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Anti-metabolites

CPX-351 + Ivosidenib for Acute Myeloid Leukemia/Myelodysplastic Syndrome

Phase 2
Recruiting
Led By Courtney DiNardo
Research Sponsored by M.D. Anderson Cancer Center
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Eastern Cooperative Oncology Group (ECOG) performance status of =< 2
Creatinine clearance >= 30 ml/min based on the Cockcroft-Gault equation
Must not have
Patients with any severe gastrointestinal or metabolic condition which could interfere with the absorption of oral study medications
Patients who have previously received either ivosidenib or CPX-351
Timeline
Screening 3 weeks
Treatment Varies
Follow Up up to 3 years
Awards & highlights
No Placebo-Only Group

Summary

This trial is studying how well CPX-351 and ivosidenib work in treating patients with leukemia or myelodysplastic syndrome that has an IDH1 mutation.

Who is the study for?
This trial is for adults with acute myeloid leukemia or high-risk myelodysplastic syndrome that have an IDH1 mutation. Participants can be new to treatment or have relapsed and must be fit enough for intensive chemotherapy (ECOG <=2). They should not have severe heart issues, a history of certain brain infections, or excessive prior anthracycline exposure. Women must avoid pregnancy and men must refrain from donating sperm during the trial.
What is being tested?
The study is testing CPX-351 (a chemo drug combo) alongside Ivosidenib in patients with specific genetic changes in their cancer cells. The goal is to see if this combination helps control the growth of cancer cells better than current treatments by blocking enzymes needed for cell growth.
What are the potential side effects?
Possible side effects include typical chemotherapy-related issues like fatigue, nausea, hair loss, increased risk of infection due to low blood counts, as well as potential liver problems indicated by elevated bilirubin levels. Ivosidenib may cause changes in heart rhythm or other organ-specific inflammation.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I can take care of myself but might not be able to do heavy physical work.
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My kidneys are functioning well enough to clear waste.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I do not have severe stomach or metabolic issues affecting medication absorption.
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I have previously been treated with ivosidenib or CPX-351.
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I have a history of PML.
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I don't have major side effects from previous cancer treatments.
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I do not have any severe health issues that could make the study treatment unsafe for me.
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I do not have severe heart failure, unstable chest pain, or a weak heart pump.
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I have received a high dose of anthracycline drugs, or a lower dose if I had radiation therapy to the chest area.
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I have been diagnosed with acute promyelocytic leukemia.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~up to 3 years
This trial's timeline: 3 weeks for screening, Varies for treatment, and up to 3 years for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Overall response rate (ORR)
Secondary study objectives
Duration of response
Event-free survival
Incidence of adverse events
+1 more
Other study objectives
Minimal residual disease (MRD) status

Side effects data

From 2020 Phase 2 trial • 56 Patients • NCT02286726
25%
Febrile Neutropenia
21%
Neutropenic Fever
17%
Lung Infection
17%
Sepsis
13%
Insomnia
8%
Pericardial Effusion
8%
Infection
8%
Hypertension
4%
Pleural Effusion
4%
Pancreatitis
4%
Intracranial Hemorrhage
4%
Cardiac Disorders
4%
Fever
4%
Joint Effusion
4%
Alanine aminotransferase Increase
4%
Anxiety
4%
Blood Bilirubin Increase
4%
Acute Coronary Syndrome
4%
Respiratory Failure
4%
Multi-Organ Failure
100%
80%
60%
40%
20%
0%
Study treatment Arm
Arm II (Intermediate-dose (75 Units/m^2) CPX-351)
Arm III (Standard-dose (100 Units/m^2) CPX-351)
Arm I (Lower-dose (50 Units/m^2) CPX-351)

Awards & Highlights

No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.

Trial Design

1Treatment groups
Experimental Treatment
Group I: Treatment (CPX-351, ivosidenib)Experimental Treatment2 Interventions
INDUCTION: Patients receive CPX-351 IV over 90 minutes on days 1, 3, and 5, and ivosidenib PO QD on days 1-28. Patients who do not achieve complete remission may receive a second cycle of induction therapy in the absence of disease progression or unacceptable toxicity. Patients achieving complete remission proceed to consolidation. CONSOLIDATION: Patients receive CPX-351 IV over 90 minutes on days 1 and 3, and ivosidenib PO QD on days 1-28. Treatment repeats every 28 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients receive ivosidenib PO QD for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients who are experiencing clinical benefit and who have not experienced excessive toxicity after completion of 2 years of maintenance may be eligible to continue therapy after discussion with the principal investigator.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Ivosidenib
2019
Completed Phase 1
~20
Liposome-encapsulated Daunorubicin-Cytarabine
2017
Completed Phase 2
~170

Find a Location

Who is running the clinical trial?

M.D. Anderson Cancer CenterLead Sponsor
3,067 Previous Clinical Trials
1,802,616 Total Patients Enrolled
Courtney DiNardoPrincipal InvestigatorM.D. Anderson Cancer Center
8 Previous Clinical Trials
618 Total Patients Enrolled

Media Library

Ivosidenib (Anti-metabolites) Clinical Trial Eligibility Overview. Trial Name: NCT04493164 — Phase 2
Myelodysplastic Syndrome Research Study Groups: Treatment (CPX-351, ivosidenib)
Myelodysplastic Syndrome Clinical Trial 2023: Ivosidenib Highlights & Side Effects. Trial Name: NCT04493164 — Phase 2
Ivosidenib (Anti-metabolites) 2023 Treatment Timeline for Medical Study. Trial Name: NCT04493164 — Phase 2
~3 spots leftby Jun 2025