Elderly Patients With Acute Myeloid Leukemia (AML), Maintenance Phase After Complete Remission (CR)

This study has been completed.
Sponsor:
Collaborator:
Celgene Corporation
Information provided by (Responsible Party):
Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang GOELAMS
ClinicalTrials.gov Identifier:
NCT01301820
First received: February 4, 2011
Last updated: April 19, 2013
Last verified: April 2013
  Purpose

Phase II Multicentric Trial Open Label, Multicenter, randomized to evaluate the efficacy of a Maintenance Therapy in First Complete Remission After Induction for Elderly (≥ 60) Fit Patients With Poor Prognosis Acute Myeloid Leukemia (AML).

The disease-free survival (DFS) of the patients included in this study will be compared to the ones of the two previously reported groups of patients treated with the same LIA induction therapy


Condition Intervention Phase
Acute Myeloid Leukemia
Drug: azacitidine
Drug: Lenalidomide
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Multicentric Trial Maintenance Therapy With 6 Monthly Revlimid® Cycles Alternated With 6 Monthly Vidaza® Cycles in First CR After Induction LIA Chemotherapy for Elderly (≥ 60) Fit Patients With Poor Prognosis Acute Myeloid Leukemia.

Resource links provided by NLM:


Further study details as provided by Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang GOELAMS:

Primary Outcome Measures:
  • DFS [ Time Frame: 18 months ] [ Designated as safety issue: No ]
    The primary objective of this study will be to improve the DFS with an alternate schema combining azacitidine and lenalidomide in elderly fit patients with previously untreated AML and with high risk cytogenetics or secondary AML, who achieved either a complete remission after an LIA induction therapy.


Secondary Outcome Measures:
  • relapse incidence OS EFS Infectious events [ Time Frame: until death ] [ Designated as safety issue: No ]
    The secondary objectives will be to determine the relapse incidence, overall survival, event free survival at 1 and 2 years of follow-up, toxicities of the treatment, incidence of infectious events.

  • gene expression and promoter methylation signatures associated with CR [ Time Frame: 0 ] [ Designated as safety issue: No ]
    To define a gene expression and promoter methylation signatures associated with CR and absence of relapse when patients received azacitidine and lenalidomide. Gene promoter methylation and gene expression profiling will be performed at diagnosis, at CR, and after 2 courses of azacitidine and lenalidomide in order to give insight within the mechanisms involved by the use of these 2 drugs and to identify new epigenetic prognostic markers.


Enrollment: 120
Study Start Date: January 2011
Study Completion Date: February 2013
Primary Completion Date: February 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
ARM A
maintenance study treatment: azacitidine sc 75 mg/m²/d (d1- d7) in first cycle: months 1,3,5,7,9 ,11 then lenalidomide 10mg/d (d1- d21) months 2,4,6,8,10,12
Drug: azacitidine
azacitidine sc 75 mg/m²/d (d1- d7)
Other Name: vidaza®
ARM B
maintenance study treatment: lenalidomide 10mg/d (d1- d21)in first cycle and months 1,3,5,7,9 ,11 then azacitidine sc 75 mg/m²/d (d1- d7) months 2,4,6,8,10,12
Drug: Lenalidomide
lenalidomide 10mg/d (d1- d21)
Other Name: revlimid®

Detailed Description:
  • The primary objective of this study will be to improve the DFS with an alternate schema combining azacitidine and lenalidomide in elderly fit patients with previously untreated AML and with high risk cytogenetics or secondary AML, who achieved either a complete remission after an LIA induction therapy
  • The secondary objectives will be to determine the relapse incidence, overall survival, event free survival at 1 and 2 years of follow-up, toxicities of the treatment, incidence of infectious events.
  • To define a gene expression and promoter methylation signatures associated with CR and absence of relapse when patients received azacitidine and lenalidomide. Gene promoter methylation and gene expression profiling will be performed at diagnosis, at CR, and after 2 courses of azacitidine and lenalidomide in order to give insight within the mechanisms involved by the use of these 2 drugs and to identify new epigenetic prognostic markers.
  Eligibility

Ages Eligible for Study:   60 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Cytologically or histologically confirmed acute myeloid leukemia (AML) with :

    • At least 60 years of age and fit for intensive chemotherapy: PS <2 (ECOG)
    • Absence of significant co-morbidities
    • Less than 75 years* of age
    • LAM with high risk features (blasts > 20% in bone marrow)
    • Poor risk cytogenetics
    • Life expectancy > 1 month
    • Affiliated to social security regimen
    • No granulocytic sarcoma as sole site of disease
    • Able and willing to provide written and signed informed consent

Exclusion Criteria:

  • Total bilirubin > 2 times upper limit of normal
  • AST and ALT and/or alkaline phosphatase > 4 times upper limit of normal if not in relation with AML.
  • Factor V < 50% without DIC (Disseminated Intravascular Coagulation)
  • NYHA class III or IV congestive heart failure (Echo < 40%, LVEF < 50%),Unstable angina pectoris, Serious cardiac arrhythmia
  • Renal failure not related to AML: serum creatinin > 170 μmol/L or clearance of creatinin ≤ 50 mL/mn
  • Known HIV 1- HIV 2 positivity
  • Prior therapy with azacitidine or lenalidomide
  • Psychiatric illness or social situations that would preclude compliance with study requirements
  • Uncontrolled infection
  • Urgent chemotherapy for DIC, spontaneous tumoral lyse syndrome, leucostase without cytogentic results
  • Women who are pregnant or breastfeeding
  • Women who are unwilling or unable to use an acceptable contraceptive method to avoid pregnancy
  • Men who are unwilling or unable to use an acceptable method of birth control
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01301820

Locations
France
Mathilde HUNAULT BERGER
Angers, France, 49033
Sponsors and Collaborators
Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang GOELAMS
Celgene Corporation
Investigators
Principal Investigator: Mathilde HUNAULT BERGER, MD PD Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang GOELAMS
  More Information

Additional Information:
No publications provided

Responsible Party: Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang GOELAMS
ClinicalTrials.gov Identifier: NCT01301820     History of Changes
Other Study ID Numbers: LAMSA-maintenance Rev-5Aza
Study First Received: February 4, 2011
Last Updated: April 19, 2013
Health Authority: France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Keywords provided by Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang GOELAMS:
maintenance treatment
Disease free survival

Additional relevant MeSH terms:
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Leukemia
Neoplasms by Histologic Type
Neoplasms
Lenalidomide
Azacitidine
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Antineoplastic Agents
Therapeutic Uses
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Enzyme Inhibitors

ClinicalTrials.gov processed this record on September 18, 2014