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Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia
This study has been completed.
Study NCT00016016   Information provided by National Cancer Institute (NCI)
First Received: May 6, 2001   Last Updated: July 23, 2008   History of Changes

May 6, 2001
July 23, 2008
February 2001
 
Complete remission (Phase II) [ Designated as safety issue: No ]
Complete remission (Phase II)
Complete list of historical versions of study NCT00016016 on ClinicalTrials.gov Archive Site
 
 
 
Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia
A Phase I/II Study of Flavopiridol (NSC 649890, IND 46,211) in Timed Sequential Combination With Cytosine Arabinoside (Ara-C) and Mitoxantrone for Adults With Poor-Risk Acute Leukemias

RATIONALE: Drugs used in chemotherapy work in different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells.

PURPOSE: Phase II trial to study the effectiveness of combining flavopiridol and cytarabine with mitoxantrone in treating patients who have acute leukemia.

OBJECTIVES:

  • Determine the toxic effects of escalating doses of flavopiridol administered with cytarabine and mitoxantrone in patients with poor-risk acute leukemias.
  • Determine whether this treatment induces clinical responses in these patients.
  • Determine whether flavopiridol is directly cytotoxic to leukemic blasts in these patients.
  • Determine whether flavopiridol can recruit and synchronize residual leukemic blasts to proliferate in these patients.

OUTLINE: This is a dose-escalation study of flavopiridol. (Phase I closed to accrual effective10/24/2003).

Patients receive flavopiridol IV over 1 hour on days 1-3 and cytarabine IV continuously on days 6-9 followed by mitoxantrone IV over 30-150 minutes on day 9. Patients achieving a partial or complete response after the first course of therapy may receive an additional course of therapy beginning 35 ± 7 days after blood count recovery.

Cohorts of 3-6 patients receive escalating doses of flavopiridol until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. (Phase I closed to accrual effective 10/24/2003). Once the MTD is reached, additional patients are accrued to receive flavopiridol at the recommended phase II dose.

PROJECTED ACCRUAL: Approximately 25-35 patients will be accrued for phase I of the study (phase I closed to accrual effective 10/24/2003). A total of 53 patients will be accrued for phase II of the study.

Phase II
Interventional
Treatment
Leukemia
  • Drug: alvocidib
  • Drug: cytarabine
  • Drug: mitoxantrone hydrochloride
 
Karp JE, Passaniti A, Gojo I, Kaufmann S, Bible K, Garimella TS, Greer J, Briel J, Smith BD, Gore SD, Tidwell ML, Ross DD, Wright JJ, Colevas AD, Bauer KS. Phase I and pharmacokinetic study of flavopiridol followed by 1-beta-D-arabinofuranosylcytosine and mitoxantrone in relapsed and refractory adult acute leukemias. Clin Cancer Res. 2005 Dec 1;11(23):8403-12.

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Completed
53
 
 

DISEASE CHARACTERISTICS:

  • One of the following histologically confirmed poor-risk acute leukemias:

    • Acute myelogenous leukemia (AML)

      • AML arising from myelodysplastic syndromes (MDS)
      • Secondary AML
      • Relapsed or refractory AML, including primary induction failure
    • Acute lymphoblastic leukemia (ALL)

      • Relapsed or refractory ALL, including primary induction failure
  • No hyperleukocytosis with at least 50,000 leukemic blasts/mm^3
  • Failure of primary induction therapy or relapse after achieving complete remission allowed if completed no more than 3 prior courses of induction/reinduction therapy
  • No active CNS leukemia

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • ECOG 0-2

Life expectancy:

  • Not specified

Hematopoietic:

  • See Disease Characteristics
  • No disseminated intravascular coagulation

Hepatic:

  • AST and ALT no greater than 2.5 times normal
  • Alkaline phosphatase no greater than 2.5 times normal
  • Bilirubin no greater than 1.5 times normal

Renal:

  • Creatinine no greater than 2.0 mg/dL

Cardiovascular:

  • No intrinsic impaired cardiac function including the following:

    • Myocardial infarction within the past 3 months
    • History of congestive heart disease or arrhythmia (regardless of time, severity, or resolution)
    • Cardiomyopathy
    • Class III or IV congestive heart failure
  • LVEF at least 45% by MUGA or echocardiogram

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No active uncontrolled infection

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • Prior autologous or allogeneic stem cell transplantation allowed provided at least 4 weeks since treatment and no presence of active graft-vs-host disease
  • At least 4 days since prior hematopoietic growth factors (e.g., epoetin alfa, filgrastim [G-CSF], sargramostim [GM-CSF], interleukin-3, or interleukin-11)
  • Prior interferon allowed
  • No concurrent immunotherapy

Chemotherapy:

  • See Disease Characteristics
  • At least 4 weeks since prior intensive chemotherapy except non-aplasia-producing agents (e.g., hydroxyurea or 6-methylpurine) and recovered
  • No other concurrent chemotherapy

Endocrine therapy:

  • Not specified

Radiotherapy:

  • No concurrent radiotherapy

Surgery:

  • Not specified

Other:

  • Prior thalidomide or imatinib mesylate allowed
  • No other concurrent investigational or commercially-available antitumor therapy
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00016016
 
CDR0000068582, JHOC-J0254, MSGCC-0052, NCI-3170
Sidney Kimmel Comprehensive Cancer Center
National Cancer Institute (NCI)
Study Chair: Judith E. Karp, MD Sidney Kimmel Comprehensive Cancer Center
National Cancer Institute (NCI)
November 2006

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP