AT9283 in Treating Young Patients With Relapsed or Refractory Acute Leukemia
A Cancer Research UK Phase I/IIa Trial of AT9283 (A Selective Inhibitor of Aurora Kinases) Given Over 72 Hours Every 21 Days Via Intravenous Infusion in Children and Adolescents Aged 6 Months to 18 Years With Relapsed and Refractory Acute Leukemia
RATIONALE: AT9283 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
PURPOSE: This phase I/IIa clinical trial is studying the side effects and best dose of AT9283 in treating young patients with relapsed or refractory acute leukemia.
調査の概要
詳細な説明
OBJECTIVES:
Primary
- To identify the maximum-tolerated dose and recommended phase IIb dose of multikinase inhibitor AT9283 in pediatric patients with relapsed or refractory acute leukemia.
Secondary
- To evaluate the safety and tolerability of this drug in these patients.
- To document evidence of efficacy of this drug in these patients.
- To investigate the pharmacokinetic profile of this drug in plasma in these patients.
Tertiary
- To assess target kinase inhibition by multikinase inhibitor AT9283 in these patients.
- To identify potential predictive molecular biomarkers in these patients.
OUTLINE: This is a multicenter study.
Patients receive multikinase inhibitor AT9283 IV continuously over 72 hours. Treatment repeats every 21 days* for 6 courses in the absence of disease progression or unacceptable toxicity. Patients achieving benefit of treatment may continue for up to 6 more courses at the discretion of the chief/principal investigator.
NOTE: *Course length may be extended to a maximum 42 days to allow for recovery of blood counts. Intrathecal therapy is permitted from course 2 onwards in patients with ALL.
Blood specimens are collected for pharmacokinetic and pharmacodynamic studies including molecular predictive biomarkers and ex vivo and in vivo measurement of kinase inhibition assessments.
After completion of study treatment, patients are followed up for 42 days or until recovery of blood counts (whichever is the sooner).
Peer Reviewed and Funded or Endorsed by Cancer Research UK.
研究の種類
入学 (実際)
段階
- フェーズ 1
連絡先と場所
研究場所
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-
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Birmingham,、イギリス、B4 6NH
- Birmingham children's Hospital
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Leeds、イギリス、LS1 3EX
- Leeds General Infirmary
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Manchester、イギリス、M13 9WL
- Royal Manchester Children's Hospital
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Newcastle upon Tyne、イギリス、NE1 4LP
- Great North Children's Hospital, Royal Victoria Infirmary
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London
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Surrey、London、イギリス、SM2 5PT
- Royal Marsden Hospital
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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 leukemia according to the following criteria:
Acute lymphoblastic leukemia (ALL) meeting any of the following criteria:
- Second relapse
- Refractory to induction therapy for first relapse
- Third or subsequent relapse
Acute myeloid leukemia (AML) meeting any of the following criteria:
- Second or subsequent relapse
- Refractory to an induction therapy for first relapse
- Without a curative treatment option
Other type of acute leukemia meeting any of the following criteria:
- First or subsequent relapse
- Refractory to induction therapy
- Not eligible for any therapy of higher curative potential
- No chronic myeloid leukemia (CML)
- Patients in relapse must have ≥ 5% blasts in the bone marrow
- Patients with refractory disease following induction must have ≥ 20% blasts in the bone marrow
- No evidence of CNS disease
PATIENT CHARACTERISTICS:
- Karnofsky performance status (PS) 50-100% OR Lansky PS 50-100%
- Life expectancy ≥ 8 weeks
- Serum bilirubin < 1.5 times upper limit of normal (ULN)
- ALT or AST < 2.5 times ULN (5 times ULN if due to leukemic infiltration of the liver)
- Creatinine clearance ≥ 60 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile female patients must use 2 of the following combined forms of contraception (oral, injected, or implanted hormonal contraception and condom OR intra-uterine device and condom OR diaphragm with spermicidal gel and condom) before, during, and for 6 months after completion of study therapy
Male patients must use 1 form of highly effective contraception (condom plus spermicidal gel) during and for 6 months after completion of study therapy
- Men with pregnant or lactating partners should be advised to use barrier-method contraception (condom plus spermicidal gel)
- No serological positivity for hepatitis B, hepatitis C, or HIV
- No congenital heart disease, with the exception of patent foramen ovale or small muscular ventricular septal deficit (within the first year of life)
- No uncontrolled arterial hypertension (defined as a systolic blood pressure [BP] and/or diastolic BP ≥ 95th percentile for age and height)
- No fractional shortening of ≤ 29% on echocardiogram
- No active graft-vs-host disease
No current non-malignant systemic disease considered high medical risk, including any of the following:
- Active uncontrolled infection
- Unstable or uncompensated respiratory or cardiac condition that makes study participation undesirable
- No other condition that, in the Investigator's opinion, would not make the patient a good candidate for the clinical trial
PRIOR CONCURRENT THERAPY:
Recovered from toxicity of prior therapy, including toxicity following hematopoietic stem cell transplantation
- Alopecia or certain grade 1 toxicities allowed at the discretion of the Investigator
- A maximum of 2 days of hydroxycarbamide 10-20 mg/kg/day (or according to local practice) in patients with AML and hyperleukocytosis allowed
- At least 7 days since prior investigational drugs (except antibodies for which a 4-week window must be observed)
At least 7 days since prior protein kinase inhibitors and intrathecal therapy
- Concurrent intrathecal therapy allowed from course 2 onwards in patients with ALL
- At least 14 days since prior cytotoxic therapy, including vincristine and other anti-neoplastics
- No prior major thoracic or abdominal surgery from which the patient has not yet recovered
- No prior aurora kinase inhibitor
No concurrent steroid therapy
- Multikinase inhibitor AT9283 administration may be commenced once steroids have started; however, steroids may not be started once multikinase inhibitor AT9283 has started
- Up to 5 days of prior oral dexamethasone (6 mg/m^2) for patients with ALL experiencing a rapid rise in blast count allowed
No other concurrent interventional clinical study
- Participation in an observational study allowed
- No other concurrent anticancer therapy or investigational drugs
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
- マスキング:なし(オープンラベル)
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 |
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Maximum-tolerated dose and recommended phase II dose of multikinase inhibitor AT9283
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二次結果の測定
結果測定 |
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Adverse events to multikinase inhibitor AT9283 and grading severity according to NCI CTCAE Version 4.02
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Partial remission, complete remission, or complete remission with incomplete bone marrow recovery using disease-specific criteria based on ANC, platelets, and % blasts in the bone marrow
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Plasma concentration measurement of multikinase inhibitor AT9283
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Tertiary outcome(s) - Ex vivo and in vivo measurement of kinase inhibition using Plasma Inhibitory Activity (PIA) assay, phosphorylated STAT5 assay, and skin-punch biopsy (measuring pHH3, p53, PCNA, Ki67 levels)
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Results of established and novel prognostic biomarkers (genetic mutations of JAK 1, 2, 3, FLT3, IKAROS, and BCR/ABL) linking to observed responses
|
協力者と研究者
スポンサー
捜査官
- 主任研究者:Josef Vormoor、Sir James Spence Institute of Child Health at Royal Victoria Infirmary
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
その他の研究ID番号
- CDR0000709775
- CRUK-CR0708-12
- EUDRACT-2009-016952-36
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。
薬理学的研究の臨床試験
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Radicle Science積極的、募集していない
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Digisight Technologies, Inc.わからない
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Fonds de la Recherche en Santé du QuébecUniversité de Montréal完了