RecruitingRecruiting
Bleximenib in Combination With Standard Induction and Consolidation Therapy Followed by Maintenance for Treatment of Patients With Acute Myeloid Leukemia (AML)
NCT07223814 · Stichting Hemato-Oncologie voor Volwassenen Nederland
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Official title
Bleximenib or Placebo in Combination With Standard Induction and Consolidation Therapy Followed by Maintenance for the Treatment of Patients With Newly Diagnosed KMT2A-rearranged or NPM1-mutant Acute Myeloid Leukemia Eligible for Intensive Chemotherapy: a Double-blind Phase 3 Study
About this study
The current standard of care treatment for adult patients with acute myeloid leukemia (AML) consists of chemotherapy and, if indicated, donor stem cell transplantation.
Bleximenib blocks the interaction between a protein called menin and another protein called KMT2A in the leukemia cells. When this interaction is disrupted in AML with mutations in the NPM1 or KMT2A gene, bleximenib can cause leukemia cells to die.
The main objective is to assess if treatment with bleximenib, when added to chemotherapy treatment will improve treatment outcome in adult participants with newly diagnosed AML who present with mutations in the NPM1 or KMT2A genes.
This is a randomized, double-blind, placebo-controlled, phase 3 clinical trial. All of the participants will receive standard chemotherapy treatment, combined with either bleximenib or a placebo. A placebo is a substance that looks like the study medicine but has no active ingredients (e.g., a sugar pill). In a double blind trial neither the participant nor the doctor know if placebo or active study drug is given.
After the end of the protocol treatment there will be an observational follow-up of 4 years from the time of inclusion of the last patient. The results of the different treatment groups will be compared.
875 previously untreated patients with AML with a specific change in the DNA of the leukemia cells (a KMT2A rearrangement or a NPM1 mutation) will be included. Participants must be 18 years or older and considered eligible for intensive chemotherapy.
Eligibility criteria
Inclusion Criteria:
1. ≥18 years of age (or the legal age of majority in the jurisdiction in which the study is taking place, whichever is greater) at the time of informed consent.
2. New diagnosis of AML (≥10% blasts in BM or peripheral blood) with mutated NPM1 or with recurring rearrangements involving KMT2A according to ICC 2022 criteria.
3. Considered eligible for intensive chemotherapy.
4. WHO/ECOG performance status ≤2.
5. Adequate renal and hepatic functions prior to randomization.
Exclusion Criteria:
1. Prior (chemo-)therapy for AML, including prior treatment with hypomethylating agents
2. Known active leukemic involvement of the central nervous system (CNS).
3. Recipient of solid organ transplant.
4. Cardiac disease:
1. Any of the following within 6 months of randomization: myocardial infarction, uncontrolled/unstable angina, congestive heart failure (NYHA Class III or IV), uncontrolled or symptomatic arrhythmias, stroke, or transient ischemic attack.
2. QTc interval using Fridericia's formula (QTcF) ≥470 ms. Prolonged QTc interval associated with bundle branch block or pacemaking is permitted.
3. Left ventricular ejection fraction (LVEF) \<40% by ECHO or MUGA scan obtained within 28 days prior to the start of study treatment.
4. Previously received cumulative dose of any combination of anthracyclines or anthracenediones of ≥500 mg/m2.
5. Chronic respiratory disease requiring supplemental oxygen.
Study design
Enrollment target: 875 participants
Allocation: randomized
Masking: double
Age groups: adult, older_adult
Timeline
Starts: 2026-03-01
Estimated completion: 2033-12
Last updated: 2026-09-01
Interventions
Drug: BleximenibDrug: CytarabineDrug: Daunorubicin or IdarubicinDrug: Placebo
Primary outcomes
- • Event-Free Survival (EFS) in adult patients with newly diagnosed NPM1m or KMT2Ar AML eligible for intensive chemotherapy (Up to 4 years and 5 months)
Sponsor
Stichting Hemato-Oncologie voor Volwassenen Nederland · other
With: German-Austrian Acute Myeloid Leukemia Study Group
Contacts & investigators
ContactM.H.G.P. Raaijmakers · contact · m.h.g.raaijmakers@erasmusmc.nl · 010 7033740
InvestigatorM.H.G.P. Raaijmakers · principal_investigator, Erasmus Medical Center
All locations (82)
US-Los Angeles CA-UCLARecruiting
Los Angeles, California, United States
US-San Francisco CA-UCSFRecruiting
San Francisco, California, United States
US-Orlando FL-ORLANDOHEALTHRecruiting
Orlando, Florida, United States
US-Atlanta GA-EMORYRecruiting
Atlanta, Georgia, United States
US-Chigago IL-UHCHICAGORecruiting
Chicago, Illinois, United States
US-Kansas City KS-KUMCRecruiting
Kansas City, Kansas, United States
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Baltimore, Maryland, United States
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St Louis, Missouri, United States
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Cincinnati, Ohio, United States
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Columbus, Ohio, United States
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Pittsburgh, Pennsylvania, United States
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Adelaide, Australia
AU-Adelaide-RAHRecruiting
Adelaide, Australia
AU-Birtinya-SUNSHINECOASTRecruiting
Birtinya, Australia
AU-Brisbane-PAHRecruiting
Brisbane, Australia
AU-Brisbane-RBWHRecruiting
Brisbane, Australia
AU-Camperdown-RPARecruiting
Camperdown, Australia
AU-Melbourne-AUSTINRecruiting
Melbourne, Australia
AU-Melbourne-MONASHRecruiting
Melbourne, Australia
AU-Melbourne-PMCCRecruiting
Melbourne, Australia
AU-Sydney-WSAHRecruiting
Sydney, Australia
AT-Linz-ORDENSKLINIKUMRecruiting
Linz, Austria
BE-Antwerpen-UZARecruiting
Antwerp, Belgium
BE-Antwerpen-ZASRecruiting
Antwerp, Belgium
BE-Brugge-AZBRUGGERecruiting
Bruges, Belgium
BE-Brussel-BORDETRecruiting
Brussels, Belgium
BE-Bruxelles-STLUCRecruiting
Brussels, Belgium
Be-Charleroi-GHDCRecruiting
Charleroi, Belgium
BE-Geel-STDIMPNARecruiting
Geel, Belgium
BE-Gent-UZGENTRecruiting
Ghent, Belgium
BE-Hasselt-VIRGAJESSE (Jessa Ziekenhuis)Recruiting
Hasselt, Belgium
BE-Haine-Saint-Paul-JOLIMONTRecruiting
Jolimont, Belgium
BE-Leuven-UZLEUVENRecruiting
Leuven, Belgium
BE-Liege-CHULIEGERecruiting
Liège, Belgium
BE-Liege-MONTLEGIARecruiting
Liège, Belgium
BE-Yvoir-MONTGODINNERecruiting
Yvoir, Belgium
EE-Tallinn-REGIONAALHAIGLARecruiting
Tallinn, Estonia
EE-Tartu-TARTURecruiting
Tartu, Estonia
FI-Helsinki-HUSRecruiting
Helsinki, Finland
FI-Kuopio-KYSRecruiting
Kuopio, Finland
FI-Oulu-OYSRecruiting
Oulu, Finland
FI-Tampere-TAYSRecruiting
Tampere, Finland
DE-Aachen-UKAACHENRecruiting
Aachen, Germany
DE-Bochum-RUBRecruiting
Bochum, Germany
DE-Bonn-UNIBONNRecruiting
Bonn, Germany
DE-Greifswald-UNIGREIFSWALDRecruiting
Greifswald, Germany
DE-Halle-UMHRecruiting
Halle, Germany
DE-Hannover-MHHANNOVERRecruiting
Hanover, Germany
DE-Heilbronn-SLKRecruiting
Heilbronn, Germany
DE-Karlsruhe-KLINIKUMKARLSRUHERecruiting
Karlsruhe, Germany
DE-Oldenburg-KLINIKUMOLDENBURGRecruiting
Oldenburg, Germany
DE-Passau-KLINIKUMPASSAURecruiting
Passau, Germany
DE-Rostock-MUROSTOCKRecruiting
Rostock, Germany
DE-Ulm-UNIKLINKULMRecruiting
Ulm, Germany
JP-Chuo-Ku-CHIBARecruiting
Chūōku, Japan
JP-Maebashi-Shi-GUNMARecruiting
Maebashi, Japan
JP-Nagasaki Shi-NAGASAKIRecruiting
Nagasaki, Japan
JP-Nishi-Gun-YAMAGATARecruiting
Yamagata, Japan
JP-Yoshida-Gun-FUKUIRecruiting
Yoshida, Japan
NL-Amersfoort-MEANDERMCRecruiting
Amersfoort, Netherlands
NL-Amsterdam-AMSTERDAMUMCRecruiting
Amsterdam, Netherlands
NL-Amsterdam-OLVGRecruiting
Amsterdam, Netherlands
NL-Arnhem-RIJNSTATERecruiting
Arnhem, Netherlands
NL-Breda-AMPHIARecruiting
Breda, Netherlands
NL-Dordrecht-ASZRecruiting
Dordrecht, Netherlands
NL-Eindhoven-MAXIMAMCRecruiting
Eindhoven, Netherlands
NL-Groningen-UMCGRecruiting
Groningen, Netherlands
NL-Leeuwarden-FRISIUSMCRecruiting
Leeuwarden, Netherlands
NL-Leiden-LUMCRecruiting
Leiden, Netherlands
NL-Maastricht-MUMCRecruiting
Maastricht, Netherlands
NL-Nieuwegein-ANTONIUSRecruiting
Nieuwegein, Netherlands
NL-Nijmegen-RADBOUDRecruiting
Nijmegen, Netherlands
NL-Rotterdam-ERASMUCMCRecruiting
Rotterdam, Netherlands
NL-Den Haag-HAGARecruiting
The Hague, Netherlands
NL-Zwolle-ISALARecruiting
Zwolle, Netherlands
ES-Palma-SSIBRecruiting
Palma de Mallorca, Spain
SE-Lund-SuhRecruiting
Lund, Sweden
CH-Bern-INSELRecruiting
Bern, Switzerland
CH-Fribourg-HFRRecruiting
Fribourg, Switzerland
CH-Geneve (14)-HCUGERecruiting
Geneva, Switzerland
CH-St. Gallen-KSSGRecruiting
Sankt Gallen, Switzerland
CH-Zürich-USZRecruiting
Zurich, Switzerland