Safety of Clofarabine With Multiagent Chemotherapy in Childhood Acute Lymphoblastic Leukemia (Vandevol)
A Phase I Dose Escalation Study of Clofarabine Given in Combination With Multi-agent Therapy for Remission Induction in Pediatric Patients With Acute Lymphoblastic Leukemia in First Relapse or Refractory to First Line Therapy -
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
I.3 Primary Objectives :
To determine the MTD of escalating doses of clofarabine starting from 20 mg/m2/day to 40 mg/m2/day from day 1 to day 5, as a replacement of cytarabine as part of a combination of etoposide, asparaginase, mitoxantrone and dexamethasone (VANDA regimen).
I.4 Secondary Objectives :
- To determine the safety and tolerability of clofarabine when used in combination with etoposide, asparaginase, mitoxantrone and dexamethasone (VANDA regimen) and determine the duration, seriousness, and relationship of adverse events that occur during the treatment and follow-up periods ; we search DLT
- To determine the Overall Response rate (OR) (Complete Remission + Complete Remission without platelet's normalization) of clofarabine plus etoposide ,asparaginase, mitoxantrone and dexamethasone (VANDA regimen) in pediatric patients with refractory or relapsed ALL at the established clofarabine RP2D.
- To document the rate of Partial Response[s] in the study population
- To document time-to-event parameters, including duration of remission, Event Free Survival (EFS), 4-month EFS, and overall survival (OS).
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
-
Besançon, France, 25000
- Besançon University Hospital
-
Lille, France, 59037
- Lille University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 1 to 21 years old at the date of acute lymphoblastic leukemia initial diagnosis
- Very early medullary first relapse occurring during the first 18th months after complete remission OR patients with second relapse OR a relapse occurring 6 months or more after myeloablative stem cell transplantation will be eligible.
- Have a Karnofsky Performance Status (KPS) of ≥70 for patients >10 years of age or a Lansky Performance Status (LPS) of ≥60 for patients ≤10 years of age.
- No concomitant malignant disease.
- No active uncontrolled infection.
- Have adequate renal and hepatic functions
- absence of concomitant severe cardiovascular disease, i.e. congestive heart failure
- Female patients of childbearing potential must have a negative serum pregnancy test within 2 weeks prior to enrollment.
- Male and female patients must use an effective contraceptive method during the study and for a minimum of 6 months after study treatment.
Exclusion Criteria:
- Current concomitant chemotherapy, radiation therapy, or immunotherapy other than as specified in the protocol.
- Use of any investigational agent within 30 days.
- Known hypersensitivity to clofarabine or excipients.
- Known hypersensitivity to mitoxantrone, etoposide or excipients.
- Allergy to both E Coli-Asparaginase and Erwinia Asparaginase
- Prior transplant less than 6 months ago.
- Trisomy 21
- Have any other severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo treatment.
- Patients with a systemic fungal, bacterial, viral, or other infection not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment).
- Pregnant or lactating patients.
- Any significant concurrent disease, illness, or psychiatric disorder that would compromise patient safety or compliance, interfere with consent, study participation, follow up, or interpretation of study results.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
maximum tolerated dose of clofarabine in combination with etoposide, asparaginase, mitoxantrone and dexamethasone
Time Frame: within the 40 days after the chemotherapy
|
within the 40 days after the chemotherapy
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
efficacy of clofarabine used in combination with etoposide, asparaginase, mitoxantrone and dexamethasone
Time Frame: 40 days after the chemotherapy
|
Complete remission rate and minimal residual disease level
|
40 days after the chemotherapy
|
|
Event free survival
Time Frame: 4 months
|
4 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Brigitte Nelken, MD PhD, Lille Unıversity Hospital, Lille, France
- Study Chair: Pıerre S Rohrlich, MD, PhD, Besançon University Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms
- Disease Attributes
- Immune System Diseases
- Neoplasms by Histologic Type
- Hematologic Diseases
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Leukemia, Lymphoid
- Leukemia
- Pathological Conditions, Signs and Symptoms
- Hemic and Lymphatic Diseases
- Recurrence
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
- Organic Chemicals
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Nucleic Acids, Nucleotides, and Nucleosides
- Hydrocarbons
- Hydrocarbons, Cyclic
- Carbohydrates
- Podophyllotoxin
- Tetrahydronaphthalenes
- Naphthalenes
- Polycyclic Aromatic Hydrocarbons
- Hydrocarbons, Aromatic
- Polycyclic Compounds
- Glucosides
- Glycosides
- Hydrolases
- Enzymes
- Enzymes and Coenzymes
- Purines
- Pregnadienes
- Pregnanes
- Steroids
- Fused-Ring Compounds
- Steroids, Fluorinated
- Nucleosides
- Pregnadienetriols
- Amidohydrolases
- Arabinonucleosides
- Anthraquinones
- Anthrones
- Anthracenes
- Quinones
- Ribonucleotides
- Nucleotides
- Adenine Nucleotides
- Purine Nucleotides
- Clofarabine
- Dexamethasone
- Etoposide
- Asparaginase
- Mitoxantrone
Other Study ID Numbers
Other Study ID Numbers
- 2009-010826-20
- 2008_40/0905 (Other Identifier: Sponsor)
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