This is a Phase I/II study evaluating safety and efficacy of proteasome inhibitor (bortezomib) in combination with CPX-351 (liposomal daunorubicin and cytarabine) for the treatment of newly-diagnosed TP53-mutated acute myeloid leukemia (TP53m AML). The primary endpoint of the study is to define safety/tolerability (phase I) and preliminary efficacy profile (phase II) of the treatment. The secondary endpoints of interest are complete remission (CR) rate, detectable minimal residual disease (MRD) status, overall response rate (ORR), rate of allogeneic hematopoietic cell transplantation (allo-HCT), treatment-related mortality (TRM), overall survival (OS), achievement of complete remission anytime in 1 year, and disease-free survival (DFS) at 1 year and 2 years. All the patient outcomes assessments will be performed as part of standard-of-care AML management. The hypothesis is the combination of bortezomib and CPX-351 will have an acceptable safety profile in this patient population based on the data from previous studies. The treatment will attenuate Nuclear Factor kB pathway activation in these cells and eradicate TP53m leukemia stem cells (LSC) leading to increased response rate and survival in these patients.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Bortezomib at assigned study dose in mg/m2 will be given subcutaneously on days 1, 4, 8, and 11
CPX-351 given intravenously on day 1, 3, and 5
Masonic Cancer Center
Minneapolis, Minnesota, United States
RECRUITINGPercentage of Participants with Complete Response
To evaluate the CR rate of bortezomib + CPX-351 for the treatment of TP53m AML.
Time frame: 2 years
Determine Maximum Tolerated Dose
Time frame: 1 year
Determine Overall Response Rate
Evaluate ORR (CR+CRi) after treatment
Time frame: 2 years
Average rate of allo-HCT among participants
Evaluate the rate of allo-HCT within 2 years among patients who received treatment
Time frame: 2 years
Overall Survival
estimate 1-year and 2-year OS, defined as the time from cohort assignment to death from any cause
Time frame: 1 year
Overall Survival
estimate 1-year and 2-year OS, defined as the time from cohort assignment to death from any cause
Time frame: 2 year
Average time to relapse
• To estimate time to relapse, defined as the time from cohort assignment to disease recurrence
Time frame: 2 year
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