A Study of Cusatuzumab Plus Azacitidine in Participants With Newly Diagnosed Acute Myeloid Leukemia Who Are Not Candidates for Intensive Chemotherapy (CULMINATE)
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ClinicalTrials.gov Identifier: NCT04023526 |
Recruitment Status :
Active, not recruiting
First Posted : July 17, 2019
Last Update Posted : December 30, 2020
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Condition or disease | Intervention/treatment | Phase |
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Leukemia, Myeloid, Acute | Drug: Azacitidine Drug: Cusatuzumab | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 103 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase 2 Study of Cusatuzumab Plus Azacitidine in Patients With Newly Diagnosed Acute Myeloid Leukemia Who Are Not Candidates for Intensive Chemotherapy |
Actual Study Start Date : | July 29, 2019 |
Estimated Primary Completion Date : | February 25, 2021 |
Estimated Study Completion Date : | March 25, 2021 |

Arm | Intervention/treatment |
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Experimental: Azacitidine 75 mg/m^2 and Cusatuzumab 10 mg/kg
Participants will receive azacitidine 75 milligram per meter square (mg/m^2) subcutaneously (SC) or intravenously (IV) on Day 1 through Day 7 and cusatuzumab 10 milligram per kilogram (mg/kg) IV on Day 3 and Day 17 of each 28-day cycle in Part 1. Part 1 findings will be reviewed by a data review committee.
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Drug: Azacitidine
Azacitidine SC or IV will be administered at a standard dose of 75 mg/m^2 on days 1-7 of each cycle. Drug: Cusatuzumab Cusatuzumab IV will be administered as 10 mg/kg or 20 mg/kg on days 3 and 17 of each cycle.
Other Name: JNJ-74494550 |
Experimental: Azacitidine 75 mg/m^2 and Cusatuzumab 20 mg/kg
Participants will receive azacitidine 75 mg/m^2 SC or IV on Day 1 through Day 7 and cusatuzumab 20 mg/kg IV on Day 3 and Day 17 of each 28-day cycle in Part 1. Part 1 findings will be reviewed by a data review committee.
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Drug: Azacitidine
Azacitidine SC or IV will be administered at a standard dose of 75 mg/m^2 on days 1-7 of each cycle. Drug: Cusatuzumab Cusatuzumab IV will be administered as 10 mg/kg or 20 mg/kg on days 3 and 17 of each cycle.
Other Name: JNJ-74494550 |
- Percentage of Participants with Complete Response (CR) [ Time Frame: Up to 1.5 years ]Percentage of participants with complete response based on European Leukemia Network (ELN) 2017 response criteria assessment will be reported.
- Percentage of Participants with CR with Partial Hematological Recovery (CRh) [ Time Frame: Up to 1.5 years ]Percentage of participants with CRh will be reported based on ELN 2017 response criteria assessment.
- Percentage of Participants with CR plus CRh [ Time Frame: Up to 1.5 years ]Percentage of participants with CR plus CRh will be reported based on ELN 2017 response criteria assessment.
- Percentage of Participants with CR with Incomplete Recovery (CRi) [ Time Frame: Up to 1.5 years ]Percentage of participants with CRi will be reported based on ELN 2017 response criteria assessment.
- Overall Response Rate (ORR) [ Time Frame: Up to 1.5 years ]ORR is defined as percentage of participants with CR, CRh and CRi based on ELN 2017 response criteria assessment.
- Percentage of Participants with CR without MRD [ Time Frame: Up to 1.5 years ]Percentage of participants with CR without minimal residual disease (MRD) will be reported and is defined as less than 1 blast or leukemic stem cell in 1,000 leukocytes (MRD level <10^-3; determined by central lab).
- Percentage of Participants with Negative MRD who Achieved CR, CRh, CRi, or Morphologic Leukemia-free State (MLFS) [ Time Frame: Up to 1.5 years ]Percentage of participants with negative MRD who achieved CR, CRh, CRi, or MLFS will be reported and is defined as less than (<) 1 blast or leukemic stem cell in 1,000 leukocytes (MRD level <10^-3).
- Time to Response [ Time Frame: Up to 1.5 years ]Time to response, defined as time from randomization in Part 1 to achieving the first response of CR, CRh, or CRi.
- Duration of Response [ Time Frame: Up to 1.4 years ]Duration of response is defined as time from achieving the first response of CR, CRh, or CRi to disease relapse or death from any cause.
- Red Blood Cell (RBC) or Platelets Transfusion Independence [ Time Frame: Up to 1.5 years ]Transfusion independence (RBC or platelets) is defined as a period of at least 56 consecutive days with no transfusion between first dose of study drug and the last dose of study drug +30 days.
- Number of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs) [ Time Frame: Up to 1.9 years ]An AE is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical/biological agent under study. An SAE is any AE that results in: death, persistent or significant disability/incapacity, requires inpatient hospitalization or prolongation of existing hospitalization, is life-threatening experience, is a congenital anomaly/birth defect and may jeopardize participant and/or may require medical or surgical intervention to prevent one of the outcomes listed above.
- Minimum Serum Concentration (Cmin) of Cusatuzumab [ Time Frame: Up to 1.9 years ]Cmin is the minimum observed serum concentration.
- Maximum Serum Concentration (Cmax) of Cusatuzumab [ Time Frame: Up to 1.9 years ]Cmax is the maximum observed serum concentration.
- Number of Participants with Anti-cusatuzumab Antibodies [ Time Frame: Up to 1.9 years ]Number of participants exhibiting anti-drug antibodies for cusatuzumab alone and in combination with azacitidine will be reported.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
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Acute myeloid leukemia (AML) according to World Health Organisation (WHO) 2016 criteria and fulfilling all of the following criteria that defines those who are "not candidates for intensive chemotherapy":
- greater than or equal to (>=)75 years of age or
- less than (<) 75 years of age with at least one of the following comorbidities: Eastern Cooperative Oncology Group (ECOG) Performance Status of 2; Severe cardiac comorbidity defined as congestive heart failure or ejection fraction less than or equal to (<=) 50 percent (%); Severe pulmonary comorbidity defined as documented pulmonary disease with lung diffusing capacity for carbon monoxide (DLCO) <=65% of expected, or forced expiratory volume in 1 second (FEV1) <=65% of expected or dyspnea at rest requiring oxygen; Moderate hepatic impairment defined according to NCI organ dysfunction classification criteria (total bilirubin >=1.5 up to 3 times upper limit of normal [ULN]); Creatinine clearance <45 milliliter per minute per 1.73 meter square (mL/ min/1.73 m^2); Comorbidity that, in the Investigator's opinion, makes the participant unsuitable for intensive chemotherapy and must be documented and approved by the Sponsor before randomization
- De novo or secondary AML
- Previously untreated AML (except: emergency leukapheresis, hydroxyurea, and/or 1 dose of cytarabine [example: 1-2 gram per meter square {g/m^2}] during the Screening Phase to control hyperleukocytosis. These treatments must be discontinued >=24 hours prior to start of study drug). Empiric all trans retinoic acid (ATRA) treatment for presumed acute promyelocytic leukemia (APL) is permitted but APL must be ruled out and ATRA must be discontinued >=24 hours prior to the start of study drug
- Not eligible for an allogeneic hematopoietic stem cell transplantation
- ECOG Performance Status score of 0, 1 or 2
Exclusion Criteria:
- Acute promyelocytic leukemia
- Leukemic involvement or clinical symptoms of leukemic involvement of the central nervous system
- Use of immune suppressive agents for the past 4 weeks before the first administration of cusatuzumab on Cycle 1 Day 3. For regular use of systemic corticosteroids, participants may only be included if free of systemic corticosteroids for a minimum of 5 days before the first administration of cusatuzumab. Treatment of adrenal insufficiency with physiologic replacement doses of corticosteroids are allowed
- Prior treatment with a hypomethylating agent for treatment of AML or myelodysplastic syndrome (MDS)
- Active malignancies (that is, progressing or requiring treatment in the last 24 months) other than the disease being treated under the study
- Any active systemic infection
- Known allergies, hypersensitivity, or intolerance to cusatuzumab or azacitidine or its excipients (that is, mannitol, an excipient of azacitidine)

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04023526

Study Director: | Janssen Research & Development, LLC Clinical Trial | Janssen Research & Development, LLC |
Responsible Party: | Janssen Research & Development, LLC |
ClinicalTrials.gov Identifier: | NCT04023526 |
Other Study ID Numbers: |
CR108609 2019-000473-23 ( EudraCT Number ) 74494550AML2001 ( Other Identifier: Janssen Research & Development, LLC ) |
First Posted: | July 17, 2019 Key Record Dates |
Last Update Posted: | December 30, 2020 |
Last Verified: | December 2020 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | The data sharing policy of the Janssen Pharmaceutical Companies of Johnson & Johnson is available at www.janssen.com/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale open Data Access (YODA) Project site at yoda.yale.edu |
URL: | https://www.janssen.com/clinical-trials/transparency |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | Yes |
Leukemia Leukemia, Myeloid Leukemia, Myeloid, Acute Neoplasms by Histologic Type Neoplasms Azacitidine |
Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Enzyme Inhibitors |