新たにKMT2A再構成白血病またはKMT2A非再構成白血病と診断された乳児に対する通常の化学療法への抗がん剤ベネトクラクスおよび/または抗がん免疫療法ブリナツモマブの追加の試験
新たに急性リンパ芽球性白血病と診断された乳児を対象に、KMT2A再構成患者をランダム化してベネトクラクスを追加したブリナツモマブと化学療法の併用療法の第2相試験
This phase II trial tests the addition of venetoclax and/or blinatumomab to usual chemotherapy for treating infants with newly diagnosed acute lymphoblastic leukemia (ALL) with a KMT2A gene rearrangement (KMT2A-rearranged [R]) or without a KMT2A gene rearrangement (KMT2A-germline [G]). Venetoclax is in a class of medications called B-cell lymphoma-2 (Bcl-2) inhibitors. It may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Blinatumomab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. Chemotherapy drugs 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. Adding venetoclax and/or blinatumomab to standard chemotherapy may be more effective at treating patients with ALL than standard chemotherapy alone, but it may also cause more side effects. This clinical trial evaluates the safety and effectiveness of adding venetoclax and/or blinatumomab to chemotherapy for the treatment of infants with KMT2A-R or KMT2A-G ALL.
調査の概要
状態
介入・治療
- 薬:Cyclophosphamide
- 薬:Doxorubicin
- 薬:Vincristine
- 手順:Computed Tomography
- 手順:Magnetic Resonance Imaging
- 手順:Echocardiography Test
- 手順:Multigated Acquisition Scan
- 生物学的:Blinatumomab
- 手順:Bone Marrow Aspiration
- 薬:Daunorubicin
- 手順:Lumbar Puncture
- 薬:Methylprednisolone
- 手順:Biospecimen Collection
- 薬:Calaspargase Pegol
- 薬:Therapeutic Hydrocortisone
- 薬:Asparaginase Erwinia chrysanthemi
- 薬:Cytarabine
- 薬:Dexamethasone
- 手順:FDG-Positron Emission Tomography
- 薬:Leucovorin
- 薬:Levoleucovorin
- 薬:Mercaptopurine
- 薬:Methotrexate
- 薬:Thioguanine
- 薬:Venetoclax
- 薬:Prednisolone
- 薬:Prednisone
詳細な説明
PRIMARY OBJECTIVES:
I. To evaluate the safety and tolerability of venetoclax in addition to a standard chemotherapy backbone and two cycles of blinatumomab in infants (aged 365 days or less at diagnosis) with newly diagnosed KMT2A-R ALL.
II. To determine in a randomized manner if the addition of venetoclax to induction chemotherapy improves end of induction minimal residual disease (MRD)-negative remission rates in infants with KMT2A-R ALL.
SECONDARY OBJECTIVES:
I. To estimate the MRD-negative remission rate for all eligible infants with KMT2A-R ALL treated with venetoclax at the recommended phase 2 dose (RP2D).
II. To compare event free survival (EFS) rates of infants with KMT2A-R ALL treated on arm B to those treated on arm A.
III. To compare 3-year EFS rates of infants with KMT2A-R ALL treated on arm A to historical controls.
IV. To determine the feasibility of treating infants with KMT2A-G ALL with a Children's Oncology Group (COG) high risk ALL chemotherapy backbone and two cycles of blinatumomab and estimate the 3-year EFS rate of infants with KMT2A-G ALL treated on arm C.
V. To characterize the pharmacokinetics (PK) of venetoclax in infants.
EXPLORATORY OBJECTIVES:
I. To describe 3-year EFS rate of infants with KMT2A-R ALL treated on arm B. II. To evaluate the use of high-throughput sequencing (HTS) for MRD detection in infant ALL compared to centralized flow cytometry.
III. To characterize the PK of calaspargase pegol in infants with ALL. IV. To report the incidence of CD19 negative relapse and myeloid switch relapse with protocol therapy.
V. To evaluate the impact of venetoclax in combination with chemotherapy on T-cell subsets and function.
VI. To describe the feasibility of T-cell collection and success of T-cell manufacturing for infants with KMT2A-R ALL who receive chimeric antigen receptor (CAR) T- cell therapy after coming off protocol therapy.
VII. To determine predictors of response and resistance to venetoclax and overall protocol therapy.
VIII. To evaluate the impact of subsequent anti-cancer therapy on overall survival after coming off protocol therapy.
IX. To compare overall survival (OS) rates of infants by arms and to historical OS rates.
OUTLINE:
STEROID PREPHASE: All patients receive prednisone or prednisolone orally (PO) or nasogastrically (NG) three times daily (TID) or methylprednisolone intravenously (IV) TID for 7 days prior to the start of induction therapy (on days 1-7).
Patients who are KMT2A gene rearrangement positive are assigned to the safety phase cohort during the safety phase of the study, or randomized between Arm A and Arm B during the expansion phase of the study. Patients who are KMT2A gene rearrangement negative are assigned to Arm C.
SAFETY PHASE COHORT (CLOSED TO ACCRUAL 06/03/2026):
INDUCTION: Patients receive venetoclax PO or NG once daily (QD) on days 1-7, 1-10, or 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy (methotrexate, hydrocortisone, cytarabine) intrathecally (IT) on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when absolute neutrophil counts (ANC) >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-central nervous system (CNS) extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine subcutaneously (SC) QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
EXPANSION PHASE: After completion of Safety phase, patients who are KMT2A gene rearrangement positive are randomized to Arm A or Arm B.
ARM A:
INDUCTION: Patients receive daunorubicin IV over 1-15 minutes on days 1 and 2, cytarabine SC or IV over 1-30 minutes on days 1-14, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29, or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
ARM B: Patients are assigned to 1 of 4 cohorts.
COHORT 1:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA + VENETOCLAX: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, venetoclax PO or NG QD on days 22-35, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
COHORT 2:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14 and 29-42, cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
COHORT 3:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14 and 29-42, cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA + VENETOCLAX: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, venetoclax PO or NG QD on days 22-35, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
COHORT 4:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
ARM C:
INDUCTION: Patients receive daunorubicin IV over 1-15 minutes on days 1 and 2, cytarabine SC or IV over 1-30 minutes on days 1-14, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29, or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and methotrexate IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, methotrexate IT on days 8, 15, and 22, vincristine IV on days 15, 22, 43, and 50, and calaspargase pegol IV over 1-2 hours on days 15 and 43. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to interim maintenance 1 the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
INTERIM MAINTENANCE 1: Patients receive vincristine IV on days 1, 15, 29, and 43, high dose methotrexate IV over 24 hours on days 1, 15, 29, and 43, mercaptopurine PO or NG on days 1-14, 15-28, 29-42, and 43-56, methotrexate IT on days 1 and 29, and leucovorin PO or NG or IV or levoleucovorin IV on days 3-4, 17-18, 31-32, and 45-46. At the end of interim maintenance 1 (day 63), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28, and methotrexate IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive methotrexate IT on days 1, 29, and 36, dexamethasone PO, NG, or IV BID on days 1-7 and 15-21, vincristine IV on days 1, 8, 15, 43, and 50, doxorubicin IV over 3-15 minutes on days 1, 8, and 15, calaspargase pegol IV over 1-2 hours on days 4 and 43, cyclophosphamide IV over 30-60 minutes on day 29, thioguanine PO or NG on days 29-42, and cytarabine SC or IV over 1-30 minutes on days 29-32 and 36-39. At the end of delayed intensification (day 63), all patients proceed directly to interim maintenance 2 the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
INTERIM MAINTENANCE 2: Patients receive vincristine IV on days 1, 11, 21, 31, and 41, methotrexate IV push over 2-5 minutes or IV over 10-15 minutes on days 1, 11, 21, 31, and 41, methotrexate IT on days 1 and 31, and calaspargase pegol IV over 1-2 hours on days 2 and 23. At the end of interim maintenance 2 (day 56), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MAINTENANCE: Patients receive methotrexate IT on day 1 of cycles 1-3, vincristine IV on day 1 of each cycle, prednisone or prednisolone PO or NG BID or methylprednisolone IV BID on days 1-5 of each cycle, mercaptopurine PO or NG on days 1-84 of each cycle, and methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of interim maintenance 1 in the absence of disease progression or unacceptable toxicity.
All patients undergo bone marrow aspiration, collection of blood samples and echocardiography (ECHO) or multigated acquisition scan (MUGA) throughout the trial. Patients may undergo computed tomography (CT), magnetic resonance imaging (MRI), fludeoxyglucose-positron emission tomography (FDG-PET), and/or lumbar puncture if clinically indicated.
After completion of study treatment, patients are followed up for up to 3 years.
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究場所
-
-
Alabama
-
Birmingham、Alabama、アメリカ、35233
- 募集
- Children's Hospital of Alabama
-
コンタクト:
- Site Public Contact
- 電話番号:205-638-9285
- メール:oncologyresearch@peds.uab.edu
-
主任研究者:
- Matthew A. Kutny
-
-
Alaska
-
Anchorage、Alaska、アメリカ、99508
- 募集
- Providence Alaska Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:907-212-6871
- メール:AKPAMC.OncologyResearchSupport@providence.org
-
主任研究者:
- Brenda J. Wittman
-
-
Arizona
-
Mesa、Arizona、アメリカ、85202
- 募集
- Banner Children's at Desert
-
コンタクト:
- Site Public Contact
- 電話番号:480-412-3100
-
主任研究者:
- Joseph C. Torkildson
-
-
Arkansas
-
Little Rock、Arkansas、アメリカ、72202-3591
- 募集
- Arkansas Children's Hospital
-
主任研究者:
- Michael W. Bishop
-
コンタクト:
- Site Public Contact
- 電話番号:501-364-7373
-
-
California
-
Loma Linda、California、アメリカ、92354
- 募集
- Loma Linda University Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:909-558-4050
-
主任研究者:
- Albert Kheradpour
-
Long Beach、California、アメリカ、90806
- 募集
- Miller Children's and Women's Hospital Long Beach
-
コンタクト:
- Site Public Contact
- 電話番号:562-933-5600
-
主任研究者:
- Jacqueline N. Casillas
-
Oakland、California、アメリカ、94611
- 募集
- Kaiser Permanente-Oakland
-
コンタクト:
- Site Public Contact
- 電話番号:877-642-4691
- メール:Kpoct@kp.org
-
主任研究者:
- Aarati V. Rao
-
Oakland、California、アメリカ、94609
- 募集
- UCSF Benioff Children's Hospital Oakland
-
主任研究者:
- Anya Levinson
-
コンタクト:
- Site Public Contact
- 電話番号:510-428-3264
- メール:PedOncRschOAK@ucsf.edu
-
Orange、California、アメリカ、92868
- 募集
- Children's Hospital of Orange County
-
コンタクト:
- Site Public Contact
- 電話番号:714-509-8646
- メール:oncresearch@choc.org
-
主任研究者:
- Elyssa M. Rubin
-
Sacramento、California、アメリカ、95817
- 募集
- University of California Davis Comprehensive Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:916-734-3089
-
主任研究者:
- Marcio H. Malogolowkin
-
San Francisco、California、アメリカ、94158
- 募集
- UCSF Medical Center-Mission Bay
-
主任研究者:
- Anya Levinson
-
コンタクト:
- Site Public Contact
- 電話番号:877-827-3222
- メール:cancertrials@ucsf.edu
-
-
Colorado
-
Aurora、Colorado、アメリカ、80045
- 募集
- Children's Hospital Colorado
-
主任研究者:
- Kelly E. Faulk
-
コンタクト:
- Site Public Contact
- 電話番号:303-764-5056
- メール:josh.b.gordon@nsmtp.kp.org
-
-
Connecticut
-
Hartford、Connecticut、アメリカ、06106
- 募集
- Connecticut Children's Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:860-545-9981
-
主任研究者:
- Michael S. Isakoff
-
New Haven、Connecticut、アメリカ、06520
- 募集
- Yale University
-
コンタクト:
- Site Public Contact
- 電話番号:203-785-5702
- メール:canceranswers@yale.edu
-
主任研究者:
- Farzana Pashankar
-
-
Delaware
-
Wilmington、Delaware、アメリカ、19803
- 募集
- Alfred I duPont Hospital for Children
-
コンタクト:
- Site Public Contact
- 電話番号:302-651-5572
- メール:Allison.bruce@nemours.org
-
主任研究者:
- Emi H. Caywood
-
-
District of Columbia
-
Washington D.C.、District of Columbia、アメリカ、20010
- 募集
- Children's National Medical Center
-
主任研究者:
- Jeffrey S. Dome
-
コンタクト:
- Site Public Contact
- 電話番号:202-476-2800
- メール:OncCRC_OnCall@childrensnational.org
-
-
Florida
-
Gainesville、Florida、アメリカ、32610
- 募集
- UF Health Cancer Institute - Gainesville
-
主任研究者:
- Brian Stover
-
コンタクト:
- Site Public Contact
- 電話番号:352-273-8010
-
Hollywood、Florida、アメリカ、33021
- 募集
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:954-265-1847
- メール:OHR@mhs.net
-
主任研究者:
- Iftikhar Hanif
-
Jacksonville、Florida、アメリカ、32207
- 募集
- Nemours Children's Clinic-Jacksonville
-
コンタクト:
- Site Public Contact
- 電話番号:302-651-5572
- メール:Allison.bruce@nemours.org
-
主任研究者:
- Emi H. Caywood
-
Miami、Florida、アメリカ、33136
- 募集
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:305-243-2647
-
主任研究者:
- Julio C. Barredo
-
Orlando、Florida、アメリカ、32806
- 募集
- Arnold Palmer Hospital for Children
-
コンタクト:
- Site Public Contact
- 電話番号:321-841-5357
- メール:Jennifer.spinelli@orlandohealth.com
-
主任研究者:
- Zhongbo Hu
-
Orlando、Florida、アメリカ、32827
- 募集
- Nemours Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:302-651-5572
- メール:Allison.bruce@nemours.org
-
主任研究者:
- Emi H. Caywood
-
Orlando、Florida、アメリカ、32803
- 募集
- AdventHealth Orlando
-
コンタクト:
- Site Public Contact
- 電話番号:407-303-2090
- メール:FH.Cancer.Research@flhosp.org
-
主任研究者:
- Fouad M. Hajjar
-
Pensacola、Florida、アメリカ、32504
- 募集
- Nemours Children's Clinic - Pensacola
-
コンタクト:
- Site Public Contact
- メール:helpdesk@childrensoncologygroup.org
-
主任研究者:
- Jeffrey H. Schwartz
-
St. Petersburg、Florida、アメリカ、33701
- 募集
- Johns Hopkins All Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:727-767-4784
- メール:Ashley.Repp@jhmi.edu
-
主任研究者:
- Jennifer B. Dean
-
Tampa、Florida、アメリカ、33607
- 募集
- Saint Joseph's Hospital/Children's Hospital-Tampa
-
コンタクト:
- Site Public Contact
- 電話番号:813-357-0849
- メール:jennifer.manns@baycare.org
-
主任研究者:
- Don E. Eslin
-
West Palm Beach、Florida、アメリカ、33407
- 募集
- Saint Mary's Medical Center
-
主任研究者:
- Matthew D. Ramirez
-
コンタクト:
- Site Public Contact
- 電話番号:561-822-4745
-
-
Georgia
-
Atlanta、Georgia、アメリカ、30329
- 募集
- Children's Healthcare of Atlanta - Arthur M Blank Hospital
-
主任研究者:
- Melinda G. Pauly
-
コンタクト:
- Site Public Contact
- 電話番号:404-785-0232
- メール:Olivia.Floyd@choa.org
-
-
Hawaii
-
Honolulu、Hawaii、アメリカ、96826
- 募集
- Kapiolani Medical Center for Women and Children
-
コンタクト:
- Site Public Contact
- 電話番号:808-983-6090
-
主任研究者:
- Wade T. Kyono
-
-
Idaho
-
Boise、Idaho、アメリカ、83712
- 募集
- Saint Luke's Cancer Institute - Boise
-
主任研究者:
- Martha M. Pacheco
-
コンタクト:
- Site Public Contact
- 電話番号:208-381-2774
- メール:eslinget@slhs.org
-
-
Illinois
-
Chicago、Illinois、アメリカ、60611
- 募集
- Lurie Children's Hospital-Chicago
-
コンタクト:
- Site Public Contact
- 電話番号:773-880-4562
-
主任研究者:
- Sara Zarnegar-Lumley
-
Chicago、Illinois、アメリカ、60637
- 募集
- University of Chicago Comprehensive Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:773-702-8222
- メール:cancerclinicaltrials@bsd.uchicago.edu
-
主任研究者:
- Gabrielle Lapping-Carr
-
Oak Lawn、Illinois、アメリカ、60453
- 募集
- Advocate Children's Hospital-Oak Lawn
-
コンタクト:
- Site Public Contact
- 電話番号:847-723-7570
-
主任研究者:
- Rebecca E. McFall
-
Park Ridge、Illinois、アメリカ、60068
- 募集
- Advocate Children's Hospital-Park Ridge
-
コンタクト:
- Site Public Contact
- メール:helpdesk@childrensoncologygroup.org
-
主任研究者:
- Rebecca E. McFall
-
Peoria、Illinois、アメリカ、61637
- 募集
- OSF Children's Hospital of Illinois
-
主任研究者:
- Prerna Kumar
-
コンタクト:
- Site Public Contact
- 電話番号:309-624-4945
- メール:ChildrensHospitalofIllinois@osfhealthcare.org
-
Springfield、Illinois、アメリカ、62702
- 募集
- Southern Illinois University School of Medicine
-
コンタクト:
- Site Public Contact
- 電話番号:217-545-7929
-
主任研究者:
- Gregory P. Brandt
-
-
Indiana
-
Indianapolis、Indiana、アメリカ、46202
- 募集
- Riley Hospital for Children
-
コンタクト:
- Site Public Contact
- 電話番号:800-248-1199
-
主任研究者:
- Amanda Saraf
-
Indianapolis、Indiana、アメリカ、46260
- 募集
- Ascension Saint Vincent Indianapolis Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:317-338-2194
- メール:research@stvincent.org
-
主任研究者:
- Bassem I. Razzouk
-
-
Iowa
-
Des Moines、Iowa、アメリカ、50309
- 募集
- Blank Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:515-241-8912
- メール:samantha.mallory@unitypoint.org
-
主任研究者:
- Samantha L. Mallory
-
-
Kentucky
-
Lexington、Kentucky、アメリカ、40536
- 募集
- University of Kentucky/Markey Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:859-257-3379
-
主任研究者:
- James T. Badgett
-
Louisville、Kentucky、アメリカ、40202
- 募集
- Norton Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:502-629-5500
- メール:CancerResource@nortonhealthcare.org
-
主任研究者:
- Michael J. Ferguson
-
-
Louisiana
-
New Orleans、Louisiana、アメリカ、70118
- 募集
- Children's Hospital New Orleans
-
主任研究者:
- Maria C. Velez-Yanguas
-
コンタクト:
- Site Public Contact
- 電話番号:504-894-5377
-
New Orleans、Louisiana、アメリカ、70121
- 募集
- Ochsner Medical Center Jefferson
-
コンタクト:
- Site Public Contact
- 電話番号:504-842-8084
- メール:Elisemarie.curry@ochsner.org
-
主任研究者:
- Craig Lotterman
-
-
Maine
-
Scarborough、Maine、アメリカ、04074
- 募集
- Maine Children's Cancer Program
-
主任研究者:
- Sei-Gyung K. Sze
-
コンタクト:
- Site Public Contact
- 電話番号:207-396-8670
- メール:clinicalresearch@mainehealth.org
-
-
Maryland
-
Baltimore、Maryland、アメリカ、21287
- 募集
- Johns Hopkins University/Sidney Kimmel Cancer Center
-
主任研究者:
- Stacy L. Cooper
-
コンタクト:
- Site Public Contact
- 電話番号:410-955-8804
- メール:jhcccro@jhmi.edu
-
Baltimore、Maryland、アメリカ、21215
- 募集
- Sinai Hospital of Baltimore
-
主任研究者:
- Jason M. Fixler
-
コンタクト:
- Site Public Contact
- 電話番号:410-601-9083
-
-
Massachusetts
-
Boston、Massachusetts、アメリカ、02215
- 募集
- Dana-Farber Cancer Institute
-
主任研究者:
- Melissa A. Burns
-
コンタクト:
- Site Public Contact
- 電話番号:877-442-3324
-
Worcester、Massachusetts、アメリカ、01655
- 募集
- UMass Memorial Medical Center - University Campus
-
コンタクト:
- Site Public Contact
- 電話番号:508-856-3216
- メール:cancer.research@umassmed.edu
-
主任研究者:
- Stefanie R. Lowas
-
-
Michigan
-
Ann Arbor、Michigan、アメリカ、48109
- 募集
- C S Mott Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:800-865-1125
-
主任研究者:
- Joshua W. Goldman
-
Grand Rapids、Michigan、アメリカ、49503
- 募集
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:616-391-1230
- メール:crcwm-regulatory@crcwm.org
-
主任研究者:
- Kathleen Y. Butler
-
Kalamazoo、Michigan、アメリカ、49007
- 募集
- Bronson Methodist Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:616-391-1230
- メール:crcwm-regulatory@crcwm.org
-
主任研究者:
- Kathleen Y. Butler
-
-
Minnesota
-
Minneapolis、Minnesota、アメリカ、55455
- 募集
- University of Minnesota/Masonic Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:612-624-2620
-
主任研究者:
- Peter M. Gordon
-
-
Mississippi
-
Jackson、Mississippi、アメリカ、39216
- 募集
- University of Mississippi Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:601-815-6700
-
主任研究者:
- Amanda Strobel
-
-
Missouri
-
Kansas City、Missouri、アメリカ、64108
- 募集
- Children's Mercy Hospitals and Clinics
-
主任研究者:
- Keith J. August
-
コンタクト:
- Site Public Contact
- 電話番号:816-302-6808
- メール:COGResearchGroup@cmh.edu
-
St Louis、Missouri、アメリカ、63110
- 募集
- Washington University School of Medicine
-
コンタクト:
- Site Public Contact
- 電話番号:800-600-3606
- メール:info@siteman.wustl.edu
-
主任研究者:
- Laura G. Schuettpelz
-
St Louis、Missouri、アメリカ、63141
- 募集
- Mercy Hospital Saint Louis
-
コンタクト:
- Site Public Contact
- 電話番号:314-251-7066
-
主任研究者:
- Robin D. Hanson
-
-
Nebraska
-
Omaha、Nebraska、アメリカ、68114
- 募集
- Children's Hospital and Medical Center of Omaha
-
コンタクト:
- Site Public Contact
- 電話番号:402-955-3949
-
主任研究者:
- Jill C. Beck
-
-
Nevada
-
Las Vegas、Nevada、アメリカ、89135
- 募集
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
-
コンタクト:
- Site Public Contact
- 電話番号:702-384-0013
- メール:research@sncrf.org
-
主任研究者:
- Joseph L. Lasky
-
-
New Hampshire
-
Lebanon、New Hampshire、アメリカ、03756
- 募集
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
主任研究者:
- Angela Ricci
-
コンタクト:
- Site Public Contact
- 電話番号:800-639-6918
- メール:cancer.research.nurse@dartmouth.edu
-
-
New Jersey
-
Hackensack、New Jersey、アメリカ、07601
- 募集
- Hackensack University Medical Center
-
主任研究者:
- Jing Chen
-
コンタクト:
- Site Public Contact
- 電話番号:551-996-2897
-
Morristown、New Jersey、アメリカ、07960
- 募集
- Morristown Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:973-971-5900
-
主任研究者:
- Kathryn L. Laurie
-
New Brunswick、New Jersey、アメリカ、08903
- 募集
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
-
主任研究者:
- Marissa Botwinick
-
コンタクト:
- Site Public Contact
- 電話番号:732-235-8675
-
Paterson、New Jersey、アメリカ、07503
- 募集
- Saint Joseph's Regional Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:973-754-2207
- メール:HallL@sjhmc.org
-
主任研究者:
- Alissa Kahn
-
-
New York
-
Albany、New York、アメリカ、12208
- 募集
- Albany Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:518-262-5513
-
主任研究者:
- Lauren R. Weintraub
-
Buffalo、New York、アメリカ、14263
- 募集
- Roswell Park Cancer Institute
-
コンタクト:
- Site Public Contact
- 電話番号:800-767-9355
- メール:askroswell@roswellpark.org
-
主任研究者:
- Lisa Niswander
-
New Hyde Park、New York、アメリカ、11040
- 募集
- The Steven and Alexandra Cohen Children's Medical Center of New York
-
コンタクト:
- Site Public Contact
- 電話番号:718-470-3460
-
主任研究者:
- Julie I. Krystal
-
New York、New York、アメリカ、10065
- 募集
- Memorial Sloan Kettering Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:212-639-7592
-
主任研究者:
- Kavitha Ramaswamy
-
New York、New York、アメリカ、10016
- 募集
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
主任研究者:
- Elizabeth A. Raetz
-
コンタクト:
- Site Public Contact
- メール:CancerTrials@nyulangone.org
-
New York、New York、アメリカ、10065
- 募集
- NYP/Weill Cornell Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:212-746-1848
-
主任研究者:
- Jaclyn Rosenzweig
-
Rochester、New York、アメリカ、14642
- 募集
- University of Rochester
-
コンタクト:
- Site Public Contact
- 電話番号:585-275-5830
-
主任研究者:
- Carol Fries Simpson
-
Syracuse、New York、アメリカ、13210
- 募集
- State University of New York Upstate Medical University
-
コンタクト:
- Site Public Contact
- 電話番号:315-464-5476
-
主任研究者:
- Melanie A. Comito
-
The Bronx、New York、アメリカ、10467
- 募集
- Montefiore Medical Center - Moses Campus
-
コンタクト:
- Site Public Contact
- 電話番号:718-379-6866
- メール:eskwak@montefiore.org
-
主任研究者:
- Alice Lee
-
Valhalla、New York、アメリカ、10595
- 募集
- New York Medical College
-
コンタクト:
- Site Public Contact
- 電話番号:914-594-3794
-
主任研究者:
- Andrew J. Bellantoni
-
-
North Carolina
-
Chapel Hill、North Carolina、アメリカ、27599
- 募集
- UNC Lineberger Comprehensive Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:877-668-0683
- メール:cancerclinicaltrials@med.unc.edu
-
主任研究者:
- Thomas B. Alexander
-
Charlotte、North Carolina、アメリカ、28203
- 募集
- Carolinas Medical Center/Levine Cancer Institute
-
コンタクト:
- Site Public Contact
- 電話番号:800-804-9376
-
主任研究者:
- Joel A. Kaplan
-
Durham、North Carolina、アメリカ、27710
- 募集
- Duke University Medical Center
-
主任研究者:
- Jessica M. Sun
-
コンタクト:
- Site Public Contact
- 電話番号:888-275-3853
-
Greenville、North Carolina、アメリカ、27834
- 募集
- East Carolina University
-
コンタクト:
- Site Public Contact
- 電話番号:252-744-1015
- メール:eubankss@ecu.edu
-
主任研究者:
- Andrea R. Whitfield
-
Winston-Salem、North Carolina、アメリカ、27157
- 募集
- Wake Forest University Health Sciences
-
コンタクト:
- Site Public Contact
- 電話番号:336-713-6771
-
主任研究者:
- Sarah Supples
-
-
North Dakota
-
Fargo、North Dakota、アメリカ、58122
- 募集
- Sanford Broadway Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:701-323-5760
- メール:OncologyClinicalTrialsFargo@sanfordhealth.org
-
主任研究者:
- Samuel J. Milanovich
-
-
Ohio
-
Akron、Ohio、アメリカ、44308
- 募集
- Children's Hospital Medical Center of Akron
-
コンタクト:
- Site Public Contact
- 電話番号:330-543-3193
-
主任研究者:
- Lauren R. Draper
-
Cincinnati、Ohio、アメリカ、45229
- 募集
- Cincinnati Children's Hospital Medical Center
-
コンタクト:
- Site Public Contact
- 電話番号:513-636-2799
- メール:cancer@cchmc.org
-
主任研究者:
- Erin H. Breese
-
Cleveland、Ohio、アメリカ、44106
- 募集
- Rainbow Babies and Childrens Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:216-844-5437
-
主任研究者:
- Duncan S. Stearns
-
Dayton、Ohio、アメリカ、45404
- 募集
- Dayton Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:800-228-4055
-
主任研究者:
- Jordan M. Wright
-
Toledo、Ohio、アメリカ、43606
- 募集
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:419-824-1842
- メール:PCIOncResearch@promedica.org
-
主任研究者:
- Jamie L. Dargart
-
-
Oklahoma
-
Oklahoma City、Oklahoma、アメリカ、73104
- 募集
- University of Oklahoma Health Sciences Center
-
コンタクト:
- Site Public Contact
- 電話番号:405-271-8777
- メール:ou-clinical-trials@ouhsc.edu
-
主任研究者:
- Rene Y. McNall-Knapp
-
-
Pennsylvania
-
Allentown、Pennsylvania、アメリカ、18103
- 募集
- Lehigh Valley Hospital-Cedar Crest
-
コンタクト:
- Site Public Contact
- 電話番号:610-402-9543
- メール:Morgan_M.Horton@lvhn.org
-
主任研究者:
- Jacob A. Troutman
-
Danville、Pennsylvania、アメリカ、17822
- 募集
- Geisinger Medical Center
-
主任研究者:
- Jagadeesh Ramdas
-
コンタクト:
- Site Public Contact
- 電話番号:570-271-5251
- メール:cancerresearch@geisinger.edu
-
Hershey、Pennsylvania、アメリカ、17033
- 募集
- Penn State Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:717-531-6012
-
主任研究者:
- Lisa M. McGregor
-
Philadelphia、Pennsylvania、アメリカ、19104
- 募集
- Children's Hospital of Philadelphia
-
コンタクト:
- Site Public Contact
- 電話番号:267-425-5544
- メール:CancerTrials@email.chop.edu
-
主任研究者:
- Kathrin M. Bernt
-
Pittsburgh、Pennsylvania、アメリカ、15224
- 募集
- Children's Hospital of Pittsburgh of UPMC
-
コンタクト:
- Site Public Contact
- 電話番号:412-692-8570
- メール:jean.tersak@chp.edu
-
主任研究者:
- Jenny Ruiz
-
-
Rhode Island
-
Providence、Rhode Island、アメリカ、02903
- 募集
- Rhode Island Hospital
-
主任研究者:
- Bradley DeNardo
-
コンタクト:
- Site Public Contact
- 電話番号:401-444-1488
-
-
South Carolina
-
Columbia、South Carolina、アメリカ、29203
- 募集
- Prisma Health Richland Hospital
-
主任研究者:
- Stuart L. Cramer
-
コンタクト:
- Site Public Contact
- 電話番号:864-522-4317
- メール:Kim.Williams3@prismahealth.org
-
Greenville、South Carolina、アメリカ、29605
- 募集
- BI-LO Charities Children's Cancer Center
-
主任研究者:
- Aniket Saha
-
コンタクト:
- Site Public Contact
- 電話番号:864-522-4317
- メール:Kim.Williams3@prismahealth.org
-
-
South Dakota
-
Sioux Falls、South Dakota、アメリカ、57117-5134
- 募集
- Sanford USD Medical Center - Sioux Falls
-
コンタクト:
- Site Public Contact
- 電話番号:605-312-3320
- メール:OncologyClinicalTrialsSF@SanfordHealth.org
-
主任研究者:
- Jordan Fritch-Hanson
-
-
Tennessee
-
Knoxville、Tennessee、アメリカ、37916
- 募集
- East Tennessee Childrens Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:865-541-8266
-
主任研究者:
- Susan E. Spiller
-
Memphis、Tennessee、アメリカ、38105
- 募集
- Saint Jude Children's Research Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:888-226-4343
- メール:referralinfo@stjude.org
-
主任研究者:
- Matthew Rees
-
Nashville、Tennessee、アメリカ、37232
- 募集
- Vanderbilt University/Ingram Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:800-811-8480
-
主任研究者:
- Brianna N. Smith
-
Nashville、Tennessee、アメリカ、37203
- 募集
- The Children's Hospital at TriStar Centennial
-
コンタクト:
- Site Public Contact
- 電話番号:615-342-1919
-
主任研究者:
- Clinton M. Carroll
-
-
Texas
-
Austin、Texas、アメリカ、78723
- 募集
- Dell Children's Medical Center of Central Texas
-
コンタクト:
- Site Public Contact
- 電話番号:512-628-1902
- メール:TXAUS-DL-SFCHemonc.research@ascension.org
-
主任研究者:
- Shannon M. Cohn
-
Corpus Christi、Texas、アメリカ、78411
- 募集
- Driscoll Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:361-694-5311
- メール:Crystal.DeLosSantos@dchstx.org
-
主任研究者:
- Nkechi I. Mba
-
Dallas、Texas、アメリカ、75390
- 募集
- UT Southwestern/Simmons Cancer Center-Dallas
-
コンタクト:
- Site Public Contact
- 電話番号:214-648-7097
- メール:canceranswerline@UTSouthwestern.edu
-
主任研究者:
- Caroline Smith
-
Dallas、Texas、アメリカ、75230
- 募集
- Medical City Dallas Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:972-566-5588
-
主任研究者:
- Maurizio L. Ghisoli
-
El Paso、Texas、アメリカ、79905
- 募集
- El Paso Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:915-298-5444
- メール:ranjan.bista@ttuhsc.edu
-
主任研究者:
- Benjamin Carcamo
-
Fort Worth、Texas、アメリカ、76104
- 募集
- Cook Children's Medical Center
-
主任研究者:
- Holly Pacenta
-
コンタクト:
- Site Public Contact
- 電話番号:682-885-2103
- メール:CookChildrensResearch@cookchildrens.org
-
Houston、Texas、アメリカ、77030
- 募集
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
主任研究者:
- Joanna S. Yi
-
コンタクト:
- Site Public Contact
- 電話番号:713-798-1354
- メール:burton@bcm.edu
-
San Antonio、Texas、アメリカ、78207
- 募集
- Children's Hospital of San Antonio
-
コンタクト:
- Site Public Contact
- 電話番号:210-704-2894
- メール:bridget.medina@christushealth.org
-
主任研究者:
- Julie Voeller
-
San Antonio、Texas、アメリカ、78229
- 募集
- Methodist Children's Hospital of South Texas
-
コンタクト:
- Site Public Contact
- 電話番号:210-575-6240
- メール:Vinod.GidvaniDiaz@hcahealthcare.com
-
主任研究者:
- Jose M. Esquilin
-
Temple、Texas、アメリカ、76508
- 募集
- Scott and White Memorial Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:254-724-5407
-
主任研究者:
- Nicholas W. McGregor
-
-
Virginia
-
Charlottesville、Virginia、アメリカ、22908
- 募集
- University of Virginia Cancer Center
-
コンタクト:
- Site Public Contact
- 電話番号:434-243-6303
- メール:uvacancertrials@hscmail.mcc.virginia.edu
-
主任研究者:
- Brian C. Belyea
-
Norfolk、Virginia、アメリカ、23507
- 募集
- Children's Hospital of The King's Daughters
-
コンタクト:
- Site Public Contact
- 電話番号:757-668-7243
- メール:CCBDCresearch@chkd.org
-
主任研究者:
- Melissa S. Mark
-
Richmond、Virginia、アメリカ、23298
- 募集
- VCU Massey Comprehensive Cancer Center
-
主任研究者:
- Jordyn R. Griffin
-
コンタクト:
- Site Public Contact
- 電話番号:804-628-6430
- メール:CTOclinops@vcu.edu
-
Roanoke、Virginia、アメリカ、24014
- 募集
- Carilion Children's
-
コンタクト:
- Site Public Contact
- 電話番号:540-266-6238
- メール:wpmccarty@carilionclinic.org
-
主任研究者:
- Erwood G. Edwards
-
-
Washington
-
Seattle、Washington、アメリカ、98105
- 募集
- Seattle Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:866-987-2000
-
主任研究者:
- Sarah E. Leary
-
Spokane、Washington、アメリカ、99204
- 募集
- Providence Sacred Heart Medical Center and Children's Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:800-228-6618
- メール:HopeBeginsHere@providence.org
-
主任研究者:
- Judy L. Felgenhauer
-
-
Wisconsin
-
Green Bay、Wisconsin、アメリカ、54301
- 募集
- Saint Vincent Hospital Cancer Center Green Bay
-
主任研究者:
- Catherine A. Long
-
コンタクト:
- Site Public Contact
- 電話番号:920-433-8889
- メール:WI_research_admin@hshs.org
-
Milwaukee、Wisconsin、アメリカ、53226
- 募集
- Children's Hospital of Wisconsin
-
コンタクト:
- Site Public Contact
- 電話番号:414-955-4727
- メール:MACCCTO@mcw.edu
-
主任研究者:
- Zachary Graff
-
-
-
-
-
San Juan、プエルトリコ、00926
- 募集
- University Pediatric Hospital
-
コンタクト:
- Site Public Contact
- 電話番号:787-474-0333
-
主任研究者:
- Maria E. Echevarria
-
-
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
Inclusion Criteria:
-
All patients must be enrolled on APEC14B1 and consented to eligibility screening (part A) prior to treatment and enrollment on AALL2321
-
Infants (aged 365 days or less) on the date of diagnosis are eligible; infants must be > 36 weeks gestational age (cumulative prenatal and postnatal age must be > 36 weeks) at the time of enrollment
-
Patients must have newly diagnosed B-acute lymphoblastic leukemia (B-ALL, 2017 World Health Organization [WHO] classification), also termed B-precursor ALL, or acute leukemia of ambiguous lineage (ALAL), which includes mixed phenotype acute leukemia. For patients with ALAL, the immunophenotype of the leukemia must comprise at least 50% B lineage
- Diagnostic immunophenotype: Leukemia cells must express CD19
Exclusion Criteria:
-
Patients with Down Syndrome
-
Patients with secondary B-ALL that developed after treatment of a prior malignancy with cytotoxic chemotherapy
-
Patients must not have received any cytotoxic chemotherapy for either the current diagnosis of infant ALL or for any cancer diagnosis prior to the initiation of protocol therapy, with the exception of:
-
Steroid pretreatment:
- PredniSONE, prednisoLONE, or methylPREDNISolone for ≤ 72 hours (3 days) in the 7 days prior to enrollment. The dose of predniSONE, prednisoLONE or methylPREDNISolone does not affect eligibility
- Inhaled and topical steroids are not considered pretreatment
- Note: Pretreatment with dexamethasone in the 28 days prior to initiation of protocol therapy is not allowed with the exception of a single dose of dexamethasone used during or within 6 hours prior to or after sedation to prevent or treat airway edema. However, prior exposure to ANY steroids that occurred > 28 days before enrollment does not affect eligibility
-
Intrathecal cytarabine or methotrexate:
- An intrathecal dose of cytarabine or methotrexate in the 7 days prior to enrollment does not affect eligibility
- Note: The preference is to defer the diagnostic lumbar puncture with intrathecal chemotherapy to day 1 of induction to allow for cytoreduction of circulating blasts and decrease the potential for central nervous system (CNS) contamination due to a traumatic tap. If done prior to day 1 of induction, these results will be used to determine CNS status
-
Hydroxyurea:
- Pretreatment with ≤ 72 hours (3 days) of hydroxyurea in the 7 days prior to enrollment does not affect eligibility
-
-
All patients and/or their parents or legal guardians must sign a written informed consent
-
All institutional, Food and Drug Administration (FDA) and National Cancer Institute (NCI) requirements for human studies must be met
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
- 介入モデル:順次割り当て
- 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:Arm A
See Detailed Description for Arm A. |
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Given IV
他の名前:
Undergo bone marrow aspiration Given IV
他の名前:
Undergo lumbar puncture
他の名前:
Undergo collection of blood samples
他の名前:
Given IV
他の名前:
Given IT
他の名前:
Given recombinant crisantaspase IM or crisantaspase IM or IV
他の名前:
Given IT or IV
他の名前:
Given PO or NG or IV
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG or IV
他の名前:
Given IV
他の名前:
Given PO or NG
他の名前:
Given IT or IV or PO or NG
他の名前:
Given PO or NG
他の名前:
|
|
実験的:Arm B, Cohort 1
See Detailed Description for Arm B, Cohort 1. |
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Given IV
他の名前:
Undergo bone marrow aspiration Given IV
他の名前:
Undergo lumbar puncture
他の名前:
Undergo collection of blood samples
他の名前:
Given IV
他の名前:
Given IT
他の名前:
Given recombinant crisantaspase IM or crisantaspase IM or IV
他の名前:
Given IT or IV
他の名前:
Given PO or NG or IV
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG or IV
他の名前:
Given IV
他の名前:
Given PO or NG
他の名前:
Given IT or IV or PO or NG
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
|
|
実験的:Arm B, Cohort 2
See Detailed Description for Arm B, Cohort 2. |
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Given IV
他の名前:
Undergo bone marrow aspiration Given IV
他の名前:
Undergo lumbar puncture
他の名前:
Undergo collection of blood samples
他の名前:
Given IV
他の名前:
Given IT
他の名前:
Given recombinant crisantaspase IM or crisantaspase IM or IV
他の名前:
Given IT or IV
他の名前:
Given PO or NG or IV
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG or IV
他の名前:
Given IV
他の名前:
Given PO or NG
他の名前:
Given IT or IV or PO or NG
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
|
|
実験的:Arm B, Cohort 3
See Detailed Description for Arm B, Cohort 3. |
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Given IV
他の名前:
Undergo bone marrow aspiration Given IV
他の名前:
Undergo lumbar puncture
他の名前:
Undergo collection of blood samples
他の名前:
Given IV
他の名前:
Given IT
他の名前:
Given recombinant crisantaspase IM or crisantaspase IM or IV
他の名前:
Given IT or IV
他の名前:
Given PO or NG or IV
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG or IV
他の名前:
Given IV
他の名前:
Given PO or NG
他の名前:
Given IT or IV or PO or NG
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
|
|
実験的:Arm B, Cohort 4
See Detailed Description for Arm B, Cohort 4. |
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Given IV
他の名前:
Undergo bone marrow aspiration Given IV
他の名前:
Undergo lumbar puncture
他の名前:
Undergo collection of blood samples
他の名前:
Given IV
他の名前:
Given IT
他の名前:
Given recombinant crisantaspase IM or crisantaspase IM or IV
他の名前:
Given IT or IV
他の名前:
Given PO or NG or IV
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG or IV
他の名前:
Given IV
他の名前:
Given PO or NG
他の名前:
Given IT or IV or PO or NG
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
|
|
実験的:Arm C
See Detailed Description for Arm C. |
Given IV
他の名前:
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Given IV
他の名前:
Undergo bone marrow aspiration Given IV
他の名前:
Undergo lumbar puncture
他の名前:
Given IV
他の名前:
Undergo collection of blood samples
他の名前:
Given IV
他の名前:
Given IT
他の名前:
Given IT or IV
他の名前:
Given PO or NG or IV
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG or IV
他の名前:
Given IV
他の名前:
Given PO or NG
他の名前:
Given IT or IV or PO or NG
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
|
|
実験的:Safety Phase Cohort
See Detailed Description for Safety Phase Cohort. (CLOSED TO ACCRUAL 06/03/2026) |
Given IV
他の名前:
Given IV
他の名前:
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Given IV
他の名前:
Undergo bone marrow aspiration Given IV
他の名前:
Undergo lumbar puncture
他の名前:
Undergo collection of blood samples
他の名前:
Given IV
他の名前:
Given IT
他の名前:
Given recombinant crisantaspase IM or crisantaspase IM or IV
他の名前:
Given IT or IV
他の名前:
Given PO or NG or IV
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG or IV
他の名前:
Given IV
他の名前:
Given PO or NG
他の名前:
Given IT or IV or PO or NG
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
|
|
実験的:Steroid Prephase(prednisone, prednisolone, methylprednisolone)
All patients receive prednisone or prednisolone PO or NG TID or methylprednisolone IV TID for 7 days prior to the start of induction therapy (on days 1-7). |
Undergo CT
他の名前:
Undergo MRI
他の名前:
Undergo ECHO
他の名前:
Undergo MUGA
他の名前:
Undergo bone marrow aspiration Undergo lumbar puncture
他の名前:
Given IV
他の名前:
Undergo collection of blood samples
他の名前:
Undergo FDG-PET
他の名前:
Given PO or NG
他の名前:
Given PO or NG
他の名前:
|
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 |
|---|---|---|
|
Incidence of dose-limiting toxicities (DLTs) (safety phase)
時間枠:For the duration of the induction + venetoclax cycle
|
For the safety phase, DLTs of the induction + venetoclax cycle of KMT2A-rearranged (R) patients will be assessed. |
For the duration of the induction + venetoclax cycle
|
|
Incidence of DLTs (expansion phase)
時間枠:During the induction, consolidation, and MARMA cycles of Arm B
|
For the expansion phase, DLTs of Arm B will be assessed and monitored for the cycles that contain venetoclax (induction, consolidation, and MARMA cycles of Arm B). |
During the induction, consolidation, and MARMA cycles of Arm B
|
|
Minimal residual disease (MRD)-negative remission rate
時間枠:At the end of induction
|
The end of induction MRD-negative remission rate will be compared between Arm A and Arm B. MRD negativity is defined as achievement of complete remission and MRD < 0.01% by flow cytometry. The MRD-negative remission rate at the end of induction between Arm A and Arm B will be compared using a one-sided Z test of proportions with Type I error of 0.15. |
At the end of induction
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
MRD-negative remission rate
時間枠:At the end of induction
|
MRD-negative remission rate at the end of induction and the standard error or 95% confidence interval will be estimated among infants with KMT2A-R acute lymphoblastic leukemia (ALL) treated with venetoclax at the RP2D. This analysis will include eligible KMT2A-R patients treated with venetoclax at the RP2D in the safety phase, as well as patients randomized to Arm B and treated with venetoclax in the expansion phase. MRD negativity is defined as < 0.01% by flow cytometry. |
At the end of induction
|
|
Event free survival (EFS) rates of infants with KMT2A-R ALL
時間枠:From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
The EFS rates from date of randomization of Arm B will be compared to Arm A. Comparison of EFS rates between Arm A and Arm B will be based on a one-sided logrank test with Type I error of 0.15. In addition, EFS rates will be estimated using the Kaplan-Meier method with Greenwood standard errors. Hazard ratios and confidence intervals will be estimated based on Cox regression models as appropriate. Cumulative incidence rates of each EFS event type (relapse, treatment failure, secondary malignant neoplasm and death) will also be estimated and presented with cumulative incidence curves and compared between arms as appropriate. |
From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
3-year EFS of infants with KMT2A-R ALL
時間枠:From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
For Arm A, the 3-year EFS rate (representing a plateau rate based on the shape of EFS curves of historical data in this patient population) from the date of randomization will be compared to the stable historical 3-year EFS rate of 35% observed in AALL0631 and other international trials. |
From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
Proportion of KMT2A-germline (G) patients in Arm C who are able to receive all treatment cycles before maintenance
時間枠:Up to interim maintenance 2
|
The feasibility of treating KMT2A-G patients with a high-risk ALL backbone and two cycles of blinatumomab (Arm C) will be assessed. Arm C treatment will be considered feasible for KMT2A-G patients if the proportion of KMT2A-G patients in Arm C who are able to receive all treatment cycles before maintenance (i.e., up to interim maintenance 2) is more than 76.8%. The proportion of patients receiving all cycles before Maintenance will be compared to 76.8% with a one-sample exact test of proportion with Type I error of 0.15. |
Up to interim maintenance 2
|
|
3-year EFS of infants with KMT2A-G ALL treated on Arm C
時間枠:From date of enrollment to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
The 3-year EFS rate from date of enrollment of KMT2A-G patients in Arm C will be estimated with the Kaplan-Meier method. |
From date of enrollment to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
Pharmacokinetics (PK) of venetoclax in infants
時間枠:On days 7, 10, and 14 of induction
|
PK samples will be collected from patients enrolled in the safety phase of the study as well as from patients randomized to Arm B in the expansion phase who consent to participate, to determine the major secondary objective of characterizing the PK of venetoclax in infants. PK samples will be evaluated in batches and standard nonlinear mixed effect modeling will be used for model building and refinement of time-concentration data. After model refinement, a non-parametric bootstrap analysis will be performed reporting the 95% confidence intervals for each PK parameter. |
On days 7, 10, and 14 of induction
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
3-year EFS of infants with KMT2A-R ALL treated on Arm B
時間枠:From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
Arm B, the 3-year EFS rate from date of randomization will be estimated, and will be compared to Arm A as described in the secondary objective, and to historical 3-year EFS. Comparison to historical rate will be based on a one-sample test of proportion with one-sided Type I error of 0.15. |
From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
Use of high-throughput sequencing (HTS) for MRD detection in infant ALL compared to centralized flow cytometry
時間枠:Up to 3 years
|
Pre-treatment HTS clonality and HTS MRD tracking results will be collected and compared to the required centralized flow cytometry-based MRD data to evaluate the feasibility and prognostic utility of HTS MRD evaluation in the infant ALL population. |
Up to 3 years
|
|
PK of calaspargase pegol in infants with ALL
時間枠:At completion of the trial, up to 3 years
|
PK of calaspargase pegol will be analyzed by monitoring asparaginase activity levels. Once a PK model is developed for calaspargase pegol, standard regression analysis will be used to describe the relationship between drug exposure and asparaginase activity. Additionally, asparaginase-associated toxicities will be described for the entire study population and correlated with activity levels when possible. The result of this analysis will be an estimation of potential optimal exposure expected to yield the maximum efficacy while limiting toxicity. These analyses will be exploratory and descriptive. |
At completion of the trial, up to 3 years
|
|
Incidence of CD19-negative relapse and myeloid switch relapse with protocol therapy
時間枠:At the time of relapse, up to 3 years
|
For patients who experience relapse, will collect information regarding the immunophenotype of the leukemic blasts at time of relapse. Will report on the rate of CD19 negative relapse as well as myeloid switch relapse for all patients enrolled on study. This analysis will be exploratory and descriptive. |
At the time of relapse, up to 3 years
|
|
Impact of venetoclax in combination with chemotherapy on T-cell subsets and function
時間枠:Prior to and following the first course of venetoclax
|
BCL-2 inhibition is reported to alter T-cell subsets, including increased activation, enhanced cytotoxicity against leukemia cells and heightened resistance to cell death. Peripheral blood and bone marrow samples will be collected prior to and following the first course of venetoclax to evaluate effects on T-cell subsets and function following venetoclax exposure. |
Prior to and following the first course of venetoclax
|
|
Feasibility of T-cell collection and success of T-cell manufacturing for infants with KMT2A-R ALL who receive chimeric antigen receptor (CAR) T-cell therapy
時間枠:After coming off protocol therapy
|
For patients that undergo T-cell collection, will collect data regarding the feasibility of T-cell collection in the context of protocol therapy. Additionally, for patients who proceed with CAR T-cell therapy after coming off protocol therapy, will collect data regarding the success of T-cell manufacturing, infusion and response to therapy in this young population, as the success of this subsequent therapy may be heavily impacted by the effect of protocol therapy on T-cell function. These analyses will be exploratory and descriptive. |
After coming off protocol therapy
|
|
Predictors of response and resistance to venetoclax and overall protocol therapy
時間枠:Before and after venetoclax exposure, up to 3 years
|
Will study the inter- and intra- patient variability in the expression of apoptotic proteins (e.g., BCL-2, MCL-1, BCL-XL) and apoptotic priming at diagnosis and identify changes that occur during induction therapy in relationship to venetoclax exposure. Will then determine whether the state of BCL-2 specific apoptotic priming correlates with outcome. Will also integrate genomic and molecular features (such as developmental state, signaling, epigenomic, transcriptomic, proteomic and metabolomic states) before and after venetoclax exposure, for those assays where this type of analysis is feasible, to determine biomarkers of response and resistance to therapy for infants with ALL. |
Before and after venetoclax exposure, up to 3 years
|
|
Impact of subsequent anti-cancer therapy on overall survival
時間枠:After coming off protocol therapy
|
For all patients who remain in study follow-up after coming off protocol therapy, data will be collected regarding subsequent cancer directed therapies received as well as relapse and survival status in order to evaluate the impact of subsequent cancer directed therapy on the overall survival of patients enrolled on this study. These analyses will be exploratory and descriptive. |
After coming off protocol therapy
|
|
Overall survival (OS) rates
時間枠:From randomization to death due to any cause, up to 3 years
|
Will compare OS rates of infants by arms and to historical OS rates. The OS rates from the date of randomization of patients with KMT2A-R ALL will be compared between Arm A and Arm B. Comparison of OS rates between Arm A and Arm B will be based on a one-sided logrank test with Type I error of 0.15. In addition, OS rates of KMT2A-R patients in Arm A and Arm B will be compared to historical rates observed in similar patients in completed studies such as AALL0631 or AALL15P1. In addition, OS from enrollment of KMT2A-G patients will be compared to historical rates. OS rates will be estimated using the Kaplan-Meier method with Greenwood standard errors. Hazard ratios and confidence intervals will be estimated based on Cox regression models as appropriate. These analyses will be largely exploratory. |
From randomization to death due to any cause, up to 3 years
|
協力者と研究者
捜査官
- 主任研究者:Erin H Breese、Children's Oncology Group
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
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 (実際)
学習記録の更新
投稿された最後の更新 (実際)
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
追加の関連 MeSH 用語
- 新生物
- 免疫系疾患
- 感染症
- ウイルス病
- 組織型別の新生物
- 血液疾患
- DNAウイルス感染症
- リンパ疾患
- リンパ増殖性疾患
- 免疫増殖性疾患
- リンパ腫、非ホジキン
- リンパ腫、B細胞
- リンパ腫
- 白血病、リンパ
- 白血病
- エプスタイン-バーウイルス感染症
- ヘルペスウイルス感染症
- 腫瘍ウイルス感染症
- ヘミックおよびリンパ疾患
- バーキットリンパ腫
- 白血病、二表現型、急性
- ホルモン
- ホルモン、ホルモン代替品、ホルモン拮抗薬
- 硫黄化合物
- 有機化学物質
- 複素環化化合物、1リング
- 複素環化化合物
- 複素環化化合物、2リング
- 複素環化化合物、融合リング
- 調査手法
- 治療
- 臨床検査技術
- 診断技術と手順
- 診断
- パンク
- 外科的処置、手術
- 核酸、ヌクレオチド、およびヌクレオシド
- 生検
- 炭化水素
- 炭化水素、周期的
- 炭水化物
- アルカロイド
- 多環芳香族炭化水素
- 炭化水素、芳香
- 多環式化合物
- グリコシド
- ヒドロラーゼ
- 酵素
- 酵素と補酵素
- インドール
- プリン
- シチジン
- ピリミジンヌクレオシド
- ピリミジン
- 妊娠
- 妊娠
- ステロイド
- 融合リング化合物
- ステロイド、フッ素化
- ベンゼン誘導体
- 化学技術、分析
- スルホン酸
- 硫酸
- スペクトル分析
- ホスホルアミドマスタード
- 窒素マスタード化合物
- マスタード化合物
- 炭化水素、ハロゲン化
- ホスホラミド
- 有機リン化合物
- ヌクレオシド
- ホルミルテトラヒドロフォレート
- テトラヒドロフォレート
- 葉酸
- 羽毛
- プテリジン
- 妊娠症
- 妊娠した
- アミドヒドロラーゼ
- ヴィンカアルカロイド
- セコロガニントリプタミンアルカロイド
- インドールアルカロイド
- インドリジジン
- インドリジン
- アラビノヌクレオシド
- アミノプテリン
- アントラサイクリン
- ナフテセン
- アミノグリコシド
- コエンザイム
- 妊娠
- 妊娠
- 11-ヒドロキシコルチコステロイド
- ヒドロキシコルチコステロイド
- 副腎皮質ホルモン
- 17-ヒドロキシコルチコステロイド
- 診断技術、神経学的
- ベンゼンスルホン酸塩
- アリルスルホン酸塩
- アリールスルホン酸
- スルフヒドリル化合物
- デキサメタゾン
- メトトレキサート
- プレドニン
- プレドニゾロン
- シクロホスファミド
- シタラビン
- ロイコボリン
- レボルイコボリン
- ドキソルビシン
- ビンクリスチン
- メチルプレドニゾロン
- ダウノルビシン
- ヒドロコルチゾン
- アスパラギナーゼ
- メルカプトプリン
- チオグアニン
- ドベシル酸カルシウム
- 標本処理
- 磁気共鳴分光法
- ベネトクラックス
- Blinatumomab
- 脊髄穿刺
- デキサメタゾン21-リン酸
- デルタコルテン
- プレシリデン
- N、n-dicyclohexyl-isoborneol-10-スルホンアミド
- CALASPARGASE PEGOL
- アザチオプリン
- メルフォス
- Auricularum
- デキサメタゾン酢酸
- アスパラギナーゼErwinia chrysanthemi組換え
- exifone
- Medrol Veriderm
その他の研究ID番号
- NCI-2024-01994
- U10CA180886 (米国 NIH グラント/契約)
- NCI-2024-01994 (レジストリ識別子:CTRP (Clinical Trial Reporting Program))
- AALL2321 (その他の識別子:CTEP)
- AALL2321 (その他の識別子:Children's Oncology Group)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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。