall response rate, ORR', 'timeFrame': 'At day28 of the first alternating and the second alternating (one alternating is VA plus low-CHA)', 'description': 'Proportion achieving PR or better (CR/CRh/CRi/MLFS/PR) per IWG criteria at each cycle completion'}, {'measure': 'Overall Survival, OS', 'timeFrame': 'Time from enrollment to death from any cause, whichever came first, assessed up to 24 months', 'description': 'Time from enrollment to death from any cause, whichever came first (censored at last follow-up for survivors)'}, {'measure': 'disease-free survival, DFS', 'timeFrame': 'From the date of first response until the date of relapse or death from any cause, whichever came first, assessed up to 24 months', 'description': 'Time from first response to relapse or death (censored at last disease assessment)'}, {'measure': 'MRD negative DFS, DFS-MRD', 'timeFrame': 'From the date of first MRD-negative status until the date of MRD-positive, relapse or death due to relapse, whichever came first, assessed up to 24months.', 'description': 'Time from first MRD-negative status to MRD-positive (confirmed by a second check within 2 weeks).'}, {'measure': 'Event-free survival, EFS', 'timeFrame': 'from enrollment until the date of treatment failure, relapse or death from any cause, whichever came first, assessed up to 24 months', 'description': 'Time from enrollment to treatment failure (not achieved PR after the first alternating, or not achieved CR after 2 alternatings, or continuous MRD positive after 4 alternatings), relapse, or death. （one alternating is VA plus low-CHA)'}, {'measure': 'Incidence of adverse events (AEs)', 'timeFrame': 'up to 3 years', 'description': 'Incidence of CTCAE v6.0-graded AEs from day 1 of treatment to study completion'}]}, 'oversightModule': {'isUsExport': False, 'isFdaRegulatedDrug': False, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Acute Myeloid Leukemia', 'Venetoclax', 'alternating', 'Homoharringtonine', 'Cladribine', 'age 60 and older', 'intensive chemotherapy unfit', 'newly diagnosed'], 'conditions': ['Intensive Chemotherapy Unfit', 'Newly Diagnosed Acute Myeloid Leukemia (AML)', 'Age ≥60']}, 'descriptionModule': {'briefSummary': 'This phase II trial tests how well VA alternating with low-dose CHA works in treating unfit patients with newly diagnosed acute myeloid leukemia (AML). This is a prospective, multi-centers, single arm phase II study aimed to overcome VEN resistance and achieve greater MRD negative rate, providing better control of treatment for unfit AML.', 'detailedDescription': 'This clinical study protocol investigates a novel treatment for newly diagnosed Acute Myeloid Leukemia (AML) patients ineligible to receive intensive chemotherapy (IC). Eligibility is defined as age ≥60 or age 18-59 with significant comorbidities. Key exclusions include specific AML subtypes including Acute promyelocytic leukemia (APL); FLT3-ITD mutations and active infections. The Intervention is a two-phase regimen. The Induction Phase consists of four alternating 28-day cycles of Venetoclax + Azacitidine (VA) and low-dose Cladribine + Homoharringtonine + Cytarabine (CHA). This is followed by a Maintenance Phase of 24 cycles of VA therapy. The Primary Endpoint is the rate of Minimal Residual Disease (MRD) negativity after two alternating cycles. Secondary Endpoints include composite complete remission rate, overall survival, and incidence of treatment-emergent adverse events. Clear Withdrawal Criteria are defined for situations involving unacceptable toxicity, lack of therapeutic benefit, or patient/investigator decision.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Understand the research and sign a written informed consent form;\n* Be newly diagnosed with AML according to WHO 2022 criteria without prior treatment;\n* or unwilling to undergo IC. Ineligibility for IC is defined as meeting any of the following criteria:\n* Age ≥ 60 years\n* Age 18-59 years but ineligible for intensive chemotherapy (IC) , meet ≥1 of the following:\n\n * Eastern Cooperative Oncology Group (ECOG) performance status ≥2 at screening;\n * Severe heart failure (congestive heart failure requiring treatment or myocardial infarction history with ejection fraction ≤50%);\n * Severe pulmonary dysfunction (DLCO ≤65%, FEV1 ≤65%, dyspnea at rest, or oxygen dependence);\n * Severe renal insufficiency requiring dialysis;\n * Child-Pugh B or C cirrhosis, or hepatic impairment with total bilirubin \\>1.5×ULN;\n* Mental illness requiring inpatient psychiatric treatment;\n* Any comorbidity deemed by physician to contraindicate IC.\n\nExclusion Criteria:\n\n* Diagnosis of: AML arising from chronic myeloid leukemia (CML); myeloid sarcoma; acute promyelocytic leukemia (APL) or presence of FLT3-ITD mutations;\n* Active malignancies (except adequately treated carcinoma in situ or basal cell carcinoma) within 2 years prior to Cycle 1 Day 1 (C1D1);\n* Major surgery or systemic anticancer therapy within 28 days before C1D1;\n* Known hypersensitivity to: Active pharmaceutical ingredients: cladribine, homoharringtonine, cytarabine, venetoclax, azacitidine; Any excipients in study drug formulations;\n* GI conditions impairing oral drug absorption: Dysphagia; short-gut syndrome; gastroparesis or related disorders;\n* Uncontrolled active infection;\n* Controlled infection permitted if: Afebrile (\\<38°C) and hemodynamically stable (SBP \\>90 mmHg, HR \\<100 bpm) for ≥72 hours pre-C1D1; on non-interacting antimicrobial regimen; active HBV/HCV infection (Chronic carriers require PI approval with viral load monitoring); HIV-positive patients receiving HAART;\n* Pregnancy/lactation or refusal of contraception: Negative serum β-hCG within 24h pre-C1D1;\n* Psychiatric disorders or social circumstances compromising protocol compliance;\n* Prior AML-directed therapy except: cytoreduction for hyperleukocytosis per institutional guidelines (hydroxyurea, leukapheresis); supportive growth factors;'}, 'identificationModule': {'nctId': 'NCT07172204', 'acronym': 'CHANCE', 'briefTitle': 'Alternating Regimen of VA and Low-dose CHA in the Treatment of Unfit Newly Diagnosed AML', 'organization': {'class': 'OTHER', 'fullName': 'First Affiliated Hospital of Zhejiang University'}, 'officialTitle': 'The Efficacy and Safety of VA Alternating With Low-dose CHA in the Treatment of Newly Diagnosed Unfit AML: a Prospective, Multi-centers, Single Arm Phase II Study', 'orgStudyIdInfo': {'id': 'IIT20250072C'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'VA alternating with low-CHA', 'description': 'single treatment arm', 'interventionNames': ['Drug: Alternately treated with VA/low CHA regimen']}], 'interventions': [{'name': 'Alternately treated with VA/low CHA regimen', 'type': 'DRUG', 'description': '1. Induction Phase (4 alternating cycles):\n\n Participants will receive 4 cycles of alternating therapy:\n * VA Cycle:\n\n * Venetoclax 400 mg PO daily on Days 1-28\n * Azacitidine 75 mg/m² SC daily on Days 1-7\n * Low-dose CHA Cycle:\n\n * Cladribine 5 mg/m² IV daily on Days 1-3\n * Homoharringtonine 1 mg/m² IV daily on Days 1-5\n * Cytarabine 20 mg SC every 12 hours on Days 1-10 Alternating sequence: VA → CHA → VA → CHA → VA → CHA → VA → CHA\n2. Maintenance Phase (24 months):\n\nFollowing induction, participants will receive:\n\n* Venetoclax 400 mg PO daily on Days 1-28\n* Azacitidine 75 mg/m² SC daily on Days 1-7 Repeated every 28 days for 24 cycles.\n\nWe aimed to compare this clinical intervention with standard VA which is:\n\n* Venetoclax 400 mg PO daily on Days 1-28\n* Azacitidine 75 mg/m² SC daily on Days 1-7 Repeated every 28 days for at least 24 cycles.', 'armGroupLabels': ['VA alternating with low-CHA']}]}, 'contactsLocationsModule': {'locations': [{'city': 'Beijing', 'state': 'Beijing Municipality', 'status': 'RECRUITING', 'country': 'China', 'contacts': [{'name': 'Honghu Zhu', 'role': 'CONTACT', 'email': 'zhuhhdoc@163.com', 'phone': '86+010-85230000'}], 'facility': 'Beijing Chao-Yang Hospital, Capital Medical University', 'geoPoint': {'lat': 39.9075, 'lon': 116.39723}}, {'city': 'Shenzhen', 'state': 'Guangdong', 'status': 'RECRUITING', 'country': 'China', 'contacts': [{'name': 'Lixin Wang', 'role': 'CONTACT', 'phone': '86+13718000488'}], 'facility': 'Shenzhen University General Hospital', 'geoPoint': {'lat': 22.54554, 'lon': 114.0683}}, {'city': 'Suzhou', 'state': 'Jiangsu', 'status': 'RECRUITING', 'country': 'China', 'contacts': [{'name': 'Suning Chen', 'role': 'CONTACT', 'email': 'chensuning@suda.edu.cn', 'phone': '86+13656205608'}], 'facility': 'the First Affiliated Hospital of Soochow University', 'geoPoint': {'lat': 31.30408, 'lon': 120.59538}}, {'city': 'Nanchang', 'state': 'Jiangxi', 'status': 'RECRUITING', 'country': 'China', 'contacts': [{'name': 'Li Yu', 'role': 'CONTACT', 'email': 'zengyulii@126.com', 'phone': '86+0791-86120120'}], 'facility': 'the Second Affiliated Hospital of Nanchang University', 'geoPoint': {'lat': 28.68396, 'lon': 115.85306}}, {'city': 'Hangzhou', 'state': 'Zhejiang', 'status': 'RECRUITING', 'country': 'China', 'contacts': [{'name': 'Jie Sun', 'role': 'CONTACT', 'email': 'jsun1492@zju.edu.cn', 'phone': '8615305714109'}], 'facility': 'Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine', 'geoPoint': {'lat': 30.29365, 'lon': 120.16142}}], 'centralContacts': [{'name': 'Jie Sun', 'role': 'CONTACT', 'email': 'jsun1492@zju.edu.cn', 'phone': '+8615305714109'}, {'name': 'Yuanyuan Dr. Zhu, M.D, Ph.D', 'role': 'CONTACT', 'email': 'zhuyyzju@zju.edu.cn', 'phone': '86-13906514060'}], 'overallOfficials': [{'name': 'Jie Dr. Sun, M.D, Ph.D', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'Bone Marrow Transplantation Center of The First Affiliated Hospital, Zhejiang University School of Medicine'}, {'name': 'Shanshan Prof. Pei, Ph.D', 'role': 'STUDY_DIRECTOR', 'affiliation': 'Liangzhu Laboratory, Zhejiang University School of Medicine'}]}, 'ipdSharingStatementModule': {'infoTypes': ['STUDY_PROTOCOL', 'SAP', 'ICF'], 'timeFrame': 'Data can be shared from the date of publication to 6 months after.', 'ipdSharing': 'YES', 'description': 'Deidentified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement.', 'accessCriteria': 'Contact the team by e-mail or other specified contact information described on publication'}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'First Affiliated Hospital of Zhejiang University', 'class': 'OTHER'}, 'collaborators': [{'name': 'AbbVie', 'class': 'INDUSTRY'}], 'responsibleParty': {'type': 'PRINCIPAL_INVESTIGATOR', 'investigatorTitle': 'Principle Attending, Associated Professor', 'investigatorFullName': 'Jie Sun', 'investigatorAffiliation': 'First Affiliated Hospital of Zhejiang University'}}}}