신규 진단 또는 재발 또는 불응성 급성 골수성 백혈병 환자 치료에서 병용 화학 요법과 Venetoclax
새로 진단되거나 재발/불응성 AML 환자를 대상으로 FLAG-IDA와 함께 표준 집중 AML 유도/공고 요법과 병용한 BCL-2 억제제 Venetoclax의 1b/2상 연구
This phase Ib/II trial studies the best dose and side effects of venetoclax and how well it works when given with combination chemotherapy in treating patients with newly diagnosed acute myeloid leukemia or acute myeloid leukemia that has come back or does not respond to treatment. Venetoclax may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as fludarabine, cytarabine, filgrastim and idarubicin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving venetoclax together with combination chemotherapy may work better in treating patients with acute myeloid leukemia.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
상세 설명
PRIMARY OBJECTIVES:
I. To evaluate the safety and tolerability and to determine the dose-limiting toxicity and the maximum tolerated dose MTD of the combination of fludarabine, cytarabine, filgrastim (GCSF), idarubicin (FLAG-IDA) + venetoclax for patients with acute myeloid leukemia (AML) (Phase 1b).
II. To determine the overall activity of this combination in patients newly diagnosed or relapsed/refractory (AML) (Phase 2).
SECONDARY OBJECTIVES:
I. Determine the preliminary assessment of efficacy by response to revised International Working Group (IWG) criteria and time to response variables including overall survival (OS), event-free survival (EFS) and duration of response (DOR).
II. Determine biomarkers that may be predictive of venetoclax activity.
OUTLINE: This is a phase I, dose-escalation study of venetoclax followed by a phase II study.
INDUCTION THERAPY: Patients receive venetoclax orally (PO) on days 1-14, fludarabine intravenously (IV) over 30 minutes on days 2-6, cytarabine IV over 4 hours on days 2-6, idarubicin IV over 15-30 minutes on days 4 and 5, filgrastim subcutaneously (SC) on days 1-7, or pegfilgrastim SC after day 5. Treatment repeats every 28 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity.
CONSOLIDATION THERAPY: Patients receive venetoclax PO on days 1-7, fludarabine IV over 30 minutes on days 2-4, cytarabine IV over 4 hours on days 2-4, filgrastim SC on days 1-7, or pegfilgrastim SC after days 3. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients may also receive idarubicin as in Induction Therapy during 1 cycle of Consolidation Therapy per the treating physician.
MAINTENANCE THERAPY: Patients receive venetoclax PO on days 1-28. Cycles repeat every 28 days for up to 1 year in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up within 30 days.
연구 유형
연구 유형
등록 (추정된)
등록
단계
단계
- 2 단계
- 1단계
연락처 및 위치
연구 연락처
연구 연락처
- 이름: DiNardo, MD
- 전화번호: (713) 794-1141
- 이메일: cdinardo@mdanderson.org
연구 장소
-
-
Texas
-
Houston, Texas, 미국, 77030
- 모병
- M D Anderson Cancer Center
-
연락하다:
- Courtney DiNardo
- 전화번호: 713-794-1141
- 이메일: cdinardo@mdanderson.org
-
수석 연구원:
- Courtney DiNardo
-
-
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Diagnosis of AML by World Health Organization (WHO) criteria. Patients with high risk myelodysplastic syndrome (MDS) as defined by the presence of >= 10% blasts are also eligible at the discretion of the principal investigator
- Patients older than 65 who are deemed fit to receive intensive chemotherapy by the treating physician will be eligible after discussion with the principal investigator (PI).
- Eastern Cooperative Oncology Group (ECOG) performance status of =< 2
- Creatinine clearance >= 30 mL/min based on the Cockcroft-Gault equation
- Total bilirubin < 1.5 x upper limit of normal (ULN) unless increase is due to Gilbert's disease or leukemic involvement
- Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) < 3 x ULN unless considered due to leukemic involvement
- Ability to understand and provide signed informed consent
- Male subjects must agree to refrain from unprotected sex and sperm donation from initial study drug administration until 90 days after the last dose of study drug
- Only patients who are relapsed, refractory, or intolerant of standard AML therapy will be eligible for Part 1 (minimum of 1 prior line of AML-directed therapy)
Exclusion Criteria:
- Patients with t(15;17) karyotypic abnormality or acute promyelocytic leukemia (French-American-British [FAB] class M3-AML)
- Patients having received any prior BCL2 inhibitor therapy
- Subject has known active central nervous system (CNS) involvement with AML
- Patients with New York Heart Association (NYHA) class III or IV congestive heart failure or left ventricular ejection fraction (LVEF) < 40% by echocardiogram or multi-gated acquisition (MUGA) scan
- Patients with a history of myocardial infarction within the last 6 months or unstable / uncontrolled angina pectoris or history of severe and/or uncontrolled ventricular arrhythmias
- Patients with known infection with human immunodeficiency virus (HIV) or active hepatitis B or C
- Patients with known dysphagia, short-gut syndrome, or other conditions that would affect the ingestion or gastrointestinal absorption of drugs administered orally
- Subject has any other significant medical or psychiatric history that in the opinion of the investigator would adversely affect participation in this study
- Subject has a white blood cell count > 25 x 10{9}/L. (Note: hydroxyurea is permitted to meet this criterion)
- Nursing women, women of childbearing potential (WOCBP) with positive urine pregnancy test, or women of childbearing potential who are not willing to maintain adequate contraception (a) appropriate method(s) of contraception include oral or injectable hormonal birth control, intrauterine device (IUD), and double barrier methods (for example a condom in combination with a spermicide)
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
|
실험적: Treatment (venetoclax, FLAG-IDA)
See detailed description. |
Given IV
다른 이름들:
Given IV
다른 이름들:
Given PO
다른 이름들:
Given SC
다른 이름들:
Given IV
다른 이름들:
Given SC
다른 이름들:
|
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Overall response rate (ORR)
기간: Up to 6 years
|
Defined as complete response (CR) + CR with incomplete blood count recovery (CRi) + partial response (PR). Will be estimated along with the 95% credible interval. |
Up to 6 years
|
|
CR/CRi rate
기간: Up to 6 years
|
Will be estimated along with the 95% credible interval. |
Up to 6 years
|
|
Hematologic response
기간: Up to 6 years
|
Will be estimated along with the 95% credible interval. |
Up to 6 years
|
|
Duration of response
기간: From the date of initial response, assessed up to 6 years
|
Defined as the number of days from the date of initial response (PR or better) to the date of first documented disease progression/relapse or death, whichever occurs first. Will be calculated for all patients. |
From the date of initial response, assessed up to 6 years
|
|
Event-free survival
기간: From the date of treatment initiation, assessed up to 6 years
|
Defined as the number of days from the date of treatment initiation (i.e., course 1 day 1) to the date of documented treatment failure, relapses from CR, or death from any cause, whichever occurs first. Will be calculated for all patients. Estimated using Kaplan-Meier method. Log-rank tests will be used to compare among subgroups of patients. |
From the date of treatment initiation, assessed up to 6 years
|
|
Overall survival
기간: Up to 6 years
|
Estimated using Kaplan-Meier method. Log-rank tests will be used to compare among subgroups of patients. |
Up to 6 years
|
|
Anti-tumor activity
기간: Up to 6 years
|
Will be summarized graphically and with descriptive statistics. |
Up to 6 years
|
|
Pharmacodynamic markers
기간: Up to 6 years
|
Two samples t-test /Wilcoxon rank sum tests will be used to compare pharmacodynamics/pharmacokinetics (PD/PK) parameters between responder and non-responders, and logistic regression analysis will also be used to evaluate the association of PD/PK parameters with response. |
Up to 6 years
|
|
Drug exposure levels
기간: Up to 6 years
|
Will be summarized graphically and with descriptive statistics. |
Up to 6 years
|
|
Overall incidence and severity of all adverse events
기간: Up to 6 years
|
Graded using Common Toxicity Criteria version 4.0. Safety data will be summarized using frequency and percentage, by category and severity. |
Up to 6 years
|
2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Morphologic leukemia-free state
기간: Up to 6 years
|
Will be estimated along with the 95% credible interval. |
Up to 6 years
|
기타 결과 측정
기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Exploratory biomarkers
기간: Up to 6 years
|
Will be summarized graphically and with descriptive statistics. Peripheral blood and bone marrow aspirate samples will be obtained at study specified time points. Biomarker assays may include, but are not limited to, BH3 profiling and characterization of BCL-2 and related proteins, and assessment of the depth of response and monitoring of disease recurrence by assessment of minimal residual disease (MRD) in the bone marrow. |
Up to 6 years
|
공동 작업자 및 조사자
협력자
협력자
수사관
수사관
- 수석 연구원: Courtney DiNardo, M.D. Anderson Cancer Center
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- 신생물
- 조직학적 유형에 따른 신생물
- 혈액 질환
- 백혈병, 골수성
- 백혈병
- 헴 및 림프병
- 백혈병, 골수성, 급성
- 펩타이드
- 아미노산, 펩티드 및 단백질
- 단백질
- 유기 화학 물질
- 이종 사이 클릭 화합물, 1- 링
- 이종 사이 클릭 화합물
- 핵산, 뉴클레오티드 및 뉴 클레오 시드
- 탄화수소
- 탄화수소, 순환
- 생물학적 요인
- 탄수화물
- 다 환식 방향족 탄화수소
- 탄화수소, 방향족
- 다 환식 화합물
- 글리코 사이드
- 시티 딘
- 피리 미딘 뉴 클레오 시드
- 피리 미딘
- 뉴 클레오 시드
- 세포 간 신호 전달 펩티드 및 단백질
- 아라비노 뉴 클레오 시드
- 안트라 사이클린
- 나프 타센
- 아미노 글리코 시드
- 당 단백질
- Glycoconjugates
- Daunorubicin
- 식민지 자극 요인
- 조혈 세포 성장 인자
- 사이토 카인
- 시타라빈
- 이다루비신
- fludarabine
- Venetoclax
- 육아 세포 콜로니 자극 인자
- 필 그라 스트 im
- Pegfilgrastim
기타 연구 ID 번호
기타 연구 ID 번호
- 2016-0979
- 2016-0979 (기타 식별자: M D Anderson Cancer Center)
- NCI-2018-01119 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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