- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT03896269
CPX-351 hoidettaessa potilaita, joilla on uusiutunut tai refraktorinen korkean riskin myelodysplastinen oireyhtymä tai krooninen myelomonosyyttinen leukemia
CPX-351:n vaiheen 1 annoksen eskalaatiotutkimus potilaille, joilla on Int-2- tai korkean riskin IPSS-myelodysplastinen oireyhtymä ja krooninen myelomonosyyttinen leukemia hypometylointiaineiden epäonnistumisen jälkeen
This phase I trial studies best dose and side effects of liposome-encapsulated daunorubicin-cytarabine (CPX-351) and how well it works in treating patients with high risk myelodysplastic syndrome or chronic myelomonocytic leukemia that has come back or has not responded to treatment. Drugs used in chemotherapy, such as liposome-encapsulated daunorubicin-cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.
Tutkimuksen yleiskatsaus
Tila
Ehdot
- Toistuva krooninen myelomonosyyttinen leukemia
- Tulenkestävä krooninen myelomonosyyttinen leukemia
- Räjäyttää yli 5 prosenttia luuytimen ydinsoluista
- Toistuva korkean riskin myelodysplastinen oireyhtymä
- Refractory korkean riskin myelodysplastinen oireyhtymä
- Räjäyttää 10-19 prosenttia luuytimen ydinsoluista
- Korkean riskin krooninen myelomonosyyttinen leukemia
Interventio / Hoito
Yksityiskohtainen kuvaus
PRIMARY OBJECTIVES:
I. To characterize the safety and tolerability of CPX-351 in patients with intermediate-2 or high-risk myelodysplastic syndrome (MDS). (Dose Escalation Stage) II. To determine the maximum tolerated dose (MTD) of intravenous CPX-351 in patients with intermediate-2 or high-risk MDS. (Dose Escalation Stage) III. To further characterize the safety and tolerability of CPX-351 in patients with intermediate-2 and high-risk MDS. (Dose-Expansion Stage) IV. To evaluate preliminary efficacy of CPX-351 in patients with intermediate-2 or high-risk MDS. (Dose-Expansion Stage)
SECONDARY OBJECTIVES:
I. To assess overall response (OR) rate. II. To assess overall survival. III. To assess duration of response. IV. To assess relapse-free survival. V. To assess safety profile.
OUTLINE: This is a dose-escalation study.
INDUCTION THERAPY: Patients receive liposome-encapsulated daunorubicin-cytarabine intravenously (IV) over 90 minutes on days 1, 3, and 5 in the absence of disease progression or unacceptable toxicity. After 2-5 weeks, patients who do not achieve a complete response (CR)/CR with incomplete bone marrow recovery (CRi)/CR with incomplete platelet recovery (CRp), have acceptable or no toxicity, and have stable disease and no disease progression may receive liposome-encapsulated daunorubicin-cytarabine IV over 90 minutes on days 1 and 3 in the absence of disease progression or unacceptable toxicity.
CONSOLIDATION THERAPY: Patients who achieve at least a hematological improvement (HI) response, receive liposome-encapsulated daunorubicin-cytarabine IV over 90 minutes on days 1 and 3. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. After 5-8 weeks, patients who do not show clinically significant disease progression or unacceptable toxicity may receive liposome-encapsulated daunorubicin-cytarabine for up to 12 additional cycles.
After completion of study treatment, patients are followed up at 30 days and then every 6 months thereafter.
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Vaihe 1
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Guillermo M Bravo
- Puhelinnumero: 713-794-3604
- Sähköposti: gmontalban1@mdanderson.org
Opiskelupaikat
-
-
Texas
-
Houston, Texas, Yhdysvallat, 77030
- Rekrytointi
- M D Anderson Cancer Center
-
Ottaa yhteyttä:
- Guillermo M. Bravo
- Puhelinnumero: 713-794-3604
-
Päätutkija:
- Guillermo M. Bravo
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Diagnosis of MDS or chronic myelomonocytic leukemia (CMML) according to World Health Organization (WHO)
- Patients are either not eligible for or choose not to proceed with a stem cell transplant at the time of enrollment
- MDS and CMML classified by International Prognostic Scoring System (IPSS) as intermediate-2/high risk with excess blasts > 5%, or with 10-19% bone marrow blasts
- No response following at least 4 cycles of therapy or relapse after initial CR, partial response (PR), or HI or progression after any number of cycles of either azacitidine, decitabine, guadecitabine or ASTX727 (oral decitabine) as single agents or in combination with other investigational agents
- Patient (or patient's legally authorized representative) must have signed an informed consent document indicating that the patient understands the purpose of and procedures required for the study and is willing to participate in the study
- Total bilirubin < 3 mg/dL (will allow less than 5 x upper limit of normal [ULN] if Gilbert's at investigator's discretion)
- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) =< 3 x ULN
- Serum creatinine clearance > 30 mL/min and no end/stage renal disease
- Hydroxyurea for control of leukocytosis or use of hematopoietic growth factors (eg, granulocyte-colony stimulating factor [G-CSF], granulocyte-macrophage colony-stimulating factor [GM-CSF], procrit, aranesp, thrombopoietins) is allowed at any time prior to or during study if considered to be in the best interest of the patient
Exclusion Criteria:
- New York Heart Association (NYHA) class III or IV congestive heart failure or left ventricular ejection fraction (LVEF) < 50 by echocardiogram or multigated acquisition (MUGA) scan
- History of myocardial infarction within the last 6 months or unstable/uncontrolled angina pectoris or history of severe and/or uncontrolled ventricular arrhythmias
- Uncontrolled infection not adequately responding to appropriate antibiotics
- Female patients who are pregnant or lactating
- Patients with reproductive potential who are unwilling to following contraception requirements (including condom use for males with sexual partners, and for females: prescription oral contraceptives [birth control pills], contraceptive injections, intrauterine devices [IUD], double-barrier method [spermicidal jelly or foam with condoms or diaphragm], contraceptive patch, or surgical sterilization) throughout the study
- Female patients with reproductive potential who have a positive urine or blood beta-human chorionic gonadotropin (beta HCG) pregnancy test at screening
- Patients receiving any other concurrent investigational agent or chemotherapy, radiotherapy, or immunotherapy (within 14 days of initiating study treatment)
- Prior cumulative anthracycline exposure of > 550 mg/m^2 daunorubicin or equivalent, or > 400 mg/m^2 in patients who received radiation therapy to the mediastinum
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: Treatment (liposome-encapsulated daunorubicin-cytarabine)
INDUCTION THERAPY: Patients receive liposome-encapsulated daunorubicin-cytarabine IV over 90 minutes on days 1, 3, and 5 in the absence of disease progression or unacceptable toxicity. After 2-5 weeks, patients who do not achieve a CR/CRi/CRp, have acceptable or no toxicity, and have stable disease and no disease progression may receive liposome-encapsulated daunorubicin-cytarabine IV over 90 minutes on days 1 and 3 in the absence of disease progression or unacceptable toxicity. CONSOLIDATION THERAPY: Patients who achieve at least a HI response, receive liposome-encapsulated daunorubicin-cytarabine IV over 90 minutes on days 1 and 3. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. After 5-8 weeks, patients who do not show clinically significant disease progression or unacceptable toxicity may receive liposome-encapsulated daunorubicin-cytarabine for up to 12 additional cycles. |
Given IV
Muut nimet:
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Incidence of adverse events (dose-escalation stage)
Aikaikkuna: Up to 30 days
|
Safety data of the patients will be summarized using descriptive statistics such as mean, standard deviation, median, and range. Toxicity type, severity, and attribution will be summarized for each patient using frequency tables. |
Up to 30 days
|
|
Maximum-tolerated dose (MTD) of liposome-encapsulated daunorubicin-cytarabine (dose-escalation stage)
Aikaikkuna: Up to 28 days
|
Defined as the highest dose level in which a dose-limiting toxicity (DLT) occurs within at most 1 out of 6 patients treated. DLTs are defined as any related non-hematological Common Terminology Criteria for Adverse Events grade >= 3 adverse events that prevent further administration of the agent at that same dose level. |
Up to 28 days
|
|
Incidence of adverse events (dose-expansion stage)
Aikaikkuna: Up to 30 days
|
Safety data of the patients will be summarized using descriptive statistics such as mean, standard deviation, median, and range. Toxicity type, severity, and attribution will be summarized for each patient using frequency tables. |
Up to 30 days
|
|
Objective response rate (ORR) (dose-expansion stage)
Aikaikkuna: Up to 1.5 years
|
Defined as complete response (CR), partial response, CR with incomplete bone marrow recovery, marrow CR or hematological improvement. Will be estimated along with 95% confidence intervals treated at the MTD (i.e., including those treated at the MTD during dose escalation and dose expansion phases). The association between ORR and patient's clinical characteristics will be examined by Wilcoxon's rank sum test or Fisher's exact test, as appropriate. |
Up to 1.5 years
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Yleinen vastausprosentti
Aikaikkuna: Jopa 1,5 vuotta
|
Jopa 1,5 vuotta
|
|
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Overall survival
Aikaikkuna: Up to 1.5 years
|
The distribution of time-to-event endpoints will be estimated using the method of Kaplan and Meier. Comparisons of time-to-event endpoints by important subgroups will be made using the log-rank tests. |
Up to 1.5 years
|
|
Duration of response
Aikaikkuna: Up to 1.5 years
|
Will be summarized using descriptive statistics such as mean, standard deviation, median and range. |
Up to 1.5 years
|
|
Relapse-free survival
Aikaikkuna: Up to 1.5 years
|
The distribution of time-to-event endpoints will be estimated using the method of Kaplan and Meier. Comparisons of time-to-event endpoints by important subgroups will be made using the log-rank tests. |
Up to 1.5 years
|
|
Incidence of adverse events
Aikaikkuna: Up to 1.5 years
|
Safety data of the patients will be summarized using descriptive statistics such as mean, standard deviation, median, and range. Toxicity type, severity, and attribution will be summarized for each patient using frequency tables. |
Up to 1.5 years
|
Yhteistyökumppanit ja tutkijat
Sponsori
Yhteistyökumppanit
Tutkijat
- Päätutkija: Guillermo M Bravo, M.D. Anderson Cancer Center
Julkaisuja ja hyödyllisiä linkkejä
Hyödyllisiä linkkejä
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
- Patologiset prosessit
- Neoplasmat
- Krooninen sairaus
- Sairauden ominaisuudet
- Neoplasmat histologisen tyypin mukaan
- Hematologiset sairaudet
- Leukemia, myeloidi
- Myelodysplastiset-myeloproliferatiiviset sairaudet
- Luuydinsairaudet
- Leukemia
- Patologiset tilat, merkit ja oireet
- Hemic- ja imusuutteet
- Leukemia, myelomonosyyttinen, krooninen
- Heterosykliset yhdisteet, 1-rengas
- Heterosykliset yhdisteet
- Terapeuttiset lääkkeet
- Lämpötilahallinnon reitit
- Lääkehoito
- Nukleiinihapot, nukleotidit ja nukleosidit
- Syytidiini
- Pyrimidiininnukleosidit
- Pyrimidiinit
- Nukleosidit
- Arabinonukleosidit
- Sytarabiini
- Injektiot
- CPX-351
Muut tutkimustunnusnumerot
- 2018-0911
- 2018-0911 (Muu tunniste: M D Anderson Cancer Center)
- NCI-2019-01558 (Rekisterin tunniste: CTRP (Clinical Trial Reporting Program))
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