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RecruitingNCT06621212Updated Sep 16, 2025

Mitoxantrone Hydrochloride Liposome, Standard-dose of Cytarabine and Venetoclax in the Treatment of R/R AML

A Phase 2 interventional study of mitoxantrone hydrochloride liposome and Cytarabine in Relapsed/Refractory Acute Myeloid Leukaemia and Myeloid Malignancy, sponsored by First Affiliated Hospital of Zhejiang University. Recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-09-16.

Sponsored by First Affiliated Hospital of Zhejiang University · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2024; still recruiting 2 years 3 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
72
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this prospective, multi-center, single-arm, phase 2 study is to evaluate the efficacy and safety of a combination regimen of mitoxantrone hydrochloride liposome injection, standard-dose of cytarabine and venetoclax (MAV) in the treatment of relapsed or refractory (R/R) AML. The study plan to enroll 72 R/R AML patients who are expected to receive laboratory tests of bone marrow and blood specimens at regular times after MAV treatment.

Read the detailed description

For patients with R/R AML, there is currently no established standard treatment. Previous research suggests that mitoxantrone could against venetoclax-resistant leukemia stem cells (LSCs) by modulating mitochondrial calcium levels. Based on the potentially synergistic killing effect of mitoxantrone and venetoclax, a phase 2 study is underway in R/R AML. Patients receive mitoxantrone hydrochloride liposome, moderate-dose of cytarabine (1.0 g/m\^2, IV, q12h, d1, 3, 5) and venetoclax (MAV) when they were enrolled.

Here the investigator also conduct another phase 2 study of MAV regimen with standard-dose of cytarabine in relapsed or refractory (R/R) AML, aiming to evaluate the efficacy and safety of MAV regimen. All participants will receive MAV treatment including 30 mg/m\^2 mitoxantrone hydrochloride liposome on day 1, 100 mg/m\^2 cytarabine on days 1-7 and 400 mg venetoclax on days 2-8 with a dose escalation on days 2-4. Each cycle consists of 4 weeks. A maximum of 2 cycles of therapy are planned.

02

Conditions studied

  • Relapsed/Refractory Acute Myeloid Leukaemia
  • Myeloid Malignancy
03

In context

Leukemia, Myeloid, Acute

2,971 studies on the registry are indexed under Leukemia, Myeloid, Acute; 745 are open to participants now.

This study's planned enrollment of 72 is above the median of 41 across 2,509 interventional studies indexed under Leukemia, Myeloid, Acute.

Browse Leukemia, Myeloid, Acute studies →

Lead sponsor

First Affiliated Hospital of Zhejiang University is the lead sponsor of 255 studies on the registry; 139 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Each subject must sign an informed consent form (ICF) indicating that he or she understands the purpose of and procedures required for the study and are willing to participate in the study.
  2. Age ≥18
  3. Clinically diagnosed relapsed/refractory AML, excluding acute promyelocytic leukemia.

    1. Patients who failed after at least 1 courses of initial induction therapy.
    2. Bone marrow blasts≥5% after CR/CRi, or reappearance of blasts in the blood in at least 2 peripheral blood samples at least one week apart, or leukemia cell infiltration appeared in extramedullary.
    3. Conversion from MRD negativity to MRD positivity after CR/CRi.
  4. Physical status score of Eastern Oncology Collaboration Group (ECOG) 0-2.
  5. Life expectancy > 3 months.
  6. AST/ALT≤2.5 ULN (for subjects with hepatic infiltration≤5 ULN); Total bilirubin≤1.5 ULN (for subjects with hepatic infiltration≤3 ULN); Serum creatinine≤1.5 ULN.

Exclusion criteria

Exclusion Criteria:

  1. Previous anti-tumor therapy meets one of the following criteria:

    1. Prior therapy with mitoxantrone or mitoxantrone liposome;
    2. Prior therapy with doxorubicin or anthracyclines, and the cumulative dose of doxorubicin > 360 mg/m\^2 (1 mg doxorubicin was equivalent to 2 mg daunorubicin or 0.5 mg idarubicin);
    3. Have received other anti-tumor therapy (including chemotherapy, targeted therapy, hormone therapy, Chinese medicines with anti-tumor activity, except those that do not affect the efficacy of the study as determined by the investigator) or participated in other clinical trials and received clinical trial drugs within 4 weeks or 5 half-lives of the drug before the study;
  2. Subjects who received strong or moderate CYP3A inducers/inhibitors or P-glycoprotein (P-gp) inhibitors within 7 days before starting study treatment;
  3. Subjects who are unable to take oral medications or have malabsorption syndrome;
  4. Cardiovascular diseases, including but not limited to:

    1. QTc interval >480 ms or long QTc syndrome in screening;
    2. Complete left bundle branch block, 2 or 3 grade atrioventricular block;
    3. Requiring treatment of serious and uncontrolled arrhythmia;
    4. New York Heart Association NYHA≥2;
    5. Cardiac ejection fraction (EF) was less than 50%;
    6. Myocardial infarction, unstable angina pectoris, severe unstable ventricular arrhythmia or any other history of arrhythmia or clinically serious pericardial disease that requires treatment within the first 6 months of enrollment, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities.
  5. Central nervous system leukemia;
  6. Previous or current occurrence of other malignancies (in addition to non-melanoma basal cell carcinoma of the skin that is effectively controlled, breast/cervical carcinoma in situ, and other malignancies that have been effectively controlled without treatment within the past five years).
  7. Subjects are suffering from any other uncontrollable disease (including but not limited to: uncontrolled diabetes and hypertension, and advanced infection);
  8. HIV infection.
  9. HBsAg or HBcAb positive, with HBV-DNA≥1x10\^3 copies/mL; or HCV-RNA≥1x10\^3 copies/mL;
  10. A history of immediate or delayed allergy to similar drug and excipients of the investigate drug.
  11. Pregnant, lactating female or subjects who refuse to use effective contraception during the study.
  12. With a history of severe neurological or psychiatric illness.
  13. Not suitable for this study as decided by the investigator.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
72 participants (estimated)

Study arms

  • Experimental
    MAV regimen

    First induction: Mitoxantrone hydrochloride liposome injection, cytarabine combined with venetoclax. Second induction: Patients who achieved PR or MLFS after the first induction cycle will receive re-induction therapy with the same initial regimen. Consolidation: For patients with CR/CRi, allo-HSCT is recommended. For those currently ineligible for allo-HSCT, age- and fitness-adapted consolidation is advised. For intensive chemotherapy: Cytarabine (\<60y: 2g/m² q12h d1-3; ≥60y: 1g/m² q12h d1-3) + Venetoclax 300mg d1-7, for 2-3 cycles. For non-intensive candidates, an appropriate regimen should be selected per investigator.

    Drug: mitoxantrone hydrochloride liposome · Drug: Cytarabine · Drug: Venetoclax

Interventions

  • Drugmitoxantrone hydrochloride liposome

    Mitoxantrone hydrochloride liposome (30 mg/m\^2) on day 1, every 4 weeks

  • DrugCytarabine

    Cytarabine (100 mg/m\^2 ) on day 1-7, every 4 weeks

  • DrugVenetoclax

    Venetoclax 100 mg on day 2,200 mg on day 3,400 mg on day 4-8, every 4 weeks

06

What researchers measure

Primary outcomes

  1. Composite complete remission (CRc) rate

    Complete remission plus complete remission with incomplete hematologic recovery (CR+CRi). Response is assessed according to the the European LeukemiaNet (ELN) 2022 criteria.

    Time frame: At the end of each cycle (each cycle is 28 days), up to 2 cycles

Secondary outcomes

  1. Overall response rate (ORR)

    CR+CRi+morphologic leukemia-free state+partial remission (CR+CRi+MLFS+PR). Response is assessed according to the the European LeukemiaNet (ELN) 2022 criteria.

    Time frame: At the end of each cycle (each cycle is 28 days), up to 2 cycles

  2. Relapsed free survival (RFS)

    Defined only for patients achieving CR or CRi. Measured from the date of achievement of remission until the date of hematologic relapse or death from any cause.

    Time frame: up to 12 months

  3. Event free survival (EFS)

    Defined for all patients in the study. Measured from day 1 of treatment to the date of treatment failure, hematologic relapse from CR/CRi or death from any cause, whichever occurs first.

    Time frame: up to 12 months

  4. overall survival (OS)

    Defined for all patients in the study. Measured from day 1 of treatment to the date of death from any cause.

    Time frame: up to 12 months

  5. Rate of CR/CRi without minimal residual disease

    Percentage of participants who achieve a CR MRD-/CRi MRD- as defined by investigators based on ELN 2022 criteria. MRD level is detected by flow cytometry and negtive MRD is defined as MRD value \<0.1%.

    Time frame: At the end of each cycle (each cycle is 28 days), up to 2 cycles

  6. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]

    The safety of the drug was evaluated by NCI-CTC AE 5.0 standard which including hematologic and non-hematologic toxicity.

    Time frame: From day 1 of treatment to 28 days after the last dose

07

Study locations

1 of 1 sites recruiting
  • The First Affiliated Hospital, Zhejiang University School of Medicine
    Hangzhou, Zhejiang 310003, China
    • Jie Jin · Contact · jiej0503@163.com · +86 571-87236896
    • Jie Jin, M.D. · Principal investigator
    • Huafeng Wang, M.D. · Sub investigator
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 16, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06621212
Lead sponsor
First Affiliated Hospital of Zhejiang University
Collaborators
CSPC Zhongnuo Pharmaceutical (Shijiazhuang) Co., Ltd.
Responsible party
Sponsor
First posted
Oct 1, 2024
Start date
Jul 5, 2024
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Sep 16, 2025

Study contacts

Jie Jin, M.D.
Contact
jiej0503@163.com
+86 571-87236896

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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