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NOT YET RECRUITING
NCT07454226
NA

ABL/JAK Inhibitors With Chemotherapy and Venetoclax for Ph-like ALL

Sponsor: Institute of Hematology & Blood Diseases Hospital, China

View on ClinicalTrials.gov

Summary

This open-label, non-randomized, single-arm, phase II exploratory study aims to evaluate the efficacy and safety of combining pathway-specific tyrosine kinase inhibitors with chemotherapy and venetoclax in patients with newly diagnosed Ph-like acute lymphoblastic leukemia (ALL). Patients are stratified by genetic alteration: those with ABL class fusions (ABL1, ABL2, PDGFRA, PDGFRB) receive olverembatinib, while those with JAK pathway alterations (CRLF2 rearrangement, JAK mutation/fusion, EPOR fusion, SH2B3 deletion, IL7R mutation) receive ruxolitinib. Both groups undergo sequential induction, consolidation, intensification, and maintenance therapy as per protocol. The primary endpoint is the rate of flow cytometry minimal residual disease (MRD)-negative complete remission (CR MRD-) at 3 months after induction therapy. Secondary endpoints include overall complete remission rate, NGS MRD-negative CR rate at 3 months, overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), cumulative incidence of relapse, and 60-day mortality.

Official title: An Open-Label, Single-Arm, Phase II Exploratory Study of ABL and JAK Kinase Inhibitors With Chemotherapy and Venetoclax in Adult Patients With Ph-like ALL

Key Details

Gender

All

Age Range

14 Years - 60 Years

Study Type

INTERVENTIONAL

Enrollment

30

Start Date

2026-03-01

Completion Date

2030-03-01

Last Updated

2026-03-06

Healthy Volunteers

No

Interventions

DRUG

Olverembatinib

Third-generation TKI targeting ABL class fusions. 40 mg every other day, continuous throughout all phases except during HD-MTX.

DRUG

Ruxolitinib

JAK1/2 inhibitor targeting JAK pathway alterations. 100 mg twice daily during CAMVT consolidation and maintenance.

DRUG

Venetoclax

BCL-2 inhibitor. Escalating doses (100→200→400 mg) during induction; 400 mg during maintenance VP cycles.

DRUG

Chemotherapy Regimen

Multi-agent chemotherapy including vincristine, prednisone, daunorubicin, cyclophosphamide, pegaspargase, cytarabine, 6-MP, MTX, and dexamethasone per protocol phases.

DRUG

Blinatumomab

Optional CD19-directed BiTE antibody. 28-day continuous infusions alternating with chemotherapy.

PROCEDURE

CAR-T Cell Therapy

Optional cellular immunotherapy preceded by fludarabine/cyclophosphamide lymphodepletion.

PROCEDURE

Allogeneic HSCT

Stem cell transplantation for eligible patients in first complete remission.