The main objective of this study is to evaluate the efficacy of venetoclax in combination with azacitidine to improve Overall Survival (OS) in Acute Myeloid Leukemia (AML) participants compared to Best Supportive Care (BSC) when given as maintenance therapy following allogeneic stem cell transplantation (SCT). This study will have 2 parts: Part 1 (Dose Confirmation), which may include participants who are greater than or equal to 18 years old; Part 2 (Randomization) which may include participants who are greater than or equal to 12 years old. During Part 1, recommended Phase 3 dose of venetoclax in combination with azacitidine will be determined and during Part 2, the efficacy and safety of venetoclax with azacitidine (Part 2 Arm A) will be compared with BSC (Part 2 Arm B).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
465
Tablet; Oral
Subcutaneous (SC) or intravenous (IV) injection
BSC is the best supportive care, without AML directed therapy, determined per the investigator and institutional guidelines.
Arizona Oncology - Scottsdale - Cancer Transplant Institute /ID# 239711
Scottsdale, Arizona, United States
University of Arizona Cancer Center - Tucson /ID# 242507
Tucson, Arizona, United States
University of Arkansas for Medical Sciences /ID# 239804
Little Rock, Arkansas, United States
City of Hope /ID# 213681
Duarte, California, United States
UCHSC Anschultz Cancer Pavilion /ID# 215618
Aurora, Colorado, United States
Number of Participants With Dose-Limiting Toxicities (DLTs) Following Administration of Venetoclax and Azacitidine (Part 1)
DLTs were any of the hematologic, nonhematologic toxicities, adverse events (AEs) occurring following administration of venetoclax and AZA as described in the protocol and evaluated by the Investigator and the sponsor.
Time frame: Up to 28 days
Overall Survival (OS) (Part 2)
OS was defined as the time from the date of randomization to the date of death from any cause.
Time frame: Up to approximately 41 months
Morphologic Relapse-Free Survival (RFS) (Part 2)
Morphologic relapse from AML was defined as bone marrow blasts of \>= 5% or reappearance of blasts in the peripheral blood not attributable to any other cause (e.g., bone marrow regeneration) in at least 2 peripheral blood samples at least one week apart or development of extramedullary disease after achieving a complete remission (CR) or complete remission with incomplete count recovery (CRi); or the date of death from any cause, whichever comes first as determined by the investigator.
Time frame: Up to approximately 41 months
Composite Relapse-Free Survival (RFS) (Part 2)
Composite RFS was defined as the time from randomization from either morphologic relapse from AML, or non-morphologic relapse from AML, whichever comes first. Non-morphologic relapse from AML was defined as increase in disease burden determined by standard methods with reappearance or acquisition of new findings with or without change in anti-leukemic treatment per investigator decision due to cytogenetic abnormalities or change in molecular marker or measurable residual disease by multiparameter flow with sensitivity to at least 10\^-3; or the date of death from any cause, whichever came first as determined by the investigator.
Time frame: Up to approximately 41 months
Graft-versus-Host Disease (GvHD)-Free, Relapse Free Survival (GRFS) (Part 2)
GRFS was defined as the time from the date of randomization to occurrence of disease relapse or incidence of GvHD or death from any cause.
Time frame: Up to approximately 41 months
Rate of Participants Without Higher Grade of GvHD (Part 2)
Rate of Participants without higher grade of GvHD was defined as the percentage of participants without grade 2 or higher for acute graft-versus-host disease (aGvHD) and moderate/severe for chronic graft-versus-host disease (cGvHD) assessed by investigator at 90 days after randomization.
Time frame: 90 days after randomization
Change From Baseline in Physical Functioning Subscore as Measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) (Part 2)
The EORTC QLQ-C30 is a 30-item participant self-report questionnaire composed of both multi-item and single scales. The physical functioning score, reported here, ranged from 0 to 100, with a higher score indicating a better level of functioning. Positive changes from baseline indicate improvement.
Time frame: Baseline, Month 6
Change From Baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Cancer Fatigue Short Form (SF) 7a Score (Part 2)
PROMIS Cancer Fatigue SF is a seven item questionnaire that assesses the impact and experience of fatigue over the past 7 days. All questions employ the following five response options: 1 = Not at all, 2 = A little bit, 3 = Somewhat, 4 = Quite a bit, and 5 = Very much. The total raw score is the sum of the responses to each question and is converted to a T-score. The T-score re-scales the total raw score to a standardized score with a mean of 50 and a standard deviation of 10. T-Scores range from 29.4 to 83.2, with higher scores indicating more fatigue. Negative changes from baseline indicate improvement.
Time frame: Baseline, Month 6
Percentage of Participants With Measurable Residual Disease (MRD) Conversion in Participants With MRD >= 10^-3 at Baseline (Part 2)
MRD conversion rate was defined as the percentage of participants who convert to MRD \< 10\^-3 after initiation of treatment. The population for MRD analysis included participants whose bone marrow was MRD positive (\>=10\^-3, as determined by central flow cytometry) at baseline prior to randomization.
Time frame: Up to approximately 41 months
Time to Deterioration in Global Health Status (GHS)/Quality of Life (QoL) in Adult Participants (Part 2)
Time to deterioration was defined as number of days from randomization to either deterioration of \>= 5 points based on the EORTC QLQ-C30 version 3 or death due to any cause. The GHS/QoL scale includes 2 questions in which participants were asked to rate their overall health and overall quality of life during the past week on a scale from 1 (very poor) to 7 (excellent). The 2 scores were averaged and transformed to a scale from 0 to 100, where a high score represents a high QoL.
Time frame: Up to approximately 41 months
Change From Baseline in European Quality-of-Life-5 Dimensional-5-Level (EQ-5D-5L) Score
The EQ-5D-5L is a generic preference instrument that has been validated in numerous populations and has 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression, each of which are rated on five levels of severity (1: no problems, 2: slight problems, 3: moderate problems, 4: severe problems, 5: extreme problems) with higher scores representing higher symptom burden. A negative change from baseline indicates improvement in health status.
Time frame: Baseline, Month 6
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Colorado Blood Cancer Institute /ID# 215980
Denver, Colorado, United States
Mayo Clinic Hospital Jacksonville /ID# 239710
Jacksonville, Florida, United States
AdventHealth Medical Group Blood & Marrow Transplant at Orlando /ID# 213985
Orlando, Florida, United States
Ann & Robert H. Lurie Children's Hospital of Chicago /ID# 215840
Chicago, Illinois, United States
The University of Chicago Medical Center /ID# 215616
Chicago, Illinois, United States
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