About this trial
This phase I trial studies the side effects and best dose of ruxolitinib (Rux) therapy alone (monotherapy) followed by Rux plus azacitidine (AZA) maintenance therapy and to see how well it works in treating patients with acute myeloid leukemia (AML) who are undergoing reduced intensity allogeneic hematopoietic stem cell transplantation (alloHSCT). AlloHSCT provides the only chance for cure for many patients with AML. AlloHSCT is a procedure in which a person receives blood-forming stem cells (cells from which all blood cells develop) from a genetically similar, but not identical, donor. This is often a sister or brother, but could be an unrelated donor. One of the common reasons for death after an alloHSCT is graft versus host disease (GVHD), which occurs when the transplanted cells from the donor attacks the recipient's normal cells. Ruxolitinib is in a class of medications called kinase inhibitors. It works to treat GVHD by blocking the signals of the cells that cause GVHD. Azacitidine is in a class of medications called demethylation agents. It works by helping the bone marrow to produce normal blood cells and by killing abnormal cells in the bone marrow. Giving Rux after the transplant may stop GVHD from occurring. Maintenance therapy with AZA, may help prevent or delay cancer from coming back. Giving Rux monotherapy followed by Rux plus AZA maintenance therapy may be safe, tolerable, and/or effective in treating patients with AML who are undergoing alloHSCT.
Eligibility criteria
Qualifiers
PART A: Willingness to provide written informed consent before any study-specific procedures or interventions are performed. For participants unable to independently provide consent, a legally authorized representative (LAR) must provide consent
PART A: Age ≥ 18 years, at the time of consent
PART A: All types and categories of AML, as defined by World Health Organization (WHO) 2022, excluding acute promyelocytic leukemia (APL)
PART A: In complete remission (CR) or complete remission with incomplete blood count recovery (CRi) after induction of remission for transition to transplant by European LeukemiaNet 2022 Risk Stratification (ELN 2022)
Disqualifiers
PART A: Patients with active central nervous system (CNS) involvement with AML. Prior diagnosis of CNS involvement of AML will be allowed if curatively treated
PART A: Patients with malabsorption syndrome or other condition that precludes oral route of drug administration
PART A: Patients with prior intolerance to any of the interventional study drugs or component of the formulations
PART A: Patients with prior failure of treatment with ruxolitinib
Trial design
Treatments tested in this trial
- Allogeneic Hematopoietic Stem Cell Transplantation
- Azacitidine
- Biospecimen Collection
- Bone Marrow Aspiration
- Bone Marrow Biopsy
- Cyclophosphamide
- Echocardiography Test
- Electronic Health Record Review
- Multigated Acquisition Scan
- Mycophenolate Mofetil
- Reduced-Intensity Transplant Conditioning Procedure
- Ruxolitinib
- Survey Administration
- Tacrolimus
Treatment groups
Sponsors and collaborators
OHSU Knight Cancer Institute
Lead sponsor
Incyte Corporation
Collaborator
Oregon Health and Science University
Collaborator