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Homoharringtonine Plus Low-Dose Cytarabine in Treating Patients With Newly Diagnosed Chronic Myelogenous Leukemia in Chronic Phase
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Purpose
| Condition | Intervention | Phase |
|---|---|---|
| Chronic Myelogenous Leukemia, BCR-ABL1 Positive Chronic Phase Chronic Myelogenous Leukemia | Drug: omacetaxine mepesuccinate Drug: cytarabine Other: laboratory biomarker analysis | Phase 2 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment |
| Official Title: | A Phase II Study of Newly Diagnosed Patients With BCR/ABL (+) Chronic Myelogenous Leukemia Treated With Combined Homoharringtonine (NSC #141633) and Low-Dose Cytarabine |
- Complete cytogenetic, major cytogenetic, and hematologic response rate [ Time Frame: Up to 9 months ]Two separate single-stage Fleming designs will be used to test hypotheses regarding the major cytogenetic response rate and the complete cytogenetic response rate. Calculated and presented with their 95% confidence intervals.
- Toxicity rates as assessed by Common Terminology Criterial version 2.0 [ Time Frame: Up to 9 months ]
- Duration of hematological response [ Time Frame: Up to 10 years ]Described with Kaplan-Meier curves.
- Time to hematological progression [ Time Frame: Up to 10 years ]Described with Kaplan-Meier curves.
| Enrollment: | 60 |
| Study Start Date: | March 1999 |
| Primary Completion Date: | August 2003 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Treatment (omacetaxine mepesuccinate, cytarabine)
Patients receive cytarabine and homoharringtonine concurrently by continuous intravenous infusion for 7 days. Courses repeat every 28 days. Patients receive a minimum of 9 courses of therapy in the absence of disease progression and unacceptable toxicity. Patients who are major cytogenetic responders at 9 months may continue therapy or switch to interferon. Minor cytogenetic responders are switched to interferon, and nonresponders are removed from therapy and given the option to switch to interferon.
|
Drug: omacetaxine mepesuccinate
Given IV
Other Names:
Drug: cytarabine
Given IV
Other Names:
Other: laboratory biomarker analysis
Correlative studies
|
Detailed Description:
PRIMARY OBJECTIVES:
I. To estimate the hematologic and cytogenetic response rate of newly diagnosed patients with BCR/ABL (+) chronic myelogenous leukemia (CML) treated with combined homoharringtonine (omacetaxine mepesuccinate) and low dose cytarabine.
II. To estimate the toxicity of these two drugs given in combination in a cooperative group setting.
SECONDARY OBJECTIVES:
I. To assess duration of hematological response and incidence of hematological progression for all patients.
II. To assess duration of cytogenetic response in patients continuing protocol therapy beyond the initial nine months.
III. To use quantitative Southern blot monitoring of blood samples to monitor molecular response rates in patients entered onto CALGB treatment studies for CML.
IV. To compare quantitative Southern blot results of blood samples with marrow cytogenetics at the time of complete molecular response.
V. To use RT-PCR to monitor the frequency of residual disease in patients who have achieved a complete blood Southern blot and marrow cytogenetic response (elimination of BCR/ABL positivity by Southern blot and absence of the Philadelphia chromosome by cytogenetics).
OUTLINE:
Patients receive cytarabine and homoharringtonine concurrently by continuous intravenous infusion for 7 days. Courses repeat every 28 days. Patients receive a minimum of 9 courses of therapy in the absence of disease progression and unacceptable toxicity. Patients who are major cytogenetic responders at 9 months may continue therapy or switch to interferon. Minor cytogenetic responders are switched to interferon, and nonresponders are removed from therapy and given the option to switch to interferon.
Patients are followed every 6 months for 10 years.
Eligibility| Ages Eligible for Study: | 16 Years and older (Child, Adult, Senior) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologic diagnosis of chronic myelogenous leukemia (CML) in chronic phase; patients in either accelerated or blastic phases are not eligible; clonal cytogenetic evolution alone does not exclude patients
-
Patients must meet one or more of the following criteria:
- Cytogenetically determined Philadelphia chromosome (Ph+)
- BCR/ABL protein detectable by immunoblotting
- Polymerase chain reaction (PCR) positive fusion transcripts for BCR/ABL
- BCR/ABL translocation present by fluorescence in situ hybridization (FISH)
- Registration within eight weeks of the diagnosis and confirmation of Ph+ or BCR/ABL+ CML
- No more than eight weeks of prior hydroxyurea therapy
- No previous therapy with homoharringtonine (HHT)
- No prior treatment for CML with agents other than hydroxyurea; thus, prior treatment for CML with agents such as interferon, busulfan or cytarabine will render patients ineligible
- Must not be a candidate for an early allogeneic bone marrow transplant; potential transplant candidates must be counseled about alternative donor transplants and must decline that treatment option
- ECOG performance status 0-2
- Non-pregnant and non-nursing; treatment under this protocol would expose an unborn child to significant risks; women and men of reproductive potential should agree to use an effective means of birth control
- Bilirubin =< x upper limit of normal
- Creatinine =< 1.5 mg/dl
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT00003694
| United States, Massachusetts | |
| Dana-Farber Harvard Cancer Center | |
| Boston, Massachusetts, United States, 02115 | |
| Principal Investigator: | Richard Stone | Cancer and Leukemia Group B |
More Information
| Responsible Party: | National Cancer Institute (NCI) |
| ClinicalTrials.gov Identifier: | NCT00003694 History of Changes |
| Other Study ID Numbers: |
NCI-2012-02786 CALGB-19804 U10CA031946 ( U.S. NIH Grant/Contract ) |
| Study First Received: | November 1, 1999 |
| Last Updated: | June 4, 2013 |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Myeloid Leukemia, Myelogenous, Chronic, BCR-ABL Positive Leukemia, Myeloid, Chronic-Phase Neoplasms by Histologic Type Neoplasms Myeloproliferative Disorders Bone Marrow Diseases Hematologic Diseases Cytarabine Homoharringtonine Harringtonines Antimetabolites, Antineoplastic |
Antimetabolites Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Antiviral Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antineoplastic Agents, Phytogenic Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Growth Inhibitors |
ClinicalTrials.gov processed this record on September 21, 2017