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S0106 Cytarabine and Daunorubicin w/ or w/o Gemtuzumab Followed By HD Cytarabine and Either Gemtuzumab or Nothing in de Novo AML

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ClinicalTrials.gov Identifier: NCT00085709
Recruitment Status : Completed
First Posted : June 16, 2004
Results First Posted : August 27, 2012
Last Update Posted : September 30, 2015
Sponsor:
Collaborator:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Southwest Oncology Group

Study Description
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Brief Summary:

RATIONALE: Drugs used in chemotherapy, such as cytarabine and daunorubicin, work in different ways to stop cancer cells from dividing so they stop growing and die. Monoclonal antibodies, such as gemtuzumab ozogamicin, can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Combining chemotherapy with gemtuzumab ozogamicin may kill more cancer cells. It is not yet known whether induction therapy using cytarabine and daunorubicin is more effective with or without gemtuzumab ozogamicin or whether postconsolidation therapy using gemtuzumab ozogamicin is more effective than no additional therapy in treating de novo (first occurrence) acute myeloid leukemia.

PURPOSE: This randomized phase III trial is comparing two different regimens of chemotherapy and monoclonal antibody therapy to see how well they work in treating patients with previously untreated de novo acute myeloid leukemia.


Condition or disease Intervention/treatment Phase
Leukemia Drug: gemtuzumab ozogamicin Other: observation Drug: Cytosine arabinoside Drug: Daunomycin Phase 3

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Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 637 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase III Study of the Addition of Gemtuzumab Ozogamicin (Mylotarg®) During Induction Therapy Versus Standard Induction With Daunomycin and Cytosine Arabinoside Followed by Consolidation and Subsequent Randomization to Post-Consolidation Therapy With Gemtuzumab Ozogamicin (Mylotarg®) or No Additional Therapy For Patients Under Age 61 With Previously Untreated De Novo Acute Myeloid Leukemia (AML)
Study Start Date : July 2004
Actual Primary Completion Date : March 2010
Actual Study Completion Date : August 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Leukemia

Arms and Interventions
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Arm Intervention/treatment
Experimental: Post-consolidation GO
Patients receive gemtuzumab ozogamicin IV over 2 hours on day 1. Treatment repeats every 28 days for 3 courses in the absence of disease progression or unacceptable toxicity.
 Drug: gemtuzumab ozogamicin
Given IV, induction Arm1 6mg/m2 D4; post-consolidation 5mg/m2 3 doses >/= 28 days apart
Other Name: mylotarg
Post-consolidation observation
Patients receive no additional therapy. Patients are observed at days 30 and 60 after randomization.
 Other: observation
No treatment given
Active Comparator: Induction 7+3
Standard induction regimen of 7 days of Ara-C (cytosine arabinoside) and 3 days of daunomycin
 Drug: Cytosine arabinoside
IV; induction Arms1/2 and reinduction 100 mg/m2/d days 1-7; consolidation 3gm/m2 q3hrs D1, 3, 5
Other Name: Ara-C

Drug: Daunomycin
IV; induction Arm1 45mg/m2 D1-3; Arm2 and reinduction 60 mg/m2 D1-3;
Other Name: daunorubicin
Active Comparator: Induction 7+3+GO
Gemtuzumab (GO) added to the standard induction regimen of 7 days of Ara-C and 3 days of daunomycin
 Drug: Cytosine arabinoside
IV; induction Arms1/2 and reinduction 100 mg/m2/d days 1-7; consolidation 3gm/m2 q3hrs D1, 3, 5
Other Name: Ara-C

Drug: Daunomycin
IV; induction Arm1 45mg/m2 D1-3; Arm2 and reinduction 60 mg/m2 D1-3;
Other Name: daunorubicin


Outcome Measures
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Primary Outcome Measures :
  1. 2-year Disease-free Survival (DFS) [ Time Frame: After completing any treatment, every 6 months for 2 years, than annually for years 3-5 ]
    Measured from data of randomization to post-consolidation therapy until relapse from complete response or death from any cause, with observations censored at the date of last contact for patients last known to be alive without report of relapse.

  2. Complete Remission [ Time Frame: After induction therapy was completed (1 or 2 months) ]

Secondary Outcome Measures :
  1. Toxicity [ Time Frame: For induction, daily for the first 10 days, then twice weekly until consolidation treatment. Weekly during consolidation treatment. Weekly if randomized to post-consolidation G.O. ]
    Number of patients with Grade 3-5 adverse events that are related to study drug by given type of adverse event


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Morphologically confirmed acute myeloid leukemia (AML) by bone marrow aspiration and biopsy* within the past 14 days

    • No M3 disease NOTE: *Patients with marked leukocytosis may be registered before the availability of biopsy results if the absolute blast count is ≥ 100,000 cells/µL
  • No blastic transformation of chronic myelogenous leukemia
  • No pre-existing hematologic disorder evolving to AML (e.g., myelodysplasia or secondary leukemia)

PATIENT CHARACTERISTICS:

Age

  • 18 to 60

Performance status

  • Zubrod 0-3

Life expectancy

  • Not specified

Hematopoietic

  • See Disease Characteristics

Hepatic

  • Bilirubin ≤ 2 times upper limit of normal (ULN)
  • AST and ALT ≤ 3 times ULN
  • No known hepatitis B or C infection
  • No known liver disease

Renal

  • Not specified

Cardiovascular

  • LVEF ≥ 50% by MUGA or echocardiogram
  • No unstable cardiac arrhythmias
  • No unstable angina

Other

  • No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I or II cancer currently in complete remission
  • Not pregnant or nursing
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • No prior systemic chemotherapy

    • Prior hydroxyurea to control high cell counts allowed
  • No more than 1 prior dose of intrathecal chemotherapy for acute leukemia
  • Concurrent intrathecal chemotherapy allowed during induction therapy

Endocrine therapy

  • Not specified

Radiotherapy

  • Not specified

Surgery

  • Not specified
Contacts and Locations
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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): NCT00085709


Locations
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Sponsors and Collaborators
Southwest Oncology Group
National Cancer Institute (NCI)
Investigators
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Study Chair: Stephen H. Petersdorf, MD Seattle Cancer Care Alliance
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Southwest Oncology Group
ClinicalTrials.gov Identifier: NCT00085709    
Other Study ID Numbers: S0106
U10CA032102 ( U.S. NIH Grant/Contract )
S0106 ( Other Identifier: SWOG )
First Posted: June 16, 2004    Key Record Dates
Results First Posted: August 27, 2012
Last Update Posted: September 30, 2015
Last Verified: September 2015
Keywords provided by Southwest Oncology Group:
untreated adult acute myeloid leukemia
adult acute eosinophilic leukemia
adult acute basophilic leukemia
adult acute monocytic leukemia (M5b)
adult acute erythroid leukemia (M6)
adult acute megakaryoblastic leukemia (M7)
adult acute minimally differentiated myeloid leukemia (M0)
adult acute myeloblastic leukemia with maturation (M2)
 adult acute myeloblastic leukemia without maturation (M1)
adult acute myelomonocytic leukemia (M4)
adult acute monoblastic leukemia (M5a)
adult acute myeloid leukemia with 11q23 (MLL) abnormalities
adult acute myeloid leukemia with inv(16)(p13;q22)
adult acute myeloid leukemia with t(16;16)(p13;q22)
adult acute myeloid leukemia with t(8;21)(q22;q22)
Additional relevant MeSH terms:
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Leukemia
Neoplasms by Histologic Type
Neoplasms
Cytarabine
Daunorubicin
Gemtuzumab
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
 Antiviral Agents
Anti-Infective Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antibiotics, Antineoplastic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Antineoplastic Agents, Immunological