- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00039117
Oblimersen, Cytarabine, and Daunorubicin in Treating Older Patients With Acute Myeloid Leukemia
A Phase I Study of G3139 ( NSC # 683428) in Combination With Cytarabine and Daunorubicin in Previously Untreated Patients With Acute Myeloid Leukemia (AML)>= 60 Years of Age
Study Overview
Status
Conditions
Detailed Description
OBJECTIVES:
I. Determine the maximum tolerated dose of daunorubicin in combination with cytarabine and oblimersen in older patients with previously untreated acute myeloid leukemia.
II. Determine the qualitative and quantitative toxic effects of this regimen in these patients.
III. Determine the pharmacokinetics of oblimersen in this regimen in these patients.
IV. Determine the disease-free survival and overall survival of patients treated with this regimen.
V. Assess the spontaneous rate of apoptosis in leukemic blasts in patients before and after initiation of treatment with oblimersen.
VI. Determine therapeutic response (complete remission) in patients treated with this regimen.
OUTLINE: This is a dose-escalation study of daunorubicin. Patients are stratified according to disease status (primary vs secondary).
INDUCTION THERAPY: Patients receive oblimersen (G3139) IV continuously on days 1-10 and cytarabine IV continuously on days 4-10. Patients also receive daunorubicin IV daily on days 4-6.
Patients with bone marrow cellularity of at least 20% and at least 5% leukemic blasts at day 17 or evidence of refractory disease receive a second induction comprising G3139 IV continuously on days 1-8, cytarabine IV continuously on days 4-8, and daunorubicin IV on days 4-5.
CONSOLIDATION THERAPY: Beginning no sooner than 14 days after hematologic recovery from induction therapy, patients receive G3139 IV continuously on days 1-8 and cytarabine IV over 4 hours on days 4-8. Patients receive a second course of consolidation therapy no sooner than 14 days after hematologic recovery from the first course.
Cohorts of 3-6 patients receive escalating doses of daunorubicin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
Patients are followed every 2 months for 2 years.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
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-
Ohio
-
Columbus, Ohio, United States, 43210
- Ohio State University Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Histologically confirmed primary or secondary acute myeloid leukemia (AML)
- More than 20% bone marrow blasts
- Myelodysplastic syndromes (MDS) or a chronic myeloproliferative disorder antecedent to AML allowed
- Therapy-related AML allowed
- No acute promyelocytic leukemia
- At least 4 weeks
- Bilirubin no greater than 2 mg/dL
- ALT and AST no greater than 2 times upper limit of normal (unless directly attributable to AML)
- Creatinine no greater than 2.5 mg/dL
- Ejection fraction at least 50% by MUGA or echocardiogram
- No symptomatic congestive heart failure
- No unstable angina pectoris
- No cardiac arrhythmia
- No allergy to any of the study medications
- No other uncontrolled concurrent illness
- No serious medical or psychiatric illness that would preclude giving informed consent
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No prior therapy for primary AML except emergency leukapheresis
- No prior anthracyclines
- No prior chemotherapy for primary AML except hydroxyurea for hyperleukocytosis
- At least 3 months since prior chemotherapy for MDS or chronic myeloproliferative disorders antecedent to AML
- No other concurrent chemotherapy
- No concurrent corticosteroids as anti-emetics
- No concurrent steroids except for adrenal failure or septic shock
- No concurrent hormonal therapy except hormones for non-disease-related conditions (e.g., insulin for diabetes, tamoxifen or equivalent for breast cancer prevention or adjuvant treatment, or estrogens or progestins for gynecologic indications)
- No prior radiotherapy for primary AML except cranial radiotherapy for CNS leukostasis
- No concurrent palliative radiotherapy
- No concurrent whole brain radiotherapy
- No other concurrent investigational or commercial agents or therapies
- No concurrent cyclooxygenase-2 inhibitors
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm I
INDUCTION THERAPY: Patients receive oblimersen (G3139) IV continuously on days 1-10 and cytarabine IV continuously on days 4-10. Patients also receive daunorubicin IV daily on days 4-6. Patients with bone marrow cellularity of at least 20% and at least 5% leukemic blasts at day 17 or evidence of refractory disease receive a second induction comprising G3139 IV continuously on days 1-8, cytarabine IV continuously on days 4-8, and daunorubicin IV on days 4-5. CONSOLIDATION THERAPY: Beginning no sooner than 14 days after hematologic recovery from induction therapy, patients receive G3139 IV continuously on days 1-8 and cytarabine IV over 4 hours on days 4-8. Patients receive a second course of consolidation therapy no sooner than 14 days after hematologic recovery from the first course. |
Correlative studies
Given IV
Other Names:
Correlative studies
Other Names:
Given IV
Other Names:
Given IV
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MTD of cytarabine and daunorubicin in combination with G3139, defined as the dose level just below the dose level at which DLT is observed in 2 patients, graded according to NCI CTC version 2.0
Time Frame: Up to day 10
|
Up to day 10
|
|
Incidence of adverse events, graded according to NCI CTC version 2.0
Time Frame: Up to 2 years
|
We will define the qualitative and quantitative toxicities in regard to organ specificity, time course, predictability, and reversibility.
|
Up to 2 years
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Overall survival
Time Frame: Up to 2 years
|
Up to 2 years
|
Pharmacokinetics of G3139
Time Frame: During induction therapy on day 1 at hour 0 and 24hours after G3139 administration; day 4 at hour 73 before cytarabine administration; day 11 at hour 0 and .5, 1, 2, 4, 6, and 8 hours
|
During induction therapy on day 1 at hour 0 and 24hours after G3139 administration; day 4 at hour 73 before cytarabine administration; day 11 at hour 0 and .5, 1, 2, 4, 6, and 8 hours
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Level of bcl-2 in circulating and/or marrow leukemic blasts before and after initiation of treatment with G3139
Time Frame: Up to 18 weeks
|
Up to 18 weeks
|
Spontaneous rate of apoptosis in leukemic blasts before and after initiation of treatment with G3139
Time Frame: Up to 18 weeks
|
Up to 18 weeks
|
Incidence of therapeutic response (complete remission [CR])
Time Frame: Up to 2 years
|
Up to 2 years
|
Disease-free survival
Time Frame: Up to 2 years
|
Up to 2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Guido Marcucci, Ohio State University
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Leukemia
- Leukemia, Myeloid
- Leukemia, Myeloid, Acute
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Antibiotics, Antineoplastic
- Cytarabine
- Daunorubicin
- Oblimersen
Other Study ID Numbers
- NCI-2012-01409
- U01CA076576 (U.S. NIH Grant/Contract)
- OSU-0164
- NCI-4630
- CDR0000069353
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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