ChiCTR2600125359 版本V1.0 版本创建时间2026/05/26 10:19:13 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2600125359 

最近更新日期:

Date of Last Refreshed on:

2026-05-26 10:19:07 

注册时间:

Date of Registration:

2026-05-26 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

利沙托克拉联合地西他滨方案用于维奈克拉治疗失败的骨髓增生异常肿瘤患者的多中心、前瞻性、单臂II期研究

Public title:

Multicenter, Prospective, Single-Arm Phase II Study of Lishatoclax Plus Decitabine in Patients With Myelodysplastic Neoplasms Who Have Failed Venetoclax Therapy

注册题目简写:

English Acronym:

研究课题的正式科学名称:

利沙托克拉联合地西他滨方案用于维奈克拉治疗失败的骨髓增生异常肿瘤患者的多中心、前瞻性、单臂II期研究

Scientific title:

Multicenter, Prospective, Single-Arm Phase II Study of Lishatoclax Plus Decitabine in Patients With Myelodysplastic Neoplasms Who Have Failed Venetoclax Therapy

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李冰 

研究负责人:

李冰 

Applicant:

Li Bing 

Study leader:

Li Bing 

申请注册联系人电话:

Applicant telephone:

+86 22 23909046

研究负责人电话:

Study leader's
telephone:

+86 22 23909046

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

libing@ihcams.ac.cn

研究负责人电子邮件:

Study leader's E-mail:

libing@ihcams.ac.cn

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国天津市和平区南京路288号

研究负责人通讯地址:

中国天津市和平区南京路288号

Applicant address:

288 Nanjing Road, Heping District, Tianjin, China

Study leader's address:

288 Nanjing Road, Heping District, Tianjin, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

中国医学科学院血液病医院(中国医学科学院血液学研究所)

Applicant's institution:

Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking

研究负责人所在单位:

中国医学科学院血液病医院(中国医学科学院血液学研究所)

Affiliation of the Leader:

Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

IIT2026020-EC-1

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

中国医学科学院血液病医院(中国医学科学院血液学研究所)伦理审查委员会

Name of the ethic committee:

Ethics Committee of Blood Diseases Hospital, Chinese Academy of Medical Sciences

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-03 00:00:00

伦理委员会联系人:

王启柔

Contact Name of the ethic committee:

Wang Qirou

伦理委员会联系地址:

中国天津市和平区南京路288号

Contact Address of the ethic committee:

288 Nanjing Road, Heping District, Tianjin, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 22 23909095

伦理委员会联系人邮箱:

Contact email of the ethic committee:

wangqirou@ihcams.ac.cn

研究实施负责(组长)单位:

中国医学科学院血液病医院(中国医学科学院血液学研究所)

Primary sponsor:

Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.

研究实施负责(组长)单位地址:

中国天津市和平区南京路288号

Primary sponsor's address:

288 Nanjing Road, Heping District, Tianjin, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

天津

市(区县):

Country:

China

Province:

Tianjin

City:

单位(医院):

中国医学科学院血液病医院(中国医学科学院血液学研究所)

具体地址:

中国天津市和平区南京路288号

Institution
hospital:

Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.

Address:

288 Nanjing Road, Heping District, Tianjin, China

经费或物资来源:

自筹

Source(s) of funding:

Self-funded

研究疾病:

骨髓增生异常肿瘤  

Target disease:

Myelodysplastic Neoplasms

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

II期临床试验 

Study phase:

2

研究设计:

单臂 

Study design:

Single arm 

研究目的:

本研究旨在首次评估利沙托克拉联合地西他滨方案在维奈克拉/治疗失败的MDS患者中的疗效与安全性,探索新方案的临床应答效果和生存获益的潜力,为二线治疗提供高级别循证依据。  

Objectives of Study:

This study aims to conduct the first evaluation of the efficacy and safety of the Lishatoclax combined with Decitabine regimen in patients with myelodysplastic neoplasms (MDS) who have failed Venetoclax therapy, exploring the clinical response and potential survival benefits of the new regimen to provide a high-level evidence-based rationale for second-line treatment.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

适合入组本研究的受试者必须符合以下所有标准: 1. 年龄大于 18 岁; 2. 经 WHO 2022 标准确诊的 MDS,IPSS-积分 > 3.5(参照附录 A); 3. ECOG 评分 <= 2; 4. 关于维奈克拉“治疗失败”定义:既往接受至少 4 个标准疗程去甲基化药物(包括至少 2 个疗程维奈克拉联合去甲基化药物治疗)治疗的患者,且符合以下任一情况即可: (1) 难治患者:未达到完全缓解(CR)和 CR equivalent 患者;关于完全缓解(CR)定义如下(参照附录 B IWG 2023 MDS 疗效标准): 1) 骨髓(BM):<5%原始粒细胞;*病态造血可能持续存在; 2) 外周血(PB):血红蛋白 >= 10 g/dL,血小板 >= 100×10^9/L;中性粒细胞 >= 1.0×10^9/L;原始细胞 0%。 (2) 疾病进展(PD):接受维奈克拉联合去甲基化药物治疗期间或治疗后,满足以下任一标准即视为疾病进展(PD): 1) 原始细胞进展:与当前治疗线开始前获取的基线样本相比,原始细胞相对增加 >= 50%,且原始细胞百分比的绝对增幅至少为 5%。 2) 血细胞减少恶化进展:在无至少另一系血细胞谱系达到上述血液学改善(HI)的情况下,在 8 周内出现新的、反复的(超过一次且间隔 >= 7 天)红细胞或血小板输注需求,且该需求与急性并发疾病(如败血症、胃肠道出血)或治疗效应无关。 3) 进展为急性髓系白血病(AML):与基线评估相比,原始细胞增加 >= 50% 且达到 >= 20% 的原始细胞。 (3) 不耐受/毒性终止:因维奈克拉不良反应无法继续治疗。 (4) 复发患者:指在接受维奈克拉联合去甲基化药物方案治疗期间或结束后,曾达到完全缓解 CR,但后续出现疾病复发(定义为骨髓原始细胞比例回升至治疗前水平,或出现新的病态造血/血细胞减少),需满足以下至少一项: 1) 骨髓原始细胞比例回升至治疗前水平(或 >= 5%)。 2) 出现新的病态造血或血细胞减少(符合 MDS 诊断标准)。 3) 出现新的细胞遗传学异常。 5. 预期生存期 >= 3 个月; 6. 主要器官功能符合: (1) ANC >= 0.5×10^9/L,PLT >= 20×10^9/L(允许输血支持) (2) TBIL <= 1.5×ULN,ALT/AST <= 2.5×ULN (3) Cr <= 1.5×ULN 或 CrCl >= 50ml/min 7. 签署知情同意书。

Inclusion criteria

Subjects eligible for enrollment in this study must meet all of the following criteria: 1. Age > 18 years; 2. MDS diagnosed according to the WHO 2022 criteria, with IPSS score > 3.5 (see Appendix A); 3. ECOG performance status score <= 2; 4. Definition of venetoclax "treatment failure": patients who have previously received at least 4 standard cycles of hypomethylating agents, including at least 2 cycles of venetoclax combined with hypomethylating agents, and meet any of the following conditions: (1) Refractory patients: patients who have not achieved complete remission (CR) or CR equivalent; complete remission (CR) is defined as follows (see Appendix B, IWG 2023 MDS response criteria): 1. Bone marrow (BM): <5% blasts; *dysplasia may persist; 2. Peripheral blood (PB): hemoglobin >= 10 g/dL, platelets >= 100×10^9/L; neutrophils >= 1.0×10^9/L; blasts 0%. (2) Disease progression (PD): during or after treatment with venetoclax combined with hypomethylating agents, disease progression (PD) is defined as meeting any of the following criteria: 1. Blast progression: compared with the baseline sample obtained before the start of the current treatment line, a relative increase in blasts >= 50%, with an absolute increase in blast percentage of at least 5%. 2. Worsening progression of cytopenia: in the absence of hematologic improvement (HI) in at least one other hematopoietic lineage, new and recurrent (more than once and at an interval of >= 7 days) red blood cell or platelet transfusion requirements occur within 8 weeks, and such requirements are unrelated to acute comorbid conditions (such as sepsis or gastrointestinal bleeding) or treatment effects. 3. Progression to acute myeloid leukemia (AML): compared with baseline assessment, blasts increase by >= 50% and reach >= 20% blasts. (3) Intolerance/toxicity-related discontinuation: inability to continue treatment due to adverse reactions to venetoclax. (4) Relapsed patients: patients who achieved complete remission (CR) during or after treatment with venetoclax combined with hypomethylating agents, but subsequently developed disease relapse, defined as a return of the bone marrow blast percentage to the pretreatment level, or the occurrence of new dysplasia/cytopenia, meeting at least one of the following: 1. Bone marrow blast percentage returns to the pretreatment level (or >= 5%). 2. New dysplasia or cytopenia occurs (meeting the diagnostic criteria for MDS). 3. New cytogenetic abnormalities occur. 5) Expected survival >= 3 months; 6) Major organ function meets the following criteria: (1) ANC >= 0.5×10^9/L, PLT >= 20×10^9/L (transfusion support is allowed) (2) TBIL <= 1.5×ULN, ALT/AST <= 2.5×ULN (3) Cr <= 1.5×ULN or CrCl >= 50 ml/min 7. Signed informed consent form.

排除标准:

1.转化为急性髓系白血病(骨髓原始细胞>= 20%);
2.活动性感染未控制(需静脉抗生素治疗);
3.严重肝肾功能不全(Child-Pugh C级或CrCl<30ml/min);
4.HIV阳性或活动性乙肝/丙肝;
5.严重心血管疾病(NYHA III-IV级,6个月内心梗或不稳定心绞痛);
6.其他恶性肿瘤病史(非黑色素瘤皮肤癌或治愈>= 5年的肿瘤除外);
7.妊娠或哺乳期妇女;
8.研究者判断不适合参与研究的其他情况;

Exclusion criteria:

1.Transformed to acute myeloid leukemia (bone marrow blasts >= ?20%);
2.Uncontrolled active infection requiring intravenous antibiotic therapy.
3.Severe hepatic or renal dysfunction (Child?Pugh class C or creatinine clearance [CrCl] 4.HIV positivity or active hepatitis B or hepatitis C infection;
5.Significant cardiovascular disease (New York Heart Association [NYHA] functional class III–IV, myocardial infarction or unstable angina within the past 6 months).
6.History of other malignancies, except for non?melanoma skin cancer or malignancies cured for >= ?5 years.
7.Pregnant or breastfeeding women.
8.Any other condition that, in the investigator’s judgment, makes the patient unsuitable for participation in the study.

研究实施时间:

Study execute time:

From 2026-01-01 00:00:00 To 2029-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-01 00:00:00 To 2027-06-30 00:00:00

干预措施:

Interventions:

组别:

Lisa-Dec 组

样本量:

24

Group:

Lisa-Dec group

Sample size:

干预措施:

利沙托克拉(Lisaftoclax)600mg/d qd 口服,d1-7;地西他滨 20mg/m^2/d,皮下注射,d1-3;每 28 天为一个疗程,共使用 4 个疗程。若与 CYP3A 抑制剂或 P-gp 抑制剂联用时,需相应降低 Lisaftoclax 剂量(强效 CYP3A 抑制剂剂量降低至 200mg;中效 CYP3A 抑制剂剂量降低至 400mg)。

干预措施代码:

Intervention:

Lisaftoclax 600mg/d qd oral, days 1-7; Decitabine 20mg/m^2/d subcutaneous injection, days 1-3; one cycle every 28 days, total 4 cycles. If combined with CYP3A inhibitors or P-gp inhibitors, reduce Lisaftoclax dose accordingly (to 200mg for strong CYP3A inhibitors, to 400mg for moderate CYP3A inhibitors).

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

天津 

市(区县):

 

Country:

China

Province:

Tianjin

City:

单位(医院):

中国医学科学院血液病医院(中国医学科学院血液学研究所) 

单位级别:

三级甲等 

Institution
hospital:

Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

江苏省人民医院(南京医科大学第一附属医院) 

单位级别:

三级甲等 

Institution
hospital:

Jiangsu Province Hospital(The First Affiliated Hospital with Nanjing Medical University)

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

四川大学华西医院 

单位级别:

三级甲等 

Institution
hospital:

West China Hospital, Sichuan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖南 

市(区县):

 

Country:

China

Province:

Hunan

City:

单位(医院):

中南大学湘雅医院 

单位级别:

三级甲等 

Institution
hospital:

Xiangya Hospital of Central South University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江西 

市(区县):

 

Country:

China

Province:

Jiangxi

City:

单位(医院):

南昌大学第一附属医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Nanchang University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

总体缓解率

指标类型:

主要指标

Outcome:

Overall remission rate

Type:

Primary indicator

测量时间点:

第1-4治疗周期后

测量方法:

骨髓穿刺/活检;除非是因为记录完全缓解(CR)所必需,骨髓检查为非强制性;达到CR的患者和治疗结束后采用流式细胞术进行微小残留病(MRD)检测;

Measure time point of outcome:

C1-C4

Measure method:

Bone marrow aspiration/biopsy; unless it is necessary to document complete remission (CR), the bone marrow examination is not mandatory; flow cytometry for minimal residual disease (MRD) detection will be performed for patients upon achieving CR and after treatment completion.

指标中文名:

安全性评估

指标类型:

次要指标

Outcome:

Safety assessment

Type:

Secondary indicator

测量时间点:

首次给药至末次给药后28天

测量方法:

记录入组至停药后28天内的不良事件及不良反应严重程度和发生率,包括总体状况安全性评估、实验室安全性检查等。采用CTCAE v5.0评估不良事件(AE),重点关注>=3级血液学毒性(中性粒细胞减少、血小板减少)及感染事件的发生率,以描述性统计(频数、百分比)呈现。

Measure time point of outcome:

From the first dose until 28 days after the last dose.

Measure method:

Adverse events, along with the severity and incidence of adverse reactions, will be recorded from enrollment until 28 days after treatment discontinuation. This includes overall safety assessments and laboratory safety examinations.

指标中文名:

中位无进展生存期(PFS)

指标类型:

次要指标

Outcome:

Median progression-free survival (PFS

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

24 个月生存率

指标类型:

次要指标

Outcome:

24Monthly survival rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

总生存期(OS)

指标类型:

次要指标

Outcome:

Overall survival (OS

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age NA years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

NA

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-05-26 10:19:07