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BMS-354825 in Treating Patients With Chronic Phase Chronic Myelogenous Leukemia That Is Resistant to Imatinib Mesylate
This study is ongoing, but not recruiting participants.
First Received: July 8, 2003   Last Updated: July 23, 2008   History of Changes
Sponsor: Jonsson Comprehensive Cancer Center
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00064233
  Purpose

RATIONALE: BMS-354825 may stop the growth of cancer cells by stopping the enzymes necessary for cancer cell growth.

PURPOSE: This phase I trial is studying the side effects and best dose of BMS-354825 in treating patients with chronic phase chronic myelogenous leukemia that is resistant to imatinib mesylate.


Condition Intervention Phase
Leukemia
Drug: dasatinib
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase I Dose-Escalation Study To Determine The Safety, Pharmacokinetics, And Pharmacodynamics Of BMS-354825 In The Treatment Of Patients With Chronic Phase Chronic Myelogenous Leukemia Who Have Hematologic Resistance To Imatinib Mesylate (Gleevec

Resource links provided by NLM:


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

Estimated Enrollment: 50
Study Start Date: November 2003
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose, maximum administered dose, dose-limiting toxicity, and a recommended phase II dose of BMS-354825 in patients with chronic phase chronic myelogenous leukemia who have hematologic resistance to imatinib mesylate.
  • Determine the safety and tolerability of this drug in these patients.
  • Determine the plasma pharmacokinetics of this drug in these patients.
  • Determine, preliminarily, the efficacy of this drug, in terms of hematologic, cytogenetic, and molecular responses in these patients.

OUTLINE: This is an open-label, dose-escalation, multicenter study.

Patients receive oral BMS-354825 once daily on days 1-5. Courses repeat every 7 days for at least 3 months in the absence of disease progression or unacceptable toxicity. Patients may receive further treatment in the absence of disease progression.

Cohorts of 3-6 patients receive escalating doses of BMS-354825 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.

Once the MTD is determined, 20 additional patients receive treatment as in phase I at the MTD of BMS-354825.

Patients are followed for at least 30 days.

PROJECTED ACCRUAL: Approximately 50 patients (30 for phase I and 20 for phase II) will be accrued for this study within 12-18 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Diagnosis of Philadelphia chromosome positive, chronic phase chronic myelogenous leukemia (CML) meeting all of the following criteria*:

    • Less than 15% blasts in peripheral blood and bone marrow
    • Less than 20% basophils in peripheral blood
    • Less than 30% blasts and promyelocytes in peripheral blood and bone marrow
    • Platelet count at least 100,000/mm^3
    • No extramedullary involvement (other than liver or spleen) NOTE: *Patients who previously met the criteria for accelerated phase or blast phase CML, responded to treatment, and currently meet the criteria for chronic phase CML are eligible
  • Primary or acquired hematologic resistance to imatinib mesylate OR intolerance to imatinib mesylate defined as follows:

    • Primary hematologic resistance is defined as failure to reach complete hematologic response (CHR) with a dose of 400 mg/day continued for at least 3 months

      • Patients with hematological progression (i.e., WBC at least 10,000/mm^3 and rising consistently on at least 2 consecutive measurements obtained at least 14 days apart) while receiving imatinib mesylate of 400 mg/day are eligible if they have received less than 3 months of therapy
    • Acquired hematologic resistance is defined as achieving a CHR, but subsequently developing a rising WBC to at least 10,000/mm^3

      • WBC must be at least 10,000/mm^3 and rising on at least 2 measurements obtained at least 14 days apart with at least 1 of these measurements greater than 15,000/mm^3
    • Intolerance is defined as having discontinued imatinib mesylate due to nonhematologic toxicity of any grade
  • CD4^+ T-cell count at least 350/mm^3

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-1

Life expectancy

  • At least 6 months

Hematopoietic

  • See Disease Characteristics
  • No significant bleeding disorder unrelated to CML
  • No acquired bleeding disorder within the past year (e.g., acquired antifactor VIII antibodies)
  • No congenital bleeding disorders (e.g., von Willebrand disease)

Hepatic

  • Bilirubin no greater than 1.5 mg/dL
  • ALT and AST no greater than 2.0 times upper limit of normal (ULN)

Renal

  • Creatinine no greater than 1.5 times ULN
  • Potassium normal*
  • Magnesium normal*
  • Serum calcium or ionized calcium at least lower limit of normal NOTE: *Patients with low levels may be repleted to be eligible

Cardiovascular

  • No uncontrolled or significant cardiovascular disease
  • No uncontrolled angina within the past 6 months
  • No congestive heart failure within the past 6 months
  • No myocardial infarction within the past 12 months
  • No history of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, or torsades de pointes)
  • No history of second or third degree heart block (may be eligible if patient has a pacemaker)
  • No diagnosed or suspected congenital long QT syndrome
  • No prolonged QTc interval on pre-entry EKG (i.e., greater than 450 msec)
  • No heart rate less than 50/minute on pre-entry EKG
  • No uncontrolled hypertension
  • No vasculitis

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception for 1 month before, during, and 1 month after study participation
  • No gastrointestinal tract bleeding within the past 6 months
  • No connective tissue disorders
  • No other serious uncontrolled medical disorder or active infection that would impair the ability to receive study therapy
  • No dementia or altered mental status that would preclude giving informed consent
  • No evidence of organ dysfunction or any clinically significant deviation from normal in physical examination, vital signs, EKG, or clinical laboratory determinations unrelated to CML
  • No prisoners or patients who are compulsorily detained (e.g., involuntary incarceration for treatment of either a psychiatric or physical [e.g., infectious disease] illness)

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 14 days since prior interferon

Chemotherapy

  • More than 14 days since prior cytarabine
  • More than 3 days since prior hydroxyurea

Endocrine therapy

  • Not specified

Radiotherapy

  • Not specified

Surgery

  • Not specified

Other

  • See Disease Characteristics
  • More than 28 days since other prior investigational or antineoplastic agents
  • More than 7 days since prior imatinib mesylate
  • At least 5 days or 5 half-lives since prior medications that inhibit platelet function, including the following:

    • Aspirin
    • Dipyridamole
    • Epoprostenol
    • Eptifibatide
    • Clopidogrel
    • Cilostazol
    • Abciximab
    • Ticlopidine
  • At least 5 days or 5 half-lives since prior anticoagulants such as warfarin or heparin/low molecular weight heparin (e.g., danaparoid, dalteparin, tinzaparin, enoxaparin)
  • At least 5 days or 5 half-lives since prior drugs accepted to have a risk of causing torsades de pointes, including the following:

    • Class IA antiarrhythmic agents (e.g., quinidine, procainamide, or disopyramide)
    • Class III antiarrhythmic agents (e.g., amiodarone, sotalol, ibutilide, or dofetilide)
    • Macrolide antibiotics (e.g., erythromycin or clarithromycin)
    • Antipsychotics (e.g., chlorpromazine, haloperidol, thioridazine, or pimozide)
    • Tricyclic antidepressants
    • Cisapride
    • Bepridil
    • Inapsine
    • Methadone
    • Arsenic
  • No concurrent drugs accepted to have a risk of causing torsades de pointes
  • No other concurrent treatment for CML
  • No concurrent dolasetron or droperidol
  • No concurrent anticoagulants
  • No concurrent medications that inhibit platelet function
  • Concurrent anagrelide for thrombocytosis due to CML allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00064233

Locations
United States, California
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, United States, 90095-1781
Sponsors and Collaborators
Jonsson Comprehensive Cancer Center
Investigators
Principal Investigator: Charles Sawyers, MD Jonsson Comprehensive Cancer Center
  More Information

Additional Information:
Publications:
Cortes J, Sawyers CL, Kantarjian HM, et al.: Long-term efficacy of dasatinib in chronic-phase CML: results from the phase I trial (CA180002). [Abstract] Blood 110 (11): A-1026, 2007.
Talpaz M, Shah NP, Kantarjian H, Donato N, Nicoll J, Paquette R, Cortes J, O'Brien S, Nicaise C, Bleickardt E, Blackwood-Chirchir MA, Iyer V, Chen TT, Huang F, Decillis AP, Sawyers CL. Dasatinib in imatinib-resistant Philadelphia chromosome-positive leukemias. N Engl J Med. 2006 Jun 15;354(24):2531-41.
Talpaz M, Kantarjian HM, Paquette R, et al.: A phase I study of BMS-354825 in patients with imatinib-resistant and intolerant chronic phase chronic myeloid leukemia (CML): results from CA180002. [Abstract] J Clin Oncol 23 (Suppl 16): A-6519, 564s, 2005.

Study ID Numbers: CDR0000310142, UCLA-0303035, BMS-CA180002
Study First Received: July 8, 2003
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00064233     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
chronic phase chronic myelogenous leukemia
relapsing chronic myelogenous leukemia
Philadelphia chromosome positive chronic myelogenous leukemia

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Hematologic Diseases
Myeloproliferative Disorders
Enzyme Inhibitors
Leukemia, Myeloid
Leukemia, Myeloid, Chronic-Phase
Protein Kinase Inhibitors
Pharmacologic Actions
Imatinib
Leukemia
Neoplasms
Therapeutic Uses
Dasatinib
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Bone Marrow Diseases

ClinicalTrials.gov processed this record on November 03, 2009