About this trial
Treatment of patients with newly diagnosed AML who are not eligible for intensive chemotherapy has remained an area of high unmet medical need. The combination therapy with two medicines, azacitidine and venetoclax, is the usual plan of action. This has brought significant progress in the treatment, but it nevertheless is not curative and the disease does relapse over time.
Revumenib blocks a specific molecule called menin in the cell nucleus. Some types of AML are reliant on menin working properly. These are leukemia cells with a change in the DNA, i.e. a mutation in the NPM1 or KMT2A gene. Revumenib can prevent the production of these types of leukemia cells by disrupting the production of this menin.
The current study investigates whether adding revumenib to the combination therapy improves the prognosis for AML patients with a mutation in the NPM1 or KMT2A gene.
This is a randomized, double-blind, placebo-controlled clinical study where subjects will be treated until disease progression, or development of side effects or death. From the moment of inclusion of the last patient, there will be a 4-year observational follow-up study in order to register survival duration and follow-up visits.
Approximately 415 previously untreated patients with a mutation in the NPM1 or KMT2A gene and with newly diagnosed AML, who are not eligible for intensive chemotherapy. Patients must be ≥18 years of age.
Eligibility criteria
Qualifiers
Patient with newly diagnosed NPM1-mutated AML, consistent with NPM1c, according to the 2022 International Consensus Classification (i.e. ≥ 10% blasts).
Central confirmation of NPM1 mutation or KMT2A rearrangement in one of the dedicated central genetic laboratories.
Age ≥ 18 years, no upper age limit.
≥ 75 years of age: ineligible for intensive chemotherapy per physician's discretion (with an ECOG performance status 0-2) .
Disqualifiers
New York Heart Association (NYHA) class III or IV congestive heart failure
Myocardial infarction
Unstable angina
Severe cardiac arrhythmias
Trial design
Treatments tested in this trial
- Revumenib
- Placebo
Treatment groups
Sponsors and collaborators
Stichting Hemato-Oncologie voor Volwassenen Nederland
Lead sponsor
German-Austrian Acute Myeloid Leukemia Study Group
Collaborator
United Kingdom AML Research Network
Collaborator