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- Klinische proef NCT00002693
Combination Chemotherapy in Treating Patients With Chronic Myelogenous Leukemia or Recurrent Acute Leukemia
PHASE I STUDY OF CONTINUOUS INFUSION CARBOPLATIN AND TOPOTECAN IN THE TREATMENT OF RELAPSED ACUTE LEUKEMIA AND BLAST CRISIS CHRONIC MYELOGENOUS LEUKEMIA
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells.
PURPOSE: Phase I trial to study the effectiveness of combination chemotherapy with carboplatin and topotecan in treating patients with chronic myelogenous leukemia or recurrent acute leukemia.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
OBJECTIVES:
- Estimate the maximum tolerated dose of carboplatin plus topotecan given as a 5-day continuous infusion in patients with recurrent acute lymphocytic or myeloid leukemia or accelerated or blastic phase chronic myelogenous leukemia.
- Assess the toxicity of this regimen in these patients.
- Gather preliminary information on the activity of this regimen in these patients.
- Examine the pharmacokinetics of topotecan when administered concurrently with carboplatin.
OUTLINE: This is a dose escalation study of topotecan. Patients are stratified according to prior bone marrow transplant (BMT) (yes vs no).
- Induction: Patients receive carboplatin and topotecan IV 3 times a day on days 1-5. Patients may also receive filgrastim (G-CSF) beginning on day 7 or 14. Retreatment is based on results of marrow exam on day 10-14. Patients with less than 5% blasts undergo a second marrow exam upon blood count recovery or on day 26-30, whichever is earlier. Patients with at least 5% blasts after day 21 receive one more course, in the absence of unacceptable toxicity and at the discretion of the investigator. Patients with no greater than 5% blasts begin G-CSF if blood counts are not recovered, then proceed to consolidation.
Cohorts of 1-6 patients receive escalating doses of topotecan until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of up to 6 patients experience dose limiting toxicity. Patients with prior BMT will not be entered at any level until 3-6 patients with no prior BMT tolerate that level.
- Consolidation (begins around day 42 of last Induction course): Patients with ALL/AML in complete remission (CR) or CML in chronic phase receive 2 additional courses (same doses) 6-8 weeks apart.
Patients experiencing a relapse after CR lasting at least 6 months may receive additional treatment.
PROJECTED ACCRUAL: A total of 15-20 patients without and 2-20 patients with prior bone marrow transfer will be accrued for this study over 2-2.5 years.
Studietype
Fase
- Fase 1
Contacten en locaties
Studie Locaties
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Minnesota
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Rochester, Minnesota, Verenigde Staten, 55905
- Mayo Clinic
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
DISEASE CHARACTERISTICS:
Acute lymphocytic or myeloid leukemia (ALL or AML) in 1 of the following categories:
- Failed to achieve a complete response (CR) with initial induction regimen
- First relapse within 1 year of initial CR
- Failed re-induction therapy at first relapse
- Second relapse after no more than 2 different induction regimens
Relapse defined as more than 10% blasts in marrow or circulating blasts in peripheral blood and either:
- Symptoms of recurrence (e.g., B symptoms)
- Evidence of impending marrow failure (i.e., cytopenias) OR
- Chronic myelogenous leukemia in accelerated or blastic phase after no more than 1 prior induction regimen
- No HLA-identical sibling marrow donor or patient ineligible for allogeneic marrow transplantation
No clinical symptoms of CNS leukemia
- Patients with history of CNS leukemia must have pretreatment lumbar puncture demonstrating absence of active CNS disease
- No active CNS disease
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- ECOG 0-2
Life expectancy:
- At least 4 weeks
Hematologic:
- Not applicable
Hepatic:
- Bilirubin less than 2 mg/dL
Renal:
- Creatinine no greater than 1.5 mg/dL
Cardiovascular:
- No congestive heart failure
- No poorly controlled arrhythmia
- No myocardial infarction within the past 3 months
Other:
- No active infection
- No other serious medical condition that would prevent compliance
- Not pregnant or nursing
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- See Disease Characteristics
Chemotherapy:
- See Disease Characteristics
- At least 24 hours since prior hydroxyurea for impending leukostasis
- No concurrent hydroxyurea glucocorticoids
- Recovered from prior chemotherapy
Endocrine therapy:
- At least 24 hours since prior glucocorticoids for impending leukostasis
- At least 7 days since prior amphotericin or aminoglycosides
- No concurrent glucocorticoids
Radiotherapy:
- Not specified
Surgery:
- Not specified
Other:
- No concurrent aminoglycoside antibiotics
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Studie stoel: Scott H. Kaufmann, MD, PhD, Mayo Clinic
Publicaties en nuttige links
Algemene publicaties
- Kaufmann S, Letendre L, Litzow M, et al.: Phase I study of continuous infusion (CI) topotecan (TPT) and carboplatin (CBDCA) for relapsed or refractory acute leukemia. [Abstract] Proceedings of the American Society of Clinical Oncology 17: A107, 1998.
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per histologisch type
- Neoplasmata
- Beenmergziekten
- Hematologische ziekten
- Myeloproliferatieve aandoeningen
- Agranulocytose
- Leukopenie
- Leukocytenstoornissen
- Leukemie
- Leukemie, myeloïde
- Neutropenie
- Leukemie, Myelogeen, Chronisch, BCR-ABL Positief
- Moleculaire mechanismen van farmacologische werking
- Enzymremmers
- Antineoplastische middelen
- Topoisomeraseremmers
- Topoisomerase I-remmers
- Carboplatine
- Topotecan
Andere studie-ID-nummers
- CDR0000064447
- P30CA015083 (Subsidie/contract van de Amerikaanse NIH)
- U01CA069912 (Subsidie/contract van de Amerikaanse NIH)
- 958101 (Andere identificatie: Mayo Clinic Cancer Center)
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