HEC73543 Versus Salvage Chemotherapy in R/R FLT3-ITD AML

Sunshine Lake Pharma

Status and phase: Enrolling; Phase 3

Conditions: Leukemia, Acute Myeloid (AML)

Treatments: Drug: LoDAC; Drug: Clifutinib; Drug: Azacitidine; Drug: FLAG-IDA; Drug: Ara-C±IDA; Drug: Decitabine

Study type: Interventional

Funder types: Industry

Identifiers

NCT05586074

HEC73543-AML-301

Details and patient eligibility

About

A randomized，multicenter, open-label Phase III, clinical study is conducted to evaluate the clinical benefit Clifutinib in Chinese patients with relapsed/ refractory (R/R) FLT3-mutated AML as shown with overall survival compared to salvage chemotherapy, and also to investigate the efficacy of Clifutinib as assessed by CR/CRh rate in these subjects.

Full description

Subjects who are at least 18 years and above at the time of signing informed consent may participate in this study. Subjects will be randomized in a 2:1 ratio to receive Clifutinib or salvage chemotherapy. Subjects will enter the screening period up to 28 days prior to the start of treatment. Prior to randomization, a salvage chemotherapy regimen will be pre-selected for each subjects; options will include low-dose cytarabine (LoDAC), azacitidine, decitabine, Ara-C±IDA or FLAG±IDA. The randomization will be stratified by response to first-line therapy and pre-selected salvage chemotherapy. Participants will be administered treatment over continuous 28-day cycles.

After treatment discontinuation, participants will have a end-of-treatment visit within 7 days after treatment discontinuation, followed by a 30-day follow-up for safety. After that, long term follow-up will be done every 90 days.

Enrollment: 324 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Subject is ≥ 18 years of age at the time of obtaining informed consent.
• Subject has a diagnosis of primary acute myeloid leukemia (AML) or AML secondary to myelodysplastic syndrome (MDS) according to WHO classification;
• Subject is refractory to or relapsed after first-line AML therapy (with or without hematopoietic stem cell transplant )
• Subject is positive for FLT3 mutation in bone marrow or whole blood as determined by the central lab
• Subject has an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
• Subject is eligible for pre-selected salvage chemotherapy at the investigator's discretion

Exclusion criteria

• Subject has received prior treatment with other FLT3 inhibitors
• Subject has AML that has relapsed after or is refractory to more than 1 line of therapy
• Subject has an active uncontrolled infection
• Subject is known to have human immunodeficiency virus infection
• Subject has any condition which, in the investigator's opinion, makes the subject unsuitable for study participation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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324 participants in 2 patient groups

Clifutinib

Experimental group

Description:

Subjects received 40 mg dose orally once a day in continuous 28-day cycles, at least 2 hours before and after food. Clifutinib treatment continued until sujects met one of the treatment discontinuation criteria.

Treatment:

Drug: Clifutinib

Salvage Chemotherapy

Active Comparator group

Description:

Subjects received chemotherapy in 28-day cycles. Subjects on Low-Dose Cytarabine (LoDAC) received 10 mg of cytarabine twice daily by subcutaneous (SC) or intravenous (IV) injection for 10\~14 days. Subjects on azacitidine received 75 mg/m\^2 daily by SC for 7 days. Subjects on decitabine received 20 mg/m\^2 daily by IV injection for 5 days. Subjects on LoDAC or azacitidine or decitabine treatment continued until they met discontinuation criteria. Subjects on Ara-C±IDA chemotherapy received cytarabine 1\~3 g/m\^2 daily by IV for 3 days and idarubicin 10 mg/m\^2 daily by IV for 3 days. Participants on FLAG-IDA chemotherapy received G-CSF 300 μg/m\^2 daily by SC for 6 days (days 1-6), fludarabine 30 mg/m\^2 daily by IV for 5 days (days 2-6), cytarabine 1\~2 g/m\^2 daily by IV for 5 days (days 2-6) and idarubicin 10 mg/m\^2 daily by IV for 3 days (days 2-4). Subjects receiving Ara-C±IDA or FLAG-IDA received 1 cycle of therapy and were assessed for response on day 28+/-2 days.

Treatment:

Drug: Decitabine

Drug: FLAG-IDA

Drug: Ara-C±IDA

Drug: Azacitidine

Drug: LoDAC