A Study of Revumenib in Combination With Intensive Chemotherapy in Participants With Acute Myeloid Leukemias

Syndax Pharmaceuticals

Status and phase: Active, not recruiting; Phase 1

Conditions: Acute Myeloid Leukemias

Treatments: Drug: Chemotherapy Regimen; Drug: Revumenib; Drug: HiDAC

Study type: Interventional

Funder types: Industry

Identifiers

NCT06226571

SNDX-5613-0708

2024-514531-18-00 (EU Trial (CTIS) Number)

Details and patient eligibility

About

The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics, and clinical activity of revumenib in combination with intensive chemotherapy in participants with newly diagnosed acute myeloid leukemia (AML) harboring alterations in KMT2A, NPM1, or NUP98 genes.

Full description

The Dose Escalation portion of this study will identify the maximum tolerated dose, or if different, the recommended Phase 2 dose of revumenib to be used in combination with intensive chemotherapy and in maintenance monotherapy following intensive chemotherapy in participants with newly diagnosed AML harboring alterations in KMT2A, NPM1, or NUP98 genes.

In the Dose Expansion portion of the study, safety and preliminary efficacy of revumenib may be explored in expansion cohorts at tolerated dose levels.

In both Dose Escalation and Dose Expansion, the treatment period will consist of an induction phase (up to 2 cycles), a consolidation phase (up to 4 cycles and could include hematopoietic stem cell transplant for participants who are transplant eligible and have an available donor), and a maintenance monotherapy phase with revumenib. The cycle duration will be 28 days.

Enrollment: 96 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Established, pathologically confirmed diagnosis of AML by World Health Organization 2022 criteria.
• Newly diagnosed and previously untreated AML and eligible to receive intensive chemotherapy.
• KMT2Ar, NPM1m, or NUP98r mutations identified by local laboratory prior to the first dose of revumenib.
• Eastern Cooperative Oncology Group performance status ≤2 and ≤1 if >65 years old.
• Adequate liver, kidney, and cardiac function.

Exclusion criteria

• Diagnosis of acute promyelocytic leukemia.
• Clinically active central nervous system leukemia (blasts detected in cerebrospinal fluid, radiographic or clinical signs and symptoms).
• Fridericia's corrected QT interval (QTcF) >450 milliseconds (average of triplicate), diagnosis or suspicion of Long QT syndrome or family history of Long QT syndrome.
• Any gastrointestinal issue of the upper gastrointestinal tract that might affect oral drug absorption or ingestion.
• Cirrhosis with a Child-Pugh score of B or C.
• Any of the following within the 6 months prior to study entry: myocardial infarction, uncontrolled/unstable angina, congestive heart failure (New York Heart Association Classification Class ≥II), life-threatening, uncontrolled arrhythmia, cerebrovascular accident, or transient ischemic attack.
• Hepatitis B, Hepatitis C, or HIV-positive with detectable viral load.
• Documented active, uncontrolled infection.
• Uncontrolled disseminated intravascular coagulation.
• Lactating/breast feeding or pregnant.
• Use of prohibited concomitant chemotherapy, radiation therapy, or immunotherapy.
• Use of strong CYP3A4 inducers or inhibitors (except for Itraconazole, Ketoconazole, Posaconazole, or Voriconazole).

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Sequential Assignment

Masking: None (Open label)

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96 participants in 1 patient group

Revumenib

Experimental group

Description:

Dose Escalation: * Induction: Sequential cohorts of escalating dose levels of revumenib with chemotherapy regimen. * Consolidation: Cohorts will receive high-dose cytarabine (HiDAC) chemotherapy followed by revumenib. * Maintenance Monotherapy: Cohorts will receive revumenib Dose Expansion: * Induction: revumenib at tolerated dose level with chemotherapy regimen. * Consolidation: Cohorts will receive revumenib with chemotherapy regimen and HiDAC. * Maintenance Monotherapy: Cohorts will receive revumenib.

Treatment:

Drug: HiDAC

Drug: Revumenib

Drug: Chemotherapy Regimen