Liposomal Mitoxantrone Plus Azacitidine and Venetoclax in Newly Diagnosed Elderly or Unfit AML
Summary
This prospective, open-label, multicenter phase Ib trial will evaluate the safety, tolerability, and RP2D of the VAM regimen (liposomal mitoxantrone + azacitidine \[AZA\] + venetoclax \[VEN\]) in elderly or unfit patients with newly diagnosed AML. A standard 3+3 dose escalation will enroll 12-30 patients, testing liposomal mitoxantrone at 8, 12, 16, and 20 mg/m². VEN duration (9 vs. 14 days) will be determined at the 8 mg/m² dose level, after which only liposomal mitoxantrone will be escalated while AZA and VEN will remain fixed. Induction therapy will consist of up to two 28-day cycles. Responders achieving CR/CRi/MLFS will be eligible for up to 4 consolidation cycles (total ≤6 cycles), after which they will proceed to maintenance with either AZA+VEN or observation.
Timeline
- Start
- 2026-10-30
- Primary completion
- 2027-12-31
- Completion
- 2032-12-31
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Azacitidine | Other / unclassified | 75 mg/m2 | Subcutaneous |
| Subject | Mitoxantrone | Small molecule | 8 mg/m2 | Intravenous |
| Subject | Mitoxantrone | Small molecule | 12 mg/m2 | Intravenous |
| Subject | Mitoxantrone | Small molecule | 16 mg/m2 | Intravenous |
| Subject | Mitoxantrone | Small molecule | 20 mg/m2 | Intravenous |
| Subject | Venetoclax | Small molecule | 400 mg | Oral |