ClinicalTrials.gg
RecruitingNCT07478991VENP-A-QUIUpdated Nov 4, 2026

Azacytidine, Venetoclax Plus Minus Quizartinib for First Line Older/Unfit AML Patients (VENP-A-QUI)

A Phase 3 interventional study of Azacitidine and Venetoclax in Acute Myeloid Leukemia, Adult, sponsored by PETHEMA Foundation. Recruiting at 52 sites in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by PETHEMA Foundation · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2026; still recruiting 4 months later.
Updated Nov 4, 2026Site recruiting status changed1 site addedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
376
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to learn if Venetoclax+Azacytidine+Quizartinib works better than standard therapy (Venetoclax+Azacytdine) to treat naïve adult patients with acute myeloid leukemia (AML) who are not suitable for standard induction therapy due to age, co-morbidities or other risk factors. The main question it aims to answer is:

- Does the combination of Venetoclax+Azacytidine+Quizartinib show more probability of overall survival than Venetoclax+Azacytdine?

Researchers will compare Venetoclax+Azacytidine+Quizartinib to Venetoclax+Azacytdine to see if Venetoclax+Azacytidine+Quizartinib works better than Venetoclax+Azacytdine to treat AML.

Participants will be randomized to one of the two treatment arms in a 1:1 ratio, both of which will have treatment cycles of 28 days.

Read the detailed description

A total of 376 subjects will be randomized to meet scientific and regulatory objectives.

Experimental arm:

  • AZA 75 mg/m2 /daily SC, days 1 to 7 in 28-day cycle.
  • Venetoclax 400 mg/daily oral for 7 days, the same days as AZA.
  • Quizartinib 60 mg/daily oral in FLT3-ITD negative and 40 mg daily in FLT3-ITD positive patients, days 8 to 21.

Standard arm:

  • AZA 75 mg/m2 /daily SC, days 1 to 7 in 28-day cycle.
  • Venetoclax 400 mg/daily oral for 28 days.ç

Participants will continue their study treatment until documented disease progression, unacceptable toxicity, withdrawal of consent, or the participant meets other protocol criteria for discontinuation or study completion.

Survival information and post treatment follow up will be collected (via telephone calls and/or clinical visits) every 3 months after the last study visit for a period of 2 years after the last patient has been enrolled into the study.

02

Conditions studied

  • Acute Myeloid Leukemia, Adult

Keywords

  • AML
  • adult
  • old/unfit
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 planned enrollment of 376 is above the median of 40 across 3,005 interventional studies indexed under Leukemia, Myeloid, Acute.

Browse Leukemia, Myeloid, Acute studies →

Lead sponsor

PETHEMA Foundation is the lead sponsor of 107 studies on the registry; 12 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

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

  1. The subject must have confirmation of AML by 2022 WHO criteria, previously untreated and be ineligible for treatment with a standard cytarabine and anthracycline based induction regimen due to age and/or comorbidities.
  2. Patients must be considered ineligible for treatment with a standard cytarabine and anthracycline induction regimen due to age or co-morbidities defined by the following criteria:

    • ≥ 75 years of age;
    • or ≥ 18 to 75 years of age with at least one of the following co-morbidities:

      • Performance Status of 2 or 3;
      • Cardiac history of cardiac heart failure (CHF) requiring treatment or (LVEF) >45% and ≤ 55% or chronic stable angina.
      • DLCO ≤ 65% or ≤ 65% and/or significant history of chronic pulmonary obstructive;
      • ≥ 30 mL/min to \< 50 ml/min (see Appendix 7);
      • Moderate hepatic impairment with total , or SGOT > 1.5 to ≤ 3.0 × ;
      • Non active/controlled prior neoplastic disease;
      • Any other patient´s comorbidity or disease condition that the physician judges to be incompatible with intensive chemotherapy must be reviewed and approved by the Clinical Trial Coordinator before study enrollment (e.g, prior neoplastic disease, high-risk cytogenetics). All patients aged less than 60 years old must be reviewed and approved by Clinical Trial Coordinator before study enrollment.
  3. ECOG performance status ≤2 for patients >75 years, ≤3 for patients ≥ 60 to 75 years of age.
  4. Male subjects who are sexually active, must agree, from Study Day 1 through at least 120 days after the last dose of study drug, to practice the protocol specified .
  5. Female subjects must be either for at least 1 year before screening OR permanently surgical sterile (bilateral oophorectomy, bilateral salpingectomy or hysterectomy) or Women of (WOCBP) must agree to practice 1 highly effective method and 1 additional effective (barrier) method of contraception, at the same time, from the time of signing the through 7 months after the last dose of study drug (female and male condoms should not be used together), or Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [e.g., calendar, ovulation, symptothermal, postovulation methods] withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception). Female subjects of childbearing potential must have negative results for pregnancy test performed and must not be lactating and breastfeeding.
  6. Subject must voluntarily sign and date an informed consent, approved by an Independent Ethics Committee (IEC)/Institutional Review Board (IRB), prior to the initiation of any screening or study specific procedures, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.

Exclusion criteria

Exclusion Criteria:

  1. Age \<18 years old at screening.
  2. Subject has received prior treatment with hypomethylating agent, FLT3 or BCL2 inhibitors.
  3. Confirmed diagnosis of prior myelodysplastic syndrome (MDS) or a myeloproliferative neoplasm (MPN) or MDS/MPNs including CMML, aCML, JMML and others. This exclusion criterion will not be applicable to patients with FLT3 or NPM1 mutations (as per technical sensitivity threshold of local and/or central laboratory), who can be enrolled.
  4. Genetic diagnosis of acute promyelocytic leukemia.
  5. Treated (excluding surgery or hormone-therapy) for another within 6 months before randomization or previously diagnosed with another malignancy and have any evidence of disease which may compromise the administration of treatment schedule.
  6. Presence of any severe psychiatric disease or physical condition that, according to the physician´s criteria, contraindicates the inclusion of the patient into the clinical trial.
  7. Serum creatinine ≥ 2.5 mg/dL or \< 30 mL/min.
  8. >1.5 times, or SGOT > 3 times the upper normal limit (unless it is attributable to AML activity).
  9. WBC >25 x 109/L before randomization.
  10. for Azacitidine, Quizartinib or Venetoclax (such as history of to any in Azacitidine, Quizartinib, or Venetoclax).
  11. Known central nervous system (CNS) active leukemia, including cerebrospinal fluid positive for AML blasts.
  12. Prior treatment with any investigational drug or device within 14 days prior to Randomization (within 2 weeks for investigational or approved immunotherapy) or currently participating in other investigational interventional procedures.
  13. Known uncontrolled or significant cardiovascular disease, including any of the following:

    1. Bradycardia of less than 50 beats per minute, unless the subject has a pacemaker;
    2. interval >450 msec;
    3. Diagnosis of or suspicion of long QT syndrome (including family history of long QT syndrome);
    4. Systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg;
    5. History of ventricular arrhythmias (eg, ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes);
    6. History of second (Mobitz II) or third degree heart block (subjects with pacemakers are eligible if they have no history of fainting or clinically relevant arrhythmias while using the pacemaker);
    7. History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to Screening;
    8. History of Class 3 or 4 heart failure;
    9. Known history of ≤45%;
    10. Complete left bundle branch block;
    11. Severe aortic stenosis
  14. Prior therapy for AML (except hydroxyurea, or maximum 1 gram/sqm/day per 2 days of cytarabine allowed to control hyperleukocytosis during the screening period).
  15. Subject must not have consumed grapefruit, grapefruit products, Seville oranges (including marmalade-containing Seville oranges), or star fruit within 3 days before anticipated first dose of Venetoclax and must consent not to consume through the last dose of Venetoclax.
  16. Active acute or chronic systemic fungal, bacterial, or viral infection not well controlled by antifungal, antibacterial or antiviral therapy at physician discretion.
  17. Known active clinically relevant liver disease (eg, active , or active )
  18. Known history of (HIV).
  19. Uncorrected Grade 3 or 4 hypokalemia, hypomagnesemia or hypocalcemia (Subjects with Grade 1 or 2 electrolyte abnormalities can be enrolled while electrolytes are being corrected).
  20. Uncontrolled hypothyroidism.
Terms in these criteria, in plain language(22)

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.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

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.

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.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
376 participants (estimated)

Study arms

  • Experimental
    Venetoclax Azacitidine and Quizartinib

    * Azacytidine 75 mg/m2 /daily SC, days 1 to 7 in 28-day cycle. * Venetoclax 400 mg/daily oral for days 1 to 7, the same days as Azacytidine, in 28-day-cycle. * Quizartinib 60 mg/daily oral in FLT3-ITD negative and 40 mg daily in FLT3-ITD positive patients, days 8 to 21.

    Drug: Azacitidine · Drug: Venetoclax · Drug: Quizartinib

  • Active comparator
    Venetoclax and Azacitidine

    * Azacytidine 75 mg/m2 /daily SC, days 1 to 7 in 28-day cycle. * Venetoclax 400 mg/daily oral for days 1 to 7, the same days as Azacytidine, in 28-day-cycle.

    Drug: Azacitidine · Drug: Venetoclax

Interventions

  • Subcutaneous injection during the first 7 days of each 28-day cycle until disease progression or end of study

  • Oral Venetoclax during the first 7 days of each 28-day cycle until disease progression or end of study

  • Oral Quizartinib during days 8 to 21 of each 28-day cycle until disease progression or end of study .

06

What researchers measure

Primary outcomes

  1. Overall Survival

    Comparison of time from diagnosis to death or last follow-up between both treatment arms.

    Time frame: 4 years

Secondary outcomes

  1. Event-free Survival rate

    To compare time from enrollment until the date of relapse from Complete Remission (CR), Complete Remission with hematologic recovery (CRh) or Complete Remission with incomplte hematologic recovery (CRi), failure to achieve CR, CRh, or CRi after 4 cycles after initiation of treatment, or death from any cause, between both treatment arms.

    Time frame: 4 years

  2. Composite Complete Response (CCR) rate

    To evaluate the CCR (CR+CRh+CRi) of the study (best response obtained on study)

    Time frame: 4 years

07

Study locations

24 of 52 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

5 registry updates since Sep 25, 2026
Sites
1 site added. 5 sites changed recruiting status (5 now recruiting)
Show 5 sites
  • Hospital Universitario de Basurto · Barakaldo, SpainNot yet recruiting→Recruiting
  • Hospital Universitario Puerta del Mar · Cadiz, SpainNot yet recruiting→Recruiting
  • Hospital Universitario Donostia · Donostia / San Sebastian, SpainNot yet recruiting→Recruiting
  • Hospital Principe de Asturias · Alcalá de Henares, SpainNot yet recruiting→Recruiting
  • Hospital Universitario Torrecárdenas · Almería, SpainNot yet recruiting→Recruiting
Show site
  • Althaia, Xarxa Asistencial de Manresa · Manresa, Spain
across 5 updates, Sep 29, 2026 – Nov 4, 2026
Show all 5 updates
  1. Nov 4, 2026
    Hospital Universitario Torrecárdenas is now Recruiting
  2. Nov 2, 2026
    Hospital Principe de Asturias is now Recruiting
  3. Oct 28, 2026
    Hospital Universitario Donostia is now Recruiting
  4. Oct 7, 2026
    1 site added. Hospital Universitario Puerta del Mar is now Recruiting
    Show site
    • Althaia, Xarxa Asistencial de Manresa · Manresa, Spain
  5. Sep 29, 2026
    Hospital Universitario de Basurto is now Recruiting

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
NCT07478991
Lead sponsor
PETHEMA Foundation
Responsible party
Sponsor
First posted
Mar 18, 2026
Start date
Jul 2, 2026
Primary completion
Apr 2030 (estimated)
Completion
Apr 2030 (estimated)
Last update
Nov 4, 2026

Study contacts

Pau Montesinos
Contact
montesinos_pau@gva.es
+3461244925
Juan José Lahuerta
Contact
jjlahuerta@telefonica.net
+34916266232
Claudia Sossa
principal investigator · Clínica FOSCAL
Joana Brioso
principal investigator · Centro Hospitalar Universitário Lisboa Norte Hospital de Santa Maria
Juan Bergua
principal investigator · Hospital San Pedro Alcántara

Oversight

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

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