The primary objective of this study is to evaluate the efficacy of entospletinib (ENTO) compared to placebo when added to chemotherapy in previously untreated nucleophosmin-1 mutated (NPM1-m) acute myeloid leukemia (AML), as defined by the rate of molecularly defined measurable residual disease (MRD).
This is a multi-center, international, double-blind, placebo-controlled study in previously untreated participants with acute myeloid leukemia (AML) harboring nucleophosmin-1 (NPM1) mutations. Upon fulfillment of all eligibility criteria, participants were randomized 1:1 to receive intensive chemotherapy in combination with either the spleen tyrosine kinase (SYK) inhibitor entospletinib (ENTO), or placebo. The study consisted of Screening, Induction, Consolidation, End-of-Treatment, and Long-term Follow-up phases.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
15
400 mg, Orally as tablets
Orally as tablets
Continuous infusion
Number of Participants With Measurable Residual Disease (MRD) Negative Complete Response (CR) Rate
MRD negative CR requires CR as defined by the European Leukemia Network (ELN) 2017 criteria (with minor modification for neutrophil and platelet count thresholds as defined by International Working Group \[IWG\]) as assessed by study site investigators, and MRD negativity (\<0.01%) in bone marrow as measured by a molecular nucleophosmin-1 mutated (NPM1-m) assay (eg, next generation sequencing) in a central laboratory upon recovery of peripheral blood counts following completion of 2 cycles of chemotherapy, no later than Day 42 of Cycle 2.
Time frame: Cycle 1 Day 1, up to Day 42 of chemotherapy cycle 2 (Cycle length = 42 days)
Event-free Survival (EFS)
EFS is defined as the time from randomization to the earliest occurrence of induction treatment failure, relapse from CR, or death from any cause. Induction treatment failure is failure to achieve morphological CR after completion of the last cycle of induction chemotherapy (no later than Day 42 of the last cycle of induction).
Time frame: Cycle 1 Day 1, up to Day 42 of chemotherapy cycle 2 (Cycle length = 42 days)
Relapse-free Survival (RFS)
RFS is defined as the time from CR until relapse or death from any cause as assessed by study site investigators.
Time frame: Cycle 1 Day 1, up to Day 42 of chemotherapy cycle 2 (Cycle length = 42 days)
Overall Survival (OS)
OS is defined as the time from randomization until death from any cause.
Time frame: Cycle 1 Day 1, up to Day 42 of chemotherapy cycle 2 (Cycle length = 42 days)
Number of Participant With Complete Response (CR) After 2 Cycles of Chemotherapy
CR as defined by ELN 2017 criteria (with minor modification for neutrophil and platelet count thresholds as defined by IWG) as assessed by study site investigators.
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Either daunorubicin or idarubicin was administered via slow intravenous (IV) push
City of Hope
Duarte, California, United States
UCLA - Jonsson Comprehensive Cancer Center
Los Angeles, California, United States
Indiana Blood & Marrow Transplantation
Indianapolis, Indiana, United States
University of Michigan Medical School
Ann Arbor, Michigan, United States
Henry Ford Health System
Detroit, Michigan, United States
Mount Sinai Health System
New York, New York, United States
Duke Cancer Institute
Durham, North Carolina, United States
Hollings Cancer Center
Charleston, South Carolina, United States
Bon Secours St. Francis Cancer Center
Greenville, South Carolina, United States
Baylor University Medical Center
Dallas, Texas, United States
...and 73 more locations
Time frame: Cycle 1 Day 1, up to Day 42 of chemotherapy cycle 2 (Cycle length = 42 days)
Number of Participants Who Experienced Treatment-emergent Adverse Events (TEAEs)
A TEAE is any untoward medical occurrence in a clinical study participant, beginning or worsening from Cycle 1, Day 1 through 30 days following study treatment completion, temporarily associated with the use of treatment, whether or not considered related to the study treatment. TEAEs were recorded according to the most current version of the Medical Dictionary for Regulatory Activities (MedDRA). Clinically significant changes in safety laboratory assessments, electrocardiograms, echocardiogram / multi-gated acquisition scans and Eastern Cooperative Oncology Group performance status findings, as assessed by the Investigator, were recorded as TEAEs.
Time frame: Cycle 1 Day 1 to 30 days following study treatment completion, (Cycle length = 42 days) maximum up to 198 days