A Study Being Conducted at Multiple Locations to Compare Safety and Efficacy of Three Different Regimens; (1) High-Dose Lenalidomide; (2) Lenalidomide + Azacitidine; or (3) Azacitidine in Subjects ≥ 65 Years With Newly-Diagnosed Acute Myeloid Leukemia
2019. június 17. frissítette: Celgene
A Phase 2, Multicenter, Randomized, Open-label, Parallel-group Study of a Lenalidomide (Revlimid®) Regimen or a Sequential Azacitidine (Vidaza®) Plus Lenalidomide (Revlimid®) Regimen Versus an Azacitidine (Vidaza®) Regimen for Therapy of Older Subjects With Newly Diagnosed Acute Myeloid Leukemia
The study aim is to compare safety and efficacy of high-dose lenalidomide regimen, sequential azacitidine and lenalidomide and an azacitidine in persons ≥65 years with newly-diagnosed acute myeloid leukemia (AML).
A tanulmány áttekintése
Állapot
Befejezve
Körülmények
Beavatkozás / kezelés
Részletes leírás
On September 11, 2013, randomization into the continuous 50 mg lenalidomide only arm was temporarily suspended based on review of the data from the first 13 participants and a high rate of discontinuation (11/13 participants).
The Data Monitoring Committee assessed the study data on September 20, 2013 and reported no safety concerns.
The high rate of early discontinuation is inconsistent with the treatment duration required for testing the study primary endpoint of survival at one year.
Consequently, Celgene has decided not to reopen the lenalidomide only arm.
Tanulmány típusa
Beavatkozó
Beiratkozás (Tényleges)
88
Fázis
- 2. fázis
Kapcsolatok és helyek
Ez a rész a vizsgálatot végzők elérhetőségeit, valamint a vizsgálat lefolytatásának helyére vonatkozó információkat tartalmazza.
Tanulmányi helyek
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Arizona
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Tucson, Arizona, Egyesült Államok, 85724
- (210) University of Arizona Cancer Center
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California
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La Jolla, California, Egyesült Államok, 92093-0960
- (180) University of California, San Diego
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Los Angeles, California, Egyesült Államok, 90048
- (240) Cedars-Sinai Medical Center
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Orange, California, Egyesült Államok, 92868
- (215) Hematology Oncology Medical Group
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Sacramento, California, Egyesült Államok, 95857
- (130) UC Davis Medical Center
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San Luis Obispo, California, Egyesült Államok, 93401
- (200) Coastal Integrative Cancer Care
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Stanford, California, Egyesült Államok, 94305
- (125) University of Stanford
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Colorado
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Aurora, Colorado, Egyesült Államok, 80045
- (115) University of Colorado Anschultz Cancer Center
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Florida
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Miami Beach, Florida, Egyesült Államok, 33140
- (145) Mount Sinai Comprehensive Cancer Center
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Illinois
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Chicago, Illinois, Egyesült Államok, 60612
- (140) Rush University Medical Center
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Kansas
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Westwood, Kansas, Egyesült Államok, 66205
- (185) The University of Kansas Cancer Center
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Kentucky
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Louisville, Kentucky, Egyesült Államok, 40202
- (175) University Lousiville
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Louisiana
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New Orleans, Louisiana, Egyesült Államok, 70072
- (195) Tulane University Hospital Tulane Cancer Center
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Minnesota
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Minneapolis, Minnesota, Egyesült Államok, 55455
- (235) University of Minnesota
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Missouri
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Saint Louis, Missouri, Egyesült Államok, 63110-1093
- (100) Washington University School of Medicine
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Montana
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Billings, Montana, Egyesült Államok, 59101
- (150) Billings Clinic
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New York
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New York, New York, Egyesült Államok, 10029-65749
- (165) Mount Sinai Medical Center New York
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Pennsylvania
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Pittsburgh, Pennsylvania, Egyesült Államok, 15224-1791
- (160) The Western Pennsylvania Hospital- Cancer Institute
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South Carolina
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Greenville, South Carolina, Egyesült Államok, 29605
- (205) Greenville Hospital System
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South Dakota
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Sioux Falls, South Dakota, Egyesült Államok, 57105
- (120) Avera Cancer Institute
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Tennessee
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Nashville, Tennessee, Egyesült Államok, 37203
- (230) Tennessee Oncology, PLLC
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Texas
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Dallas, Texas, Egyesült Államok, 75390-9179
- (105) University of Texas Southwestern Medical Center Simmons Comprehensive Cancer Center
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San Antonio, Texas, Egyesült Államok, 78229
- (155) Cancer Care Centers of South Texas
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Wisconsin
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Madison, Wisconsin, Egyesült Államok, 53792
- (135) University of Wisconsin
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Alberta
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Calgary, Alberta, Kanada, T2N 4N2
- (402) Tom Baker Cancer Centre
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Edmonton, Alberta, Kanada, T6G 1Z1
- (405) University of Alberta Hospital
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Manitoba
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Winnipeg, Manitoba, Kanada, R3E 0V9
- (401) Cancer Care Manitoba
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Nova Scotia
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Halifax, Nova Scotia, Kanada, B3H 2Y9
- (403) Queen Elizabeth II Health Sciences Centre - VG Site
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Ontario
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Ottawa, Ontario, Kanada, K1H 8L6
- (404) The Ottawa Hospital
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Toronto, Ontario, Kanada, M5G 2M9
- (400) Princess Margaret Hospital
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Részvételi kritériumok
A kutatók olyan embereket keresnek, akik megfelelnek egy bizonyos leírásnak, az úgynevezett jogosultsági kritériumoknak. Néhány példa ezekre a kritériumokra a személy általános egészségi állapota vagy a korábbi kezelések.
Jogosultsági kritériumok
Tanulmányozható életkorok
65 év és régebbi (Idősebb felnőtt)
Egészséges önkénteseket fogad
Nem
Tanulmányozható nemek
Összes
Leírás
Inclusion Criteria:
- Newly diagnosed acute myeloid leukemia (AML), AML with antecedent hematologic disorder or therapy-related AML
- Male or female subjects aged ≥ 65
- Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
- White blood cell (WBC) count ≤ 10 x 10⁹/L at screening
Exclusion Criteria:
- Previous treatment with azacitidine, decitabine, cytarabine or lenalidomide
- Previous cytotoxic or biologic treatment of any kind for AML or prior use of targeted therapy agents.
- Suspected or proven acute promyelocytic leukemia
- Prior bone marrow or stem cell transplantation
- Candidate for allogeneic bone marrow or stem cell transplantation
- AML antecedent hematologic disorder such as chronic myelogenous leukemia or myeloproliferative neoplasms
- Presence of malignant disease within the previous 12 months with exceptions
Tanulási terv
Ez a rész a vizsgálati terv részleteit tartalmazza, beleértve a vizsgálat megtervezését és a vizsgálat mérését.
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Kezelés
- Kiosztás: Véletlenszerűsített
- Beavatkozó modell: Párhuzamos hozzárendelés
- Maszkolás: Nincs (Open Label)
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
|---|---|
|
Kísérleti: Lenalidomide in combination with azacitidine
Repeated cycles of azacitidine 75 mg/m^2/day subcutaneous (SC) on Days 1-7 and lenalidomide 50 mg/day by mouth (PO) on Days 8-28 followed by a 14-day break plus best supportive care
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Azacitidine at 75 mg/m^2/day subcutaneous on Days 1-7
Más nevek:
Lenalidomide 50 mg PO daily x 28 days for the first 2 cycles then 25 mg PO daily x 28 days for the next 2 cycles followed by continuous 28-day cycles of lenalidomide 10 mg PO daily
Más nevek:
The use of BSC was considered as concomitant treatment and must be documented as concomitant medication. BSC includes, but is not limited to, treatment with Red Blood Celll (RBC) or whole blood transfusions, fresh frozen plasma transfusions, platelet transfusions, antibiotic or antifungal therapy, and nutritional support |
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Kísérleti: Lenalidomide - single agent
Lenalidomide 50 mg PO daily for 28 days for the first 2 cycles and lenalidomide 25 mg daily for 28 days for the next 2 cycles followed by continuous 28-day cycles of lenalidomide 10 mg daily PO plus best supportive care
|
Lenalidomide 50 mg PO daily x 28 days for the first 2 cycles then 25 mg PO daily x 28 days for the next 2 cycles followed by continuous 28-day cycles of lenalidomide 10 mg PO daily
Más nevek:
The use of BSC was considered as concomitant treatment and must be documented as concomitant medication. BSC includes, but is not limited to, treatment with Red Blood Celll (RBC) or whole blood transfusions, fresh frozen plasma transfusions, platelet transfusions, antibiotic or antifungal therapy, and nutritional support |
|
Kísérleti: Azacitidine-single agent
Repeated cycles of azacitidine 75mg/m^2/day subcutaneous on Days 1-7 followed by a 21-day break plus best supportive care
|
Azacitidine at 75 mg/m^2/day subcutaneous on Days 1-7
Más nevek:
The use of BSC was considered as concomitant treatment and must be documented as concomitant medication. BSC includes, but is not limited to, treatment with Red Blood Celll (RBC) or whole blood transfusions, fresh frozen plasma transfusions, platelet transfusions, antibiotic or antifungal therapy, and nutritional support |
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
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Kaplan Meier Estimates for One Year Survival
Időkeret: Up to 24 months
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One-year survival rate was defined as all deaths within one year from the date of randomization.
All others censored at the at year 1 or date of discontinuation
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Up to 24 months
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Overall Survival
Időkeret: From date of randomization until the date of the first documented date of progression or date of death of any cause; the overall median follow-up for survivng participants was 4.1 months (range 0.2 to 54.8 months)
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Overall Survival reported at the end of the study are for those participants who were alive at the end of the study
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From date of randomization until the date of the first documented date of progression or date of death of any cause; the overall median follow-up for survivng participants was 4.1 months (range 0.2 to 54.8 months)
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Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
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Percentage of Participants With a Complete Response or Morphologic Incomplete Response.
Időkeret: Complete Response or Morphologic Incomplete Response data not analyzed.
|
Based on IWG response criteria for AML. Complete remission (CR), morphologic complete remission (CR) was defined as < 5% bone marrow blasts, an absolute neutrophil count ≥ 1 x 10^9/L, platelets ≥100 x 10^9/L, and transfusion independence (no transfusions for 1 week prior to each assessment). No duration of these findings is required for confirmation of this response. Morphologic CR with incomplete blood count recovery (CRi) was defined as a morphologic complete remission but the ANC count may be <1 x 10^9/L and/or the platelet count may be <100 x 10^9/L. Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed. |
Complete Response or Morphologic Incomplete Response data not analyzed.
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Duration of Remission (DoR)
Időkeret: Duration of Remission (DoR) time frame not analyzed.
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Duration of remission was defined as the time from the date of CR or CRi until relapse.
Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
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Duration of Remission (DoR) time frame not analyzed.
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Cytogenetic Complete Remission Rate (CRc)
Időkeret: Cytogenetic Complete Remission timeframe was not analyzed.
|
The CRc response category is comprised of the subset of participants who had abnormal cytogenetics at baseline and subsequently achieved CR during treatment in conjunction with a reversion to a normal karyotype.
For the primary definition of CRc, a normal karyotype is defined as no clonal abnormalities after review of at least 10 metaphases using conventional cytogenetic techniques.
Cytogenetic complete remission rate (CRc) 1) CR criteria met AND 2) Abnormal karyotype present at baseline AND 3) Reversion to normal karyotype at time of CR (based on ≥ 10 metaphases), where date of cytogenetic sample = date of BM sample used for the CR assessment.
Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
|
Cytogenetic Complete Remission timeframe was not analyzed.
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Percentage of Participants With an Overall Response Rate (CR +CRi+ PR)
Időkeret: Overall response rate time frame was not analyzed.
|
Morphologic complete remission (CR) is defined as a leukemia-free state defined as less than 5% blasts in a one marrow aspirate with spicules and with at least 200 nucleated cells (there should be no blasts with auer rods) and ANC of ≥ 1 x 10^9/L, a platelet count ≥ 100 x 10^9/L, no transfusions for 1 week prior to each assessment.
No duration of these findings is required for confirmation of this response.
Morphologic complete remission with incomplete blood count recovery was defined as a morphologic complete remission but the ANC may be < 1 x 10^9/L and/or the platelet count may be < 100 x 10^9/L.
Partial remission was defined as an ANC > 1 x 10^9/L and platelet count ≥ 100 x 10^9/L with a > 50% decrease in the percentage of bone marrow blasts to 5% to 25% (a blast count value of ≤ 5% may also be considered a partial remission if auer rods are present).
Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
|
Overall response rate time frame was not analyzed.
|
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Progression-Free Survival (PFS)
Időkeret: Progression-Free survival data and time frame was not analyzed.
|
PFS is defined as the time from randomization to the first observation of documented disease progression or death from any cause whichever occurred first.
Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
|
Progression-Free survival data and time frame was not analyzed.
|
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Event-Free Survival (EFS)
Időkeret: Event-Free survival time was not analyzed.
|
EFS was defined as the interval from the date of randomization to the date of treatment failure, progressive disease, relapse after CR or CRi, or death from any cause, whichever occurred first.
Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
|
Event-Free survival time was not analyzed.
|
|
Relapse-Free Survival (RFS)
Időkeret: Relapse-Free survival time frame was not analyzed.
|
RFS is defined only for subjects that achieve CR and CRi and is measured as the interval from that date to the date of disease relapse, death from any cause, whichever occurs first, censoring at the last visit date for subjects alive in continuous CR/CRi.
Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
|
Relapse-Free survival time frame was not analyzed.
|
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Percentage of Participants With 30-Day Treatment-Related Mortality
Időkeret: 30 days
|
30-day mortality rate was defined as death from any cause within 30 days after first dose.
|
30 days
|
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Number of Participants With Treatment Emergent Adverse Events (TEAE)
Időkeret: From the first dose of study drug up to 28 days after the last dose of study drug; up to 15 May 2018
|
TEAEs were defined as those events that started on or after the first day of study drug up until 28 days after the last dose of study drug; Serious AE (SAE) = any AE which results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability; is a congenital anomaly/birth defect; constitutes an important medical event.
Severity of AEs were graded based upon the participants symptoms according to the Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0); and according to the scale: Grade (Gr) 1 = Mild - transient or mild discomfort; no medical intervention required; Grade 2 = Moderate - mild to moderate limitation in activity; Grade 3 = Severe; Grade 4 = Life threatening; Grade 5 = Death
|
From the first dose of study drug up to 28 days after the last dose of study drug; up to 15 May 2018
|
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Number of Participants With a Second Primary Malignancy
Időkeret: From randomization of the last participant up to a minimum of 4 years following discontinuation
|
Second primary malignancies were monitored as events of interest and reported as serious adverse events regardless of the treatment arm the participant was enrolled in.
|
From randomization of the last participant up to a minimum of 4 years following discontinuation
|
Egyéb eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Percentage of Participants Alive at One Year
Időkeret: Up to 12 months
|
Defined as the percentage of participants who survived at one year
|
Up to 12 months
|
Együttműködők és nyomozók
Itt találhatja meg a tanulmányban érintett személyeket és szervezeteket.
Szponzor
Nyomozók
- Tanulmányi igazgató: Robert Gale, MD, Celgene
Publikációk és hasznos linkek
A vizsgálattal kapcsolatos információk beviteléért felelős személy önkéntesen bocsátja rendelkezésre ezeket a kiadványokat. Ezek bármiről szólhatnak, ami a tanulmányhoz kapcsolódik.
Tanulmányi rekorddátumok
Ezek a dátumok nyomon követik a ClinicalTrials.gov webhelyre benyújtott vizsgálati rekordok és összefoglaló eredmények benyújtásának folyamatát. A vizsgálati feljegyzéseket és a jelentett eredményeket a Nemzeti Orvostudományi Könyvtár (NLM) felülvizsgálja, hogy megbizonyosodjon arról, hogy megfelelnek-e az adott minőség-ellenőrzési szabványoknak, mielőtt közzéteszik őket a nyilvános weboldalon.
Tanulmány főbb dátumok
Tanulmány kezdete (Tényleges)
2012. április 27.
Elsődleges befejezés (Tényleges)
2015. május 19.
A tanulmány befejezése (Tényleges)
2018. május 15.
Tanulmányi regisztráció dátumai
Először benyújtva
2011. május 19.
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
2011. május 20.
Első közzététel (Becslés)
2011. május 24.
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
2019. június 25.
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
2019. június 17.
Utolsó ellenőrzés
2019. június 1.
Több információ
A tanulmányhoz kapcsolódó kifejezések
Kulcsszavak
További vonatkozó MeSH feltételek
- Neoplazmák szövettani típus szerint
- Neoplazmák
- Leukémia
- Leukémia, mieloid
- Leukémia, mieloid, akut
- A gyógyszerek élettani hatásai
- A farmakológiai hatás molekuláris mechanizmusai
- Enzim gátlók
- Antimetabolitok, daganatellenes
- Antimetabolitok
- Antineoplasztikus szerek
- Immunológiai tényezők
- Angiogenezis gátlók
- Angiogenezist moduláló szerek
- Növekedést elősegítő anyagok
- Növekedésgátlók
- Lenalidomid
- Azacitidin
Egyéb vizsgálati azonosító számok
- CC-5013-AML-001
Ezt az információt közvetlenül a clinicaltrials.gov webhelyről szereztük be, változtatás nélkül. Ha bármilyen kérése van vizsgálati adatainak módosítására, eltávolítására vagy frissítésére, kérjük, írjon a következő címre: register@clinicaltrials.gov. Amint a változás bevezetésre kerül a clinicaltrials.gov oldalon, ez a webhelyünkön is automatikusan frissül. .