Posaconazole Versus Micafungin for Prophylaxis Against Invasive Fungal Infections During Neutropenia in Patients Undergoing Chemotherapy for Acute Myelogenous Leukemia, Acute Lymphocytic Leukemia or Myelodysplastic Syndrome

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2014 by Memorial Sloan-Kettering Cancer Center
Sponsor:
Collaborator:
Astellas Pharma US, Inc.
Information provided by (Responsible Party):
Memorial Sloan-Kettering Cancer Center
ClinicalTrials.gov Identifier:
NCT01200355
First received: September 9, 2010
Last updated: March 13, 2014
Last verified: March 2014

September 9, 2010
March 13, 2014
September 2010
September 2015   (final data collection date for primary outcome measure)
To compare rates of clinical failure between patients who receive posaconazole and those who receive micafungin. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
Clinical failure is defined as: 1) need for systemic antifungal therapy (AmBisome) for > 3 consecutive days for presumptive fungal infection, toxicity or intolerance of study medication or 2) death.
Same as current
Complete list of historical versions of study NCT01200355 on ClinicalTrials.gov Archive Site
  • To compare the number of days on study drug between patients who receive posaconazole and patients who receive micafungin. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare the incidence of possible, probable or proven IFI between patients who receive posaconazole and those who receive micafungin during treatment phase [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare the incidence of possible, probable or proven IFI between patients who receive posaconazole and those who receive micafungin [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare the rates of discontinuation of study medication for any reason between patients who receive posaconazole and those who receive micafungin. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare overall survival rates at 6 weeks (12 weeks) from randomization between the two treatment arms. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare the number of days on study drug between patients who receive posaconazole and patients who receive micafungin. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare the incidence of possible, probable or proven IFI between patients who receive posaconazole and those who receive micafungin during treatment phase [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare the incidence of possible, probable or proven IFI between patients who receive posaconazole and those who receive micafungin [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare the rates of discontinuation of study medication for any reason between patients who receive posaconazole and those who receive micafungin. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • To compare overall survival rates at 6 weeks (12 weeks)from randomization between the two treatment arms. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
Not Provided
Not Provided
 
Posaconazole Versus Micafungin for Prophylaxis Against Invasive Fungal Infections During Neutropenia in Patients Undergoing Chemotherapy for Acute Myelogenous Leukemia, Acute Lymphocytic Leukemia or Myelodysplastic Syndrome
A Randomized Open-Label Trial of Posaconazole Versus Micafungin for Prophylaxis Against Invasive Fungal Infections During Neutropenia in Patients Undergoing Chemotherapy for Acute Myelogenous Leukemia, Acute Lymphocytic Leukemia or Myelodysplastic Syndrome

The purpose of this study is to compare the effects, good and/or bad, of posaconazole and micafungin in preventing fungal infections after chemotherapy for acute leukemia or myelodysplastic syndrome. When people take chemotherapy, they are more likely to get infections. Posaconazole has been approved for the prevention of fungal infections in patients who receive induction chemotherapy for acute leukemia and myelodysplastic syndrome. Posaconazole is available only as an oral suspension and has to be given with food. After chemotherapy, many patients are not able to tolerate food or oral medication because of severe mucositis. Patients unable to tolerate food and oral medications cannot take posaconazole.

Micafungin is an antifungal medication that is given only intravenously. Micafungin is approved for the treatment of certain fungal infections and for preventing fungal infections in patients who receive bone marrow transplant. The investigators know that micafungin is safe. Micafungin has not been tested for the prevention of fungal infections in patients receiving chemotherapy for acute leukemia and myelodysplastic syndrome. Because micafungin is given by vein, it can be given even in patients who cannot take food or medications by mouth after chemotherapy. In this study the investigators want to compare micafungin to posaconazole when given for the prevention of fungal infections in leukemia and myelodysplastic syndrome patients.

Not Provided
Interventional
Phase 4
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Acute Myelogenous Leukemia
  • Myelodysplastic Syndrome
  • Drug: micafungin
    Micafungin 100 mg intravenously once daily. Randomized treatment will be initiated 24-48 h after completion of the last dose of chemotherapy.
  • Drug: posaconazole
    Posaconazole 400 mg orally twice daily. Randomized treatment will be initiated 24-48 h after completion of the last dose of chemotherapy.
  • Experimental: micafungin
    This is a single institution (MSKCC), randomized, open-label comparative trial of micafungin and posaconazole administered as prophylaxis against fungal infections during neutropenia following induction chemotherapy for myelogenous leukemia (AML), acute lymphocytic leukemia (ALL), myelodysplastic syndrome (MDS).
    Intervention: Drug: micafungin
  • Experimental: posaconazole
    This is a single institution (MSKCC), randomized, open-label comparative trial of micafungin and posaconazole administered as prophylaxis against fungal infections during neutropenia following induction chemotherapy for myelogenous leukemia (AML), acute lymphocytic leukemia (ALL), myelodysplastic syndrome (MDS).
    Intervention: Drug: posaconazole
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
114
September 2015
September 2015   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Subjects of greater than or equal to 18 years of age of either sex and of any race.

Disease definition:

  • Anticipated or documented prolonged neutropenia (ANC<500/mm3 [0.5x109/L]) at baseline or likely to develop within 3 to 5 days and lasting for at least 7 days due to:
  • Intensive induction chemotherapy for new diagnosis of acute myelogenous leukemia, acute lymphocytic leukemia or myelodysplastic syndrome receiving standard anthracycline based chemotherapy
  • Re-induction of acute myelogenous or lymphocytic leukemia after primary relapse
  • Myelodysplastic syndromes requiring induction (myelosuppressive) chemotherapy
  • Female subjects of childbearing potential must have a negative serum pregnancy test as per MSKCC guidelines.
  • Able to swallow oral medications

Exclusion Criteria:

  • Subjects with history of presumed or proven invasive fungal infection within 30 days of randomization.
  • Subjects who are taking the following:

Drugs known to interact with posaconazole and that may lead to life-threatening side effects (terfenadine, cisapride, and ebastine at entry or within 24 hours before entry, or astemizole at entry or within 10 days before entry); b. Drugs known to lower the serum concentration/efficacy of posaconazole: cimetidine, rifampin, carbamazepine, phenytoin, rifabutin, barbiturates, and isoniazid at entry or within 24 hours before entry; c. Subjects who are planned to receive > 2mg flat dose of vinca alkaloids.

  • Subjects with a history of hypersensitivity or idiosyncratic reactions to azole agents.
  • Subjects with renal insufficiency (estimated creatinine clearance less than 20 mL/minute at baseline or likely to require dialysis during the study).
  • Subjects having an electrocardiogram with a prolonged QTc interval by manual reading: QTc greater than 490 msec.
  • Subjects with moderate or severe liver dysfunction at baseline, defined as aspartate aminotransferase, alanine aminotransferase, or alkaline phosphatase levels greater than 5 times the upper limit of normal (ULN), or a total bilirubin level greater than 3 times the ULN.
  • Subjects who are undergoing re-induction chemotherapy and have participated in this study during their first induction chemotherapy.
  • Subjects who will be receiving dasatinib.
Both
18 Years and older
No
Contact: Genovefa Papanicolaou, MD 212-639-8361
Contact: Rana Kaplan, MD 212-639-8025
United States
 
NCT01200355
10-038
Not Provided
Memorial Sloan-Kettering Cancer Center
Memorial Sloan-Kettering Cancer Center
Astellas Pharma US, Inc.
Principal Investigator: Genovefa Papanicolaou, MD Memorial Sloan-Kettering Cancer Center
Memorial Sloan-Kettering Cancer Center
March 2014

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