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ABT-888 and Topotecan With or Without Carboplatin in Treating Patients With Relapsed or Refractory Acute Leukemia, High-Risk Myelodysplasia, or Aggressive Myeloproliferative Disorders
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), July 2009
First Received: December 20, 2007   Last Updated: December 19, 2009   History of Changes
Sponsor: Sidney Kimmel Comprehensive Cancer Center
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00588991
  Purpose

RATIONALE: ABT-888 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as topotecan and carboplatin, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving ABT-888 together with topotecan and carboplatin may kill more cancer cells.

PURPOSE: This phase I trial is studying the side effects and best dose of ABT-888 when given together with topotecan with or without carboplatin in treating patients with relapsed or refractory acute leukemia, high-risk myelodysplasia, or aggressive myeloproliferative disorders.


Condition Intervention Phase
Chronic Myeloproliferative Disorders
Leukemia
Myelodysplastic Syndromes
Drug: ABT-888
Drug: carboplatin
Drug: topotecan hydrochloride
Other: pharmacological study
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase 1 Study of ABT-888 in Combination With Topotecan Plus Carboplatin for Relapsed and Refractory Acute Leukemias and High-Risk Myelodyplasias and Myeloproliferative Disorders

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Feasibility, tolerability, and toxicities of ABT-888 as assessed by NCI-CTCAE v3.0 [ Designated as safety issue: Yes ]
  • Maximum tolerated dose of ABT-888 [ Designated as safety issue: Yes ]
  • Clinical response [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Pharmacokinetics and pharmacodynamics of ABT-888 [ Designated as safety issue: No ]

Estimated Enrollment: 40
Study Start Date: November 2007
Detailed Description:

OBJECTIVES:

Primary

  • To determine the feasibility, tolerability, and toxicities of ABT-888 when administered alone and in combination with topotecan hydrochloride with or without carboplatin in patients with relapsed or refractory acute leukemia, high-risk myelodysplasia, or aggressive myeloproliferative disorders.
  • To determine the maximum tolerated dose of ABT-888 when administered with topotecan hydrochloride and carboplatin in these patients.
  • To determine if ABT-888 when administered with topotecan hydrochloride and carboplatin can induce clinical responses in these patients.

Secondary

  • To determine the pharmacokinetics of ABT-888 when administered alone and in combination with topotecan hydrochloride with or without carboplatin in these patients.
  • To obtain pharmacodynamic data regarding the ability of ABT-888 to inhibit poly (ADP-ribose) levels in leukemic blasts.
  • To obtain descriptive data regarding the mutational status and/or methylation status of key genes in selected DNA repair pathways (Fanconi complementation groups A-F, Blooms, and ataxia-telangiectasia) in leukemic blasts.

OUTLINE: This is a multicenter, dose-escalation study of ABT-888.

Patients receive oral ABT-888 twice daily on days 1-8 and topotecan hydrochloride with or without carboplatin IV continuously over 120 hours on days 3-7. Treatment repeats every 28-63 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample collection periodically for pharmacokinetic studies.

After completion of study therapy, patients are followed for 30 days.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Pathologically confirmed diagnosis of 1 of the following:

    • Acute myeloid leukemia, acute lymphoblastic leukemia, or high-risk myelodysplastic syndromes that has relapsed at least once or is refractory, including primary induction failure

      • No acute progranulocytic leukemia (M3)
    • Aggressive phase high-risk myeloproliferative disorders (i.e., polycythemia vera , essential thrombocythemia, or Ph-negative chronic myelogenous leukemia) meeting ≥ 1 of the following criteria:

      • Marrow blasts > 5%
      • Peripheral blood blasts plus progranulocytes > 10%
      • New onset or increasing myelofibrosis
      • New onset or > 25% increase in hepatomegaly or splenomegaly
      • New onset constitutional symptoms (i.e., fever, weight loss, splenic pain, or bone pain)
    • Chronic myelomonocytic leukemia meeting either of the following criteria:

      • 5-19% bone marrow blasts (aggressive)
      • At least 20% marrow blasts (transformation)
  • Patients who failed primary induction therapy or relapsed after achieving complete remission are eligible
  • No active CNS leukemia

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • No hyperleukocytosis with ≥ 50,000 blasts/μL
  • AST, ALT, and alkaline phosphatase ≤ 5 times upper limit of normal
  • Bilirubin ≤ 2.0 mg/dL (in the absence of Gilbert syndrome, hemolysis, or leukemic infiltration)
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • LVEF ≥ 45% by MUGA or ECHO
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 30 days after completion of study therapy
  • No active disseminated intravascular coagulation
  • No active uncontrolled infection

    • Patients with infection that is under active treatment and controlled with antibiotics are eligible
  • No other life-threatening illness
  • No mental deficits and/or psychiatric history that would preclude giving informed consent or following protocol
  • No prior or current seizure disorder

PRIOR CONCURRENT THERAPY:

  • No more than 3 prior cytotoxic regimens
  • At least 3 weeks since prior cytotoxic chemotherapy
  • At least 2 weeks since prior radiotherapy
  • At least 4 weeks since prior autologous or allogeneic stem cell transplantation

    • No active graft-versus-host disease
  • At least 1 week since prior biologic therapies, including hematopoietic growth factors
  • At least 24 hours since prior hydroxyurea, steroids, imatinib mesylate, arsenic trioxide, interferon, or other noncytotoxic agents for blast count control
  • No prior ABT-888
  • No other concurrent chemotherapy, radiotherapy, or immunotherapy
  • No concurrent antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational or commercial agents or therapies for this cancer
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00588991

Locations
United States, Maryland
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Recruiting
Baltimore, Maryland, United States, 21231-2410
Contact: Clinical Trials Office - Sidney Kimmel Comprehensive Cancer Ce     410-955-8804     jhcccro@jhmi.edu    
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center
Investigators
Study Chair: Judith E. Karp, MD Sidney Kimmel Comprehensive Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000579626, JHOC-J0783
Study First Received: December 20, 2007
Last Updated: December 19, 2009
ClinicalTrials.gov Identifier: NCT00588991     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent adult acute lymphoblastic leukemia
adult acute myeloid leukemia with 11q23 (MLL) abnormalities
adult acute myeloid leukemia with inv(16)(p13;q22)
adult acute myeloid leukemia with t(16;16)(p13;q22)
adult acute myeloid leukemia with t(8;21)(q22;q22)
recurrent adult acute myeloid leukemia
de novo myelodysplastic syndromes
previously treated myelodysplastic syndromes
secondary myelodysplastic syndromes
essential thrombocythemia
Philadelphia chromosome negative chronic myelogenous leukemia
polycythemia vera
chronic myelomonocytic leukemia
adult acute minimally differentiated myeloid leukemia (M0)
adult acute myeloblastic leukemia without maturation (M1)
adult acute myeloblastic leukemia with maturation (M2)
adult acute myelomonocytic leukemia (M4)
adult acute monoblastic leukemia (M5a)
adult acute monocytic leukemia (M5b)
adult erythroleukemia (M6a)
adult pure erythroid leukemia (M6b)
adult acute megakaryoblastic leukemia (M7)
relapsing chronic myelogenous leukemia

Additional relevant MeSH terms:
Disease
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Precancerous Conditions
Antineoplastic Agents
Hematologic Diseases
Myelodysplastic Syndromes
Myeloproliferative Disorders
Enzyme Inhibitors
Carboplatin
Pharmacologic Actions
Leukemia
Preleukemia
Neoplasms
Pathologic Processes
Therapeutic Uses
Syndrome
Topotecan
Bone Marrow Diseases

ClinicalTrials.gov processed this record on February 08, 2010