- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00053287
Fludarabine/Carboplatin/Topotecan w/Thalidomide for Relapsed/Refractory AML, CML and MDS
Phase II Study of Fludarabine, Carboplatin, and Topotecan With Thalidomide for Patients With Relapsed/Refractory or High Risk Acute Myelogenous Leukemia, Chronic Myeloid Leukemia and Advanced Myelodysplastic Syndromes
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Thalidomide may stop the growth of cancer cells by stopping blood flow to the tumor. Combining chemotherapy with thalidomide may kill more cancer cells.
PURPOSE: Phase II trial to study the effectiveness of combining fludarabine, carboplatin, and topotecan with thalidomide in treating patients who have relapsed or refractory acute myeloid leukemia, chronic myelogenous leukemia, or advanced myelodysplastic syndromes.
Study Overview
Status
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Determine the response rate of patients with relapsed/refractory or high-risk acute myeloid leukemia, chronic myelogenous leukemia, or advanced myelodysplastic syndromes treated with fludarabine, carboplatin, topotecan, and thalidomide.
- Determine the non-hematologic toxicity profile and time to hematopoietic recovery in patients treated with this regimen.
- Determine the effects of this regimen on changes in biologic parameters that may predict response in these patients.
- Correlate bone marrow microvascular density before and after treatment with response in these patients.
- Determine the prognostic value of pretreatment plasma and serum levels of vascular endothelial growth factor (VEGF) and/or the modulation of serum levels of VEGF during treatment in predicting response in these patients.
OUTLINE: Patients are stratified according to diagnosis (previously untreated acute leukemia vs other).
Patients receive fludarabine IV over 5-10 minutes and carboplatin IV over 24 hours on days 1-5 followed by topotecan IV continuously over 72 hours. Patients receive oral thalidomide daily beginning within days 1-3 and continuing in the absence of disease progression or unacceptable toxicity.
Patients with residual disease on day 16-18 may receive a second course of chemotherapy as above. Patients who achieve remission may receive a third course of chemotherapy as above as consolidation beginning 4-8 weeks after completion of prior chemotherapy.
Patients are followed monthly for 6 months.
PROJECTED ACCRUAL: A total of 40 patients (20 per stratum) will be accrued for this study.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Ohio
-
Cleveland, Ohio, United States, 44106-5065
- Ireland Cancer Center at University Hospitals Case Medical Center, Case Comprehensive Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Diagnosis of 1 of the following:
Acute myeloid leukemia meeting 1 of the following criteria:
- Previously untreated and not a candidate for anthracycline-based chemotherapy
- In first or second relapse or refractory
- Secondary to chemotherapy or an antecedent hematologic disorder and treated with no more than 1 prior intensive induction regimen
- Chronic myelogenous leukemia in blast crisis at diagnosis or after prior imatinib mesylate
Myelodysplastic syndromes (MDS)
- Refractory anemia with excess blasts (RAEB) or RAEB in transformation
Must meet at least 1 of the following criteria:
- Absolute neutrophil count no greater than 500/mm^3
- Platelet or red cell transfusion-dependent after no more than 1 prior intensive induction chemotherapy
Acute promyelocytic leukemia
- t(15, 17)
- Failed prior treatment with tretinoin and arsenic
- Relapsed disease at least 3 months after prior autologous stem cell transplantation
- No active CNS leukemia
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-3
Life expectancy
- At least 8 weeks
Hematopoietic
- See Disease Characteristics
Hepatic
- Bilirubin no greater than 2.0 mg/dL
- AST and ALT less than 3 times upper limit of normal
Renal
- Creatinine clearance at least 50 mL/min
Cardiovascular
- Ejection fraction at least 40%
- No poorly controlled cardiac disease
Pulmonary
- No poorly controlled pulmonary disease
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile female patients must use 1 highly effective and 1 additional method of contraception for 4 weeks before, during, and for at least 4 weeks after study
- Male patients must use effective contraception during and for 4 weeks after study
- Willing and able to comply with the System for Thalidomide Education and Prescribing Safety (STEPS) program
- HIV negative
- No poorly controlled infection
- No other active malignancy
- No severe peripheral neuropathy
PRIOR CONCURRENT THERAPY:
Biologic therapy
- See Disease Characteristics
- Prior thalidomide allowed for MDS
- At least 5 days since prior hematopoietic growth factors
- At least 2 weeks since prior biologic therapy
- No prior allogeneic bone marrow transplantation
Chemotherapy
- See Disease Characteristics
- At least 24 hours since prior hydroxyurea
Endocrine therapy
- At least 24 hours since prior corticosteroids
Radiotherapy
- Not specified
Surgery
- Not specified
Other
- At least 2 weeks since prior cytotoxic anticancer therapy
- Prior amifostine allowed for MDS
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
Outcome Measure |
Time Frame |
---|---|
Complete response rate
Time Frame: 6 weeks after treatment
|
6 weeks after treatment
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Brenda W. Cooper, MD, Ireland Cancer Center at University Hospitals Case Medical Center, Case Comprehensive Cancer Center
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study 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
Keywords
- refractory anemia with excess blasts
- refractory anemia with excess blasts in transformation
- de novo myelodysplastic syndromes
- previously treated myelodysplastic syndromes
- secondary myelodysplastic syndromes
- adult acute myeloid leukemia with 11q23 (MLL) abnormalities
- adult acute myeloid leukemia with inv(16)(p13;q22)
- adult acute myeloid leukemia with t(15;17)(q22;q12)
- adult acute myeloid leukemia with t(16;16)(p13;q22)
- adult acute myeloid leukemia with t(8;21)(q22;q22)
- secondary acute myeloid leukemia
- recurrent adult acute myeloid leukemia
- untreated adult acute myeloid leukemia
- atypical chronic myeloid leukemia
- myelodysplastic/myeloproliferative disease, unclassifiable
- blastic phase chronic myelogenous leukemia
- relapsing chronic myelogenous leukemia
- adult acute promyelocytic leukemia (M3)
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms by Histologic Type
- Neoplasms
- Disease
- Bone Marrow Diseases
- Hematologic Diseases
- Precancerous Conditions
- Syndrome
- Myelodysplastic Syndromes
- Leukemia
- Preleukemia
- Myeloproliferative Disorders
- Myelodysplastic-Myeloproliferative Diseases
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Topoisomerase Inhibitors
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Anti-Bacterial Agents
- Leprostatic Agents
- Topoisomerase I Inhibitors
- Carboplatin
- Thalidomide
- Fludarabine
- Fludarabine phosphate
- Topotecan
Other Study ID Numbers
- CWRU1902
- P30CA043703 (U.S. NIH Grant/Contract)
- CASE-CWRU-1902
- CELGENE-CWRU-1902
- CASE-1902
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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