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Clinical Trials in Germany / NCT04385290
Recruiting Phase 1/2

Combination of Midostaurin and Gemtuzumab Ozogamicin in First-line Standard Therapy for Acute Myeloid Leukemia (MOSAIC)

NCT04385290 · tracked via the Priya Life Science Germany tracker
Phase
Phase 1/2
Started
2020-09-04
Last updated
2025-09-08

Condition(s) studied

Acute Myeloid Leukemia

Investigational drug(s) / intervention(s)

MODULE: conventional chemotherapy (Cytarabine+Daunorubicin) in combination with midostaurin+GOAll Daunorubicin trials (63) →All Midostaurin trials (5) →MAGNOLIA-trial: Midostaurin associated with conventional chemotherapy (AraC+DNR)+GOMAGNOLIA-trial: conventional chemotherapy (AraC+DNR)+GOMAGMA-trial:GO associated with conventional chemotherapy (AraC+DNR)+Midostaurin →MAGMA-trial: conventional chemotherapy (AraC+DNR)+Midostaurin →

MODULE: conventional chemotherapy (Cytarabine+Daunorubicin) in combination with midostaurin+GO: Midostaurin (IMP) induction: 25 mg or 50 mg peroral BID, days 8 to 21 depending on assigned dose level GO (IMP) induction: 3 mg/m\^2 i.v. max 4.5 mg, on day1, or on days 1, 4, or days 1, 4, 7 depending on assigned dose level Daunorubicin (DNR, non-IMP) induction: 60 mg/m\^2/day i.v., days 1 to 3 Cytarabine (AraC, non-IMP) induction: 200 mg/m\^2/day cont. infusion, days 1 to 7

MAGNOLIA-trial: Midostaurin associated with conventional chemotherapy (AraC+DNR)+GO: Midostaurin (IMP): RP2D peroral, days 8 to 21, induction cycle 1; 50 mg peroral BID, days 8 to 21 induction cycle 2; 50 mg peroral BID, days 8 to 21, 3 consolidation cycles; 50 mg peroral BID, days 1 to 28, 12 maintenance cycles; GO (IMP): 3 mg/m\^2 i.v. max 4.5 mg, RP2D, 1 induction cycle only Daunorubicin (DNR, non-IMP): 60 mg/m\^2 i.v., days 1 to 3 of induction cycle 1 and 2 in good and moderate responders; 50 mg/m\^2/day i.v., days 1 to 3 of induction cycle 2 in non-responders Cytarabine (AraC, non-IMP): 200 mg/m\^2/day cont. infusion, days 1 to 7 of induction cycles 1 and 2 in good and moderate responders; 3000/1500 mg/m\^2/day i.v. BID, days 1 to 3 of induction cycle 2 in non-responders; 3000/1500 mg/m\^2 i.v. BID, days 1, 3, 5 of consolidation, 3 cycles

MAGNOLIA-trial: conventional chemotherapy (AraC+DNR)+GO: GO (IMP): 3 mg/m\^2 i.v. max 4.5 mg on days 1, 4, 7; 1 induction cycle only Daunorubicin (DNR, non-IMP): 60 mg/m\^2/day i.v., days 1 to 3 of induction cycle 1 and 2 in good and moderate responders; 50 mg/m\^2/day i.v., days 1 to 3 of induction cycle 2 in non-responders Cytarabine (AraC, non-IMP): 200 mg/m\^2/day cont. infusion, days 1 to 7 of induction cycles 1 and 2 in good and moderate responders; 3000/1500 mg/m\^2/day i.v. BID, days 1 to 3 of induction cycle 2 in non-responders; 3000/1500 mg/m\^2 i.v. BID, days 1, 3, 5 of consolidation, 3 cycles

MAGMA-trial:GO associated with conventional chemotherapy (AraC+DNR)+Midostaurin: Midostaurin (IMP): RP2D peroral, days 8 to 21, induction cycle 1; 50 mg peroral BID, days 8 to 21, induction cycle 2; 50 mg peroral BID, days 8 to 21, 3 consolidation cycles; 50 mg peroral BID, days 1 to 28, 12 maintenance cycles; GO (IMP): 3 mg/m\^2 i.v. max 4.5 mg, RP2D, 1 induction cycle only Daunorubicin (DNR, non-IMP): 60 mg/m\^2/day i.v., days 1 to 3 of induction cycles 1-2 in good and moderate responders; 50 mg/m\^2/day i.v., days 1 to 3 of induction cycle 2 in non-responders Cytarabine (AraC, non-IMP): 200 mg/m\^2/day cont. infusion, days 1 to 7 of induction cycles 1 and 2 in good and moderate responders; 3000/1500 mg/m\^2/day i.v. BID, days 1 to 3 of induction cycle 2 in non-responders; 3000/1500 mg/m\^2 i.v. BID, days 1, 3, 5 of consolidation, 3 cycles

MAGMA-trial: conventional chemotherapy (AraC+DNR)+Midostaurin: Midostaurin (IMP): RP2D peroral, days 8 to 21, induction cycle 1; 50 mg peroral BID, days 8 to 21 induction cycle 2; 50 mg peroral BID, days 8 to 21, 3 consolidation cycles; 50 mg peroral BID, days 1 to 28, 12 maintenance cycles Daunorubicin (DNR, non-IMP): 60 mg/m\^2/day i.v., days 1 to 3 of induction cycle 1 and 2 in good and moderate responders; 50 mg/m\^2/day i.v., days 1 to 3 of induction cycle 2 in non-responders Cytarabine (AraC, non-IMP): 200 mg/m\^2/day cont. infusion, days 1 to 7 of induction cycles 1 and 2 in good and moderate responders; 3000/1500 mg/m\^2/day i.v. BID, days 1 to 3 of induction cycle 2 in non-responders; 3000/1500 mg/m\^2 i.v. BID, days 1, 3, 5 of consolidation, 3 cycles

Study summary

This phase I/II clinical trial evaluates the safety and efficacy of the combined administration of midostaurin and gemtuzumab ozogamicin in the frame of first-line standard chemotherapy in newly diagnosed acute myeloid leukemia (AML) patients displaying a cytogenetic aberration or fusion transcript in the core-binding factor (CBF) genes or FMS-like tyrosine Kinase 3 (FLT3) mutation.

Eligibility

Sex
ALL
Min age
18 Years
Max age
75 Years
Healthy volunteers
No
Inclusion Criteria: * Written informed consent * Newly diagnosed AML according to the criteria of the World Health Organisation plus the following molecular or cytogenetic specifications: * Phase I Trial - MODULE: * t(8;21)/RUNX1-RUNX1T1 or * inv(16) or t(16;16)/CBFB-MYH11 or * FLT3-ITD or * FLT3-tyrosine kinase domain (FLT3-TKD) * Phase II Trial - MAGNOLIA * t(8;21)/RUNX1-RUNX1T1 or * inv(16) or t(16;16)/CBFB-MYH11 * Phase II Trial - MAGMA * FLT3-ITD or * FLT3-TKD * Absence of mutations in CBF genes (i.e. t(8;21)/RUNX1-RUNX1T1 or inv(16) or t(16;16)/CBFB-MYH11) * Male and female patients aged * 18 - ≤ 75 years in Phase I Trial - MODULE * 18 - ≤ 70 years in Phase II Trials - MAGMA and MAGNOLIA * Eastern Cooperative Oncology Group (ECOG) Score of 0-2 * Life expectancy \> 14 days * Adequate hepatic and renal function * alanine aminotransferase / aspartate transaminase ≤ 2.5 x ULN * Bilirubin \< 2 x upper limits of normal * Creatinine \< 1.5 x upper limits of normal or Creatinine clearance \> 40 ml/min * White blood cell count \< 30 × 10\^9/L. Note: Hydroxyurea and/or a dose of 100-200 mg/m\^2 cytarabine per day for up to 3 days (for emergency use for clinical stabilization) is permitted to meet this criterion. Exclusion Criteria (all study parts): * Previous antineoplastic treatment for AML other than hydroxyurea and/or cytarabine for emergency use (100-200 mg/m\^2 per day on maximal 3 days) * Previous treatment with anthracyclines * central nervous system involvement * Isolated extramedullary AML * Uncontrolled infection * AML after antecedent myelodysplasia (MDS) with prior cytotoxic treatment (e.g., azacytidine or decitabine) * Any investigational agent within 30 days or 5 half-lives, whichever is greater, prior to day 1. An investigational agent is defined as an agent with no approved medical use in adults or in pediatric patients * Prior treatment with a FLT3 inhibitor (e.g., midostaurin, quizartinib, sorafenib) * Strong CYP3A4/5 enzyme inducing drugs unless they can be discontinued or replaced prior to enrollment * Any other known disease or concurrent severe and/or uncontrolled medical condition (e.g., cardiovascular disease including congestive heart failure or active uncontrolled infection) that could compromise participation in the study * Impairment of gastrointestinal (GI) function or GI disease that might alter significantly the absorption of midostaurin * Confirmed diagnosis of HIV infection, * Active viral hepatitis unless serology demonstrates clearance of infection. Occult or prior hepatitis B virus (HBV) infection, defined as negative hepatitis B surface antigen and positive total hepatitis core antibodies, may be included if HBV DNA is undetectable, provided that patients are willing to undergo monthly DNA testing. Patients who have protective titers of hepatitis B surface antibody after vaccination or prior cured hepatitis B are eligible. Patients for hepatitis C virus (HCV) antibody are eligible provided PCR is negative for HCV RNA. * Cardiovascular abnormalities, including any of the following: * History of myocardial infarction, angina pectoris, Coronary Artery Bypass Grafting within 6 months prior to starting study treatment * Clinically uncontrolled cardiac arrhythmias (e.g., ventricular tachycardia), complete left bundle branch block, high-grade atrioventricular block (e.g., bifascicular block, Mobitz type II and third degree atrioventricular block) * Uncontrolled congestive heart failure * Left ventricular ejection fraction of \< 50% * Poorly controlled arterial hypertension * Pregnant or nursing (lactating) women * Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they fulfill at least one of the following criteria: * Post-menopausal (12 months of natural amenorrhea or 6 months of amenorrhea with serum follicule stimulating hormone \> 40 U/ml) * Postoperative (i.e. 6 weeks) after bilateral ovariectomy with or without hysterectomy * Women of childbearing potential must have a negative serum pregnancy test performed within 7 days before the first dose of study drug * Continuous and correct application of a contraception method with a Pearl Index of \< 1% (e.g. implants, depots, oral contraceptives, intrauterine device) from initial study drug administration until at least 7 months after the last dose of gemtuzumab ozogamicin and at least 4 months after the last dose of midostaurin, whichever period is longer. A hormonal contraception method must always be combined with a barrier method (e.g. condom) * Sexual abstinence * Vasectomy of the sexual partner * Sexually active males unless they use a condom during intercourse while taking the drug during treatment, and for at least 4 months after stopping treatment and should not father a child in this period. A condom is required to be used also by vasectomized men as well as during intercourse with a male partner in order to prevent delivery of the drug via semen * Unwillingness or inability to comply with the protocol * Known hypersensitivity to midostaurin, GO, cytarabine or daunorubicin or to any of the excipients of midostaurin, GO, cytarabine or daunorubicin.

Primary outcome measure(s)

Trial sites (21)

FacilityCityRegionStatus
LMU Klinikum, Campus Großhadern München Bavaria Recruiting
Universitätsklinikum Essen Essen North Rhine-Westphalia Recruiting
Universitätsklinikum Aachen Aachen Germany Recruiting
Universitätsklinikum Augsburg Augsburg Germany Not Yet Recruiting
Klinikum Chemnitz gGmbH Chemnitz Germany Recruiting
Universitätsklinikum Dresden Dresden Germany Recruiting
Johann Wolfgang Goethe-Universität Frankfurt am Main Germany Recruiting
Universitätsklinikum Halle Halle Germany Recruiting
Universitätsklinikum Heidelberg Heidelberg Germany Recruiting
Universitätsklinikum Jena Jena Germany Recruiting
Universitätsklinikum Schleswig-Holstein Kiel Germany Recruiting
Gemeinschaftsklinikum Mittelrhein gGmbH Koblenz Germany Recruiting
Universitätsklinikum Leipzig Leipzig Germany Recruiting
Klinikum Mannheim gGmbH Mannheim Germany Recruiting
Philipps-Universität Marburg Fachbereich Medizin Marburg Germany Recruiting
Rotkreuzklinikum München gGmbH München Germany Recruiting
Universitätsklinikum Münster Münster Germany Recruiting
Klinikum Nürnberg-Nord Nuremberg Germany Not Yet Recruiting
Krankenhaus Barmherzige Brüder Regensburg Germany Recruiting
Robert-Bosch-Krankenhaus Stuttgart Germany Recruiting
Rems-Murr-Klinikum Winnenden Winnenden Germany Recruiting

More Technische Universität Dresden trials in Germany

Other trials for the same condition

Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT04385290 on ClinicalTrials.gov ↗ ← All trials in Germany