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
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.
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.
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 →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.
Clinically diagnosed relapsed/refractory AML, excluding acute promyelocytic leukemia.
Exclusion Criteria:
Previous anti-tumor therapy meets one of the following criteria:
Cardiovascular diseases, including but not limited to:
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
Mitoxantrone hydrochloride liposome (30 mg/m\^2) on day 1, every 4 weeks
Cytarabine (100 mg/m\^2 ) on day 1-7, every 4 weeks
Venetoclax 100 mg on day 2,200 mg on day 3,400 mg on day 4-8, every 4 weeks
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
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
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
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
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
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
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
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First Affiliated Hospital of Zhejiang University