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Acute Lymphoblastic LeukemiaPhase 2ABCNCT06220487

A Single-arm, Open-label Study of Olverembatinib, CD3/CD19 Bispecific T-cell Engager, and Chidamide in Patients With Newly Diagnosed Ph+ALL

A Phase 2 study testing Prednisone, Olverembatinib, Blinatumomab, Chidamide in people with Acute Lymphoblastic Leukemia and Philadelphia Chromosome, run by Nanfang Hospital, Southern Medical University at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

ABC study is a phase 2, single-arm, open-label study of Olverembatinib, CD3/CD19 Bispecific T-cell Engager, and Chidamide in patients with newly diagnosed Philadelphia Chromosome-positive acute lymphoblastic leukemia (Ph+ALL). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Prednisone, Olverembatinib, Blinatumomab, Chidamide
Could I receive a placebo?
No, everyone receives an active treatment
How many people
67 participants
Where
1 siteChina
Study dates
1 Feb 2024to 1 Jan 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

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

  • Signed written informed consent;
  • Newly diagnosed adult B-precursor Ph+ ALL;
  • Age greater or equal to 18 years;
  • ECOG Performance Status 0-1;
  • Ineligible for allo-HSCT.
  • Renal and hepatic function as defined below:
Show all 12Show fewer
  • AST (GOT), ALT (GPT), and AP <2 x upper limit of normal (ULN). Creatinine clearance equal or greater than 50 mL/min.
  • Pancreatic function as defined below:
  • Serum amylase less or equal to 1.5 x ULN Serum lipase less or equal to1.5 x ULN
  • Normal cardiac function;
  • Negative HIV test, negative HBV DNA and HCV RNA;
  • Negative pregnancy test in women of childbearing potential.

Who cannot join

  • History of receiving systemic chemotherapy or CAR-T therapy for ALL.
  • Impaired cardiac function, including any one of the following:
  • .LVEF <45% as determined by MUGA scan or echocardiogram. .Complete left bundle branch block. .Use of a cardiac pacemaker.
  • ST depression of >1mm in 2 or more leads and/or T wave inversions in 2 or more contiguous leads. .Congenital long QT syndrome. .History of or presence of significant ventricular or atrial arrhythmia. .Clinically significant resting bradycardia (<50 beats per minute). .QTc >450 msec on screening ECG (using the QTcF formula). .Right bundle branch block plus left anterior hemiblock, bifascicular block. .Myocardial infarction within 3 months prior to starting olverembatinib . .Angina pectoris.
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of olverembatinib or chidamide (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection). .History of or current autoimmune disease. .History of or current relevant CNS pathology. .Presence of CNS leukemia. .History of or current autoimmune disease. .History of other malignancies. .Presence active infection.
  • Nursing women or women of childbearing potential not willing to use an effective form of contraception during participation in the study and at least 3 months thereafter or male patients not willing to ensure effective contraception during participation in the study and at least three months thereafter.
  • Not eigiable for this study, decided by PI

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Hongsheng Zhou, M.D; Ph.D contact

+862062787349

hanson_tcm@hotmail.com

China1 site, 1 recruiting
  • Dept of Hematology, Nanfang Hospital, Southern Medical University

    Guangzhou, Guangdong, 510515

    Zhixiang Wang, Dr., +862062787349, nuannuan.66@163.com

    Recruiting

Other trials in China

About this study

Official title: A Single-arm, Open-label Study of Olverembatinib, CD3/CD19 Bispecific T-cell Engager, and Chidamide in Patients With Newly Diagnosed Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia

ABC study is a phase 2, single-arm, open-label study of Olverembatinib, CD3/CD19 Bispecific T-cell Engager, and Chidamide in patients with newly diagnosed Philadelphia Chromosome-positive acute lymphoblastic leukemia (Ph+ALL). This study combined third generation TKI (Olverembatinib), histone deacetylase inhibitors (Chidamide) and CD3/CD19 bispecific T-cell engager (Blinatumomab) as first line regimen (ABC regimen) for Ph+ ALL. Investigatorsaim to explore the efficacy and safety of ABC regimen. The primary endpoint is the complete molecular remission (CMR) at 3 months, secondary endpoints are overall survival (OS), event-free survival (EFS), adverse event (AE), IKZF1del, IKZF1plus, IKZF1lpus/CD20 subgroup EFS/OS.

Read the detailed description

Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) is now a relatively favorable-risk leukemia with the development of potent BCR::ABL1 tyrosine kinase inhibitors (TKIs). Achievement of an early and deep complete molecular remission (CMR) is an important end point in Ph+ ALL and identifies patients who may not need allogeneic hematopoietic stem cell transplantation (allo-HSCT). The chemotherapy-free D-ALBA trial of dasatinib and blinatumomab was safe and effective in patients with newly diagnosed Ph-positive ALL and resulted in an estimated 3-year OS rate of 80% (NEJM 2020, 2022). To further improve the outcomes, the potent third-generation TKIs, ponatinib and olverembatinib (ASH 2023, abs 1504), were added to chemotherapy or immunotherapy, resulted in an overall CMR rate of 84%-90%, a 5-year survival rate of 73%, most patients did not undergo allo-HSCT.

Of note, IKZF1plus subgroup still stands for high-risk for Ph+ALL and exhibit poor outcome even in TKI plus blinatumomab, which indicate IKZF1del confers resistance to immunotherapy. our previous study found that HDACi tucidinostat/chidamide could restore the expression and functionality of IKZF1 in IKZF1del samples, including increased expression of CD19 and reduced focal adhesion (Blood (2021) 138 (Supplement 1): 514.).

ABC study is a phase 2, single-arm, open-label study of Olverembatinib, CD3/CD19 Bispecific T-cell Engager, and Chidamide in patients with newly diagnosed Philadelphia Chromosome-positive acute lymphoblastic leukemia (Ph+ALL). This study combined third generation TKI (Olverembatinib), histone deacetylase inhibitors (Chidamide) and CD3/CD19 bispecific T-cell engager (Blinatumomab) as first line regimen (ABC regimen) for Ph+ ALL. Investigators aim to explore the efficacy and safety of ABC regimen. The primary endpoint is the complete molecular remission (CMR) at 3 months, secondary endpoints are overall survival (OS), event-free survival (EFS), adverse event (AE), IKZF1del, IKZF1plus, IKZF1lpus/CD20 subgroup EFS/OS.

Being tested
Prednisone, Olverembatinib, Blinatumomab, Chidamide
Keywords
Olverembatinib, CD3/CD19 Bispecific T-cell Engager, Histone Deacetylase Inhibitor, Chidamide, Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia, Acute Lymphoblastic Leukemia, Ph-positive
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma, Philadelphia Chromosome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Prednisone, Olverembatinib, Blinatumomab, ChidamideDrug

    Phase One. Induction Consolidation, for 1 year. 1.1 Pretreatment ×1 cycle. Prednisone,1mg/kg/d, from day 1 to 14;

    1.2 Induction Therapy × 1 cycle. A: OlverembAtinib (at a dose of 40 mg Qod), from day 8 to 42. B: Blinatumomab (at a dose of 28 μg per day), from day 15 to 28. C: Chidamide (at a dose of 10 mg Qod), from day 9 to 41.

    1.3 Consolidation Block × 5 cycles. A: Olverembatinib (at a dose of 40 mg Qod) was administered from day 1 to 42. B: Blinatumomab (at a dose of 28 μg perday) was administered from day 1 to 14. C: Chidamide (at a dose of 10 mg Qod) was administered from day 14 to 41.

    Phase Two. Maintenance Therapy, for 3 years. 2.1 A: Olverembatinib (at a dose of 40 mg Qod) was administered from day 1 to 42.

    C: Chidamide (at a dose of 10 mg Qod) was administered from day 14 to 41.

    Phase Three. Follow-up, for 5 years.

Study groups in NCT06220487
Study groupRoleWhat they receive
ABC protocolExperimentalAdult patients with Ph-positive ALL eligble for this study will begin treatment with ABC protocol, as (A) olverembAtinib, (B) Blinatumomab and (C) Chidamide after pre-treatment with glucocorticoid, including induction and consolidation therapy for one year, and subsequent maintenance therapy for three years.
Receives: Drug: Prednisone, Olverembatinib, Blinatumomab, Chidamide

What is being measured

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

  1. Complete Molecular Response (CMR)

    CMR was defined as the absence of a detectable BCR::ABL1 transcript with a sensitivity of 0.01%.

    Measured: at 3 months

Secondary outcomes (9)
  1. Overall survival (OS)

    OS was measured from time of study entry to the time of death or last follow-up

    Measured: at 3 and 5 years

  2. Event-free survival (EFS)

    EFS was measured from complete remission to the time of relapse or death

    Measured: at 3 and 5 years

  3. Adverse Events

    Measured: at 1, 3 and 5 years

  4. Event-free survival (EFS) of IKZF1del subgroup

    Measured: at 3 and 5 years

  5. Overall survival (OS) of IKZF1del subgroup

    Measured: at 3 and 5 years

  6. Event-free survival (EFS) of IKZF1plus subgroup

    Measured: at 3 and 5 years

  7. Overall survival (OS) of IKZF1plus subgroup

    Measured: at 3 and 5 years

  8. Event-free survival (EFS) of IKZF1plus/CD20 subgroup

    Measured: at 3 and 5 years

  9. Overall survival (OS) of IKZF1plus/CD20 subgroup

    Measured: at 3 and 5 years

Timeline

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

  1. First posted24 Jan 2024
  2. Study start1 Feb 2024 (estimated)
  3. Primary completion31 Dec 2025 (estimated)
  4. Study completion1 Jan 2028 (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
67 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06220487
Sponsor's protocol ID
NFEC-2023-441
Acronym
ABC
Status last verified
Jan 2024
First submitted
3 Dec 2023
Last updated
24 Jan 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Foa R, Bassan R, Vitale A, Elia L, Piciocchi A, Puzzolo MC, Canichella M, Viero P, Ferrara F, Lunghi M, Fabbiano F, Bonifacio M, Fracchiolla N, Di Bartolomeo P, Mancino A, De Propris MS, Vignetti M, Guarini A, Rambaldi A, Chiaretti S; GIMEMA Investigators. Dasatinib-Blinatumomab for Ph-Positive Acute Lymphoblastic Leukemia in Adults. N Engl J Med. 2020 Oct 22;383(17):1613-1623. doi: 10.1056/NEJMoa2016272.

    PubMed 33085860
  • Jabbour E, Short NJ, Jain N, Huang X, Montalban-Bravo G, Banerjee P, Rezvani K, Jiang X, Kim KH, Kanagal-Shamanna R, Khoury JD, Patel K, Kadia TM, Daver N, Chien K, Alvarado Y, Garcia-Manero G, Issa GC, Haddad FG, Kwari M, Thankachan J, Delumpa R, Macaron W, Garris R, Konopleva M, Ravandi F, Kantarjian H. Ponatinib and blinatumomab for Philadelphia chromosome-positive acute lymphoblastic leukaemia: a US, single-centre, single-arm, phase 2 trial. Lancet Haematol. 2023 Jan;10(1):e24-e34. doi: 10.1016/S2352-3026(22)00319-2. Epub 2022 Nov 16.

    PubMed 36402146

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Prednisone, Olverembatinib, Blinatumomab, Chidamide in people with Acute Lymphoblastic Leukemia and Philadelphia Chromosome, run by Nanfang Hospital, Southern Medical University at 1 site in China.

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 12 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 24 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hongsheng Zhou, M.D; Ph.D (+862062787349, hanson_tcm@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Complete Molecular Response (CMR) (time frame: at 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06220487, which also lists 2 linked publications.

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 24 Jan 2024.

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