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Ph 1 Study of ADI-PEG 20 Plus Low Dose Cytarabine in Older Patients With AML

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT02875093
Recruitment Status : Recruiting
First Posted : August 23, 2016
Last Update Posted : May 16, 2018
Information provided by (Responsible Party):
Polaris Group

Brief Summary:
Assessment of safety and tolerability of drug combination and determine time on treatment, Overall survival (OS) and response rate with patient disease burden, and type of disease

Condition or disease Intervention/treatment Phase
Acute Myeloid Leukemia Drug: ADI-PEG 20 Drug: Cytarabine Phase 1

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase 1 Study of ADI-PEG 20 Plus Low Dose Cytarabine in Older Patients With Acute Myeloid Leukemia
Actual Study Start Date : January 20, 2017
Estimated Primary Completion Date : April 2020
Estimated Study Completion Date : November 2020

Arm Intervention/treatment
ADI-PEG 20 Plus Low Dose Cytarabine
This is a phase 1, open label trial of ADI-PEG 20 (18 and 36 mg/m2) weekly in combination with low-dose cytarabine (20 mg BID [twice daily] for 10 days, every 28 days)
Drug: ADI-PEG 20
Investigational Medicine

Drug: Cytarabine
low-dose cytarabine 20 mg BID twice daily for 10 days, every 28 days

Primary Outcome Measures :
  1. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] [ Time Frame: through study completion; anticipated to be 2 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   17 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. AML diagnosed by morphologic (with >20% blasts in blood or bone marrow) and histochemical and/or cell surface marker criteria.
  2. Patients with AML must fall into one of the following:

    1. Patients with AML (i.e., > 20% bone marrow blasts) who are deemed unfit* for intensive chemotherapy with refractory or relapsed disease. The patients must have been refractory to at least one cycle of cytarabine containing regimens or at least two cycles of azacitidine or similar hypomethylating agents.
    2. Patients with untreated AML (i.e., > 20% bone marrow blasts) with intermediate risk karyotype (MRC risk group) who are deemed unfit for intensive chemotherapy.
    3. Patients with untreated AML with adverse risk karyotype (MRC risk group) who are deemed unfit for intensive chemotherapy and who are intolerant of azacitidine (or other hypomethylating agents) or who are unable to access azacitidine or other hypomethylating agents.

      • Patients unfit for conventional intensive chemotherapy are defined as having at least one of the following based on the conceptual criteria of Ferrara (2013):

        1. Advanced age (over 75 years).
        2. Cardiac impairment with ejection fraction ≤ 50% or heart failure (NYHA class 2) or ischemic heart disease with stable angina.
        3. Pulmonary impairment: chronic obstructive pulmonary disease (COPD) stage 1-2 (forced expiratory volume in one second [FEV1] > 49%) or other comparable respiratory disease with forced vital capacity (FVC) > 50%.
        4. Hepatic comorbidity with Child-Pugh grade A cirrhosis
        5. Chronic kidney disease stage 3 but with creatinine clearance > 30 mls/min
        6. Any other comorbidity that the physician judges to be incompatible with intensive chemotherapy.
  3. Age > 17 years.
  4. ECOG performance status of 0-2.
  5. Bone marrow aspirate and/or biopsy for testing for ASS1-deficiency. This must be a fresh sample obtained after any prior chemotherapy and before enrollment in this study. ASS1-deficiency is not required for study entry, but the fresh bone marrow sample must be processed either before or within 1 week of first study dose (see Section 10 for more details).

Exclusion Criteria:

A subject will not be eligible for study participation if he/she meets any of the exclusion criteria:

  1. Patients with uncontrolled infections requiring intravenous (IV) antibiotic/antiviral therapy are not eligible for entry onto the study; patients on prophylactic antibiotics or antivirals are acceptable.
  2. Pregnancy or lactation.
  3. Expected non-compliance.
  4. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure (New York Heart Association Class III or IV), unstable angina, ventricular cardiac arrhythmia (other than ventricular ectopy), severe pulmonary comorbidity: COPD grade 3-4 (FEV1 <50%) or other comparable documented pulmonary disease with FVC <50%, or dyspnea at rest or requiring oxygen at home, cognitive impairment: current mental illness requiring psychiatric hospitalization, institutionalization or intensive outpatient management, or uncontrolled current cognitive status (as confirmed by the specialist; dependence on a caregiver is permitted as long as this is well controlled), severe hepatic comorbidity: liver Child-Pugh grade B-C cirrhosis or acute viral hepatitis, social situations that would limit compliance with study requirements or DIC causing coagulopathy not correctable with factor replacement.
  5. Subjects who have had any anti-leukemia treatment prior to entering the study and have not recovered to baseline (except alopecia) or≤ Grade 1 AEs, or deemed irreversible from the effects of prior cancer therapy. AEs > Grade 1 that are not considered a safety risk by the Sponsor and Investigator may be allowed upon agreement with both.

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 identifier (NCT number): NCT02875093

Contact: John Bomalaski, MD 858-452-6688 ext 114
Contact: Gisela Peterson, MD, CCRA 858-452-6688 ext 127

Kaohsiung Medical University Chung-Ho Memorial Hospital Recruiting
Kaohsiung, Taiwan, 807
Contact: Ta-Chih Liu, MD         
National Cheng Kung University Hospital Recruiting
Tainan, Taiwan, 704
Contact: Tsao-Yun Chen, M.D.         
Chang Gung Memorial Hospital - Linkou Recruiting
Taoyuan, Taiwan, 33305
Contact: Ming-Chung Kuo, M.D.         
Sponsors and Collaborators
Polaris Group

Responsible Party: Polaris Group Identifier: NCT02875093     History of Changes
Other Study ID Numbers: POLARIS2016-001
First Posted: August 23, 2016    Key Record Dates
Last Update Posted: May 16, 2018
Last Verified: May 2018

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Neoplasms by Histologic Type
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs