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Homoharringtonine, Lisaftoclax, and Azacitidine for AML After Venetoclax-Based Therapy Failure
Sponsor: Guangdong Second Provincial General Hospital
Summary
Venetoclax (Ven) resistance is common in the treatment of acute myeloid leukemia (AML). Patients with Ven resistance have poor response and survival, except those with specific targeted therapy. Whether we could use new BCL-2 inhibitors to replace Ven and combine with the agents which have been shown to enhance the antilekeumia effect of BCL-2 inhibitors, to overcome Ven resistance? This is unknown up until now. This multi-center, prospective, open-label, single-arm study will evaluate the efficacy and safety of homoharringtonine combined with lisaftoclax and azacitidine (HLA) as salvage therapy for adults with AML after failure of a Ven-containing regimen. Ven treatment failure is defined as no response after at least two consecutive cycles of a Ven-containing regimen or relapse during continued, protocol-compliant Ven-based therapy after a prior response. The study plans to enroll 73 participants. The primary endpoint is the overall response rate after two treatment cycles. Secondary endpoints include complete remission (CR), CR with incomplete blood count recovery (CRi), measurable residual disease (MRD) negativity, survival and relapse, and treatment-related adverse events.
Official title: A Multi-Center, Prospective, Open-Label, Single-Arm Study of Homoharringtonine Combined With Lisaftoclax and Azacitidine in Patients With Acute Myeloid Leukemia After Failure of Venetoclax-Based Therapy
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
73
Start Date
2026-09-01
Completion Date
2028-08-31
Last Updated
2026-09-10
Healthy Volunteers
No
Conditions
Interventions
Lisaftoclax (APG-2575)
Lisaftoclax will be administered orally on Days 1-14 of each 28-day cycle: 200 mg on Day 1, 400 mg on Day 2, and 600 mg once daily on Days 3-14. If concomitant use of a CYP3A4 inhibitor is required, the protocol specifies a reduced lisaftoclax dose of 200-400 mg/day according to the instruction.
homoharringtonine
Homoharringtonine will be administered at 1 mg/m\^2 by intravenous infusion once daily on Days 1-7 of each 28-day cycle.
Azacitidine (AZA)
Azacitidine will be administered at 75 mg/m\^2 by subcutaneous injection once daily on Days 1-7 of each 28-day cycle.
Locations (1)
Guangdong Second Provincial General Hospital
Guangzhou, Guangdong, China