Fludarabine Phosphate, Cytarabine, Filgrastim-sndz, Gemtuzumab Ozogamicin, and Idarubicin Hydrochloride in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome
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| ClinicalTrials.gov Identifier: NCT00801489 |
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Recruitment Status :
Recruiting
First Posted : December 3, 2008
Last Update Posted : February 13, 2023
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| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Acute Myeloid Leukemia With Inv(16)(p13.1q22); CBFB-MYH11 Acute Myeloid Leukemia With t(16;16)(p13.1;q22); CBFB-MYH11 Acute Myeloid Leukemia With t(8;21); (q22; q22.1); RUNX1-RUNX1T1 de Novo Myelodysplastic Syndrome High Risk Myelodysplastic Syndrome Inv(16) Myelodysplastic Syndrome With Excess Blasts t(16;16) t(8;21) Untreated Adult Acute Myeloid Leukemia | Drug: Cytarabine Drug: Decitabine Biological: Filgrastim-sndz Drug: Fludarabine Phosphate Drug: Gemtuzumab Ozogamicin Drug: Idarubicin Other: Laboratory Biomarker Analysis | Phase 2 |
PRIMARY OBJECTIVES:
I. Evaluate the safety of a regimen incorporating fludarabine phosphate (fludarabine), high-dose cytarabine, filgrastim-sndz, gemtuzumab ozogamicin and idarubicin hydrochloride (idarubicin) in patients with untreated inv(16) or t(8;21) acute myeloid leukemia (AML).
II. Evaluate the complete remission rates achieved in this population with this regimen.
SECONDARY OBJECTIVES:
I. Assess the proportion of patients with untreated inv(16) or t(8;21) AML who, having entered complete remission (CR) on this regimen, remain alive in CR two years from CR date.
II. Assess whether the quantitative polymerase chain reaction (Q-PCR) results can be used in detecting relapse in these patients.
OUTLINE:
REMISSION INDUCTION: Patients receive filgrastim-sndz subcutaneously (SC) once daily (QD) beginning on day -1 and continuing until blood count recovery. Patients also receive fludarabine phosphate intravenously (IV) over 30 minutes on days 1-5, cytarabine IV over 4 hours on days 1-5, gemtuzumab ozogamicin IV over 2 hours on day 1. Patients not in remission after their first induction therapy may repeat remission induction therapy.
POST-REMISSION THERAPY: Patients receive filgrastim-sndz SC on day -1, fludarabine phosphate IV over 30 minutes on days 1-3, cytarabine IV over 4 hours on days 1-3, gemtuzumab ozogamicin IV over 2 hours on day 1 of courses 1 or 2 and 5 or 6, and idarubicin hydrochloride IV over 30 minutes on days 2 and 3 of one post-remission course (post-remission courses 3 or 4) determined by the treating physician after discussion with the PI if suboptimal qPCR response (qPCR > 0.01 after post-remission cycle 2 or 3). Treatment repeats every 4-6 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
FURTHER MODIFICATION OF POST-REMISSION THERAPY: Patients older than 60, with significant comorbidities, experiencing life-threatening complications, prolonged cytopenias, or not achieving complete molecular response may receive decitabine IV over 1 hour daily for 5 days after discussion with the principal investigator. Treatment repeats every 4-6 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 6 months for 2 years.
| Study Type : | Interventional (Clinical Trial) |
| Estimated Enrollment : | 200 participants |
| Allocation: | N/A |
| Intervention Model: | Single Group Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | A Phase 2 Study of Fludarabine, Cytarabine, Filgrastim-sndz,Gemtuzumab Ozogamicin and Idarubicin in Newly Diagnosed Core Binding Factor Associated Acute Myelogenous Leukemia |
| Actual Study Start Date : | April 4, 2007 |
| Estimated Primary Completion Date : | December 30, 2023 |
| Estimated Study Completion Date : | December 30, 2023 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: Treatment (filgrastim, fludara, cytara, gemtuzu, idarubicin)
See Detailed Description
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Drug: Cytarabine
Given IV
Other Names:
Drug: Decitabine Given IV
Other Names:
Biological: Filgrastim-sndz Given SC
Other Names:
Drug: Fludarabine Phosphate Given IV
Other Names:
Drug: Gemtuzumab Ozogamicin Given IV
Other Names:
Drug: Idarubicin Given IV
Other Names:
Other: Laboratory Biomarker Analysis Correlative studies |
- Complete remission rate [ Time Frame: Up to 2 years ]
- Toxicity rate [ Time Frame: Up to 2 years ]
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients must have untreated AML, or high-risk myelodysplastic syndromes (MDS) (refractory anemia with excess blasts, [RAEB], or RAEB "in transformation" [RAEB-t]) characterized by t(8;21), inv(16), or t(16;16); the presence of additional abnormalities is irrelevant
- Patients must provide written consent
- Participants will not be excluded based on performance status; for patients with Eastern Cooperative Oncology Group (ECOG) performance status >= to 3 the dosing schedule will be discussed with study chairman
- Patients with organ dysfunction will not be excluded from the study; for patients with evidence of organ dysfunction (creatinine >= 1.5, cardiac ejection fraction =< 50%, total bilirubin >=2 and aspartate aminotransferase [AST]/alanine aminotransferase [ALT] >= 3 times upper limit of normal [ULN]), dose adjustments/omissions will be made
- Up to one cycle of prior induction therapy will be permitted to include patients in whom presence of "good-risk" cytogenetics was initially missed; if the patient is in remission from induction therapy, he/she will receive post-remission therapy; if the patient is not in remission then he/she will receive induction therapy
- Patients of child bearing potential should practice effective methods of contraception
Exclusion Criteria:
- Pregnant and lactating females will be excluded
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00801489
| Contact: Gautam Borthakur | 713-563-1586 | gborthak@mdanderson.org |
| United States, Texas | |
| M D Anderson Cancer Center | Recruiting |
| Houston, Texas, United States, 77030 | |
| Contact: Gautam Borthakur 713-563-1586 | |
| Principal Investigator: Gautam Borthakur | |
| Principal Investigator: | Gautam Borthakur | M.D. Anderson Cancer Center |
| Responsible Party: | M.D. Anderson Cancer Center |
| ClinicalTrials.gov Identifier: | NCT00801489 |
| Other Study ID Numbers: |
2007-0147 NCI-2012-01659 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) 2007-0147 ( Other Identifier: M D Anderson Cancer Center ) |
| First Posted: | December 3, 2008 Key Record Dates |
| Last Update Posted: | February 13, 2023 |
| Last Verified: | January 2023 |
| Studies a U.S. FDA-regulated Drug Product: | Yes |
| Studies a U.S. FDA-regulated Device Product: | No |
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Leukemia Leukemia, Myeloid Leukemia, Myeloid, Acute Preleukemia Myelodysplastic Syndromes Anemia, Refractory, with Excess of Blasts Syndrome Disease Pathologic Processes Neoplasms by Histologic Type Neoplasms Bone Marrow Diseases Hematologic Diseases Precancerous Conditions Anemia, Refractory |
Anemia Cytarabine Fludarabine Fludarabine phosphate Decitabine Idarubicin Gemtuzumab Calicheamicins Lenograstim Antineoplastic Agents Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Immunosuppressive Agents Immunologic Factors |