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A Multicenter, Open-Label, Dose-Finding Clinical Trial to Assess the Safety, Pharmacokinetics, Pharmacodynamics, and Clinical Efficacy of RVU120 in Combination with Venetoclax in Participants with Acute Myeloid Leukemia Who Failed Prior Therapy with Venetoclax and a Hypomethylating Agent (RIVER-81)
EU CTIS ID: 2023-505911-19-00
What this study is testing
Part 1 only: To determine the RD of RVU120 plus Ven to be administered in AML patients failing prior Ven + HMA Part 2 and 3: To evaluate the anti-leukemic activity of RVU120 when given in combination with Ven, including measurable residual disease (MRD) response were applicable, in AML patients failing prior Ven + HMA
- Therapeutic exploratory (Phase II)
A plain-language read of the study's public EU CTIS listing. The study team confirms the details.
Who can take part
You may be able to join if
- Written informed consent provided prior to any study-related procedure.
- Must have recovered from the toxic effects of previous treatments to at least Grade 1, except for neurotoxicity (which should return at least to Grade 2 or baseline), or alopecia.
- Clinical laboratory parameters as follows: - Peripheral WBC count, no upper limit at Screening, but must be <25 x10^9/L on Day 1 prior to first dose of study drug (see acceptable methods of cytoreduction above) - Platelet count >10,000/μL at the time of first study drug administration (platelet infusion is permitted) - Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3X the upper limit of normal (ULN) - Direct bilirubin ≤1.5X ULN - Creatinine clearance ≥50 mL/min (Cockcroft and Gault formula; Section 10.7).
- Adequate cardiac function confirmed by left ventricular ejection fraction ≥40% as per echocardiography.
- For women of childbearing potential (WOCBP), a negative pregnancy test must be confirmed during Screening and prior to first dose of ≤3 days prior to first dose of study drug. WOCBP must commit to using a highly effective method of contraception during study participation and until 28 weeks (approximately 6.5 months) after the last dose of RVU120 (Section 10.4) OR For males, an effective barrier method of contraception must be used during study participation and until 28 weeks (approximately 6.5 months) after the last dose of RVU120, if the participant is sexually active with a WOCBP (Section 10.4).
- Agree not to donate blood, eggs (ova) or sperm, during study participation and until 28 weeks (approximately 6.5 months) after the last dose of RVU120 (Section 10.4).
You likely can't join if
- 1. Active central nervous system (CNS) leukemia.
- 18. Pregnant or breastfeeding.
- 2. Diagnosis of acute promyelocytic leukemia (APL), the M3 subtype of AML.
- 19. Any other prior or current medical condition, intercurrent illness, surgical history, physical or electrocardiogram (ECG) findings, laboratory abnormalities, or extenuating circumstance (e.g., alcohol or drug addiction) that, in the Investigator’s- or the Sponsor’s opinion, could jeopardize participant safety or interfere with the objectives of the study.
- 3. Previous treatment with CDK8 and/or CDK19-targeted therapy.
- 4. Major surgery within 28 days prior to first dose of study drug.
See the full eligibility criteria
Who can join
- Written informed consent provided prior to any study-related procedure.
- Must have recovered from the toxic effects of previous treatments to at least Grade 1, except for neurotoxicity (which should return at least to Grade 2 or baseline), or alopecia.
- Clinical laboratory parameters as follows: - Peripheral WBC count, no upper limit at Screening, but must be <25 x10^9/L on Day 1 prior to first dose of study drug (see acceptable methods of cytoreduction above) - Platelet count >10,000/μL at the time of first study drug administration (platelet infusion is permitted) - Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3X the upper limit of normal (ULN) - Direct bilirubin ≤1.5X ULN - Creatinine clearance ≥50 mL/min (Cockcroft and Gault formula; Section 10.7).
- Adequate cardiac function confirmed by left ventricular ejection fraction ≥40% as per echocardiography.
- For women of childbearing potential (WOCBP), a negative pregnancy test must be confirmed during Screening and prior to first dose of ≤3 days prior to first dose of study drug. WOCBP must commit to using a highly effective method of contraception during study participation and until 28 weeks (approximately 6.5 months) after the last dose of RVU120 (Section 10.4) OR For males, an effective barrier method of contraception must be used during study participation and until 28 weeks (approximately 6.5 months) after the last dose of RVU120, if the participant is sexually active with a WOCBP (Section 10.4).
- Agree not to donate blood, eggs (ova) or sperm, during study participation and until 28 weeks (approximately 6.5 months) after the last dose of RVU120 (Section 10.4).
- Investigator considers the participant to be suitable for participation in the clinical study by assessing that they: - understand the requirements of the clinical study and can give informed consent - can comply with study medication dosing requirements and all study-related procedures and evaluations - are not considered to be potentially unreliable and/or not cooperative.
- Has received all Coronavirus disease-19 (COVID-19) vaccinations per institutional standards.
- Age ≥18 years at time of provision of informed consent.
- AML diagnosis according to the 2022 World Health Organization (WHO) classification (Arber 2022).
- Relapsed or refractory AML per the ELN 2022 (Döhner 2022) - Participants with <10% bone marrow cellularity may be enrolled where immunophenotyping of the bone marrow demonstrates this is due to underlying disease and not to potential myelotoxicity e.g., where >50% of cells have AML phenotype.
- Failed first-line treatment with Ven + HMA specified as any of the following: - Participants who do not achieve at least morphologic leukemia-free state (MLFS) or partial remission (PR), or are progressing after at least 2 cycles of Ven + HMA - Participants who do not achieve CR, CRh, or CRi, after 4 cycles of Ven + HMA - Participants relapsing any time after treatment with Ven + HMA.
- No alternative, approved therapeutic options likely to produce clinical benefit.
- Eastern Cooperative Oncology Group (ECOG) performance score of 0-2 (Section 10.6).
- Life expectancy of at least 12 weeks.
- No other anti-cancer treatment received for 14 days or 5 half-lives, whichever is shorter, prior to first dose of study drug.
What rules you out
- 1. Active central nervous system (CNS) leukemia.
- 18. Pregnant or breastfeeding.
- 2. Diagnosis of acute promyelocytic leukemia (APL), the M3 subtype of AML.
- 19. Any other prior or current medical condition, intercurrent illness, surgical history, physical or electrocardiogram (ECG) findings, laboratory abnormalities, or extenuating circumstance (e.g., alcohol or drug addiction) that, in the Investigator’s- or the Sponsor’s opinion, could jeopardize participant safety or interfere with the objectives of the study.
- 3. Previous treatment with CDK8 and/or CDK19-targeted therapy.
- 4. Major surgery within 28 days prior to first dose of study drug.
- 5. Hematopoietic stem cell transplant within 120 days prior to first dose of study drug.
- 6. Active, ≥Grade 2 acute graft versus host disease (GVHD), active moderate-to-severe chronic GVHD, or requirement for systemic immunosuppressive medications for GVHD.
- 7. Evidence of ongoing and uncontrolled systemic bacterial, fungal, or viral infection and acute inflammatory conditions (including pancreatitis).
- 8. Known seropositivity or history of active viral infection with human immunodeficiency virus (HIV) infection defined as any of the following: •CD4+ T-cell count of less than 350 cells/µL at Screening •AIDS‑defining opportunistic infection within the past 12 months •On established antiretroviral therapy (ART) for less than 4 weeks or presenting with a viral load of more than 400 copies/mL prior to Screening •On ART or prophylactic antimicrobials that are expected to cause significant drug-drug interactions or overlapping toxicities with study treatment. Note: HIV testing is not required unless mandated locally.
- 9. Ongoing significant liver disease such as cirrhosis, drug-induced liver injury, active hepatitis, or chronic persistent hepatitis B and/or C - positive serologic or polymerase chain reaction (PCR) test results for acute or chronic HBV infection. Participants whose HBV infection status cannot be determined by serologic test results must be negative for HBV by PCR to be eligible for study participation. (https://www.cdc.gov/hepatitis/hbv/interpretationOfHepBSerologicResults.htm) - acute or chronic HCV infection. Participants who are positive for HCV antibody must be negative for HCV by PCR to be eligible for study participation.
- 10. Impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of RVU120 (e.g., active inflammatory bowel disease, ulcerative disease, malabsorption syndrome, short bowel syndrome, uncontrolled nausea, vomiting or diarrhea).
- 11. Ongoing drug-induced pneumonitis.
- 12. Concurrent participation in another investigational clinical trial.
- 13. Taking any medications, herbal supplements, or other substances that are known to be strong inhibitors or moderate/strong inducers or sensitive substrates of CYPXXX, within less than 5 half-lives prior to first dose of study drug (Section 10.8)
- 14. Taking medications, over-the-counter medications, foods or herbal supplements that are known to be strong or moderate inhibitors of CYP3A or P-gp, within less than 5 half-lives prior to first dose of study drug. Note: Azole antifungals used in clinical practice for prophylaxis or maintenance are allowed (following the Ven prescribing information), except during Cycle 1 for participants enrolled to Part 1.
- 15. Significant cardiac dysfunction defined as myocardial infarction within 12 months of first dose of study drug, New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled dysrhythmias, poorly controlled angina (Section 10.9) or left ventricular ejection fraction (LVEF) <40% as per echocardiography or multiple gated acquisition (MUGA) scan.
- 16. History of ventricular arrhythmia, or QTc ≥470 ms (Fridericia’s formula; Section 10.10).
- 17. Prior history of malignancies other than AML, unless the participant has been free of the disease for 5 years or more prior to Screening, or the following apply: - basal cell carcinoma of the skin - non-metastatic squamous cell carcinoma of the skin - carcinoma in situ of the cervix - carcinoma in situ of the breast - carcinoma in situ of the bladder - incidental histological finding of prostate cancer (Tumor/Node/Metastasis stage of T1a or T1b). Note: Any exception should be discussed with the Medical Monitor.
The study team makes the final eligibility decision.
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 65+ years, 18-64 years. The study team makes the final eligibility decision.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.