Trial record 5 of 32 for:    Open Studies | "Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative"

Aflibercept in Treating Patients With Myelodysplastic Syndromes

This study is currently recruiting participants.
Verified November 2012 by National Cancer Institute (NCI)
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00509249
First received: July 30, 2007
Last updated: November 20, 2012
Last verified: November 2012
  Purpose

This phase II trial is studying how well aflibercept works in treating patients with myelodysplastic syndromes. Aflibercept may be able to carry cancer-killing substances directly to myelodysplastic syndrome cells. It may also stop the growth of cancer cells by blocking blood flow to the cancer


Condition Intervention Phase
Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative
Chronic Myelomonocytic Leukemia
de Novo Myelodysplastic Syndromes
Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable
Previously Treated Myelodysplastic Syndromes
Secondary Myelodysplastic Syndromes
Biological: ziv-aflibercept
Other: laboratory biomarker analysis
Other: pharmacological study
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of VEGF Trap (NSC 724770) in Patients With MDS

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Hematological response rate, defined as either CR or PR [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Hematological improvement as defined by monolineage or bilineage response or a greater than 50% decrease in transfusion requirement [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]
    Will be estimated using the product-limit method of Kaplan and Meier.

  • Time to leukemic transformation or death [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]
    Will be estimated using the product-limit method of Kaplan and Meier.

  • Toxicity profile assessed using NCI CTCAE v.3.0 [ Time Frame: Up to 3 years ] [ Designated as safety issue: Yes ]
    Toxicity information recorded will include the type, severity, time of onset, time of resolution, and the probable association with the study regimen. Tables will be constructed to summarize the observed incidence by severity and type of toxicity.

  • Assessment of biological correlates [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 55
Study Start Date: September 2007
Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Patients will receive aflibercept IV over 1 hour on day 1. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.
Biological: ziv-aflibercept
Given IV
Other Names:
  • aflibercept
  • vascular endothelial growth factor trap
  • VEGF Trap
  • Zaltrap
Other: laboratory biomarker analysis
Correlative studies
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies

Detailed Description:

OBJECTIVES:

I. To determine the antitumor activity of aflibercept as assessed by the hematological response rate.

II. To determine overall and progression-free survival in patients with myelodysplastic syndromes.

III. To assess hematologic improvement and time to leukemic transformation. IV. To assess the toxicity profile of aflibercept in this patient population. V. To perform correlative studies to better understand the ability of aflibercept to reach and modulate its respective targets.

OUTLINE: This is a multicenter study.

Patients will receive aflibercept IV over 1 hour on day 1. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity.

Blood and bone marrow samples will be obtained periodically for pharmacokinetic and biomarker correlative studies. Pharmacokinetic analysis by ELISA; anti-aflibercept antibody measurements; analysis of VEGF and VEGFR expression; and analysis of gene expression by quantitative PCR will be conducted. The effect of aflibercept on apoptosis and proliferation of CD34+ cells will also be analyzed by flow cytometry based assays.

After completion of study treatment, patients are followed periodically.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have histologically or cytologically confirmed myelodysplastic syndromes (MDS), including any of the following:

    • Secondary MDS
    • MDS/myeloproliferative disorders (MPD) (e.g., chronic myelomonocytic leukemia or atypical chronic myeloid leukemia)
    • IPSS scores of 0.5 or greater (≥ INT-1) OR transfusion dependent despite use of growth factors
    • No more than 20% blasts in the marrow
    • Patients who have not responded after 3 courses of hypomethylating agents (azacitidine or decitabine) OR; who are unable to tolerate hypomethylating agents OR who refused to receive hypomethylating agents are eligible for this study
  • ECOG performance status ≤ 2 (Karnofsky ≥ 60%)
  • Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
  • AST/ALT ≤ 2.5 x ULN
  • Creatinine ≤ 1.5 x ULN OR creatinine clearance ≥ 60 mL/min
  • Urine protein:creatinine ratio < 1 OR urine protein < 500 mg by 24-hour urine collection
  • PT INR ≤ 1.5
  • Patients with PT INR > 1.5 on full-dose anticoagulants (e.g., warfarin) are eligible provided both of the following criteria are met:

    • Patient has an in-range INR (usually between 2 and 3) and is on a stable dose of oral anticoagulant or low molecular weight heparin
    • Patient has no active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices)
  • Not pregnant or nursing
  • Fertile patients must use effective contraception during and for at least 6 months after completion of study treatment
  • Prior DNA-demethylating agent therapy or lenalidomide therapy allowed
  • Prior treatment with other molecular agents, such as thalidomide, valproic acid, or imatinib mesylate allowed

Exclusion Criteria:

  • Evidence of active malignancies other than squamous cell or basal cell carcinoma of the skin
  • Known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to agents used in the study
  • Serious or non-healing wound, ulcer, or bone fracture
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
  • Significant traumatic injury within the past 28 days
  • Clinically significant cardiovascular disease, including any of the following:

    • History of cerebrovascular accident (CVA) within the past 6 months
    • Uncontrolled hypertension, defined as blood pressure > 150/100 mm Hg or systolic BP > 180 mm Hg if diastolic blood pressure < 90 mm Hg (on at least 2 repeated determinations on separate days) within the past 3 months
    • Myocardial infarction or unstable angina within the past 6 months
    • New York Heart Association class III or IV congestive heart failure, serious cardiac arrhythmia requiring medication, or unstable angina pectoris within the past 6 months
  • Clinically significant peripheral vascular disease within the past 6 months
  • Pulmonary embolism, deep vein thrombosis (DVT), or other thromboembolic event within the past 6 months
  • Evidence of bleeding diathesis or coagulopathy
  • Concurrent uncontrolled illness including, but not limited to, ongoing or active infection or psychiatric illness/social situation that would limit compliance with study requirements
  • Prior cytotoxic chemotherapy for MDS
  • Molecular therapy or immunosuppressive agents (including steroids) within the past 3 weeks
  • Other prior antiangiogenesis agents
  • Coronary artery bypass graft (CABG) within the past 6 months
  • Valproic acid should be discontinued at least 24 hours before aflibercept administration, unless needed for seizure control
  • Major surgical procedure or open biopsy within the past 28 days
  • Core biopsy (other than bone marrow biopsy) within the past 7 days
  • Anticipation of need for major surgical procedures during the course of the study
  • Patients may not be receiving any other investigational agents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00509249

Locations
United States, California
City of Hope Medical Center Recruiting
Duarte, California, United States, 91010
Contact: Mark H. Kirschbaum    626-256-4673    mkirschbaum@coh.org   
Principal Investigator: Mark H. Kirschbaum         
Sponsors and Collaborators
Investigators
Principal Investigator: Mark Kirschbaum City of Hope Medical Center
  More Information

No publications provided

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00509249     History of Changes
Other Study ID Numbers: NCI-2009-00180, PHII-73, N01CM62209, CDR0000558101
Study First Received: July 30, 2007
Last Updated: November 20, 2012
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative
Neoplasms
Leukemia
Leukemia, Myeloid
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myelomonocytic, Chronic
Myelodysplastic Syndromes
Preleukemia
Leukemia, Myelomonocytic, Acute
Myeloproliferative Disorders
Myelodysplastic-Myeloproliferative Diseases
Neoplasms by Histologic Type
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions
Endothelial Growth Factors
Growth Substances
Physiological Effects of Drugs
Pharmacologic Actions

ClinicalTrials.gov processed this record on April 17, 2014