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

2016年4月21日 更新者：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.

調査の概要

状態

完了

条件

介入・治療

研究の種類

介入

入学 (実際)

43

段階

  • フェーズ2
  • フェーズ 1

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

  • アメリカ
    • California
      • Orange、California、アメリカ
        • Teva Investigational Site 17
      • San Diego、California、アメリカ
        • Teva Investigational Site 12
    • Florida
      • St. Petersburg、Florida、アメリカ
        • Teva Investigational Site 10
    • Maryland
      • Baltimore、Maryland、アメリカ
        • Teva Investigational Site 8
    • Massachusetts
      • Boston、Massachusetts、アメリカ
        • Teva Investigational Site 16
    • Michigan
      • Detroit、Michigan、アメリカ
        • Teva Investigational Site 9
    • Mississippi
      • Jackson、Mississippi、アメリカ
        • Teva Investigational Site 1
    • Missouri
      • Kansas City、Missouri、アメリカ
        • Teva Investigational Site 5
      • St. Louis、Missouri、アメリカ
        • Teva Investigational Site 14
    • New York
      • New York、New York、アメリカ
        • Teva Investigational Site 15
    • Oregon
      • Portland、Oregon、アメリカ
        • Teva Investigational Site 18
    • Pennsylvania
      • Hershey、Pennsylvania、アメリカ
        • Teva Investigational Site 11
      • Philadelphia、Pennsylvania、アメリカ
        • Teva Investigational Site 7
    • Tennessee
      • Memphis、Tennessee、アメリカ
        • Teva Investigational Site 19
    • Texas
      • Dallas、Texas、アメリカ
        • Teva Investigational Site 3
      • Fort Worth、Texas、アメリカ
        • Teva Investigational Site 4
      • Houston、Texas、アメリカ
        • Teva Investigational Site 13
    • Washington
      • Seattle、Washington、アメリカ
        • Teva Investigational Site 2
    • Wisconsin
      • Milwaukee、Wisconsin、アメリカ
        • Teva Investigational Site 6
  • イスラエル
      • Jerusalem、イスラエル
        • Teva Investigational Site 501
      • Petach Tikva、イスラエル
        • Teva Investigational Site 503
      • Ramat Gan、イスラエル
        • Teva Investigational Site 502
  • オーストラリア
      • Herston、オーストラリア
        • Teva Investigational Site 300
      • Parkville、オーストラリア
        • Teva Investigational Site 301
      • Randwick、オーストラリア
        • Teva Investigational Site 302
  • カナダ
      • Toronto、カナダ
        • Teva Investigational Site 100
  • シンガポール
      • Singapore、シンガポール
        • Teva Investigational Site 320
  • ニュージーランド
      • Auckland、ニュージーランド
        • Teva Investigational Site 303
  • ブラジル
      • Barretos-SP、ブラジル
        • Teva Investigational Site 615
      • Caxias do Sul、ブラジル
        • Teva Investigational Site 616
      • Curitiba-PR、ブラジル
        • Teva Investigational Site 613
      • Porto Alegre、ブラジル
        • Teva Investigational Site 612
      • Porto Alegre、ブラジル
        • Teva Investigational Site 614
      • Sao Paulo、ブラジル
        • Teva Investigational Site 610
      • Sao Paulo、ブラジル
        • Teva Investigational Site 611
      • Sao Paulo-SP、ブラジル
        • Teva Investigational Site 617
  • ベラルーシ
      • Minsk、ベラルーシ
        • Teva Investigational Site 520
  • ポーランド
      • Bialystok、ポーランド
        • Teva Investigational Site 531
      • Lublin、ポーランド
        • Teva Investigational Site 530
      • Warszawa、ポーランド
        • Teva Investigational Site 532
  • メキシコ
      • Guadalajara、メキシコ
        • Teva Investigational Site 603
      • Mexico City、メキシコ
        • Teva Investigational Site 600
      • Mexico City、メキシコ
        • Teva Investigational Site 601
      • Monterrey、メキシコ
        • Teva Investigational Site 602
  • ロシア連邦
      • Moscow、ロシア連邦
        • Teva Investigational Site 511
      • St. Petersburg、ロシア連邦
        • Teva Investigational Site 510
  • 大韓民国
      • Seoul、大韓民国
        • Teva Investigational Site 330
      • Seoul、大韓民国
        • Teva Investigational Site 331
      • Seoul、大韓民国
        • Teva Investigational Site 332
      • Seoul、大韓民国
        • Teva Investigational Site 333

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

1年～20年 (子、大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

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：なし
  • 介入モデル：単一グループの割り当て
  • マスキング：なし（オープンラベル）

武器と介入

参加者グループ / アーム
介入・治療
実験的：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.
薬：ベンダムスティン

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
メジャーの説明
時間枠
Recommended Phase II Dose (RP2D) of Bendamustine
時間枠：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)
時間枠：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

二次結果の測定

結果測定
メジャーの説明
時間枠
Best Overall Tumor Response Rate
時間枠：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
時間枠：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)
時間枠：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)
時間枠：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)
時間枠：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)
時間枠：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)
時間枠：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.

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Teva Branded Pharmaceutical Products R&D, Inc.

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

一般刊行物

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2010年8月1日

一次修了 (実際)

2011年8月1日

研究の完了 (実際)

2011年8月1日

試験登録日

最初に提出

2010年3月16日

QC基準を満たした最初の提出物

2010年3月16日

最初の投稿 (見積もり)

2010年3月18日

学習記録の更新

投稿された最後の更新 (見積もり)

2016年5月23日

QC基準を満たした最後の更新が送信されました

2016年4月21日

最終確認日

2016年4月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

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

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。

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