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Trial record 13 of 18 for:    "Chromosomal Disease" | "Mercaptopurine"

Dasatinib Combined With Chemotherapy in Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia

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ClinicalTrials.gov Identifier: NCT02523976
Recruitment Status : Active, not recruiting
First Posted : August 14, 2015
Last Update Posted : March 22, 2019
Sponsor:
Information provided by (Responsible Party):
wang, jianxiang, Institute of Hematology & Blood Diseases Hospital

Brief Summary:
In this single-center, open-label, no control,prospective clinical trial, a total of 30 Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) patients will be enrolled. Dasatinib 100 mg per day will be given orally along with combination chemotherapy starting day 8 of induction chemotherapy. Dasatinib will be given continuously (if it's tolerable) for 2 years since achievement of complete remission (CR) as part of consolidation chemotherapy and maintenance therapy.Patients can receive allogeneic hematopoietic stem cell transplantation (HSCT) or autologous HSCT whenever possible during their first CR. Otherwise, they will finish the consolidation chemotherapy. The purpose of current study is to determine the clinical efficacy and tolerability of combination therapy of Dasatinib with multi-agent chemotherapy in newly-diagnosed Ph+ ALL.

Condition or disease Intervention/treatment Phase
Acute,Leukemia, Lymphoid Drug: Dasatinib Drug: prednisone Drug: cyclophosphamide Drug: daunorubicin Drug: vincristine Drug: cytarabine Drug: mercaptopurine Drug: methotrexate Drug: dexamethasone Drug: mitoxantrone Drug: etoposide Procedure: allogeneic hematopoietic stem cell transplantation Procedure: autologous hematopoietic stem cell transplantation Phase 2

Detailed Description:

In this single-center, open-label, Phase II study, nonrandomized,no control,prospective clinical trial,a total of 30 Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) patients will be enrolled.Patients will be diagnosed according to morphologic,immunologic, cytogenetic and molecular(MICM) criteria, including bone marrow morphology, immunophenotype, cytogenetic and molecular genetic (BCR/ABL gene, qualitative and quantitative analysis) examination.

Dasatinib 100 mg per day will be given orally along with combination chemotherapy starting day 8 of induction chemotherapy. Dasatinib will be given continuously (if it's tolerable) for 2 years since achievement of complete remission (CR) as part of consolidation chemotherapy and maintenance therapy.Patients can receive allogeneic hematopoietic stem cell transplantation (HSCT),or patients who keep BCR/ABL negative can receive autologous HSCT whenever possible during their first CR. Otherwise, they will finish the consolidation chemotherapy. Total duration of follow-up will be 2 year after last enrollment.

Pre-treatment evaluation will include complete blood count (CBC) with reticulocyte count, chemistry, electrolytes, coagulation, hepatitis profile, chest X-ray.Evaluation during treatment will include: CBC every two days during myelosuppression, chemistry, electrolytes, coagulation before each cycles of chemotherapy. Quantitative PCR (RQ-PCR) for Bcr-Abl will be done from bone marrow mononuclear cells at diagnosis, at CR, and before each cycles of consolidation chemotherapy,then every 3 months during maintenance therapy. For patients who undergo allogeneic HSCT, quantitative PCR for Bcr-Abl will be done from bone marrow mononuclear cells at the initiation of conditioning, and then every 3 months. PCR will be done in IS standardized lab.

Side effects of combination therapy will be monitored and described according to Common Toxicity Criteria, version 4.0 (National Cancer Institute, USA).

The purpose of current study is to determine the clinical efficacy and tolerability of combination therapy of Dasatinib with multi-agent chemotherapy in newly-diagnosed Ph+ ALL.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 30 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Dasatinib Plus Multi-agent Chemotherapy for New Diagnosed Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia
Study Start Date : August 2015
Estimated Primary Completion Date : August 2019
Estimated Study Completion Date : August 2019


Arm Intervention/treatment
Experimental: Arm A
Dasatinib 100 mg per day will be given orally along with combination chemotherapy starting day 8 of induction chemotherapy. Dasatinib will be given continuously (if it's tolerable) for 2 years since achievement of complete remission (CR) as part of consolidation chemotherapy and maintenance therapy.Patients can receive allogeneic hematopoietic stem cell transplantation (HSCT),or patients who keep BCR/ABL negative can receive autologous HSCT whenever possible during their first CR. Otherwise, they will finish the consolidation chemotherapy.
Drug: Dasatinib
Second-generation tyrosine kinase inhibitor

Drug: prednisone
Drug: cyclophosphamide
Drug: daunorubicin
Drug: vincristine
Drug: cytarabine
Drug: mercaptopurine
Drug: methotrexate
Drug: dexamethasone
Drug: mitoxantrone
Drug: etoposide
Procedure: allogeneic hematopoietic stem cell transplantation
Procedure: autologous hematopoietic stem cell transplantation



Primary Outcome Measures :
  1. Overall survival (OS) [ Time Frame: From date of diagnosis until the date of death from any cause, assessed up to 60 months. ]

Secondary Outcome Measures :
  1. Disease-free survival (DFS) [ Time Frame: From the date of complete remission(CR) until the date of documented relapse,assessed up to 60 months. ]
  2. The complete remission (CR) rate [ Time Frame: Participants will be followed for the duration of the treatment, an expected average of 6 months. ]
  3. The molecular CR rate [ Time Frame: Participants will be followed for the duration of the treatment, an expected average of 24 months. ]
  4. The plasma level of dasatinib in the regimen [ Time Frame: Up to 3 months. ]
  5. The Cerebrospinal fluid level of dasatinib in the regimen [ Time Frame: Up to 6 months. ]
  6. Number of adverse event of combined treatment [ Time Frame: Participants will be followed for the duration of the treatment, an expected average of 24 months. ]
  7. Grade of adverse event of combined treatment [ Time Frame: Participants will be followed for the duration of the treatment, an expected average of 24 months. ]


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Ages Eligible for Study:   18 Years to 55 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patients aged 18 to 60 years with De novo Philadelphia chromosome positive (Philadelphia chromosome positive or BCR/ABL transcript positive) acute lymphoblastic leukemia.
  2. Eastern Cooperative Oncology Group (ECOG) Performance status 2.
  3. Adequate end organ function as defined by: Total bilirubin ≤ 1.5 x upper limit of normal(ULN); serum glutamic-oxaloacetic transaminase(SGOT) and serum glutamic pyruvic transaminase(SGPT) ≤ 2.5 x ULN; Creatinine ≤ 1.5 x ULN; Serum amylase and lipase ≤ 1.5 x ULN; Alkaline phosphatase ≤ 2.5 x ULN unless considered tumor related; Patients must have adequate cardiac function (ejection fraction ≥ 45 % on Multiple Gated Acquisition (MUGA) scan).
  4. Patients must have the following laboratory values (≥ lower limit of normal (LLN) or corrected to within normal limits with supplements prior to the first dose of study medication.): Potassium ≥ LLN; Magnesium ≥ LLN; Phosphorus ≥ LLN
  5. Patients should sign informed consent form.

Exclusion Criteria:

  1. Impaired cardiac function:

    Long QT syndrome or a known family history of long QT syndrome; clinically significant resting brachycardia (<50 beats per minute); ejection fraction < 45 % on MUGA scan. QTc interval > 450 msec on baseline ECG (using the QTcF formula). If QTcF interval>450 msec and electrolytes are not within normal ranges, electrolytes should be corrected and then the patient re-screened for QTc. Myocardial infarction within 12 months prior to starting study; other clinically significant heart disease (e.g. unstable angina, congestive heart failure or uncontrolled hypertension, uncontrolled arrhythmias).

    Patients who are currently receiving treatment with any medications that have the potential to prolong the QT interval and the treatment cannot be either discontinued or switched to a different medication prior to starting study drug.

  2. Other concurrent severe and/or uncontrolled medical conditions:

    Patients with another primary malignant disease, except those that do not currently require treatment; acute or chronic liver, pancreatic or severe renal disease; another severe and/or life-threatening medical disease.

  3. Patients who are: (a) pregnant, (b) breast feeding, (c) of childbearing potential without a negative pregnancy test prior to baseline and (d) male or female of childbearing potential unwilling to use contraceptive precautions throughout the trial (post-menopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential).
  4. Who is known human deficiency virus (HIV) positive.
  5. Use of any other investigational agent in the last 30 days.

Information from the National Library of Medicine

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): NCT02523976


Locations
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China, Tianjin
Institute of Hematology & Blood Diseases Hospital
Tianjin, Tianjin, China, 300020
Sponsors and Collaborators
Institute of Hematology & Blood Diseases Hospital
Investigators
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Principal Investigator: Jianxiang Wang, Dr. Institute of Hematology & Blood Diseases Hospital

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Responsible Party: wang, jianxiang, Dr., Institute of Hematology & Blood Diseases Hospital
ClinicalTrials.gov Identifier: NCT02523976     History of Changes
Other Study ID Numbers: IHBDH-IIT2015001
First Posted: August 14, 2015    Key Record Dates
Last Update Posted: March 22, 2019
Last Verified: March 2019
Keywords provided by wang, jianxiang, Institute of Hematology & Blood Diseases Hospital:
Acute
Leukemia
Lymphoid
Philadelphia chromosome
dasatinib
Additional relevant MeSH terms:
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Chromosome Aberrations
Mercaptopurine
Leukemia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia, Lymphoid
Philadelphia Chromosome
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Translocation, Genetic
Pathologic Processes
Cytarabine
Dexamethasone
Prednisone
Cyclophosphamide
Methotrexate
Etoposide
Vincristine
Dasatinib
Daunorubicin
Mitoxantrone
Anti-Inflammatory Agents
Antiemetics
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Gastrointestinal Agents