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Study of Bendamustine Hydrochloride for the Treatment of Pediatric Patients With Relapsed or Refractory Acute Leukemia

21. april 2016 opdateret af: Teva Branded Pharmaceutical Products R&D, Inc.

An Open-Label Study of Bendamustine Hydrochloride for the Treatment of Pediatric Patients With Relapsed or Refractory Acute Leukemia

The primary objective of phase 1 of this study is to establish the recommended phase II dose (RP2D). The primary objective of phase 2 of this study is to evaluate the safety and efficacy of bendamustine at the recommended pediatric dose for the treatment of pediatric patients with relapsed or refractory acute leukemia.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

43

Fase

  • Fase 2
  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Australien
      • Herston, Australien
        • Teva Investigational Site 300
      • Parkville, Australien
        • Teva Investigational Site 301
      • Randwick, Australien
        • Teva Investigational Site 302
  • Brasilien
      • Barretos-SP, Brasilien
        • Teva Investigational Site 615
      • Caxias do Sul, Brasilien
        • Teva Investigational Site 616
      • Curitiba-PR, Brasilien
        • Teva Investigational Site 613
      • Porto Alegre, Brasilien
        • Teva Investigational Site 612
      • Porto Alegre, Brasilien
        • Teva Investigational Site 614
      • Sao Paulo, Brasilien
        • Teva Investigational Site 610
      • Sao Paulo, Brasilien
        • Teva Investigational Site 611
      • Sao Paulo-SP, Brasilien
        • Teva Investigational Site 617
  • Canada
      • Toronto, Canada
        • Teva Investigational Site 100
  • Den Russiske Føderation
      • Moscow, Den Russiske Føderation
        • Teva Investigational Site 511
      • St. Petersburg, Den Russiske Føderation
        • Teva Investigational Site 510
  • Forenede Stater
    • California
      • Orange, California, Forenede Stater
        • Teva Investigational Site 17
      • San Diego, California, Forenede Stater
        • Teva Investigational Site 12
    • Florida
      • St. Petersburg, Florida, Forenede Stater
        • Teva Investigational Site 10
    • Maryland
      • Baltimore, Maryland, Forenede Stater
        • Teva Investigational Site 8
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater
        • Teva Investigational Site 16
    • Michigan
      • Detroit, Michigan, Forenede Stater
        • Teva Investigational Site 9
    • Mississippi
      • Jackson, Mississippi, Forenede Stater
        • Teva Investigational Site 1
    • Missouri
      • Kansas City, Missouri, Forenede Stater
        • Teva Investigational Site 5
      • St. Louis, Missouri, Forenede Stater
        • Teva Investigational Site 14
    • New York
      • New York, New York, Forenede Stater
        • Teva Investigational Site 15
    • Oregon
      • Portland, Oregon, Forenede Stater
        • Teva Investigational Site 18
    • Pennsylvania
      • Hershey, Pennsylvania, Forenede Stater
        • Teva Investigational Site 11
      • Philadelphia, Pennsylvania, Forenede Stater
        • Teva Investigational Site 7
    • Tennessee
      • Memphis, Tennessee, Forenede Stater
        • Teva Investigational Site 19
    • Texas
      • Dallas, Texas, Forenede Stater
        • Teva Investigational Site 3
      • Fort Worth, Texas, Forenede Stater
        • Teva Investigational Site 4
      • Houston, Texas, Forenede Stater
        • Teva Investigational Site 13
    • Washington
      • Seattle, Washington, Forenede Stater
        • Teva Investigational Site 2
    • Wisconsin
      • Milwaukee, Wisconsin, Forenede Stater
        • Teva Investigational Site 6
  • Hviderusland
      • Minsk, Hviderusland
        • Teva Investigational Site 520
  • Israel
      • Jerusalem, Israel
        • Teva Investigational Site 501
      • Petach Tikva, Israel
        • Teva Investigational Site 503
      • Ramat Gan, Israel
        • Teva Investigational Site 502
  • Korea, Republikken
      • Seoul, Korea, Republikken
        • Teva Investigational Site 330
      • Seoul, Korea, Republikken
        • Teva Investigational Site 331
      • Seoul, Korea, Republikken
        • Teva Investigational Site 332
      • Seoul, Korea, Republikken
        • Teva Investigational Site 333
  • Mexico
      • Guadalajara, Mexico
        • Teva Investigational Site 603
      • Mexico City, Mexico
        • Teva Investigational Site 600
      • Mexico City, Mexico
        • Teva Investigational Site 601
      • Monterrey, Mexico
        • Teva Investigational Site 602
  • New Zealand
      • Auckland, New Zealand
        • Teva Investigational Site 303
  • Polen
      • Bialystok, Polen
        • Teva Investigational Site 531
      • Lublin, Polen
        • Teva Investigational Site 530
      • Warszawa, Polen
        • Teva Investigational Site 532
  • Singapore
      • Singapore, Singapore
        • Teva Investigational Site 320

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

1 år til 20 år (Barn, Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Key Inclusion Criteria:

  • The patient has histologically proven acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML) that has relapsed or is refractory to the last regimen, and the patient is without alternative curative therapy.
  • The patient's last myelosuppression therapy ended at least 2 weeks before the first dose of study drug.
  • Nonhematologic acute toxic effects of prior therapy have resolved to grade 2 or less according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE).
  • The patient has adequate liver function with bilirubin values less than or equal to 1.5 times the upper limit of normal (ULN) and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values less than or equal to 5 times the age-appropriate ULN.
  • The patient has adequate renal function with serum creatinine values less than 2 times ULN.
  • The patient has Karnofsky or Lansky performance status of 60 or greater. Patients older than 16 years of age will be scored according to the Karnofsky scale and patients 16 years of age or younger will be scored according to the Lansky scale.
  • The patient may have had hematopoietic stem cell transplantation.
  • Women of childbearing potential (not surgically sterile) must use a medically accepted method of contraception and must agree to continue use of this method for the duration of treatment and for 30 days after the end of treatment.
  • Men not surgically sterile or who are capable of producing offspring must practice abstinence or use a barrier method of birth control, and must agree to continue use of this method for the duration of treatment and for 30 days after the end of treatment.
  • The patient must be willing and able to comply with study restrictions and to remain at the clinic for the required duration during the study period, and willing to return to the clinic for the follow-up evaluation as specified in this protocol.

Key Exclusion Criteria:

  • The patient has any active, uncontrolled systemic infection, severe concurrent disease, or symptomatic untreated central nervous system (CNS) involvement.
  • The patient has evidence of active graft versus host disease.
  • The patient has a known human immunodeficiency virus (HIV) infection.
  • The patient has active hepatitis B or hepatitis C infection.
  • The patient is a pregnant or lactating woman. Any women becoming pregnant during the study will be withdrawn from the study immediately.
  • The patient has any serious uncontrolled medical or psychological disorder that would impair the ability of the patient to receive study drug.
  • The patient has any condition that places the patient at unacceptable risk or confounds the ability of the investigators to interpret study data.
  • The patient has received any other investigational agent within 30 days of study entry.
  • The patient has known hypersensitivity to bendamustine or mannitol.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Bendamustine
Bendamustine 90 or 120 mg/m^2 administered as an intravenous (IV) infusion over 60 minutes on Days 1 and 2 of each 21-day cycle (maximum of 12 total cycles), with delays up to 2 weeks for neutrophil and platelet count recovery, for up to a 35-day cycle.
Medicin: Bendamustine

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Recommended Phase II Dose (RP2D) of Bendamustine
Tidsramme: Induction Cycle (21- to 35-day cycle)
RP2D was determined by a traditional 3+3 dose escalation design, with the following restrictions: only doses of 60, 90, 120, and 150 mg/m^2 were explored, and escalation to 150 mg/m^2 would only occur if the 120 mg/m^2 dose was deemed safe and pharmacokinetic data indicate subtherapeutic exposure as compared with adults. The first cohort was administered bendamustine at the 90 mg/m^2 dose; de-escalation to the 60 mg/m^2 dose would only occur if the starting dose led to dose-limiting toxicity (DLT) in 2 or more participants. A DLT was defined as any study drug-related nonhematologic adverse event (AE) that was grade 4 for toxicity by National Cancer Institute's Common Toxicity Criteria for AEs, version 4. In addition, grade 3 or above allergic reaction or skin rash were considered DLTs. Hematologic AEs were not considered DLTs. The dose level at which at least 2 of 3 or 2 of 6 participants had a DLT was considered as exceeding the RP2D. The RP2D was the dose 1 step below that level.
Induction Cycle (21- to 35-day cycle)
Overall Response Rate (ORR)
Tidsramme: Assessed at each treatment cycle (21 to 35 days), for a maximum of 12 cycles
ORR was calculated as follows: number of participants in the primary analysis set achieving a best overall response of complete remission without platelet recovery (CRp) or complete remission (CR), divided by the number of participants in the primary analysis set. The most positive response for each patient during the study was counted. The 95% CI was calculated using binomial parameter exact method. Response was determined by the investigator, and evaluated per Jeha et al, 2006: A CR required no evidence of circulating blasts or extramedullary disease, an M1 marrow (≤ 5% bone marrow blasts), and recovery of peripheral counts (platelets ≥ 100 × 10^9/L and absolute neutrophil count ≥ 1.0 × 10^9/L). A CR without platelet recovery (CRp) required all of the criteria for a CR with the exception of platelet recovery.
Assessed at each treatment cycle (21 to 35 days), for a maximum of 12 cycles

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Best Overall Tumor Response Rate
Tidsramme: At each treatment cycle (21 to 35 days), for a maximum of 12 cycles
Biological activity of bendamustine was defined as achieving a best response of partial response (PR), CRp, or CR. Rate was calculated as follows: number of participants in the primary analysis set achieving a best overall response of PR, CRp, or CR, divided by the number of participants in the primary analysis set. The most positive response for each patient during the study was counted. The 95% CI was calculated using binomial parameter exact method. Response was determined by the investigator, and evaluated per Jeha et al, 2006: A PR had to meet the following criteria: complete disappearance of circulating blasts and an M2 marrow (≥ 5% and ≤ 25% bone marrow blasts) and appearance of normal progenitor cells or an M1 marrow that did not qualify for CR or CRp. See Outcome Measure 2 for full definitions for CRp and CR.
At each treatment cycle (21 to 35 days), for a maximum of 12 cycles
Best Overall Tumor Response Rate, by Phase
Tidsramme: At each treatment cycle (21 to 35 days), for a maximum of 12 cycles
Biological activity of bendamustine was defined as achieving a best response of partial response (PR), CRp, or CR. Rate was calculated as follows: number of participants in the primary analysis set achieving a best overall response of PR, CRp, or CR, divided by the number of participants in the primary analysis set. The most positive response for each patient during the study was counted. The 95% CI was calculated using binomial parameter exact method. Response was determined by the investigator, and evaluated per Jeha et al, 2006: A PR had to meet the following criteria: complete disappearance of circulating blasts and an M2 marrow (≥ 5% and ≤ 25% bone marrow blasts) and appearance of normal progenitor cells or an M1 marrow that did not qualify for CR or CRp. See Outcome Measure 2 for full definitions for CRp and CR.
At each treatment cycle (21 to 35 days), for a maximum of 12 cycles
Duration of Response (DOR)
Tidsramme: At each treatment cycle (21 to 35 days), for a maximum of 12 cycles
DOR was determined for the participants with CR or CRp in the primary analysis set, defined as the time from first achieving remission to the time when progression was diagnosed, the participant died, or the participant started receiving new antineoplastic therapy. Data from participants who do not progress were censored at the last valid assessments. Median DOR and its 95% confidence interval was determined based on the Kaplan-Meier method. Data from participants who received a transplant were censored at the time of the transplant.
At each treatment cycle (21 to 35 days), for a maximum of 12 cycles
Maximum Observed Plasma Drug Concentration (Cmax) for Bendamustine and Its Metabolites (M3 and M4)
Tidsramme: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.
Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.
Time to Maximum Plasma Drug Concentration (Tmax) for Bendamustine and Its Metabolites (M3 and M4)
Tidsramme: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.
Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.
Area Under the Plasma Drug Concentration by Time Curve From Time 0 Until the Last Measurable Plasma Concentration (AUC0-t) for Bendamustine and Its Metabolites (M3 and M4)
Tidsramme: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.
Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.
Area Under the Plasma Drug Concentration by Time Curve From Time 0 Until 24 Hours After Study Drug Administration (AUC0-24) for Bendamustine and Its Metabolites (M3 and M4)
Tidsramme: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.
Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Teva Branded Pharmaceutical Products R&D, Inc.

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. august 2010

Primær færdiggørelse (Faktiske)

1. august 2011

Studieafslutning (Faktiske)

1. august 2011

Datoer for studieregistrering

Først indsendt

16. marts 2010

Først indsendt, der opfyldte QC-kriterier

16. marts 2010

Først opslået (Skøn)

18. marts 2010

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

23. maj 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

21. april 2016

Sidst verificeret

1. april 2016

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • C18083/2046
  • 2010-020768-40 (EudraCT nummer)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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