Clinical Trial to Assess the Safety and Tolerability of the Combination of Low-dose Cytarabine or Azacitidine Plus Venetoclax and Quizartinib in Newly Diagnosed AML Patients Aged Equal or More Than 60 Years Old

Inclusion Criteria

• •1. Newly diagnosed AML.
• •2. Morphological diagnosis of AML (WHO criteria 2008).
• •3. Patient must be considered be ineligible for treatment with a standard cytarabine and anthracycline induction regimen due to age or co-morbidities defined by the following criteria: 3.1. ≥ 71 years of age; 3.2. ≥ 60 to 70 years of age with at least one of the following co-morbidities:
• •* ECOG Performance Status of 2 or 3;
• •* Cardiac history of CHF requiring treatment or Ejection Fraction ≤ 55% or chronic stable angina;
• •* DLCO ≤ 65% or FEV1 ≤ 65% or significant history of chronic pulmonary obstructive;
• •* Creatinine clearance ≥ 30 mL/min to \< 50 ml/min
• •* Moderate hepatic impairment with total bilirubin, SGPT or SGOT \> 1.5 to ≤ 3.0 × ULN
• •* 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 Trial Coordinators before study enrollment (e.g, prior MDS or MPS, high-risk cytogenetics)
• •4. ECOG performance status ≤ 3.
• •5. 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 contraception (see Section 0).
• •6. Female subjects must be either postmenopausal for at least 1 year before screening OR permanently surgical sterile (bilateral oophorectomy, bilateral salpingectomy or hysterectomy) OR Women of Childbearing Potential (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 informed consent through 4 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.
• •7. Subject must voluntarily sign and date an informed consent, approved by an Independent Ethics Committee (IEC) 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.
• •7. History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to Screening;
• •8. History of New York Heart Association Class 3 or 4 heart failure;
• •9. Known history of left ventricular ejection fraction (LVEF) ≤45% or less than the institutional lower limit of normal;
• •10. Complete left bundle branch block;
• •13. Prior therapy for AML (except hydroxiurea).
• •14. Subject enrolling into a dose-escalation cohort must not have received a known strong or moderate inducer or inhibitor of cytochrome P450 (CYP) 3A within 7 days before the first Quizartinib or Venetoclax dose. Subject enrolling into a safety expansion cohort must not have received a known strong or moderate inducer or strong inhibitor of CYP3A within 7 days before the first Quizartinib or Venetoclax dose.
• •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 hepatitis B, or active hepatitis C)
• •18. Known history of human immunodeficiency virus (HIV).
• •19. History of hypersensitivity to any excipients in the Quizartinib, Venetoclax or other study medication.
• •20. Non mutated FLT3-ITD subjects will be considered ineligible during the randomized Phase II after 48 non mutated FLT3-ITD subjects have been randomized.