Leridistim Compared With Filgrastim in Treating Older Patients With Acute Myeloid Leukemia

June 18, 2013 updated by: Memorial Sloan Kettering Cancer Center

Clinical Protocol for a Phase II Study of Leridistim (SC-70935) in Adult Patients (Age>55) With Acute Myeloid Leukemia (AML) Receiving Chemotherapy With the Cytarabine and Daunorubicin "7+3" Regimen

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Colony-stimulating factors such as leridistim and filgrastim increase the number of immune cells found in bone marrow or peripheral blood and may help a person's immune system recover from the side effects of chemotherapy.

PURPOSE: Randomized phase II trial to compare the effectiveness of leridistim with that of filgrastim to reduce side effects in older patients who are receiving cytarabine and daunorubicin for acute myeloid leukemia.

Study Overview

Detailed Description

OBJECTIVES: I. Determine the maximum tolerated dose or hematopoietically active dose of leridistim administered with induction chemotherapy in older patients with acute myeloid leukemia. II. Determine the effect of leridistim on the duration of grade IV neutropenia during the induction course in these patients. III. Determine the safety and tolerability of leridistim in these patients. IV. Compare the effect of leridistim vs filgrastim (G-CSF) on the duration of thrombocytopenia, the incidence of infection, and the need for IV antibiotics in these patients. V. Compare the effect of leridistim vs G-CSF on the number of days of platelet and/or red blood cell transfusions in these patients.

OUTLINE: This is a dose escalation study of leridistim and then a randomized, open label, multicenter study. Patients are randomized to one of two treatment arms. All patients receive induction chemotherapy consisting of daunorubicin IV over 15-30 minutes on days 1-3 and cytarabine IV continuously on days 1-7. Patients who do not achieve aplasia after one induction course may receive a second course. Dose Escalation Phase: Patients receive leridistim subcutaneously (SQ) every other day beginning on day 11-14 and continuing for 42 days or until blood counts recover. Cohorts of 6 patients receive escalating doses of leridistim until the maximum tolerated dose (MTD) or hematopoietically active dose (HAD) has been determined. The MTD is defined as the dose prior to the dose level at which at least 2 of the same dose limiting toxicities occur in different patients. Consolidation Phase: Patients then receive consolidation chemotherapy consisting of cytarabine IV over 1 hour every 12 hours (patients 70 years and under) or every 24 hours (patients over 70 years) on days 1-6. Beginning 24-48 hours after completion of consolidation chemotherapy, patients receive leridistim as above. Randomized Phase: Eligible patients will receive induction and consolidation chemotherapy as outlined above. Then patients are randomized to one of two treatments. Arm I: Patients receive leridistim SQ every other day for up to 42 days or until blood counts recover. Arm II: Patients receive filgrastim (G-CSF) SQ daily for up to 42 days or until blood counts recover. Patients are followed at day 30 and then at 6 and 12 months.

PROJECTED ACCRUAL: A total of 86 patients (36 for phase I and 50 for phase II) will be accrued for this study.

Study Type

Interventional

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • New York
      • New York, New York, United States, 10021
        • Memorial Sloan-Kettering Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

55 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

DISEASE CHARACTERISTICS: Induction phase: Cytologically proven de novo acute myeloid leukemia (not M3) Eligible to receive cytarabine and daunorubicin Circulating blast count no greater than 75,000/mL (hydroxyurea or leukapheresis allowed to decrease blast count) No blast transformation of chronic myelogenous leukemia No myelodysplastic syndrome or antecedent hematologic disorder longer than 6 months Post Induction Phase: Severe bone marrow aplasia (less than 5% blasts and less than 10% cellularity) No persistent leukemia after 2 induction courses

PATIENT CHARACTERISTICS: Age: 55 and over Performance status: Not specified Life expectancy: Not specified Hematopoietic: See Disease Characteristics Hepatic: Bilirubin no greater than 2.0 mg/dL Renal: Creatinine no greater than 2.0 mg/dL Cardiovascular: No significant cardiac disease No cardiac arrhythmia No uncontrolled hypertension No recent myocardial infarction or ischemia Other: No uncontrolled metabolic condition that would preclude study No psychiatric condition that would preclude study HIV negative Hepatitis B surface antigen negative No known hypersensitivity to corticosteroids, E. coli protein, interleukin-3, SC-55494, SC-68420, leridistim, milodistim, or filgrastim (G-CSF)

PRIOR CONCURRENT THERAPY: Biologic therapy: No prior interleukin-3, milodistim, SC-55494, SC-68420, or leridistim No prior peripheral blood stem cell or bone marrow transplantation No concurrent epoetin alfa or interleukin-11 Chemotherapy: See Disease Characteristics No prior chemotherapy Endocrine therapy: Not specified Radiotherapy: No prior radiotherapy Surgery: At least 2 weeks since prior surgery (except catheter placement or biopsy) Other: At least 3 weeks since prior investigational drug No other concurrent investigational drug

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: Mark Lawrence Heaney, MD, PhD, Memorial Sloan Kettering Cancer Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 1999

Primary Completion (Actual)

August 1, 2000

Study Completion (Actual)

August 1, 2000

Study Registration Dates

First Submitted

January 28, 2000

First Submitted That Met QC Criteria

August 6, 2004

First Posted (Estimate)

August 9, 2004

Study Record Updates

Last Update Posted (Estimate)

June 19, 2013

Last Update Submitted That Met QC Criteria

June 18, 2013

Last Verified

June 1, 2013

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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