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Acute Myelogenous Leukemia (AML) Due to TherapyPhase 2NCT04231851

CPX-351 and Glasdegib for Newly Diagnosed Acute Myelogenous Leukemia With MDS Related Changes or Therapy-related Acute Myeloid Leukemia

A Phase 2 study testing Glasdegib and CPX-351 in people with Acute Myelogenous Leukemia (AML) Due to Therapy and Acute Myeloid Leukemia With Myelodysplasia-Related Changes, run by University of California, Irvine at 4 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record

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Trial summary

This is a phase 2 single-arm, open-label clinical trial determining efficacy of CPX-351 in combination with Glasdegib in subjects with Acute Myelogenous Leukemia with myelodysplastic syndrome related changes or therapy-related acute myeloid leukemia. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Glasdegib and CPX-351
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
4 sitesUnited States
Study dates
19 Feb 2020to 30 Jun 2027
Phase
Phase 2

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

  • Previously untreated therapy-related AML or AML with myelodysplastic related changes as described by World Health Organization (WHO) 2016
  • AML arising in MDS (including CMML) or MDS/MPN syndrome
  • AML with MDS-related cytogenetic abnormalities (Appendix A, metaphase FISH allowable as surrogate for cytogenetics)
  • AML with multi-lineage dysplasia involving the presence of 50% or more dysplastic cells in at least two cell lines and in the absence of mutation in NPM1 or biallelic CEBPA (as per WHO 2016)
  • Adults 18 years of age or older
  • ECOG performance status 0 to 2
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  • Adequate organ function as defined as:
  • Left Ventricular Ejection Fraction (LVEF) > 50%
  • Serum total bilirubin < 2.0 mg/dL, unless considered due to Gilbert's disease or leukemic involvement
  • AST, ALT and alkaline phosphatase < 3 times the upper limit of normal, unless considered due to leukemic involvement
  • Serum creatinine < 2.0 mg/dL, or creatinine clearance > 40 mL/min based on Cockcroft-Gault GFR
  • Absence of unstable cardiac disease defined as myocardial infarction within 6 months, uncontrolled heart failure, or uncontrolled cardiac arrhythmia
  • Ability to understand and the willingness to sign a written informed consent or subject's legally authorize representative (LAR) has provided informed consent prior to any study-specific activities/procedures being initiated when the subject has any kind of condition that, in the opinion of the investigator, may compromise the ability of the subject to give written informed consent
  • Women of child-bearing potential and men with partners of child-bearing potential must agree to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication
  • A woman of child-bearing potential is any female (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
  • Has not undergone a hysterectomy or bilateral oophorectomy; or
  • Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)
  • Women of child-bearing potential has negative pregnancy test within 72 hours of initiating study drug dosing
  • Male subjects must agree to use a latex condom during sexual contact with females of childbearing potential even if they have had a successful vasectomy starting with the first dose of study therapy through 120 days after the last dose of study therapy
  • Leukapheresis, corticosteroid and hydroxyurea are permitted as initial management of hyperleukocytosis at the investigator's discretion for up to 7 days after starting study therapy. Hyperleukocytosis is defined as greater than 30k WBC. When possible, a bone marrow biopsy for screening should be performed prior to the initiation hyperleukocytosis

Who cannot join

  • Prior treatment with Glasdegib or CPX-351
  • Previously treated AML except for initial management of hyperleukocytosis. Treatment with hypomethylating therapy for MDS is allowable but not since their diagnosis of AML. No prior treatment with cytarabine or daunorubicin are allowed
  • Concurrent FLT3 mutation that the treating physician deems necessary to treat with midostaurin, whereas patients with FLT3-mutated AML not treated with midostaurin can be enrolled. Patients with known Core Binding Factor -t(8;21), inv(16), t(16;16) are allowed for study participation at the treating investigator's discretion
  • Active CNS or testicular involvement by leukemia; diagnostic lumbar puncture is not required
  • History of neurologic disorder including but not limited to: prior seizure, epilepsy, structural brain abnormality, benign brain tumor, stroke, brain injuries, dementia, movement disorder or other significant CNS abnormalities
  • Baseline QT corrected interval based on Fridericia's formula (QTcF) interval > 450 ms
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  • Acute coronary syndrome in the past 12 months, NYHA class III or VI
  • Known history of Wilson's disease or other copper handling disorder
  • History of GI malabsorptive disease
  • Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy
  • Known HIV infection
  • Active hepatitis B or hepatitis C infection (patients who successfully completed curative hepatitis C therapy can be enrolled)
  • Any uncontrolled infection, active bacterial or viral infection manifesting as fevers or hemodynamic instability within the past 72 hours
  • Proven active invasive fungal infection
  • Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment
  • Severe or uncontrolled medical disorder that would, in the investigator's opinion, impair ability to receive study treatment (i.e., uncontrolled diabetes, chronic renal disease, chronic pulmonary disease or active, uncontrolled infection, psychiatric illness/social situations that would limit compliance with study requirements
  • Current or anticipated use of other investigational agents
  • For patients with prior anthracycline exposure, the cumulative life-time dose should not exceed 386mg/m2 at the time of study entry (to convert different anthracycline to daunorubicin-equivalent, see Appendix H for conversion factors)

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • University of California, Los Angeles

    Los Angeles, California, 90095

  • Chao Family Comprehensive Cancer Center, University of California, Irvine

    Orange, California, 92868

  • University of California, Davis

    Sacramento, California, 95817

  • University of California, San Francisco

    San Francisco, California, 94143

Other trials in United States

About this study

Official title: Phase II Study of the Combination of CPX-351 and Glasdegib in Previously Untreated Patients With Acute Myelogenous Leukemia With MDS Related Changes or Therapy-related Acute Myeloid Leukemia

This is a phase 2 single-arm, open-label clinical trial determining efficacy of CPX-351 in combination with Glasdegib in subjects with Acute Myelogenous Leukemia with myelodysplastic syndrome related changes or therapy-related acute myeloid leukemia.

Being tested
Glasdegib, CPX-351
Keywords
Therapy-Related AML, AML with MDS related changes
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.

  • GlasdegibDrug

    Also called DAURISMO™

    Given PO

  • CPX-351Drug

    Also called Daunorubicin and cytarabine, VYXEOS®

    Given IV

Study groups in NCT04231851
Study groupRoleWhat they receive
CPX-351 and GlasdegibExperimentalIn Induction, subjects receive 44mg/m2/100mg/m2 IV on days 1, 3 and 5 and Glasdegib 100mg PO daily on days 6 to 28. If re-induction is needed: Subjects receive 44mg/m2/100mg/m2 IV on days 1 and 3 and Glasdegib 100mg PO daily on days 4 to 28. In consolidation: Subjects receive 29mg/m2/65mg/m2 IV on days 1 and 3 and Glasdegib 100mg PO daily on days 4 to 28. If maintenance is required, Subjects receive Glasdegib 100mg PO daily for up to one year
Receives: Drug: Glasdegib; Drug: CPX-351

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With Event-Free Survival at 6 Months

    This is defined as the percentage of subjects with event-free survival (EFS) at 6 months. EFS is defined as the number of months where patients are in a remission state.

    Measured: 6 months

Secondary outcomes (6)
  1. Number of Participants With Grade 3-5 Adverse Events

    To evaluate the tolerability of administering CPX-351 in combination with glasdegib in patients with newly diagnosed with Acute Myeloid Leukemia (AML) with Myelodysplastic Syndrome (MDS) related changes or treatment-related AML from the start of treatment, duration of treatment and up to 4 weeks after completion of study treatment. Toxicity and adverse events are based on the CTCAE (NCI Common Terminology Criteria for Adverse Events) Version 5.0.

    Measured: From the start date of treatment until 4 weeks after removal of treatment due to disease progression, toxicity, delay of treatment, or withdrawal of treatment, whichever came first, an average of 1 year.

  2. Overall Response Rate

    To assess the overall response rate to the combination of CPX-351 and glasdegib Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions. The overall response rate (ORR) is defined as the rate of complete remissions (CR) and complete remission with incomplete count recovery (CRi). ORR = CR + CRi

    Measured: From the start date of treatment until first date of CR/CRi or an average of 1 year.

  3. Durability of Response

    Durability of response is measured by relapse-free survival (RFS). RFS is defined as the amount of time a patient remains in remission after having achieved a CR or CRi

    Measured: From the start date of treatment until first date of CR/CRi for up to 709 days.

  4. Overall Survival of Patients Who Received the Combination of CPX-351 and Glasdegib

    To evaluate the overall survival of patients with newly diagnosed with Acute Myeloid Leukemia (AML) with Myelodysplastic Syndrome (MDS) related changes or treatment-related AML.

    Measured: Time from screening biopsy until the last patient is enrolled or until death from any cause, for up to 25.7 months.

  5. Time to Normal Hematopoiesis as Assessed by Laboratory Studies

    To evaluate the time to normal hematopoiesis, process by which blood cells are formed, as determined by laboratory studies inclusive of complete blood counts (CBCs)

    Measured: From the start date of treatment until laboratory studies confirmation of normal hematopoiesis or an average of 1 year

  6. Number of Participants Who go on to Receive an Allogenic Hematopoietic Stem Cell Transplant

    This is defined as the number of participants who continue on to receive an allogenic hematopoietic stem cell transplant after induction, re-induction, or consolidation.

    Measured: Up to 3 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jan 2020
  2. Study start19 Feb 2020
  3. Primary completion30 Jun 2024
  4. Study completion30 Jun 2027 (estimated)

Resources

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04231851
Sponsor's protocol ID
20195533
Other IDs
UCI 18-105, UCHMC1913
Status last verified
Oct 2025
First submitted
14 Jan 2020
Last updated
16 Jul 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

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