Status:

ACTIVE_NOT_RECRUITING

Entrectinib in Combination With ASTX727 for the Treatment of Relapsed/Refractory TP53 Mutated Acute Myeloid Leukemia

Lead Sponsor:

OHSU Knight Cancer Institute

Collaborating Sponsors:

Oregon Health and Science University

Genentech, Inc.

Conditions:

Acute Myeloid Leukemia

Recurrent Acute Myeloid Leukemia

Eligibility:

All Genders

18+ years

Phase:

PHASE1

Brief Summary

This phase I trial tests the safety, side effects, and best dose of entrectinib when given with ASTX727 in treating patients with acute myeloid leukemia (AML) that has come back (relapsed) or that doe...

Detailed Description

PRIMARY OBJECTIVE: I. To determine the maximum tolerated dose (MTD) of decitabine and cedazuridine (ASTX727) combined with entrectinib in relapsed/refractory (R/R) AML patients with TP53 mutations. ...

Eligibility Criteria

Inclusion

  • Must be able to understand and willing to sign an informed consent document.
  • Participants aged 18 years or older.
  • Morphologically documented AML in patients with relapsed/refractory disease, defined as having \>= 20% blasts in bone marrow or peripheral blood.
  • Documented TP53 mutation as seen on standard diagnostics in AML.
  • Aspartate aminotransferase (AST) \< 3 × upper limit of normal (ULN).
  • Alanine aminotransferase (ALT) \< 3 × ULN.
  • Total bilirubin \< 1.5 × ULN (except for patients with known Gilbert's syndrome).
  • Adequate renal function as defined by calculated creatinine clearance (according to the Cockcroft-Gault equation) \> 40 mL/min OR serum creatinine \< 1.5 × ULN.
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) =\< 2.
  • Must be able to take oral medication.
  • Individuals of childbearing potential (IOCBP) must agree to use highly-effective method(s) of contraception during the study and six months after the last dose of study drugs. IOCBP must have a negative pregnancy test prior to study enrollment.
  • Sperm producing individuals must agree to use an adequate method of contraception starting with the first dose of study therapy through 3 months after the last dose of study drugs.
  • Participants must be recovered from any clinically relevant toxic effects of any prior surgery, radiotherapy, or other therapy intended for the treatment of their cancer.

Exclusion

  • Isolated myeloid sarcoma (patients must have blood or marrow involvement with AML to enter the study).
  • Acute promyelocytic leukemia (M3).
  • Active central nervous system (CNS) involvement by AML.
  • Clinical signs/symptoms of leukostasis which has failed urgent therapy of at least 3 days duration, which may have included hydroxyurea or leukapheresis.
  • Known active human immunodeficiency virus (HIV), active hepatitis B or active hepatitis C infection.
  • Disseminated intravascular coagulopathy with active bleeding or signs of thrombosis.
  • Patients who have received an investigational agent (for any indication) within 5 half-lives of the agent or who have agent-related toxicity that has not resolved to grade 1 or less. If the half-life of an investigational agent is unknown, patients must wait 1 week after discontinuing it before receiving the first dose of study treatment. An investigational agent is one for which there is no approved indication by the United States (US) Food and Drug Administration (FDA).
  • Prior entrectinib for other malignancies (prior decitabine therapy will not be excluded).
  • Patients with psychological, familial, social, or geographic factors that otherwise preclude them from giving informed consent, following the protocol, or potentially hamper compliance with study treatment and follow-up.
  • Patients who are otherwise felt unable to comply with the protocol, in the opinion of the investigator.
  • Any other significant medical condition, including psychiatric illness or laboratory abnormality, that would preclude the patient participating in the trial or would confound the interpretation of the results of the trial.
  • Patients with the following will be excluded: uncontrolled intercurrent illness including, but not limited to, symptomatic (New York Heart Association \[NYHA\] class III or IV) congestive heart failure, unstable angina pectoris, serious cardiac arrhythmia, myocardial infarction at presentation of AML, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Patients with medical comorbidities that will preclude safety evaluation of the combination should not be enrolled.
  • Patients with uncontrolled infection shall not be enrolled until infection is treated and controlled.
  • Participants with prior documented history of malabsorption syndrome (e.g., short gut syndrome) that might limit the bioavailability of study medications will be excluded.

Key Trial Info

Start Date :

October 28 2022

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

June 30 2026

Estimated Enrollment :

13 Patients enrolled

Trial Details

Trial ID

NCT05396859

Start Date

October 28 2022

End Date

June 30 2026

Last Update

October 17 2025

Active Locations (1)

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OHSU Knight Cancer Institute

Portland, Oregon, United States, 97239