Cytarabine With or Without VNP40101M in Treating Patients With Relapsed Acute Myeloid Leukemia
A Phase III Randomized of Cloretazine™ (VNP40101M) and Cytosine Arabinoside (AraC) in Patients With Acute Myeloid Leukemia in First Relapse
RATIONALE: Drugs used in chemotherapy, such as cytarabine and VNP40101M, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells.
PURPOSE: This randomized phase III trial is studying cytarabine and VNP40101M to see how well they work compared to cytarabine alone in treating patients with relapsed acute myeloid leukemia.
調査の概要
詳細な説明
OBJECTIVES:
Primary
- Compare the complete response (CR) and CR (with platelet count < 100,000/mm^3 but ≥ 20,000/mm^3 [transfusion independent for ≥ 7 consecutive days]) (CRp) rates in patients with acute myeloid leukemia in first relapse treated with cytarabine with vs without VNP40101M.
Secondary
- Compare time to progression in patients treated with these regimens.
- Compare duration of response in patients treated with these regimens.
- Compare the survival of patients treated with these regimens.
- Compare the toxicity of these regimens in these patients.
OUTLINE: This is a randomized, double-blind, placebo-controlled, parallel group, multicenter study. Patients are stratified according to age (< 60 years vs ≥ 60 years) and duration of first complete response (CR) or CR (with platelet count < 100,000/mm³ but ≥ 20,000/mm³ [transfusion independent for ≥ 7 consecutive days]) (CRp) (< 12 months vs ≥ 12 months).
Induction therapy: Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive cytarabine IV continuously on days 1-3 and VNP40101M IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
- Arm II: Patients receive cytarabine as in arm I and placebo IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
In both arms, patients demonstrating at least 20% reduction of blasts in bone marrow (based on total cellularity and percent blasts) after course 1 may receive 1 additional course of induction therapy between days 35-60 in the absence of disease progression or unacceptable toxicity. Patients achieving CR or CRp after 1 or 2 courses of induction therapy proceed to consolidation therapy.
- Consolidation therapy: Beginning 6 weeks after initial documentation of CR or CRp, patients receive 1 course of consolidation therapy, as per induction therapy, according to their randomized treatment arm. These patients may then proceed to other consolidation, maintenance, and/or intensification therapy (including stem cell transplantation) off study at the discretion of the physician.
After completion of study treatment, patients are followed monthly for 6 months, every 2 months for 6 months, and then every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 420 patients (280 in arm I and 140 in arm II) will be accrued for this study within 24-30 months.
研究の種類
入学 (予想される)
段階
- フェーズ 3
連絡先と場所
研究場所
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California
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Los Angeles、California、アメリカ、90095-1781
- Jonsson Comprehensive Cancer Center at UCLA
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Los Angeles、California、アメリカ、90089-9181
- USC/Norris Comprehensive Cancer Center and Hospital
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Orange、California、アメリカ、92868
- Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
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San Francisco、California、アメリカ、94115
- UCSF Comprehensive Cancer Center
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Connecticut
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Hartford、Connecticut、アメリカ、06105
- Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
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Florida
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Miami、Florida、アメリカ、33136
- University of Miami Sylvester Comprehensive Cancer Center
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Tampa、Florida、アメリカ、33612
- Veterans Affairs Medical Center - Tampa (Haley)
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Illinois
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Chicago、Illinois、アメリカ、60637-1470
- University of Chicago Cancer Research Center
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Chicago、Illinois、アメリカ、60611-3013
- Robert H. Lurie Comprehensive Cancer Center at Northwestern University
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Indiana
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Indianapolis、Indiana、アメリカ、46260
- American Health Network - North Meridian
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Maryland
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Baltimore、Maryland、アメリカ、21201
- Greenebaum Cancer Center at University of Maryland Medical Center
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Massachusetts
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Boston、Massachusetts、アメリカ、02115
- Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
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Nevada
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Las Vegas、Nevada、アメリカ、89135
- Nevada Cancer Institute
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New Mexico
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Albuquerque、New Mexico、アメリカ、87106
- New Mexico Cancer Care Alliance
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New York
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Buffalo、New York、アメリカ、14263-0001
- Roswell Park Cancer Institute
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Valhalla、New York、アメリカ、10595
- New York Medical College
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North Carolina
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Durham、North Carolina、アメリカ、27710
- Duke Comprehensive Cancer Center
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Greenville、North Carolina、アメリカ、27858
- Brody School of Medicine at East Carolina University
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Ohio
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Columbus、Ohio、アメリカ、43214-3998
- Riverside Methodist Hospital Cancer Care
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Pennsylvania
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Hershey、Pennsylvania、アメリカ、17033-0850
- Penn State Cancer Institute at Milton S. Hershey Medical Center
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Pittsburgh、Pennsylvania、アメリカ、15224
- Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital
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South Carolina
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Charleston、South Carolina、アメリカ、29425
- Hollings Cancer Center at Medical University of South Carolina
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Tennessee
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Nashville、Tennessee、アメリカ、37232-6838
- Vanderbilt-Ingram Cancer Center
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Texas
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Houston、Texas、アメリカ、77030-4009
- M.D. Anderson Cancer Center at University of Texas
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England
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Birmingham、England、イギリス、B9 5SS
- Birmingham Heartlands Hospital
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Cambridge、England、イギリス、CB2 2QQ
- Addenbrooke's Hospital at Cambridge University Hospitals NHS Foundation Trust
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Leicester、England、イギリス、LE1 5WW
- Leicester Royal Infirmary
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London、England、イギリス、SE5 9RS
- King's College Hospital
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Manchester、England、イギリス、M13 9WL
- Manchester Royal Infirmary
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Wales
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Cardiff、Wales、イギリス、CF14 4XW
- University Hospital of Wales
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Groningen、オランダ、9713 GZ
- University Medical Center Groningen
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British Columbia
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Vancouver、British Columbia、カナダ、V5Z 4E3
- Vancouver Hospital and Health Science Center
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New Brunswick
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Saint John、New Brunswick、カナダ、E2L 4L2
- Saint John Regional Hospital
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Newfoundland and Labrador
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St. John's、Newfoundland and Labrador、カナダ、A1B 3V6
- Memorial University of Newfoundland
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Nova Scotia
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Halifax、Nova Scotia、カナダ、B3H 1V7
- Capital District Health Authority Center for Clinical Research
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Ontario
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Ottawa、Ontario、カナダ、K1H 8L6
- Ottawa Hospital Regional Cancer Centre - General Campus
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Toronto、Ontario、カナダ、M5G 2M9
- Princess Margaret Hospital
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Athens、ギリシャ、10676
- Evaggelismos Hospital
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Rio Patras、ギリシャ、GR-26500
- University of Patras Medical School
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Belgrade、セルビア、11000
- Clinical Centre of Serbia
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Nis、セルビア、18000
- Clinical Centre Nis
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Novi Sad、セルビア、21000
- Clinic Centre Novi Sad
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Berlin、ドイツ、D-12200
- Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
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Cologne、ドイツ、D-50924
- Medizinische Universitaetsklinik I at the University of Cologne
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Frankfurt、ドイツ、D-60596
- Universitaetsfrauenklinik Frankfurt
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Heidelberg、ドイツ、D-69115
- Universitätsklinikum Heidelberg
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Muenster、ドイツ、D-48149
- Medizinische Klinik und Poliklinik A - Universitaetsklinikum Muenster
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Munich、ドイツ、D-81377
- Klinikum der Universitaet Muenchen - Grosshadern Campus
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Wurzburg、ドイツ、D-97070
- University Würzburg
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Besancon、フランス、25030
- Centre Hospitalier Regional de Besancon - Hopital Jean Minjoz
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Lyon、フランス、69437
- Hôpital Édouard Herriot
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Marseille、フランス、13273
- Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes
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Nantes、フランス、44093
- CHR Hotel Dieu
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Pessac、フランス、33604
- Hopital Haut Lévêque
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Brussels、ベルギー、1200
- Cliniques Universitaires Saint-Luc
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Leuven、ベルギー、B-3000
- U.Z. Gasthuisberg
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Montigny-le-Tilleul、ベルギー、6110
- CHU Charleroi - Site Vesale
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Gdansk、ポーランド、80-211
- Medical University of Gdańsk
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Lodz、ポーランド、90-419
- Medical University of Lodz
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Lublin、ポーランド、20-954
- Centrum Onkologii Ziemi Lubelskiez
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Warsaw、ポーランド、00-957
- Institute of Haematology and Blood Transfusion
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Warsaw、ポーランド、00-909
- Wojskowy Instytut Medyczny
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Histologically confirmed acute myeloid leukemia (AML)
- Any WHO classification, excluding acute promyelocytic leukemia
- At least 10% blasts by bone marrow aspirate and/or biopsy
In first relapse after achieving a first complete response (CR) OR CR (with platelet count < 100,000/mm³ but ≥ 20,000/mm³ [transfusion independent for ≥ 7 consecutive days]) (CRp) that lasted ≥ 3 months but ≤ 24 months after completion of the initial induction regimen
- Relapse confirmed by recurrence of blasts in peripheral blood, bone marrow histopathology, and/or histologically confirmed CNS or extramedullary disease
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-2
Life expectancy
- Not specified
Hematopoietic
- See Disease Characteristics
Hepatic
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST ≤ 3 times ULN
- Chronic hepatitis allowed
Renal
- Creatinine ≤ 2.0 mg/dL
Cardiovascular
- No myocardial infarction within the past 3 months
- No uncontrolled arrhythmias
- No uncontrolled congestive heart failure
Pulmonary
- No severe chronic obstructive pulmonary disease
- No requirement for supplemental oxygen at rest
Immunologic
No uncontrolled active infection
- Infections that are controlled and under active treatment with antibiotics allowed
- No evidence of invasive fungal infection by blood or tissue cultures
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months after completion of study treatment
- No clinical evidence of another active malignancy by tumor marker, pathology, or radiologic studies
- No other severe medical condition that would preclude study treatment
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- At least 12 hours since prior hydroxyurea
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Not specified
Other
- No prior treatment while in first relapse except hydroxyurea
- No other concurrent standard or investigational treatment for AML
- No concurrent disulfiram (Antabuse®)
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- マスキング:ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Induction therapy arm I
Patients receive cytarabine IV continuously on days 1-3 and VNP40101M IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
|
与えられた IV
Given IV
|
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アクティブコンパレータ:Induction therapy arm II
Patients receive cytarabine as in arm I and placebo IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
|
与えられた IV
与えられた IV
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
|---|
|
全体の回答率
|
二次結果の測定
結果測定 |
|---|
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毒性
|
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応答時間
|
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全体的な反応
|
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腫瘍進行までの時間
|
協力者と研究者
スポンサー
捜査官
- Bonny L. Johnson, RN, MSN、Vion Pharmaceuticals
出版物と役立つリンク
一般刊行物
- Giles F, Vey N, DeAngelo D, Seiter K, Stock W, Stuart R, Boskovic D, Pigneux A, Tallman M, Brandwein J, Kell J, Robak T, Staib P, Thomas X, Cahill A, Albitar M, O'Brien S. Phase 3 randomized, placebo-controlled, double-blind study of high-dose continuous infusion cytarabine alone or with laromustine (VNP40101M) in patients with acute myeloid leukemia in first relapse. Blood. 2009 Nov 5;114(19):4027-33. doi: 10.1182/blood-2009-06-229351. Epub 2009 Aug 26.
- Giles FJ, Stock W, Vey N, et al.: A double blind placebo-controlled randomized phase III study of high dose continuous infusion cytosine arabinoside (araC) with or without cloretazine in patients with first relapse of acute myeloid leukemia (AML). [Abstract] Blood 108 (11): A-1970, 2006.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
- 11q23 (MLL) 異常を伴う成人急性骨髄性白血病
- inv(16)(p13;q22)を伴う成人急性骨髄性白血病
- t(16;16)(p13;q22)を伴う成人急性骨髄性白血病
- t(8;21)(q22;q22)を伴う成人急性骨髄性白血病
- 再発性成人急性骨髄性白血病
- 成人急性巨核芽球性白血病 (M7)
- 成人急性低分化型骨髄性白血病 (M0)
- 成人急性単芽球性白血病 (M5a)
- 成人急性単球性白血病 (M5b)
- 成熟を伴う成人急性骨髄芽球性白血病(M2)
- 成熟していない成人急性骨髄芽球性白血病 (M1)
- 成人急性骨髄単球性白血病 (M4)
- 成人急性好塩基球性白血病
- 成人急性好酸球性白血病
- 成人赤白血病 (M6a)
- 成人純粋赤血球性白血病 (M6b)
追加の関連 MeSH 用語
その他の研究ID番号
- CDR0000430677
- VION-CLI-037
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。