Recruiting
Phase 1

8-Chloroadenosine & Venetoclax

Sponsor:

City of Hope Medical Center

Code:

NCT05263284

Conditions

Acute Myeloid Leukemia

Recurrent Acute Myeloid Leukemia

Refractory Acute Myeloid Leukemia

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

8-Chloroadenosine

Venetoclax

Study Details

Brief summary:

This phase I trial tests the safety, side effects, and best dose of a new 8-chloroadenosine in combination with venetoclax in treating patients with acute myeloid leukemia that has come back (relapsed) or does not respond to treatment (refractory). 8-Chloroadenosine may help block the formation of growths that may become cancer. Venetoclax is in a class of medications called B-cell lymphoma-2 (BCL-2) inhibitors. It may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Giving 8-chloroadenosine in combination with venetoclax may help prevent the disease from coming back in patients with acute myeloid leukemia.

Conditions

Acute Myeloid Leukemia

Recurrent Acute Myeloid Leukemia

Refractory Acute Myeloid Leukemia

Study ID

NCT05263284

Start date

Oct 31, 2022

Status verified date

Aug, 2026

Completion date

Jan 25, 2029

Anticipated

Primary completion date

Jan 25, 2029

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Documented informed consent of the participant and/or legally authorized representative.
  • Age: >= 18 years.
  • Eastern Cooperative Oncology Group (ECOG) =< 2.
  • Life expectancy > 3 months.
  • Patients with histologically confirmed acute myeloid leukemia (AML), according to World Health Organization (WHO) criteria, with relapsed/refractory disease.
  • Patients must have any one of the following treatment history criteria:

  • Relapsed AML

  • Failed at least 1 line of salvage therapy or
  • Untreated relapse and are not candidates for allogeneic hematopoietic stem cell transplantation (alloHCT)
  • De novo AML

  • have not achieved complete response (CR) after 2 lines of therapy or
  • refractory to frontline therapy and not eligible for alloHCT
  • AML evolving from myelodysplastic syndrome (MDS) or myeloproliferative disorder who have failed hypomethylating agents (HMA) or induction chemotherapy
  • Patients who have relapsed after allo-HCT are eligible if they are at least 3 months after HCT, do not have active graft versus host disease (GVHD) and are off immunosuppression except for maintenance dose of steroids (prednisone 10 mg/day or less).
  • Male subjects must agree to not donate sperm while taking protocol therapy through at least 90 days after the last dose.
  • White blood cell (WBC) =< 25 x 10\^9/L prior to initiation of venetoclax. Cytoreduction with hydroxyurea prior to treatment and/or during cycle 1 may be required.
  • Total bilirubin =< 1.5 X upper limit of normal (ULN) (unless has Gilbert's disease).
  • Aspartate aminotransferase (AST) =< 2.5 x ULN.
  • Alanine aminotransferase (ALT) =< 2.5 x ULN.
  • Creatinine clearance of >= 50 mL/min per 24 hour urine test or the Cockcroft-Gault formula.
  • QTc =< 480 ms.
  • Women of childbearing potential (WOCBP): negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
  • Agreement by females and males of childbearing potential\* to use an effective method of birth control or abstain from heterosexual activity for the course of the study through at least 6 months (females) and 3 months (males) after the last dose of protocol therapy.

  • Childbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for > 1 year (women only).

Exclusion Criteria:

  • Current or planned use of other investigational agents, antineoplastic, biological, chemotherapy, or radiation therapy during the study treatment period, or within 2 weeks prior to day 1 of protocol therapy, with the following exception:

  • Hydroxyurea which may be continued through cycle 1.
  • Expected to undergo HCT within 120 days of enrollment.
  • Current or planned use of agents that prolong or suspected to prolong QTc.
  • Received strong or moderate CYP3A inducers or St. John's Wort within 7 days prior to day 1 of protocol therapy.
  • Received strong or moderate CYP3A inhibitors, or consumed grapefruit, grapefruit products, Seville oranges (including marmalade containing Seville oranges) or Star fruit within 3 days prior to day 1 of protocol therapy.
  • P-glycoprotein (P-gp) inhibitors within 7 days prior to day 1 of protocol therapy.
  • Narrow therapeutic index P-gp substrates within 7 days prior to day 1 of protocol therapy.
  • Acute promyelocytic leukemia.
  • Active central nervous system (CNS) leukemia.
  • Active fungal infection or bacterial sepsis.
  • Class III/IV cardiovascular disability according to the New York Heart Association classification.
  • Participants with clinically significant arrhythmia or arrhythmias not stable on medical management within two weeks of enrollment. Subjects with controlled, asymptomatic atrial fibrillation can enroll.
  • History of acute cardiovascular ischemic event, i.e., myocardial infarction or unstable angina within 6 months of enrollment.
  • History of unexplained syncope, significant histories of CAD (requiring revascularization by percutaneous coronary intervention \[PCI\] or coronary artery bypass grafting \[CABG\]), cardiomyopathy (ejection fraction \[EF\] < 50%).
  • Prior surgery or gastrointestinal dysfunction that may affect drug absorption (e.g., gastric bypass surgery, gastrectomy).
  • Unable to swallow capsules, has a partial or small bowel obstruction, or has a gastrointestinal condition resulting in a malabsorptive syndrome (e.g. small bowel resection with malabsorption).
  • Active peptic ulcer disease.
  • Other active malignancy except for localized skin cancer, bladder, prostate, breast or cervical carcinoma in situ.
  • Females only: Pregnant or breastfeeding.
  • Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures.
  • Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics).

Study Design

Enrollment

30 participants

Anticipated

Intervention Model

Single group

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Treatment (8-chloroadenosine, venetoclax)

Patients receive 8-Cl-Ado IV over 4 hours daily on days 1-5 and venetoclax PO QD on days 1-28. Treatment repeats every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

Interventions

8-Chloroadenosine

Given IV

Venetoclax

Given PO

Primary outcome measure

  • Incidence of adverse events (AEs) [ Time Frame: Up to 1 year ]
  • Dose limiting toxicity (DLT) [ Time Frame: Up to 1 cycle (Each cycle is 28 days) ]

Central Contacts and Locations

Locations

City of Hope Medical Center

Recruiting

Duarte, California, United States, 91010

Contacts

Vinod Pullarkat

626-359-8111vpullarkat@coh.org

Principal Investigator:

Vinod Pullarkat

More Information

Sponsor

City of Hope Medical Center

Last update posted

Aug 21, 2026

Last verified

Aug, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by City of Hope Medical Center on 2026-08-21.