Acute Myeloid Leukemia (AML) Clinical Trial
Official title:
Dose Finding Safety Run-in Phase Followed by a Randomized Phase II Trial of Intensive Chemotherapy With or Without Volasertib (BI 6727) Administered Prior or After Chemotherapy in Patients With Newly Diagnosed High-Risk Myelodysplastic Syndrome (MDS) and Acute Myeloid Leukemia (AML)
Randomized Phase II Trial of Intensive Chemotherapy With or Without Volasertib (BI 6727) in Patients With Newly Diagnosed High-Risk Myelodysplastic Syndrome (MDS) and Acute Myeloid Leukemia (AML)
The trial is a randomized, Phase II, open label multi-center trial in adult patients with
newly diagnosed AML or high-risk MDS as defined in the inclusion/exclusion criteria.
An initial safety run-in study will be performed administering intensive induction therapy
consisting of daunorubicin and cytarabine with the study drug volasertib administered prior
or after chemotherapy, as well as consolidation therapy consisting of intermediate-dose
cytarabine with the study drug volasertib administered prior or after chemotherapy. After
establishing the volasertib dose, the randomized Phase II portion of the trial will begin:
Patients will be equally randomized to DA (daunorubicin, cytarabine), V-DA (volasertib
administered prior to daunorubicin, cytarabine), and DA-V (volasertib administered after
daunorubicin, cytarabine). All patients will receive a second induction cycle with reduced
daunorubicin and cytarabine doses. Patients refractory to the first induction cycle and
patients not achieving a CR/CRi after two induction cycles will be off-study and followed up.
Patients in CR/CRi after induction therapy will proceed to consolidation therapy.
Consolidation will be stratified based on the genetic risk profile (according to ELN
criteria) and patient-related factors (e.g., age, HCT-CI, comorbidities, patient wish).
Patients with a favorable genetic risk profile and those patients considered ineligible for
allogeneic HCT will receive repetitive cycles of consolidation according to initial
randomization, either MiDAC, V-MiDAC (volasertib administered prior to cytarabine), or
MiDAC-V (volasertib administered after cytarabine). All other patients are assigned to
allogeneic HCT.
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