Acute Myeloid LeukemiaPhase 3NCT03151408
An Efficacy and Safety Study Of Pracinostat In Combination With Azacitidine In Adults With Acute Myeloid Leukemia
A Phase 3 study testing Pracinostat and Azacitidine in people with Acute Myeloid Leukemia, run by Helsinn Healthcare SA at 138 sites in 16 countries.
Trial summary
This is a Phase III, multicenter, double-blind, randomized study of pracinostat vs. placebo with azacitidine (AZA) as background therapy in patients ≥ 18 years of age with newly diagnosed acute myeloid leukemia (AML), excluding acute promyelocytic leukemia and cytogenetic low-risk AML, who are unfit to receive… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Myeloid Leukemia
- What is being tested?
- Pracinostat and Azacitidine
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 406 participants
- Where
- 138 sitesin 16 countries
- Study dates
- 23 Jun 2017to 20 Aug 2020
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male or female patient ≥ 18 years of age with newly diagnosed, histologically or cytologically confirmed, AML including de novo, secondary to antecedent hematologic disorders, or treatment-related disease with intermediate or unfavorable-risk cytogenetics
- Unable to receive intensive chemotherapy regimens at enrollment, based on one of the following:
- Age ≥ 75 years, or
- Age < 75 years with at least 1 of the following co-morbidities:
- An ECOG performance status of 2
- Clinically significant cardiovascular disease defined as:
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- Left ventricular ejection fraction (LVEF) ≤ 50%, measured within 3 months prior to Day 1 confirmed by ECHO/MUGA ii. Congestive heart failure requiring medical therapy iii. Chronic stable angina requiring medical therapy iv. Prior cerebrovascular accident with sequelae c. Clinically significant pulmonary disease defined as: i. Forced expiratory volume in 1 second (FEV1) ≤ 65% of expected ii. Lung diffusing capacity for carbon monoxide (DLCO) ≤ 65% of expected Confirmed by pulmonary tests. d. Diabetes mellitus with symptomatic end-organ damage (e.g., retinopathy, nephropathy, neuropathy, vasculopathy) e. Autoimmune inflammatory conditions (e.g., rheumatoid arthritis, systemic lupus erythematous, inflammatory bowel disease, or similar) requiring chronic disease modifying therapy (e.g., etanercept, adalimumab, infliximab, rituximab, methotrexate, or similar) f. Class III obesity defined as a Body Mass Index (BMI) > 40 kg/m2 g. Renal impairment defined as serum creatinine > 1.3 mg/dL (> 115 µmol/L) or creatinine clearance <70 ml/min h. Clinically significant cognitive impairment defined as requiring medical therapy and/or assistance with activities of daily living
- 20% blasts in bone marrow
- Peripheral white blood cell (WBC) count 30,000/µL For cyto-reduction, hydroxyurea is allowed during screening and up to Cycle 1, Days 1-14, to reduce WBC count to < 30,000 µL prior to Day 1. After Cycle 1, Day 14, hydroxyurea is prohibited.
- ECOG performance status ≤ 2
- Adequate organ function as evidenced by the following laboratory findings:
- Total bilirubin ≤ 2 × upper limit of normal (ULN) or < 3 x ULN for patients with Gilbert-Meulengracht Syndrome
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 × ULN
- Serum creatinine ≤ 1.5 × ULN according to institutional standards or creatinine clearance ≥ 50 mL/min
- QT-interval corrected according to Fridericia's formula (QTcF) ≤ 450 ms on electrocardiogram (ECG) at Screening
- Male patient who is surgically sterile, or male patient who is willing to agree to remain completely abstinent (refrain from heterosexual intercourse) or who use barrier contraceptive measures and agree to refrain from donating sperm during the entire study treatment period and for 3 months after the last administration of study drug
- Female patient who is of childbearing potential willing to use adequate contraceptive measures while participating on study, OR willing to completely abstain from heterosexual intercourse during the entire study treatment period
- Female patient who is of childbearing potential must have a negative serum pregnancy test result within 3 weeks prior to starting study drugs.
- Willing to provide voluntary written informed consent before performance of any study related procedure not part of normal medical care
- Willing and able to understand the nature of this study and to comply with the study and follow-up procedures.
Who cannot join
- Able to receive intensive induction chemotherapy
- AML-associated inv(16)/t(16;16)/del(16q), t(15;17) (i.e. promyelocytic leukemia) with/without secondary aberrations; t(8;21) lacking del (9q) or complex karyotypes
- Presence of an active malignant disease within the last 12 months, with the exception of adequately treated cervical cancer in-situ, non-melanoma skin cancer and superficial bladder tumors (Ta [non-invasive tumor], Tis [carcinoma in situ] and T1 [tumor invades lamina propria]). Other malignancies may be considered after consultation with the Medical Monitor
- Life-threatening illnesses other than AML, uncontrolled medical conditions or organ system dysfunction that, in the Investigator's opinion, could compromise the patient's safety or put the study outcomes at risk
- Uncontrolled arrhythmias; any Class 3-4 cardiac diseases as defined by the New York Heart Association (NYHA) functional classification
- Evidence of AML central nervous system (CNS) involvement
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- Previous chemotherapy for AML except for the following, which are allowed:
- Hydroxyurea for cytoreduction
- One course of hypomethylating agent therapy (i.e.; up to 7 doses of azacitidine or 3-5 days of decitabine) within 30 days prior to enrollment (Day 1)
- Use of experimental drugs ≤ 30 days prior to screening
- Received prior HDAC inhibitor therapy
- Received prior treatment with a hypomethylating agent, except as allowed in Exclusion Criterion 7.b
- Known hypersensitivity to any components of pracinostat, azacitidine, or mannitol
- History of human immunodeficiency virus (HIV) or an active and uncontrolled infection with hepatitis C virus (HCV) or hepatitis B virus (HBV)
- Gastrointestinal (GI) tract disease that causes an inability to take oral medication, malabsorption syndrome, or a requirement for IV alimentation; prior surgical procedures affecting absorption; or uncontrolled inflammatory GI disease (e.g., Crohn's disease, ulcerative colitis)
- Any disease(s), psychiatric condition, metabolic dysfunction, or findings from a physical examination or clinical laboratory test result that would cause reasonable suspicion of a disease or condition, that contraindicates the use of pracinostat and/or AZA, that may increase the risk associated with study participation, that may affect the interpretation of the results, or that would make the patient inappropriate for this study
- Breast-feeding woman
- current smokers(use of patches, chewing gums and vaping nicotine conaining fluids is permitted). Patients who stopped smoking at least 8 day prior to first pracinostat dosing can be enrolled, provided they refrain from smoking during the whole study
- prohibited concomitant medications
- uncontrolled infections
- receive more than 1 prior cycle of HMA or bone marrow transplant for any prior hematological disorder antecedent to AML
Trial locations and contacts
138 sites in 16 countries.
138 sites in 16 countries
United States30 sites
Rcca Md Llc
Bethesda, Maryland, 20187
Saint alphonsus Regional medical center-cancer care center
Boise, Idaho, 83706
Emily Couric Clinical cancer center
Charlottesville, Virginia, 22908
University Hospital Cleveland Medical Center
Cleveland, Ohio, 44106
Pontchartrain Cancer Center (Research Location)
Covington, Louisiana, 70433
VA North texas Health Care sytem,Dallas VA Medical Center div. Hematology Oncology
Dallas, Texas, 75216
Duke University Medical Center-2400 Pratt Street
Durham, North Carolina, 27710
Michigan Center of Medical Research
Farmington Hills, Michigan, 48336
GHS Cancer Institute
Greenville, South Carolina, 29615
MD Anderson Cancer Center
Houston, Texas, 77030
100 Mercy Way
Joplin, Montana, 64804
University of Tennessee Medical Center
Knoxville, Tennessee, 37920
10666 N.Torrey Pines-Scripps Cancer Center
La Jolla, California, 92037
UC San Diego Moores Cancer Center
La Jolla, California, 92093-0698
Michigan State University
Lansing, Michigan, 48910
Norton Cancer Institute, St. Matthews Campus
Louisville, Kentucky, 40207
Loyola University Chicago
Maywood, Illinois, 60153
Mercy Clinic Oncology & Hematology
Oklahoma City, Oklahoma, 73120
Mayo clinic hospital
Phoenix, Arizona, 85054
Mayo clinic
Rochester, Minnesota, 55905
Swedish Cancer Institute
Seattle, Washington, 98104
Thomas Reeve Chauncey
Seattle, Washington, 98108
Mercy Research
Springfield, Missouri, 65804
Stony Brook University
Stony Brook, New York, 11794
Arizona Oncology Associates, East Valley Cancer Center
Tempe, Arizona, 85284
University of Arizona cancer center-north campus
Tucson, Arizona, 85724
Oklahoma cancer specialist and research institute
Tulsa, Oklahoma, 74146
Georgetown University Medical Center
Washington D.C., District of Columbia, 20007
Universitz of Kansas Cancer Center
Westwood, Kansas, 66205
UMass Memorial medical center-university campus
Worcester, Massachusetts, 01655
Italy13 sites
AOU Policlinico Consorziale di Bari
Bari, 70124
AOU Policlinico Sant'Orsola-Malpighi
Bologna, 40138
Azienda Ospedaliera-Università Careggi
Florence, 50134
Ospedale Policlinico San Martino
Genova, 16132
ospedale Vito Fazzi
Lecce, 73100
Ospedale San Raffaele-U.O. Ematologia e TMO
Milan, Lombardy, 20132
Azienda Ospedaliera Universitaria Federico II
Naples, 80131
Azienda Ospedaliere Antonio Cardarelli,
Naples, 80131
Ospedale la Maddalena, UO Oncoematologia e TMO
Palermo, PA, 90146
Fondazione IRCCS policlinico San Matteo Pavia
Pavia, 27100
Fondazione PTV-Policlinico Tor Vergata
Roma, 00133
Policlinico Universitario Gemelli
Roma, 00168
Azienda Ospedaliera Ordine Mauriziano
Torino, 10128
Spain12 sites
Hosp.Universitario A Coruña-Hospital Teresa Herrera
A Coruña, Galicia, 15006
Institut Català D'Oncologia (ICO)
Badalona, Barcelona, 08916
"Hospital Universitario Vall d'Hebron
Barcelona, 08035
Hospital de La Santa Creu i Sant Pau
Barcelona, 08041
Hospital San Pedro de Alcantara
Cáceres, Extremadura, 10003
Hospital Clinico San Carlos
Madrid, 28040
Hospital Universitario la Paz
Madrid, 28046
Hospital Univers itario HM Sanchinarro
Madrid, 28050
Hospital Universitario Son Espases
Palma de Mallorca, Isla Baleares, 07120
Hospital Uni vcrsitario de Salamanca
Salamanca, 37007
Hospital Universitario Virgen del Rocio
Seville, 46013
Hospital Universitario y Politecnico de La Fe
Valencia, 46026
Brazil10 sites
Hospital de Cancer de Barretos
Barretos, 1478-400
Hospital Santa Casa de Belo Horizonte -Serviyo de Oncologia Clinica
Belo Horizonte, 30.150-221
Liga Paranaense de Com bate ao Cancer - Hospital Erasto Gaertner
Curitiba, Paraná, 81520-060
Centro de Pesquisas Oncologicas - CEPON
Florianópolis, 88034-000
Ce ntro de Pesquisas Hospital Amara l Ca rvalh o
Jaú, São Paulo, 17210-080
Hospital de ClÃ-nicas de Porto Alegre
Porto Alegre, 90035-903
Institute Nacional de Cancer Jose de Alencar Gomes da Silva-INCA
Rio de Janeiro, 20231-050
Faculdade de Medicina do ABC - Centro de Estudos e Pesquisas de Hematologia e Oncologia
Santo André, 09060-870
Hospital de Base de Sao Jose do Rio Preto
São José do Rio Preto, 15090-000
Centro de Pesquisa Clinica do Hospital Santa Marcelina
São Paulo, São Paulo, 0827-120
Australia9 sites
Sunshine coast university hospital
Birtinya, Queensland, 4575
The Northern hospital Pharmacy Department, Ground Floor
Epping, Victoria, 3076
Barwon Health, University Hospital Geelong
Geelong, Victoria, 3220
Austin Hospital, Clinical Trial Pharmacy
Heidelberg, Victoria, 3084
Royal Hobart Hospital
Hobart, Tasmania, 7000
Liverpool Hospital
Liverpool, New South Wales, 2170
Liverpool hospital
Liverpool, 2170
Royal Perth Hospital
Perth, 6000
Prince of Wales Hospital
Randwick, 2031
Germany8 sites
Klinikum St. Marien Amberg
Amberg, Bavaria, 92224
Charité-Universitätsmedizin - 1. Campus Mitte
Berlin, 10117
Klinikum Chemnitz gGmbH
Chemnitz, 09116
Universitatsklinikum Erlangen
Erlangen, Bavaria, 91054
SRH Wald-Klinikum Gera GmbH
Gera, 07548
Marien Hospital Herne-Universitätsklinikum der Ruhr-Universität Bochum
Herne, North Rhine-Westphalia, 44625
Staedtisches krankenhaus kiel
Kiel, 24116
Universitaet Mainz
Mainz, 55131
France7 sites
CHU Amiens Picardie-Site Sud-Service d'Hematologie
Amiens, 800054
L'Hopital privé du Confluent SAS
Nantes, 44277
CHU de Nice, Archet 1 Hospital-Hematology department
Nice
Hospital saints Louis
Paris, 75475
Haut-Leveque-Service d'hématologie clinique et de thérapie cellular
Pessac, 33604
Centre Hospitalier Lyon Sud
Pierre-Bénite, 69495
Centre Henri Becquerel
Rouen, 76028
South Korea7 sites
Inje university Busan Paik Hospital
Busan, 47392
Chonnam National University Hwasun Hospital
Hwasun, 58128
Gachon University Gil medical center, div hematology
Incheon, 21565
Seoul National University Hospital, Div.Hematology/Oncology
Seoul, 0080
Sumsung medical center
Seoul, 06351
Seoul St.Mary Hospital, div hemato-oncology
Seoul, 06591
Ulsan University Hospital
Ulsan, 44033
Taiwan7 sites
Changhua Christian Hospital
Changhua, 50006
Hematology and Oncology, Changhwa Christian Hospital
Changhua, 500
Kaohsiung Medical University Chung-Ho Memorial Hospital
Kaohsiung City, 807
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung City, 83301
China Medical University Hospita
Taichung, 40447
Division of Hematology, National Taiwan University Hospital
Taipei, 100
koo-Foundation Sun Yat-Sen Cancer Center
Taipei, 112
Argentina6 sites
Hospital italiano de Buenos Aires
Ciudad Autonoma de Buenos Aire, Buenos Aires, C1181ACH
Instituto Medico Especializado Alexander Fleming
Ciudad Autonoma de Buenos Aire, Buenos Aires, C1426ANZ
sanatorio Allende
Córdoba, X5000JHQ
H ospi tal Privado de Cordoba
Córdoba, X5016KEH
hospital Italiano la Plata
La Plata, Buenos Aires, B1900AXI
Sanatorio Britanico SA Paraguay 40, 3P
Rosario, Santa Fe Province, 2000
Hungary6 sites
St. Istvan & St. Laszlo Hospital, Deapartment of Hematology and Stem Cell Transplantation
Budapest, H-1097
University of Debrecen Clinical Center
Debrecen, H-4032
Somogy Megyei Kaposi Mor Oktato Korhaz, Dep. Of Haematology
Kaposvár, 7400
Szabolcs-Szatmar-Bereg megyei Korhazak es Egyetemi Oktatokorhaz â€" Josa Andras Oktatokorhaz, Hematologiai Osztaly
Nyíregyháza, II-1065
university of Pécs
Pécs, Baranya, 7624
Pecsi Egyetem I. Belgy6gyaszati Klinika
Pécs, Baranya, H-7624
Romania6 sites
Spitalul Clinic Colentina
Bucharest, 020125
clinical hospital Coltea Bld
Bucharest, 030171
Spitalul Universitar de Urgenta Bucuresti
Bucharest, 050098
Oncological Institute "Ion Chiricuta"
Cluj-Napoca, 400015
Spitalul Clinic Filantropia
Craiova, Jud.dolj, 200143
institutu Regional de Oncologie Iasi
Iași, 700483
Czechia5 sites
"Fakultni nemocnice Hradec Kralove,
Hradec Králové, 5oo 05
Fakultni nemocnice Olomuc
Olomouc, 77900
"Fakultni nemocnice Kralovske Vinohrady,
Prague, 100 34
Fakultni nemocnice Kralovske Vinohrady,
Prague, 10034
Vseobecna fakultni nemocnice
Prague, I28 08
United Kingdom5 sites
Blackpool Teaching Hospitals NHS Foundation Trust
Blackpool, Lancashire, FY3 8NR
Bradford Teaching Hospitals NHS Foundation trust
Bradford, BD9 6RJ
University Hospitals Coventry and Warwickshire NHS Trust
Coventry, CV2 2DX
Royal Devon & Exeter Hospital (Wonford site)
Exeter, Devon, EX25DW
Royal Liverpool University Hospital
Liverpool, L7 8XP
Poland4 sites
Wojewodzkie Wielospecjalistyczne Centrum onkologii I traumatologii
Lodz, 93-513
Examen Sp. Z o.o.,
Poznan, 60-192
Specjalistyc:my Szpi tal im. dra Alfreda Sokolowskiego
Wałbrzych, 58-309
Uniwersytecki Szpital Kliniczny
Wroclaw, 50-556
Austria3 sites
Krankenhaus der Elisabethinen Linz GmbH
Linz, 4020
Müllner Hauptstrabe 48
Salzburg, 5020
General Hospital Hietzing
Vienna, 1130
About this study
Official title: A Phase III, Double-Blind, Placebo-Controlled, Multicenter, Randomized Study Of Pracinostat In Combination With Azacitidine In Patients ≥18 Years With Newly Diagnosed Acute Myeloid Leukemia Unfit For Standard Induction Chemotherapy
This is a Phase III, multicenter, double-blind, randomized study of pracinostat vs. placebo with azacitidine (AZA) as background therapy in patients ≥ 18 years of age with newly diagnosed acute myeloid leukemia (AML), excluding acute promyelocytic leukemia and cytogenetic low-risk AML, who are unfit to receive intensive remission induction chemotherapy due to age ≥ 75 years or comorbidities. Patients will be randomized in a 1:1 ratio to one of two groups: Group A (experimental group) to receive pracinostat plus AZA and Group B (control group) to receive placebo plus AZA. Randomization will be stratified by cytogenetic risk category (intermediate vs. unfavorable-risk, according to SWOG Cytogenetic Risk Category Definitions) and ECOG performance status (0-1 vs. 2). Treatments will be administered based on 28-day cycles, with pracinostat/placebo administered orally once every other day, 3 times a week for 3 weeks, followed by one week of no treatment and AZA administered for 7 days of each cycle. Study treatment should continue until there is documented disease progression, relapse from complete remission (CR), or non-manageable toxicity. A minimum of 6 cycles may be required to achieve a complete remission. Once permanently discontinued from study treatment, patients will enter the Long-term Follow-up phase of the study and will be followed for assessment of disease progression, if applicable, and survival every 3 months (±1 month) until death. The end of this study is defined when 390 events (deaths) have occurred and the study is unblinded for final overall survival analysis. Patients who are receiving study treatment at the end of the study may have the opportunity to continue to receive the study drugs to which they were randomized to (Post- Study Observation Period), until the Sponsor informs the Investigators of the appropriate course of action based on the study results. The Post-Study Observation Period is defined as the period starting from the end of the study for a maximum of 12 months.
- Conditions
- Acute Myeloid Leukemia
- Being tested
- Pracinostat, Placebos, Azacitidine
- Keywords
- AML
- Medical subject headings
- Leukemia, Myeloid, Acute
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PracinostatDrug
Also called SB939
60 mg capsule
PlacebosDrug
capsule
AzacitidineDrug
Also called AZA
SC or IV injection
| Study group | Role | What they receive |
|---|---|---|
| Pracinostat plus AZA | Experimental | 60 mg capsule orally, once a day, 3 times a week for 3 weeks, followed by 1 week of rest of each 28-day cycle. As a background therapy azacitidine (AZA) will be administered at a dose of 75 mg/m2 by SC or IV injection daily for 7 days of each 28-day cycle. Receives: Drug: Pracinostat; Drug: Azacitidine |
| Placebo plus AZA | Placebo comparator | 1 capsule orally, once a day, 3 times a week for 3 weeks, followed by 1 week of rest of each 28-day cycle. As a background therapy azacitidine (AZA) will be administered at a dose of 75 mg/m2 by SC or IV injection daily for 7 days of each 28-day cycle. Receives: Drug: Placebos; Drug: Azacitidine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival
OS measures the time from randomization to death due to any cause.
Measured: 826 days
Secondary outcomes (4)
Morphologic Complete Remission (CR) Rate
The CR rate is the proportion of patients who achieve a morphologic CR according to the response criteria
- <5% blasts in a bone marrow aspirate sample with spicules
- There should be no blasts with Auer rods
- No EMD
- Absolute Neutrophil Count (ANC) ≥1,000/μL
- Platelet count of ≥100,000/μL
- Patient must be independent of transfusions (for at least 1week before each assessment)
Measured: 744 days
Complete Remission Without Minimal Residual Disease (CRmrd) Rate
proportion of patients who achieve a CR without minimal residual disease by multicolor flow cytometry according to the following criteria
- Morphologic CR
- Minimal Residual Disease (MRD) by MFC negative
Measured: 826 days
Cytogenetic Complete Remission (CRc) Rate
The CRc rate is the proportion of patients who achieve a reversion to a normal karyotype at CR within the study period. This endpoint applies only to patients with abnormal cytogenetic at enrollment according to the following criterion
Morphologic CR plus reversion to a normal karyotype (defined as no clonal abnormalities detected in a minimum of 20 mitotic cells)
Measured: 826 days
Transfusion Independence (TI)
Transfusion independence rate is defined as the proportion of patients who show eight weeks or over without red blood cell (RBC-TI) and/or platelet (PLT-TI) transfusion during study period
Measured: 826 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 May 2017
- Study start23 Jun 2017
- Primary completion20 Aug 2020
- Study completion20 Aug 2020
Why it stopped: The IDMC recommended to stop the study prematurely due to a lack of efficacy.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Acute Myeloid LeukemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 406 participants (actual)
Sponsor and investigators
- Lead sponsor
- Helsinn Healthcare SA
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Clinipace Worldwide
- Responsible party
- Sponsor
- Investigators
- Guillermo Garcia-Manero, MD, Study chair, MD Anderson
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03151408
- Sponsor's protocol ID
- PRAN-16-52
- Status last verified
- Feb 2022
- First submitted
- 5 May 2017
- Last updated
- 10 Mar 2022
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 10 Mar 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III, Double-Blind, Placebo-Controlled, Multicenter, Randomized Study Of Pracinostat In Combination With Azacitidine In Patients ≥18 Years With Newly Diagnosed Acute Myeloid Leukemia Unfit For Standard Induction Chemotherapy
- ClinicalTrials.gov ID
- NCT03151408
- Acronym / sponsor ID
- PRAN-16-52
- Conditions
- Acute Myeloid Leukemia
- Keywords
- AML
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: The IDMC recommended to stop the study prematurely due to a lack of efficacy.
- Enrolment
- 406 participants (actual)
- Lead sponsor
- Helsinn Healthcare SAIndustry (pharma, biotech, devices)
- Collaborators
- Clinipace Worldwide
- Study start
- 23 Jun 2017 (actual)
- Primary completion
- 20 Aug 2020 (actual)
- Study completion
- 20 Aug 2020 (actual)
- First posted
- 12 May 2017 (actual)
- Results
- Posted 10 Mar 2022
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a Phase III, multicenter, double-blind, randomized study of pracinostat vs. placebo with azacitidine (AZA) as background therapy in patients ≥ 18 years of age with newly diagnosed acute myeloid leukemia (AML), excluding acute promyelocytic leukemia and cytogenetic low-risk AML, who are unfit to receive intensive remission induction chemotherapy due to age ≥ 75 years or comorbidities. Patients will be randomized in a 1:1 ratio to one of two groups: Group A (experimental group) to receive pracinostat plus AZA and Group B (control group) to receive placebo plus AZA. Randomization will be stratified by cytogenetic risk category (intermediate vs. unfavorable-risk, according to SWOG Cytogenetic Risk Category Definitions) and ECOG performance status (0-1 vs. 2). Treatments will be administered based on 28-day cycles, with pracinostat/placebo administered orally once every other day, 3 times a week for 3 weeks, followed by one week of no treatment and AZA administered for 7 days of each cycle. Study treatment should continue until there is documented disease progression, relapse from complete remission (CR), or non-manageable toxicity. A minimum of 6 cycles may be required to achieve a complete remission. Once permanently discontinued from study treatment, patients will enter the Long-term Follow-up phase of the study and will be followed for assessment of disease progression, if applicable, and survival every 3 months (±1 month) until death. The end of this study is defined when 390 events (deaths) have occurred and the study is unblinded for final overall survival analysis. Patients who are receiving study treatment at the end of the study may have the opportunity to continue to receive the study drugs to which they were randomized to (Post- Study Observation Period), until the Sponsor informs the Investigators of the appropriate course of action based on the study results. The Post-Study Observation Period is defined as the period starting from the end of the study for a maximum of 12 months.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Pracinostat plus AZA | Experimental | Drug: Pracinostat, Drug: Azacitidine60 mg capsule orally, once a day, 3 times a week for 3 weeks, followed by 1 week of rest of each 28-day cycle. As a background therapy azacitidine (AZA) will be administered at a dose of 75 mg/m2 by SC or IV injection daily for 7 days of each 28-day cycle. |
| Placebo plus AZA | Placebo comparator | Drug: Placebos, Drug: Azacitidine1 capsule orally, once a day, 3 times a week for 3 weeks, followed by 1 week of rest of each 28-day cycle. As a background therapy azacitidine (AZA) will be administered at a dose of 75 mg/m2 by SC or IV injection daily for 7 days of each 28-day cycle. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (20 listed)
- Male or female patient ≥ 18 years of age with newly diagnosed, histologically or cytologically confirmed, AML including de novo, secondary to antecedent hematologic disorders, or treatment-related disease with intermediate or unfavorable-risk cytogenetics
- Unable to receive intensive chemotherapy regimens at enrollment, based on one of the following:
- 20% blasts in bone marrow
- Peripheral white blood cell (WBC) count 30,000/µL For cyto-reduction, hydroxyurea is allowed during screening and up to Cycle 1, Days 1-14, to reduce WBC count to < 30,000 µL prior to Day 1. After Cycle 1, Day 14, hydroxyurea is prohibited.
- ECOG performance status ≤ 2
Key exclusion criteria (21 listed)
- Able to receive intensive induction chemotherapy
- AML-associated inv(16)/t(16;16)/del(16q), t(15;17) (i.e. promyelocytic leukemia) with/without secondary aberrations; t(8;21) lacking del (9q) or complex karyotypes
- Presence of an active malignant disease within the last 12 months, with the exception of adequately treated cervical cancer in-situ, non-melanoma skin cancer and superficial bladder tumors (Ta [non-invasive tumor], Tis [carcinoma in situ] and T1 [tumor invades lamina propria]). Other malignancies may be considered after consultation with the Medical Monitor
- Life-threatening illnesses other than AML, uncontrolled medical conditions or organ system dysfunction that, in the Investigator's opinion, could compromise the patient's safety or put the study outcomes at risk
- Uncontrolled arrhythmias; any Class 3-4 cardiac diseases as defined by the New York Heart Association (NYHA) functional classification
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PracinostatAlso: SB93960 mg capsule | Drug | Pracinostat plus AZA |
| Placeboscapsule | Drug | Placebo plus AZA |
| AzacitidineAlso: AZASC or IV injection | Drug | Placebo plus AZA, Pracinostat plus AZA |
Primary outcome
Overall Survival
Time frame: 826 days
OS measures the time from randomization to death due to any cause.
4 secondary outcomes
Morphologic Complete Remission (CR) Rate
Time frame: 744 days
Complete Remission Without Minimal Residual Disease (CRmrd) Rate
Time frame: 826 days
Cytogenetic Complete Remission (CRc) Rate
Time frame: 826 days
Transfusion Independence (TI)
Time frame: 826 days
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Mar 2022.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Guillermo Garcia-Manero, MD study chair
MD Anderson
138 sites in 16 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Pracinostat and Azacitidine in people with Acute Myeloid Leukemia, run by Helsinn Healthcare SA at 138 sites in 16 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 20 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 10 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 138 sites in United States, Italy, Spain, Brazil, Australia and 11 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 10 Mar 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall Survival (time frame: 826 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Mar 2022.