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    Clinical Trial Results:
    INTERNATIONAL MULTICENTER, OPEN-LABEL, PHASE 2 STUDY TO TREAT MOLECULAR RELAPSE OF PEDIATRIC ACUTE MYELOID LEUKEMIA WITH AZACITIDINE

    Summary
    EudraCT number
    2017-003422-32
    Trial protocol
    DE   AT   NL   SE   BE   DK  
    Global end of trial date
    15 Dec 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    15 May 2025
    First version publication date
    15 May 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AMoRe2017
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    GPOH gGmbH
    Sponsor organisation address
    Holsterhauser Platz 2, Essen, Germany, 45147
    Public contact
    Katharina Waack-Buchholz, Pädiatrisches Forschungsnetzwerk gGmbH, 0049 020174949611, waack.katharina@gpoh-trials.org
    Scientific contact
    Dirk Reinhardt, Päd. Forschungsnetzwerk, 0049 02017494960, dirk.reinhardt@gpoh-trials.org
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    12 Dec 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Dec 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the effect of azacitidine treatment in AML subjects at molecular relapse after CR1 with regard to molecular response prior to further treatment (reinduction / HSCT)
    Protection of trial subjects
    Children and young adults with AML in molecular relapse after CR1 will be considered for participation in this study. The subject and/or guardian(s) (as appropriate by local law and regulations) will be provided with a written ICF and will be given the opportunity to ask any questions concerning the study. The ICF must be signed by the subject and/or guardian(s) (as appropriate by local law and regulations) prior to the subject participating in any study procedures. The ICF must be signed before performance of any study related activity. Subjects who fail screening should be managed according to standard practice (including chemotherapy) in the responsible institution. For subjects who are rescreened, the ICF will need to be signed again, as well as all screening procedures repeated. Subjects will sign ICF and start the screening process at the following time points: Subjects will remain in the Screening Period for up to 10 days until the molecular relapse has been confirmed in PB and BM aspirate by the study reference laboratory. Once the molecular relapse has been confirmed, and provided that all other criteria for the study are satisfied, the subject will be enrolled.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Feb 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 2
    Country: Number of subjects enrolled
    Austria: 3
    Country: Number of subjects enrolled
    Germany: 15
    Worldwide total number of subjects
    20
    EEA total number of subjects
    20
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    2
    Children (2-11 years)
    11
    Adolescents (12-17 years)
    3
    Adults (18-64 years)
    4
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Dates of recruitment period: 03/2018 - 02/2023 Territories: Germany, The Netherlands, Austria Total number of patients: 20

    Pre-assignment
    Screening details
    MRD sreening accoring to standard of care

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    No blinding implemented.

    Arms
    Arm title
    Azacitidine
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Azacitidine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Intravenous azacitidine 75 mg/m2, Days 1 to 7 of a 28-day cycle for up to 3 cycles initially. In case of decline of MRD during azacitidine treatment additional cycles are allowed (maximum 6 cycles).

    Number of subjects in period 1
    Azacitidine
    Started
    20
    Completed
    19
    Not completed
    1
         laboratory measurement error
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    -

    Reporting group values
    Overall trial Total
    Number of subjects
    20 20
    Age categorical
    Units: Subjects
        3 months to <21 years
    20 20
    Gender categorical
    Units: Subjects
        Female
    9 9
        Male
    11 11
    Subject analysis sets

    Subject analysis set title
    Full analysis
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All subjects eligible for the analysis of the primary and secondary endpoint.

    Subject analysis sets values
    Full analysis
    Number of subjects
    19
    Age categorical
    Units: Subjects
        3 months to <21 years
    19
    Age continuous
    Units:
        
    ( )
    Gender categorical
    Units: Subjects
        Female
    9
        Male
    10

    End points

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    End points reporting groups
    Reporting group title
    Azacitidine
    Reporting group description
    -

    Subject analysis set title
    Full analysis
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All subjects eligible for the analysis of the primary and secondary endpoint.

    Primary: To evaluate the effect of azacitidine treatment in AML subjects at molecular relapse after CR1 with regard to molecular response prior to further treatment (reinduction / HSCT)

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    End point title
    To evaluate the effect of azacitidine treatment in AML subjects at molecular relapse after CR1 with regard to molecular response prior to further treatment (reinduction / HSCT) [1]
    End point description
    End point type
    Primary
    End point timeframe
    During the recruitment period.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Singel arm study: The statistical analysis for an endpoint is not mandatory.
    End point values
    Azacitidine
    Number of subjects analysed
    19 [2]
    Units: totals
        Molecular stabilization
    3
        Molecular progression
    1
        Molecular improvement
    5
        Hematological/clinical relapse
    10
    Notes
    [2] - n = 1 drop-out due to measurement error, not eligible for analysis
    No statistical analyses for this end point

    Secondary: To assess the safety of azacitidine treatment in children and adolescents with a molecular relapse of AML. Disease free and overall survival post molecular relapse; quality of life

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    End point title
    To assess the safety of azacitidine treatment in children and adolescents with a molecular relapse of AML. Disease free and overall survival post molecular relapse; quality of life
    End point description
    AE reports
    End point type
    Secondary
    End point timeframe
    Start of recruitment until 12/23.
    End point values
    Azacitidine
    Number of subjects analysed
    19 [3]
    Units: totals
        AE Grade 1
    78
        AE Grade 2
    36
        AE Grade 3
    29
        AE Grade 4
    8
        AE Grade 5
    0
    Notes
    [3] - n = 1 drop-out due to measurement error, not eligible for analysis
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Start at first patient in, ended 12/2023
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE Short Name
    Dictionary version
    5.0
    Reporting groups
    Reporting group title
    Subject eligible for analysis
    Reporting group description
    All subject that recieved at least one cycle of protocol treatment.

    Serious adverse events
    Subject eligible for analysis
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 19 (15.79%)
         number of deaths (all causes)
    4
         number of deaths resulting from adverse events
    0
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Febrile Neutropenia
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Fever
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Flu like symptoms
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Subject eligible for analysis
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    6 / 19 (31.58%)
    Cardiac disorders
    Tachycardia
    Additional description: Garde 2
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Bradycardia
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Hypotension
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    White blood cells decreased
    Additional description: all grades
         subjects affected / exposed
    3 / 19 (15.79%)
         occurrences all number
    13
    Anemia
    Additional description: all grades
         subjects affected / exposed
    2 / 19 (10.53%)
         occurrences all number
    16
    Platelet count decreased
    Additional description: all grades
         subjects affected / exposed
    3 / 19 (15.79%)
         occurrences all number
    22
    Lymphocyte count decreased
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Thrombocytopenia intermittend
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Hypernatremia
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    LDH increased
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    2
    Low potassium
    Additional description: Grade 2
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    General disorders and administration site conditions
    Pain
    Additional description: Grade 1 and 2
         subjects affected / exposed
    6 / 19 (31.58%)
         occurrences all number
    8
    Edema
    Additional description: Grade 1
         subjects affected / exposed
    3 / 19 (15.79%)
         occurrences all number
    5
    Fall
    Additional description: Grade 2
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Allergic reaction to thrombocyte infusion
    Additional description: Grade 3
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Hematoma
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Reduced general condition
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Malaise
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Drowsiness
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Agitation
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Gastrointestinal disorders
    Nausea
    Additional description: all grades
         subjects affected / exposed
    4 / 19 (21.05%)
         occurrences all number
    9
    Vomiting
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Diarrhea
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Flatulences intermitted
    Additional description: Grade 2
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Constipation
    Additional description: Grade 1
         subjects affected / exposed
    2 / 19 (10.53%)
         occurrences all number
    2
    Mucositis
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Gum bleeding
    Additional description: Grade 2
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Hepatobiliary disorders
    Blood bilirubin increased
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    2
    Aspartate aminotransferase increased
    Additional description: Grade 1 and 2
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    5
    Alanine aminotransferase increased
    Additional description: Grade 2 and 3
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Rash
    Additional description: Grade 1 and 3
         subjects affected / exposed
    2 / 19 (10.53%)
         occurrences all number
    3
    Exanthema
         subjects affected / exposed
    2 / 19 (10.53%)
         occurrences all number
    2
    Flaky skin
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Redness skin
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Warts
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Itching
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Renal and urinary disorders
    Creatinin increased
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    GTT increased
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    3
    Hyperuricemia
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Myalgia
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Infections and infestations
    Febrile neutropenia
    Additional description: Grade 3
         subjects affected / exposed
    2 / 19 (10.53%)
         occurrences all number
    2
    Cough
    Additional description: Grade 1 and 2
         subjects affected / exposed
    2 / 19 (10.53%)
         occurrences all number
    6
    Lung infection
    Additional description: Grade 3
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    Flu like symptoms
    Additional description: Grade 2 and 3
         subjects affected / exposed
    2 / 19 (10.53%)
         occurrences all number
    2
    Sore throat
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1
    CRP increased
    Additional description: Grade 3
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    4
    Herpes simplex labialis reactivation
    Additional description: Grade 1
         subjects affected / exposed
    1 / 19 (5.26%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    21 Feb 2020
    Substantial amendment included: - Contacts and contact details updated as appropriate - Inclusion criteria, methodology, study design, screening period, molecular progression: MRD Value removed - Treatment period: Dose corrected, Flowchart was also corrected - Pregancy (Harmonization international protocols) - Treatment Administration and Schedule (Harmonization international protocols) - Regulatory Considerations (Harmonization international protocols)

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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