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Annamycin

Phase 2

Acute Myeloid Leukaemia (AML) | Small molecule | Oncology |Moleculin Biotech, Inc.|Last Updated: Aug 5, 2026

Target and mechanism

ModalitySmall molecule

Also known as Liposomal Annamycin, Liposomal Annamycin (L-Annamycin)

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment312

FDA Designations

ORPHAN_DRUGFAST_TRACK

Clinical trial landscape

Annamycin · 5 trials · 4 indications

Phase 2 1Phase 1 4
NCT06788756L-Annamycin for Injection in Combination With Cytarabine Injection as Second Line Therapy for Remission Induction in Adult Subjects With Refractory/Relapsed AMLAcute Myeloid Leukaemia (AML)
RECRUITING312 Analytics
PHASE2RECRUITING
L-Annamycin for Injection in Combination With Cytarabine Injection as Second Line Therapy for Remission Induction in Adult Subjects With Refractory/Relapsed AML
Acute Myeloid Leukaemia (AML)Unlock trial analytics

Study Endpoints

Primary Endpoints

Part A -Determination of Optimal Dosage Regimen
From initiation of the first randomized treatment cycle until the first post treatment bone marrow assessment, assessed up to Day 49

1\. To identify the optimal dosage regimen of L Annamycin for Injection (190 versus 230 mg/m2/day) in combination with Cytarabine Injection (2.0 g/m2/day) as second line therapy for remission induction in adult subjects with refractory/relapsed acute myeloid leukemia (AML) as measured by rate of complete remission (CR) after one treatment cycle.

Part B - Expansion at Optimal Dosage Regimen
From initiation of the first randomized treatment cycle until the first post treatment bone marrow assessment, assessed up to Day 49

To confirm the superior efficacy of the optimal dosage regimen of L-Annamycin for Injection in combination with Cytarabine Injection (determined in Part A) versus placebo in combination with Cytarabine Injection as second line therapy for remission induction in adult subjects with refractory/relapsed AML as measured by rate of CR after one treatment cycle

Evaluate the safety and identify the MTD/RP2D of L-Annamycin in combination with a standard regimen of cytarabine (Ara-C, cytosine arabinoside)
Day 1 through Day 28

The number of patients who experience dose-limiting toxicities (DLT) will be captured at each dose level of LAnnamycin in order to determine the MTD/RP2D

Dose Limiting Toxicity
21 days

Number of patients with a dose limiting toxicity (DLT) at each dose evaluated

Evaluation of safety and identification of the MTD/RP2D for L-Annamycin
Day 1 through Day 28

The number of patients who experience dose-limiting toxicities (DLT) will be captured at each dose level of L-Annamycin in order to determine the MTD/RP2D

Dose-limiting Toxicity
Day 28

Number of patients with a dose-limiting toxicity (DLT) at each dose evaluated

Secondary Endpoints

Part A -Comparison of Efficacy as Measured by Overall Survival (OS)
From date of randomization to treatment (Day 1) to the date of death from any cause, assessed up to 2 years after the first dose of randomized study drug
Part B - Confirmation of Efficacy of the Optimal Dosage Regimen as Measured by Overall Survival (OS)
From date of randomization to treatment (Day 1) to the date of death from any cause, assessed up to 2 years after the first dose of randomized study drug
Pharmacokinetics - Area under the plasma concentration
Pre-dose and at 0.25, 0.5, 1, 2, 4, 8,12 and 24 hours after the start of liposomal annamycin infusion on Day 1 and Day 3
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelFACTORIAL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Part A / Treatment Arm 1PLACEBO_COMPARATORplacebo (0.9% Sodium Chloride Injection, i.e., the diluent for L-Annamycin for Injection) for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days
Part A / Treatment Arm 2ACTIVE_COMPARATOR190 mg/m2/day L-Annamycin for Injection for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days.
Part A / Treatment Arm 3ACTIVE_COMPARATOR230 mg/m2/day L-Annamycin for Injection for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days.
Part B / Treatment Arm 1PLACEBO_COMPARATORPlacebo (0.9% Sodium Chloride Injection) for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days (i.e., the same as Treatment Arm 1 of Part A).
Part B / Treatment Arm XACTIVE_COMPARATOROptimal dosage regimen (as determined in Part A) of L Annamycin for Injection (190 mg/m2/day or 230 mg/m2/day) for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days (i.e., the same as Treatment Arm 2 or 3, respectively, of Part A).
Liposomal annamycinEXPERIMENTAL -
Liposomal Annamycin (L-Annamycin)EXPERIMENTAL -

Interventions

NameTypeDescription
Placebo in combination with Cytarabine InjectionDRUGplacebo (0.9% Sodium Chloride Injection, i.e., the diluent for L-Annamycin for Injection) for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days.
Liposomal Annamycin Injection in combination with Cytarabine InjectionDRUG190 mg/m2/day L-Annamycin for Injection for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days.
Liposomal Annamycin for Injection in combination with Cytarabine Injection.DRUGoptimal dosage regimen (as determined in Part A) of L Annamycin for Injection (190 mg/m2/day or 230 mg/m2/day) for three consecutive days in combination with 2.0 g/m2/day Cytarabine Injection for five consecutive days (i.e., the same as Treatment Arm 2 or 3, respectively, of Part A).
Liposomal AnnamycinDRUG2-hour intravenous infusion liposomal annamycin daily for 3 consecutive days followed by 18 days off study drug (i.e., one treatment cycle = 21 days).
CytarabineDRUGAdministered during cycle 1 at a dose of 2.0 g/m2/day by 4 hours IV infusion for 5 consecutive days and this dose will remain constant for all cohorts, including the expansion phase.
Liposomal Annamycin (L-Annamycin)DRUG2-hour intravenous (IV) infusion of L-Annamycin on Day 1 followed by 20 days off of study drug (i.e., 1 treatment cycle= 21 days)
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Eligibility Criteria

Age Range18 Years to 80 Years
SexALL
Healthy VolunteersNo
Study Sites28

Inclusion Criteria: 1. Has a pathologically confirmed diagnosis of AML per the 2022 International Consensus Classification (ICC) as adopted in the European LeukemiaNet (ELN) 2022 recommendations for the diagnosis and management of AML. The tests and procedures used to establish the diagnosis of AML...

Countries:United StatesCzechiaGeorgiaItalyLithuaniaPolandRomaniaSpainUkraine
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Recent Changes (Last 90 Days)

LOWAug 5, 2026NCT06788756lastUpdatePostDate: changed
LOWJun 18, 2026NCT06788756lastUpdatePostDate: changed
LOWJun 18, 2026NCT06788756lastUpdatePostDate: changed
LOWJun 18, 2026NCT06788756lastUpdatePostDate: changed
LOWJun 18, 2026NCT06788756lastUpdatePostDate: changed