The purpose of this study is to determine the clinical benefit of XY0206 therapy in participants with FLT3-ITD mutated AML who are refractory to or have relapsed after prior AML therapy as shown with overall survival (OS) compared to salvage chemotherapy. In addition, this study is also to investigate the efficacy of XY0206 as assessed by CR/CRh rate in these subjects。
Participants considered an adult according to local regulations at the time of signing informed consent will be randomized in a 2:1 ratio to receive XY0206 or salvage chemotherapy. Participants will enter the screening period up to 14 days prior to the start of treatment. Prior to randomization, the investigator will preselect a salvage chemotherapy regimen for each participant; options will include low-dose cytarabine (LoDAC),azacitidine, fludarabine, cytarabine and granulocyte colony-stimulating factor (FLAG) or mitoxantrone, etoposide and cytarabine (MEC) . The randomization will be stratified by remission from previous treatment and preselected salvage chemotherapy. Participants will be administered treatment over continuous 28-day cycles. Participants who have a donor identified and with complete remission after treatment may undergo hematopoietic stem cell transplant (HSCT) without leaving the study. After treatment discontinuation, participants will have a end-of-treatment visit within 7 days after treatment discontinuation, followed by a 30-day follow-up for safety. After that, long term follow-up will be done every 90 days.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
312
Dosage form:Tablet;Multiple dose phase:Take the medicine once a day,37.5mg at a time.4 weeks of continuous medication is one course of treatment. After the first course of treatment, the subjects can continue to receive the experimental drug treatment until the subjects meet the withdrawal criteria.
Low-dose Cytarabine (LoDAC) or azacitidine, fludarabine, cytarabine and granulocyte colony-stimulating factor (FLAG) or mitoxantrone, etoposide, cytarabine (MEC)will be administered by subcutaneous (SC) and/or intravenous (IV) injections.
Interim analysis: Complete remission(CR)/CR with partial hematologic recovery(CRh) rate in the experimental group.
The complete remission and complete remission with partial hematological recovery (CR/CRh) rate was defined as the number of subjects who achieved either CR or CRh at any of the postbaseline visits divided by the number of subjects in the analysis population.
Time frame: up to 3 years.
The final analysis: Overall Survival(OS).
Overall survival was defined as the time from the date of randomization until the date of death from any cause.
Time frame: up to 3 years .
Key secondary end point: Event-Free Survival (EFS).
Event-free survival (EFS) is defined as the time from the date of randomization until the date of documented relapse, treatment failure or death whichever occurs first.
Time frame: up to 3 years.
Key secondary end point: CR/CRh rate .
The CR/CRh rate was defined as the number of subjects who achieved either CR or CRh at any of the postbaseline visits divided by the number of subjects in the analysis population.
Time frame: up to 3 years.
CR rate.
The CR rate was defined as the number of subjects who achieved the best response of CR divided by the number of subjects in the analysis population.
Time frame: up to 3 years.
Duration of remission (DOR).
Duration of remission included duration of composite complete remission (CRc), duration of complete remission (CR)/ complete remission with partial hematologic recovery (CRh), duration of CRh, duration of CR and duration of response (CRc + partial remission (PR).
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Time frame: up to 3 years.
Composite complete remission rate.
CRc rate is defined as the remission rate of all CR, CRh , CR with incomplete hematologic recovery(CRi) or Morphologic leukemia- free state(MLFS).
Time frame: up to 3 years.
minimal residual disease(MRD) negative rate
MRD negative rate is defined as the percentage of participants without MRD.
Time frame: up to 3 years.
Time to remission(TTR).
Time to remission(TTR) is defined as the time from the date of randomization until the date of is defined as the time from the date of randomization until the date of remission.
Time frame: up to 3 years.
Transplantation rate.
Transplantation rate is defined as the percentage of participants undergoing hematopoietic stem cell transplant (HSCT).
Time frame: up to 3 years.
Safety assessed by adverse events.
An adverse event (AE) is defined as any untoward medical occurrence in a participant administered a study drug or has undergone study procedures and which does not necessarily have a causal relationship with this treatment.
Time frame: up to 3 years.
Population pharmacokinetic of XY0206.
Observed trough concentration (Ctrough).
Time frame: Cycle 1 Day 15: predose and up to 4 hours post-dose; Day 28 predose of subsequent cycles. A cycle is 28 days.