The purpose of this study is to evaluate the efficacy and safety of Venetoclax, Azacitidine Plus Orebatinib in newly diagnosed Philadelphia chromosome-positive Acute Lymphoblastic Leukemia.
This is a phase Ⅱ, single-arm, open Label, multicenter clinical study in newly diagnosed Ph-positive acute lymphoblastic leukemia patients. The patients will receive venetoclax, azacitidine and orebatinib regimen in the induction treatment. The patients who respond to induction treatment will undergo consolidation treatment, and an optional allogeneic hematopoietic stem cell transplantation and post-transplantation maintenance treatment with induction therapy according to patient's wishes.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
100mg d1, 200mg d2, 400mg d2-21, oral (Adjusted according to the plasma concentration of venetoclax on day 4),every 28 days for a treatment cycle.
75mg/m2 qd, d1-d7, subcutaneous injection, every 28 days for a treatment cycle.
20mg qod, d4-d21, oral, every 28 days for a treatment cycle.
The First Affiliated Hospital of Soochow University
Suzhou, Jiangsu, China
RECRUITINGcomplete molecular remission(CMR)
Proportion of patients achieving CMR at the end of 1 or 2 cycles
Time frame: End of cycle 1 and 2 (each cycle is 28 days)
CR
Complete remission (CR) was defined as \< 5% bone marrow blasts in an aspirate with spicules and independent of transfusions.
Time frame: End of cycle 1 and 2 (each cycle is 28 days)
CRi
CR with incomplete hematologic recovery (CRi) was defined as \<5% bone marrow blasts, either ANC\<1×10\^9/L or platelets \< 100×10\^9/L, transfusion independence but with persistence of cytopenia.
Time frame: End of cycle 1 and 2 (each cycle is 28 days)
MRD-negative CR
Minimal residual disease (MRD)-negative CR was defined as a leukemic cell count below the sensitivity threshold of 1×10-4 (0.01%) bone marrow mononuclear cells (MNCs) by multiparameter flow cytometry.
Time frame: End of cycle 1 and 2 (each cycle is 28 days)
CCyR
Complete cytogenetic response (CCyR) was defined as lack of Ph in ≥ 20 bone marrow metaphases.
Time frame: End of cycle 1 and 2 (each cycle is 28 days)
MMR
Major molecular response (MMR) was defined as a BCR-ABL/ABL transcript ratio of 0.1% (international scale).
Time frame: End of cycle 1 and 2 (each cycle is 28 days)
Number of adverse events
Adverse events are evaluated with CTCAE V5.0
Time frame: End of cycle 1 and 2 (each cycle is 28 days)
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RFS
Relapse-free survival (RFS) was the duration from the day of CR to leukemia relapse, death, or last follow-up
Time frame: 1 year
OS
Overall survival (OS) was the time from enrollment to death for any reason.
Time frame: 1 year