ClinicalTrials.gg
Active, not recruitingNCT05001828Updated Oct 15, 2026

Study of ADI-PEG 20, Venetoclax and Azacitidine in Acute Myeloid Leukemia

A Phase 1 interventional study of ADI-PEG 20 in Acute Myeloid Leukemia, Adult, sponsored by Polaris Group. Active, not recruiting at 3 sites in United States. Open to participants aged 18 Years to 99 Years. Per ClinicalTrials.gov, last updated 2026-10-15.

Sponsored by Polaris Group · Phase 1, Interventional, and Treatment

Updated Oct 15, 2026Primary completion movedStudy completion movedGo to Updates ↓
Phase
Phase 1
Study type
Interventional
Enrollment
38
Allocation
Non-randomized
Ages
18 Years to 99 Years
Sex
All
01

Study summary

Pegylated arginine deiminase (ADI-PEG 20) will be combined with venetoclax and azacitidine for treatment of subjects with previously treated or untreated with high risk factor acute myeloid leukemia (AML). Venetoclax and azacitidine are front-line therapy for such patients, and ADI-PEG 20 will be added to this regimen in a phase IA/B study.

Read the detailed description

This is an open label, single arm, phase 1 trial with recommended phase 2 dose (RP2D) cohorts based on subject inclusion criteria.

Lead In: 6 patients will be enrolled to be treated with standard dose of azacitidine and venetoclax and the expected RP2D of ADI-PEG 20 (dose level 0). In case of DLT occurring in >1 patient in cycle 1, 6 additional patients will be accrued at dose level -1 of ADI-PEG 20 while keeping the doses of azacitidine and venetoclax unchanged (Dose level -1). Enrollment to cohort 1 and 2 will start after ≤1 patient out of 6 encounters DLT in cycle 1 at one of these dose levels. The 6 patients enrolled at that dose level will be counted for efficacy analysis. Cohort 1: Relapsed or refractory AML: target response 25%. Historical expectation for venetoclax and azacitidine is 15%.

Cohort 2: Newly diagnosed high risk AML: Target response 55%. Historical expectation for venetoclax and azacitidine is 40%.

Treatment may be continued for a maximum of 24 cycles or 104 doses of ADI-PEG 20 (study Week 103), whichever is reached first.

02

Conditions studied

  • Acute Myeloid Leukemia, Adult
03

In context

Leukemia, Myeloid, Acute

3,667 studies on the registry are indexed under Leukemia, Myeloid, Acute; 816 are open to participants now.

This study's enrollment of 38 is close to the median of 40 across 3,005 interventional studies indexed under Leukemia, Myeloid, Acute.

Browse Leukemia, Myeloid, Acute studies →

Lead sponsor

Polaris Group is the lead sponsor of 20 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 99 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Cohort 1: Previously treated (/recurrent) or refractory AML based on the 2022 revision to the World Health Organization (WHO) criteria (Arber 2022)
  • Cohort 2: Untreated AML per 2022 WHO (Arber 2022) criteria with high-risk features and not a candidate for intensive chemotherapy because of age 60 years or older, age-related comorbidities, cardiac disease, prior anthracycline use, high probability of treatment-related mortality, or otherwise would not benefit from intensive chemotherapy treatment.
  • Age ≥ 18 years
  • reasonably adequate for evaluating the treatment
  • White blood cell (WBC) count of 10 × 109/L or less. (Use of hydroxyurea to control WBC is allowed till 48 hours prior to protocol treatment)
  • Adequate renal function: Creatinine ≤ 1.5 x (ULN) or > 40 mL/minute (measured or calculated according to the Cockcroft-Gault formula)
  • Adequate liver function

    • Total ≤ 1.5 x ULN
    • and AST both ≤ 2.5 x institutional ULN or ≤ 5 times the ULN for patients with leukemic involvement of liver

Exclusion criteria

Exclusion Criteria:

  • Prior treatments as follows:

    1. Cohort 1: >2 cycles of prior combination treatment with venetoclax+hypomethelating agent (i.e. azacitidine, decitabine) is exclusionary. All other prior treatment for antecedent hematological disorders and/or for AML is permitted.
    2. Cohort 2: Prior treatment for antecedent hematological disorders with venetoclax or chemotherapy or any prior treatment for their AML is exclusionary. However, treatment with other agents, including hydroxyurea or ≤2 cycles of hypomethylating agent (i.e. azacitidine, decitabine), for MDS or myeloproliferative neoplasm is permitted.
  • Cohort 2: Favorable risk AML per European LeukemiaNet (ELN) 2022 criteria (Döhner 2022)
  • Known active CNS involvement by leukemia
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
38 participants (actual)

Study arms

  • Experimental
    Previously Treated AML

    Previously treated AML based on the revised revised 2022 WHO criteria with age at least 18 years.

    Drug: ADI-PEG 20

  • Experimental
    Untreated AML With High Risk Features

    Untreated AML per 2022 WHO criteria with high-risk features and not a candidate for intensive chemotherapy because of age 60 years or older, age-related comorbidities, cardiac disease, prior anthracycline use, high probability of treatment-related mortality, or otherwise would not benefit from intensive chemotherapy treatment.

    Drug: ADI-PEG 20

Interventions

  • ADI-PEG 20 in combination with venetoclax and azacitidine

    Also known as: Venetoclax, Azacitidine

06

What researchers measure

Primary outcomes

  1. Determine the RP2D of ADI-PEG 20 in combination with venetoclax and azacitidine, per the number of subjects with treatment-related adverse events by current CTCAE

    Time frame: 6 months

Secondary outcomes

  1. Determine preliminary evidence of tumor activity, per the revised 2017 European LeukemiaNet criteria

    Time frame: 2 years

  2. Determine the peripheral blood arginine levels of ADI-PEG 20 in combination with venetoclax and azacitidine

    Time frame: 2 years

  3. Determine the peripheral blood citrulline levels of ADI-PEG 20 in combination with venetoclax and azacitidine

    Time frame: 2 years

  4. Determine the anti-drug antibodies of ADI-PEG 20 in combination with venetoclax and azacitidine

    Time frame: 2 years

07

Study locations

3 sites
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2022 (actual). Primary completion is estimated for Jan 2027, 57 months after the start.

Of 183 industry-sponsored phase 1 interventional studies under Leukemia, Myeloid, Acute, half reached primary completion within 40 months of starting (the median), counting those still running; a quarter within 29 and three quarters within 62. This study's planned 57 months is above that.

Counting every sponsor, half of 488 studies reached it within 49 months; a quarter within 31 and three quarters within 76.

Since we started tracking on Sep 25, 2026, the dates moved once, on Oct 15, 2026: primary completion May 2026 → Jan 2027 and completion Dec 2026 → Jan 2027.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Jul 26, 2021
First posted
Aug 12, 2021
StartActual
Apr 5, 2022
Primary completionEst.
Jan 2027was May 2026
CompletionEst.
Jan 2027was Dec 2026
Last update
Oct 15, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Primary completion
May 2026→Jan 2027
Oct 15, 2026
Study completion
Dec 2026→Jan 2027
Oct 15, 2026
Show all 1 update
  1. Oct 15, 2026
    Primary completion May 2026→Jan 2027
    Study completion Dec 2026→Jan 2027
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05001828
Lead sponsor
Polaris Group
Responsible party
Sponsor
First posted
Aug 12, 2021
Start date
Apr 5, 2022
Primary completion
Jan 2027 (estimated)
Completion
Jan 2027 (estimated)
Last update
Oct 15, 2026

Study contacts

John S Bomalaski, MD
study director · Polaris Group

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Pegargiminase

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