Olutasidenib as Maintenance Therapy Treatment for IDH1 Mutant AML
This phase I trial tests the safety, side effects, feasibility and how well giving olutasidenib works as maintenance therapy treatment for patients with IDH1 mutation acute myeloid leukemia (AML). Olutasidenib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. This study may allow researchers to determine whether olutasidenib can help patients with IDH1-positive AML stay in remission longer after initial treatment.
Inclusion Criteria
- Histologically or cytologically confirmed non-acute promyelocytic IDH1 mutant AML. IDH1 mutation may be identified by next generation sequencing (NGS) or PCR based methods and identified at time of diagnosis or any other timepoint prior to enrollment
- Completed induction and/or consolidation intended as per treating physician to reach complete response (complete response [CR], complete response with partial hematologic recovery [CRh], or complete response with incomplete hematologic recovery [CRi]) or morphologic leukemia free state (MLFS) at time of study enrollment. Patients must be within 90 days of their last cycle of upfront therapy
- Age ≥ 18 years
- Calculated creatinine clearance (by Cockroft-Gault) ≥ 30 mL/min
- Total bilirubin ≤ 2 × upper limit of normal (ULN) * Note: patients with Gilbert’s syndrome may be included if total bilirubin is ≤ 3 × ULN and direct bilirubin is ≤ 2 × ULN
- Serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≤ 3 × ULN
- Eastern Cooperative Oncology Group (ECOG) 0, 1, or 2 or Karnofsky performance status (KPS) > 50%
- Able to take oral medications
- Women of childbearing potential must consent to effective contraception during study treatment and at least 6 months following the last dose. Effective methods of contraception include oral or injectable hormonal birth control, intrauterine device (IUD), and double--barrier methods. (ie, combination of male condom with either cap, diaphragm or sponge with spermicide)
- Male participants who are sexually active with a woman of childbearing potential and who have not had vasectomies must be willing to use a barrier method of contraception and refrain from sperm donation from initial study drug until 90 days after last dose of study drug
Exclusion Criteria
- History of hypersensitivity or allergic reaction to olutasidenib or its components
- Corrected QT interval (QTc) (Fredericia calculation) > 450 ms (after corrective action is taken)
- History of Torsades de Pointes
- Any gastrointestinal condition thought by the treating investigator to impair oral absorption of medication
- Stem cell transplant eligible and planned within 60 days of study start date in the opinion of the treating investigator
- Uncontrolled intercurrent illness or infection (those with controlled HIV, hepatitis, or other chronic infections are eligible)
- Female participants who are pregnant or intend to donate eggs during the study or for 6 months after receiving their last dose of study drug
- Nursing women, women of childbearing potential with positive pregnancy test, or women of childbearing potential who are not willing to maintain adequate contraception. (Appropriate method(s) of contraception include oral or injectable hormonal birth control, IUD, and double-barrier methods)
- Male participants who intend to donate sperm during the course of this study or for 3 months after last dose
- Participants receiving, or are expected to require during the study, any concomitant medications that may interfere with efficacy, metabolism, or safety of the investigational agent, including drugs known to cause QT prolongation. for which drug interactions with olutasidenib would be prohibitory
- Concurrent chemotherapy for non-AML malignancy that is expected to interfere with the efficacy, metabolism, or safety of the agent under investigation
- Received non-intensive upfront therapy including hypomethylating agent (HMA)/venetoclax based
- Currently receiving other targeted therapies or AML directed therapies, including but not limited to other IDH1 or IDH2 inhibitors, FLT3 inhibitors, BCL-2 inhibitors, menin inhibitors
- Other investigational agents in another clinical trial within 4 weeks prior to enrollment
- Systemic corticosteroids above physiologic replacement doses (10mg/day prednisone or equivalent), unless used to tread IDH differentiation syndrome or as part of a prespecified protocol exception
- Medical, psychological, or social condition that, in the opinion of the investigator, may increase the participant’s risk or limit the participant’s adherence with study requirements
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT07130695.
Locations matching your search criteria
United States
Virginia
Richmond
PRIMARY OBJECTIVES:
I. Assess the feasibility of olutasidenib after upfront AML therapy with intensive induction and/or consolidation in IDH1 mutant AML.
II. Assess the tolerability of olutasidenib after upfront AML therapy with intensive induction and/or consolidation in IDH1 mutant AML.
SECONDARY OBJECTIVES:
I. Measure progression free survival with preliminary comparisons to propensity matched historical controls treated at Massey Cancer Center with respect to age, upfront treatment regimen, and disease biology as per European Leukemia Network (ELN) 2022 classification.
II. Estimate overall survival, with preliminary comparisons to propensity matched historical controls treated at Massey Cancer Center with respect to age, upfront treatment regimen, and disease biology as per ELN 2022 classification.
III. Assess minimal residual disease (MRD) negativity rates by both polymerase chain reaction (PCR) based and flow cytometric methodologies.
IV. Estimate rates of ability to proceed with transplant given maintenance opportunities.
V. Characterize quality of life (QOL) metrics by short form (SF)-36.
OUTLINE:
Patients receive olutasidenib orally (PO) twice daily (BID) on days 1-28 of each cycle. Cycles repeat every 28 days for 2 years in the absence of disease progression, unacceptable toxicity or proceeding to stem cell transplantation. Patients undergo bone marrow biopsy and/or aspiration and blood sample collection throughout the study.
After completion of study treatment, patients are followed up for 2 years from registration.
Trial PhasePhase I
Trial Typetreatment
Lead OrganizationVCU Massey Comprehensive Cancer Center
Principal InvestigatorKeri Renee Maher
- Primary IDMCC-25-22096
- Secondary IDsNCI-2026-00868
- ClinicalTrials.gov IDNCT07130695