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AL AmyloidosisPhase 1/2NCT05451771

Venetoclax-Dexamethasone in Relapsed and/or Refractory t(11;14) Amyloidosis

A Phase 1/2 study testing Venetoclax Oral Tablet, 200 mg, FISH assay and Venetoclax Oral Tablet, 400 mg in people with AL Amyloidosis, run by Columbia University at 4 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The purpose of this study is assess safety, safest dose, and effectiveness of venetoclax in combination with dexamethasone in participants with t(11;14) positive relapsed (comes back) or refractory (did not get better) light chain amyloidosis. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
AL Amyloidosis
What is being tested?
Venetoclax Oral Tablet, 200 mg, FISH assay and Venetoclax Oral Tablet, 400 mg
Could I receive a placebo?
No, everyone receives an active treatment
How many people
53 participants
Where
4 sitesUnited States
Study dates
26 Oct 2022to Sep 2027
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years at time of signing Informed Consent Form
  • Ability to comply with the study protocol, in the investigator's judgment
  • Confirmed diagnosis of systemic AL amyloidosis by mass spectrometry or immunohistochemistry (IHC) on a tissue biopsy
  • Has received ≥1 prior lines of therapy, including an anti-cluster of differentiation 38 (CD 38) monoclonal antibody
  • Participants with a history of autologous hematopoietic cell transplantation must have recovered from any transplant-related toxicities
  • Presence of t(11;14) on FISH at any time since diagnosis (Eligibility must confirmed by FISH testing at Columbia University Irving Medical Center (CUIMC)
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2

Who cannot join

  • Known hypersensitivity to any of the study drugs
  • History of other malignancy that could affect compliance with the protocol or interpretation of results (Patients with a history of curatively treated basal or squamous cell carcinoma of the skin, in situ carcinoma of the cervix, breast cancer, or Hodgkin's Lymphoma are generally eligible. Patients with a malignancy that has been treated, but not with curative intent, will be excluded, unless the malignancy has been in remission without treatment for ≥ 2 years prior to enrollment.)
  • Evidence of other clinically significant uncontrolled condition(s) including, but not limited to, uncontrolled systemic infection (viral, bacterial, or fungal)
  • Patients on renal replacement therapy
  • Known GI disease or GI procedure that could interfere with oral absorption (including difficulty swallowing)
  • New York Heart Association (NYHA) Class III or IV heart failure
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  • Mayo stage three-B (IIIB) with N-terminal pro-hormone B-type natriuretic peptide (NT-Pro BNP) > 8500 pg/mL
  • Prior exposure to anti-apoptotic protein B-cell lymphoma 2 (BCL-2) inhibitors
  • Patients with human immunodeficiency virus (HIV) who are not on highly active antiretroviral therapy (HAART) or those with active hepatitis A, B, or C infection
  • Patients meeting criteria for symptomatic multiple myeloma by one of the following:(a) Lytic lesions on imaging (b) Plasmacytoma, (c) Hypercalcemia without any alternate etiology, or (c) Bone marrow plasma cell infiltrate of greater than 60%

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • Boston Medical Center

    Boston, Massachusetts, 02118

  • Froedtert Hospital & the Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

  • New York Presbyterian Hospital/Columbia University Irving Medical Center

    New York, New York, 10032

  • Mayo Clinic Rochester

    Rochester, Minnesota, 55905

Other trials in United States

About this study

Official title: An Open-label Phase I/II Trial of Venetoclax-Dexamethasone in Relapsed and/or Refractory t(11;14) Systemic Light-Chain Amyloidosis

The purpose of this study is assess safety, safest dose, and effectiveness of venetoclax in combination with dexamethasone in participants with t(11;14) positive relapsed (comes back) or refractory (did not get better) light chain amyloidosis.

Read the detailed description

This study is a phase 1/2 study of venetoclax-dexamethasone combination therapy in relapsed/refractory t(11;14) systemic immunoglobulin light chain amyloidosis (AL) amyloidosis. The phase 1 is a dose escalation designed to determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) of venetoclax in combination with low-dose weekly dexamethasone. There will be four candidate-dosing cohorts of venetoclax with or without dexamethasone in the Phase I dose-escalation. Dose escalation will be guided by the Bayesian optimal interval (BOIN) design with accelerated titration up to a total sample size of 15 participants.

The phase 2 portion is a randomized open-label study comparing the MTD or RP2D of venetoclax in combination with dexamethasone versus investigator's choice (daratumumab, pomalidomide, bendamustine, or ixazomib (with or without dexamethasone).

Conditions
AL Amyloidosis
Being tested
Venetoclax Oral Tablet, 200 mg, FISH assay, Venetoclax Oral Tablet, 400 mg, Dexamethasone Oral, 10 mg, Dexamethasone Oral, 20 mg
Keywords
Light Chain Amyloidosis, Protein Misfolding Disorder
Medical subject headings
Immunoglobulin Light-chain Amyloidosis, Proteostasis Deficiencies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Venetoclax Oral Tablet, 200 mgDrug

    Also called Venclexta

    200 mg oral tablet daily

  • FISH assayDevice

    Also called t(11;14) FISH assay

    Cytogenetic analysis is intended for evaluation of relapsed/refractory AL amyloidosis using fluorescence in situ hybridization (FISH) using known translocation probes. Bone marrow aspirate (BMA) samples are collected in lavender top (Ethylenediaminetetraacetic acid (EDTA)) or green top (Sodium heparin) tubes. Specimen tubes shall be transported at room temperature to the laboratory on the same day of collection.

  • Venetoclax Oral Tablet, 400 mgDrug

    Also called Venclexta

    400 mg oral tablet daily

  • Dexamethasone Oral, 10 mgDrug

    Also called Decadron, Hemady

    10 mg oral tablet weekly

  • Dexamethasone Oral, 20 mgDrug

    Also called Decadron, Hemady

    20 mg oral tablet weekly

  • Daratumumab InjectionDrug

    Also called Darzalex

    Daratumumab will be administered at a dose of 16 mg/kg by IV infusion once weekly for weeks 1 to 8, every 2 weeks for weeks 9 to 24, and every 4 weeks thereafter for a maximum of 6 months of therapy. If subcutaneous formulation is available, participants can also receive subcutaneous daratumumab (1800 mg in 15 ml) in the same schedule.

  • BendamustineDrug

    Also called Treanda

    Bendamustine will be given at an initial dose of 100 mg/m^2 intravenously on days 1 and 2 in each 28-day cycle.

  • PomalidomideDrug

    Also called Pomalyst

    Pomalidomide will be administered at an initial dose of 2 mg per days on days 1-21 every 28 days.

  • IxazomibDrug

    Also called Ninlaro

    Ixazomib will be administered at an initial dose of 4 mg per days on days 1, 8, and 15 every 28 days.

  • Venetoclax MTD with DexamethasoneDrug

    Venetoclax MTD (200 mg or 400 mg) with Dexamethasone (10 mg or 20 mg) as determined by the phase I results

Study groups in NCT05451771
Study groupRoleWhat they receive
Phase 1: Venetoclax 200 mgExperimentalCohort 1: Venetoclax 200 mg tablet, once daily for up to 2 cycles after achieving best response, for a maximum of 6 cycles (1 cycle = 28 days)
Receives: Drug: Venetoclax Oral Tablet, 200 mg; Device: FISH assay
Phase 1: Venetoclax 400mgExperimentalCohort 2: Venetoclax 400 mg tablet, once daily for up to 2 cycles after achieving best response, for a maximum of 6 cycles (1 cycle = 28 days)
Receives: Device: FISH assay; Drug: Venetoclax Oral Tablet, 400 mg
Phase 1: Venetoclax 400mg + Dexamethasone 10 mgExperimentalCohort 3: Venetoclax 400 mg tablet, once daily and Dexamethasone 10 mg tablet once weekly, for up to 2 cycles after achieving best response, for a maximum of 6 cycles (1 cycle = 28 days)
Receives: Device: FISH assay; Drug: Venetoclax Oral Tablet, 400 mg; Drug: Dexamethasone Oral, 10 mg
Phase 1: Venetoclax 400mg + Dexamethasone 20 mgExperimentalCohort 4: Venetoclax 400 mg tablet, once daily and Dexamethasone 20 mg tablet once weekly, for up to 2 cycles after achieving best response, for a maximum of 6 cycles (1 cycle = 28 days)
Receives: Device: FISH assay; Drug: Venetoclax Oral Tablet, 400 mg; Drug: Dexamethasone Oral, 20 mg
Phase 2: Venetoclax MTD with DexamethasoneExperimentalVenetoclax MTD (200 mg or 400 mg) with Dexamethasone (10 mg or 20 mg) as determined by the phase I results
Receives: Drug: Venetoclax MTD with Dexamethasone
Phase 2: Control Arm (Investigator's Choice)Active comparatorParticipants will receive one of the following as determined by the investigator: Daratumumab, Pomalidomide, Bendamustine, or Ixazomib (+/- dexamethasone)
Receives: Drug: Dexamethasone Oral, 20 mg; Drug: Daratumumab Injection; Drug: Bendamustine; Drug: Pomalidomide; Drug: Ixazomib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants with Dose Limiting Toxicities (DLT) (Phase 1)

    The number of participants with dose limiting toxicities for each treatment dose will be used to determine the MTD. Dose limiting toxicity defined as grade 4 neutropenia lasting more than 5 days, any grade febrile neutropenia, grade 4 thrombocytopenia, grade 3 thrombocytopenia with bleeding, other therapy related non-hematologic toxicity of grade 2 or higher that requires discontinuation of therapy, clinical tumor lysis syndrome (TLS), laboratory TLS if the metabolic abnormalities are considered clinically significant by the investigator. All other grade 3 or higher adverse events (AEs) will be considered as DLTs with a few exceptions.

    Measured: Up to 6 cycles (approximately 6 months)

  2. Hematologic ≥ Very Good Partial Response (VGPR) Rate (Phase 2)

    Hematologic ≥VGPR rate defined as proportion of participants achieving VGPR, low serum differential free light chain concentration (dFLC) partial response (PR), or a complete (CR).

    VGPR is defined as the difference between involved and uninvolved free light chain (FLC) [dFLC] < 40 mg/L. Low dFLC PR is defined as achieving a dFLC<10 mg/L, low dFLC PR will be considered as a deep hematologic response and included in the ≥VGPR category). CR is defined as negative serum and urine immunofixation electrophoresis along with a serum free light chain ratio that lies within the normal range or skewed towards the non-amyloid forming light chain, as per institutional laboratory values

    Measured: Up to 6 cycles (approximately 6 months)

Secondary outcomes (9)
  1. Overall Organ Response Rate (ORR) (Phase 2)

    ORR defined as proportion of evaluable participants achieving organ response in each involved organ

    Measured: Up to 1 year

  2. Progression Free Survival (PFS) (Phase 2)

    PFS defined as time from the date of enrollment to hematologic progression or death, whichever is earlier

    Measured: Up to 1 year

  3. Overall Hematologic Response Rate (HRR) (Phase 2)

    HRR defined as proportion of patients achieving partial response (PR) or better

    Measured: Up to 1 year

  4. Duration of Hematologic Response (DOHR) (Phase 2)

    DOHR defined as time from the date of first documentation of hematologic response to the date of first documented hematologic disease progression

    Measured: Up to 1 year

  5. Time to hematologic ≥VGPR (Phase 2)

    Time to hematologic ≥VGPR defined as time from the first dose of study treatment to achievement of deep hematologic response (VGPR, low dFLC PR, or a CR)

    Measured: Up to 1 year

  6. Time to next treatment (TTNT) (Phase 2)

    TTNT defined as time from the date of enrollment to initiation of a subsequent line of therapy

    Measured: Up to 1 year

  7. Major Organ Deterioration-Progression Free Survival (MOD-PFS) (Phase 2)

    MOD-PFS defined as time from the date of enrollment to one of the following events (whichever occurs first): death, clinical manifestation of cardiac/renal failure, or development of hematologic progression of disease

    Measured: Up to 1 year

  8. Overall Survival (OS) (Phase 2)

    OS defined as the time from the date of enrollment to death from any cause

    Measured: Up to 1 year

  9. Patient-reported outcomes (PROs) (Phase 2)

    PROs defined as longitudinal score of "Physical Functioning" domain of Patient-Reported Outcomes Measurement Information System (PROMIS)-29 Profile v2.0 The Physical Functioning domain contains four items with a 1 (unable to do) to 5 (without any difficulty) numeric rating.

    Measured: Start of each cycle (Day 1 of each 28 day cycle) and Follow-up (every 8 weeks for up to 1 year)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jul 2022
  2. Study start26 Oct 2022
  3. Primary completionSep 2027 (estimated)
  4. Study completionSep 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
53 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05451771
Sponsor's protocol ID
AAAT8639
Status last verified
Oct 2026
First submitted
6 Jul 2022
Last updated
8 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes

Publications

  • Locke M, Nieto M. AL Amyloidosis: Current Treatment and Outcomes. Adv Hematol. 2025 Mar 3;2025:7280805. doi: 10.1155/ah/7280805. eCollection 2025.

    PubMed 40226119

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Venetoclax Oral Tablet, 200 mg, FISH assay and Venetoclax Oral Tablet, 400 mg in people with AL Amyloidosis, run by Columbia University at 4 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 8 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants with Dose Limiting Toxicities (DLT) (Phase 1) (time frame: Up to 6 cycles (approximately 6 months)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05451771, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Oct 2026.

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Clinical Trial NCT05451771 | AzTrials