New Three-Drug cocktail aims to beat back aggressive leukemia before transplant
NCT ID NCT06483906
First seen Jun 27, 2026 · Last updated Jun 27, 2026
Summary
This phase 2 trial tests a three-drug combination (venetoclax, azacitidine, and homoharringtonine) followed by a stem cell transplant in 56 adults aged 18-55 with newly diagnosed, intermediate- or high-risk acute myeloid leukemia (AML). The goal is to see if this approach improves survival and reduces the chance of the cancer coming back. Participants receive up to four cycles of the drug combo before transplant, with close monitoring for side effects and disease response.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- Venetoclax, azacitidine, and homoharringtonine (VAH regimen)
- What this could lead to
- If successful, this combination could offer a more effective way to control aggressive AML and improve long-term survival after a stem cell transplant.
- What could go wrong
- This is a small, early-phase trial (56 people) with no comparison group. The treatment involves strong chemotherapy and a transplant, which carry serious risks like infection and graft-versus-host disease.
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Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 2
Tests whether the treatment actually works, and watches for side effects, in a larger group.
- Participants
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About 56 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Jul 2024
- Expected to finish
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Jul 2028
An estimate. End dates often move.
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 to 55 years
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: 1. Age between 18 and 55 years, inclusive, regardless of gender. 2. Diagnosed with AML (excluding APL) according to the 2022 International Consensus Classification (ICC) for AML \[1\]. 3. Evaluated as intermediate/high-risk AML based on the 2022 ELN AML guidelines (see Appendix 1). 4. No prior treatment for acute leukemia, including hypomethylating agents used for leukemia or myelodysplastic syndromes (MDS), except for hydroxyurea. 5. Patients must have a suitable hematopoietic stem cell donor. 6. Hematopoietic cell transplantation comorbidity index (HCT-CI) score ≤ 2. 7. ECOG (Eastern Cooperative Oncology Group) performance status: 0-2. 8. Adequate liver, kidney, and cardiopulmonary function, meeting the following requirements: 1. Serum creatinine ≤ 1.5x ULN (the upper limit of normal); 2. Cardiac function: Ejection fraction ≥ 50%; 3. Baseline oxygen saturation \> 92%; 4. Total bilirubin ≤ 1.5 x ULN; ALT and AST ≤ 2.0 x ULN; 5. Pulmonary function: DLCO (corrected for hemoglobin) ≥ 40% and FEV1 (Forced Expiratory Volume in 1 second) ≥ 50%. 9\) Patients must have the ability to understand and be willing to participate in this study and sign an informed consent form. Exclusion Criteria: 1. Acute promyelocytic leukemia. 2. Presence of extramedullary disease manifestations at diagnosis or during treatment, including central nervous system involvement. 3. History of malignancies other than myeloid neoplasms within the past 5 years prior to screening, except adequately treated cervical carcinoma in situ, basal cell carcinoma, squamous cell carcinoma of the skin, and localized prostate cancer after radical surgery, and ductal carcinoma in situ after radical surgery. 4\) ECOG \> 2. 5) HCT-CI score ≥ 3. 6) Any unstable systemic diseases, including but not limited to unstable angina, recent cerebrovascular accidents or transient ischemic attacks within the 3 months prior to screening, myocardial infarction within the 3 months prior to screening, congestive heart failure (New York Heart Association \[NYHA\] class ≥ III), severe arrhythmias requiring drug treatment after pacemaker implantation, significant liver, kidney, or metabolic diseases, and pulmonary arterial hypertension. 7\) Active, uncontrolled infections, including those associated with hemodynamic instability, new or worsening infection symptoms or signs, new infectious lesions on imaging, or persistent unexplained fever without signs or symptoms of infection. 8\) Conditions requiring treatment such as grade 2 or higher seizures, paralysis, aphasia, recent severe cerebral infarction, severe traumatic brain injury, dementia, Parkinson's disease, or schizophrenia. 9\) HIV-infected individuals. 10) Active hepatitis B (HBV) or active hepatitis C (HCV) requiring antiviral therapy. Patients at risk of HBV reactivation, are defined as those who are positive for hepatitis B surface antigen or core antibody without receiving antiviral therapy. 11\) History of autoimmune diseases. 12) Pregnant or breastfeeding women. 13)Fertile males and females unwilling to use contraception during the treatment period and for 12 months after treatment.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
1 site. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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Shanghai General hospital,Shanghai Jiao Tong University School of Medicine
RECRUITINGShanghai, Shanghai Municipality, China
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Other studies related to the condition(s) this trial covers.
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- Two-Drug combo targets leukemia that outsmarted its first treatment
- Tweaking donor cells may shield older transplant patients from a dangerous complication
- Can a drug and donor cells stop leukemia from returning after transplant?
- New drug combination targets Hard-to-Treat blood cancers