A Study of Clofarabine for Older Patients With Newly Diagnosed Acute Myelogenous Leukemia (AML) (CLASSIC II)

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. Read our disclaimer for details. Identifier: NCT00373529
Recruitment Status : Completed
First Posted : September 8, 2006
Results First Posted : March 24, 2011
Last Update Posted : April 14, 2014
Information provided by (Responsible Party):
Sanofi ( Genzyme, a Sanofi Company )

Brief Summary:

Clolar (clofarabine injection) is approved by the Food and Drug Administration (FDA) for the treatment of pediatric patients 1 to 21 years old with relapsed acute lymphoblastic leukemia (ALL) who have had at least 2 prior treatment regimens.

This study will evaluate the efficacy of clofarabine in elderly patients with acute myelogenous leukemia (AML) who are unlikely to benefit from treatment with intensive chemotherapy regimens (cytarabine and anthracycline based regimens) used in younger patients with AML.

Condition or disease Intervention/treatment Phase
Acute Myelogenous Leukemia Acute Myeloid Leukemia Drug: clofarabine Phase 2

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 116 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of Single Agent Clofarabine in Previously Untreated Older Adult Patients With Acute Myelogenous Leukemia (AML) for Whom Standard Induction Chemotherapy is Unlikely to be of Benefit
Study Start Date : October 2006
Actual Primary Completion Date : May 2008
Actual Study Completion Date : May 2010

Arm Intervention/treatment
Experimental: Clofarabine
Participants received an induction cycle of clofarabine 30 mg/m^2/day intravenous infusion for 5 consecutive days. Participants could then receive up to 5 additional cycles, repeated minimally every 28 days, of clofarabine 20 mg/m^2/day intravenous infusion for 5 consecutive days.
Drug: clofarabine

Induction cycle 1: cycle 1 of clofarabine 30 mg/m^2/day as a 1-hour intravenous infusion for 5 consecutive days.

Reinduction (cycle 2) and/or Consolidation cycles (cycles 2-6): cycles repeated minimally every 28 days, of clofarabine 20 mg/m^2/day as a 1-hour intravenous infusion for 5 consecutive days.

Other Name: clolar

Primary Outcome Measures :
  1. Percentage of Participants Achieving Overall Remission (OR) After No More Than Two Cycles (Approximately Month 2) [ Time Frame: approximately Month 2 ]
    Best response was assessed by the Independent Response Review Panel(IRRP) after two cycles of treatment. Overall remission(OR) is the sum of complete remission(CR) and complete remission in the absence of platelet recovery(CRp). CR includes normal values for peripheral blood cell counts (absolute neutrophil and platelet) and leukemic blast cells from bone marrow biopsy or aspirate, and absence of extramedullary disease. Partial remission(PR) includes recovery of peripheral blood cells with improved but still abnormal values in leukemic blast cells.

Secondary Outcome Measures :
  1. Kaplan Meier Estimate for Duration of Remission (DOR) [ Time Frame: Up to 2 years ]
    DOR was defined as the number of days from achievement of OR as assessed by the Independent Response Review Panel (IRRP) until IRRP-determined disease recurrence or death (any cause), plus 1 day. Participants who initiated alternative antileukemic treatment while in remission were censored on the date the therapy was initiated or on the date of last follow-up.

  2. Kaplan Meier Estimate for Disease-free Survival (DFS) [ Time Frame: Up to 2 years ]
    DFS was defined as the number of days from achievement of IRRP-determined overall response until IRRP-determined disease recurrence or death (any cause), regardless of intervening alternative antileukemic treatment, plus 1 day.

  3. Kaplan Meier Estimates for Overall Survival (OS) [ Time Frame: Up to 2 years ]
    OS was defined as the number of days from first dose of clofarabine until death for all participants, plus 1 day.

  4. Overall Participant Counts Summarizing Adverse Events (AEs) During the Treatment and Follow-up Periods [ Time Frame: Up to 2 years ]

    Participants with AEs that occurred during the treatment and follow-up periods. AEs were classified according to severity (graded using National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] version 3.0) and relationship to study drug. Treatment emergent is defined as any event that either first presents after baseline or worsens in severity after baseline.

    NCI Common Terminology Criteria for Severity:

    Grade 1= Mild AE, Grade 2= Moderate AE, Grade 3= Severe AE, Grade 4= Life-threatening or disabling AE, Grade 5= Death related to AE

  5. Percentage of Participants Who Died Within Thirty Days of Treatment (30-day Mortality Rate) [ Time Frame: up to Day 30 ]
    Percentage of participants who died within 30 days of the first dose of study drug, regardless of cause.

Other Outcome Measures:
  1. Number of Participants Achieving Overall Remission After A Maximum of Two Cycles by Subgroup of Baseline Prognostic Factors [ Time Frame: approximately Month 2 ]
    The number of participants within each subgroup of baseline prognostic factors of the full analysis set who achieved a best response of either a complete response (CR) or a complete response in the absence of platelet recovery (CRp) as determined by the Independent Response Review Panel following a maximum of two cycles of treatment.

Information from the National Library of Medicine

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Ages Eligible for Study:   60 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Diagnosis of AML (de novo, secondary or with an antecedent hematologic disorder [AHD])
  • Age ≥ 60 years
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Presence of at least one adverse prognostic factor: Age ≥ 70 years; or AHD; or ECOG performance status of 2; or Intermediate or unfavorable (i.e., adverse) karyotype defined as any cytogenetic profile except the presence of any of the following:

    • t(8;21)(q22;q22)
    • inv(16)(p13;q22 or t(16;16)(p13;q22)
    • t(15;17)(q22;q12) and variants.
  • Adequate renal and hepatic function: Total bilirubin ≤ 1.5 x upper limit of normal (ULN); Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN; and Serum creatinine ≤ 1.0 mg/dL; if serum creatinine > 1.0 mg/dL, then the estimated glomerular filtration rate (GFR) must be > 60 mL/min/1.73 m^2 as calculated by the Modification of Diet in Renal Disease (MDRD) equation
  • Adequate cardiac function: left ventricular ejection fraction (LVEF) ≥ 40% or left ventricular fractional shortening ≥ 22%

Exclusion Criteria:

  • Diagnosis of acute promyelocytic leukemia
  • Prior treatment with clofarabine
  • Prior treatment for AML or an antecedent hematologic disorder
  • Prior hematopoietic stem cell transplant (HSCT)
  • Prior radiation therapy to the pelvis
  • Investigational agent received within 30 days prior to the first dose of study drug
  • Ongoing uncontrolled systemic infection
  • Diagnosis of another malignancy, unless the patient has been disease-free for at least 5 years following the completion of curative intent therapy with the following exceptions: Patients with treated non-melanoma skin cancer, in-situ carcinoma or cervical intraepithelial neoplasia regardless of disease-free duration are eligible for this study if definitive treatment for the condition has been completed; Patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on PSA value are eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed
  • Clinical evidence of central nervous system (CNS) involvement
  • Severe concurrent medical condition or psychiatric disorder that would preclude study participation
  • Positive human immunodeficiency virus (HIV) test

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): NCT00373529

  Hide Study Locations
United States, Arizona
Mayo Clinical Hospital
Phoenix, Arizona, United States
Arizona Cancer Center
Tucson, Arizona, United States
United States, California
USC/Norris Comprehensive Cancer Center and Hospital
Los Angeles, California, United States
Scripps Cancer Center
San Diego, California, United States
United States, Colorado
Rocky Mountain Cancer Centers
Denver, Colorado, United States
United States, Connecticut
Cancer Center of Central Connecticut
Southington, Connecticut, United States
United States, Georgia
Emory University School of Medicine
Atlanta, Georgia, United States
Medical College of Georgia
Augusta, Georgia, United States
United States, Illinois
Rush University Medical Center
Chicago, Illinois, United States
United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
United States, Michigan
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, United States
United States, New York
Mount Sinai School of Medicine
New York, New York, United States
United States, Oregon
Oregon Health and Science University
Portland, Oregon, United States
United States, Pennsylvania
Penn State Hershey Medical Center
Hershey, Pennsylvania, United States
United States, Tennessee
Vanderbilt University Medical Center
Nashville, Tennessee, United States
United States, Texas
University of MD Anderson Cancer Center
Houston, Texas, United States
Cancer Care Centers of South Texas
San Antonio, Texas, United States
United States, Utah
University of Utah - Huntsman Cancer Institute
Salt Lake City, Utah, United States
United States, Washington
Seattle Cancer Care Alliance
Seattle, Washington, United States
United States, West Virginia
West Virginia University - HSC
Morgantown, West Virginia, United States
Sponsors and Collaborators
Genzyme, a Sanofi Company
Study Director: Medical Monitor Genzyme, a Sanofi Company

Publications of Results:
Responsible Party: Genzyme, a Sanofi Company Identifier: NCT00373529     History of Changes
Other Study ID Numbers: CLO24300606
First Posted: September 8, 2006    Key Record Dates
Results First Posted: March 24, 2011
Last Update Posted: April 14, 2014
Last Verified: March 2014

Keywords provided by Sanofi ( Genzyme, a Sanofi Company ):
Acute myelogenous leukemia
Acute myeloid leukemia
newly Diagnosed AML

Additional relevant MeSH terms:
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Neoplasms by Histologic Type
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents