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- Klinische proef NCT00112554
Cytarabine With or Without VNP40101M in Treating Patients With Relapsed Acute Myeloid Leukemia
A Phase III Randomized of Cloretazine™ (VNP40101M) and Cytosine Arabinoside (AraC) in Patients With Acute Myeloid Leukemia in First Relapse
RATIONALE: Drugs used in chemotherapy, such as cytarabine and VNP40101M, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells.
PURPOSE: This randomized phase III trial is studying cytarabine and VNP40101M to see how well they work compared to cytarabine alone in treating patients with relapsed acute myeloid leukemia.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
OBJECTIVES:
Primary
- Compare the complete response (CR) and CR (with platelet count < 100,000/mm^3 but ≥ 20,000/mm^3 [transfusion independent for ≥ 7 consecutive days]) (CRp) rates in patients with acute myeloid leukemia in first relapse treated with cytarabine with vs without VNP40101M.
Secondary
- Compare time to progression in patients treated with these regimens.
- Compare duration of response in patients treated with these regimens.
- Compare the survival of patients treated with these regimens.
- Compare the toxicity of these regimens in these patients.
OUTLINE: This is a randomized, double-blind, placebo-controlled, parallel group, multicenter study. Patients are stratified according to age (< 60 years vs ≥ 60 years) and duration of first complete response (CR) or CR (with platelet count < 100,000/mm³ but ≥ 20,000/mm³ [transfusion independent for ≥ 7 consecutive days]) (CRp) (< 12 months vs ≥ 12 months).
Induction therapy: Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive cytarabine IV continuously on days 1-3 and VNP40101M IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
- Arm II: Patients receive cytarabine as in arm I and placebo IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
In both arms, patients demonstrating at least 20% reduction of blasts in bone marrow (based on total cellularity and percent blasts) after course 1 may receive 1 additional course of induction therapy between days 35-60 in the absence of disease progression or unacceptable toxicity. Patients achieving CR or CRp after 1 or 2 courses of induction therapy proceed to consolidation therapy.
- Consolidation therapy: Beginning 6 weeks after initial documentation of CR or CRp, patients receive 1 course of consolidation therapy, as per induction therapy, according to their randomized treatment arm. These patients may then proceed to other consolidation, maintenance, and/or intensification therapy (including stem cell transplantation) off study at the discretion of the physician.
After completion of study treatment, patients are followed monthly for 6 months, every 2 months for 6 months, and then every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 420 patients (280 in arm I and 140 in arm II) will be accrued for this study within 24-30 months.
Studietype
Inschrijving (Verwacht)
Fase
- Fase 3
Contacten en locaties
Studie Locaties
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Brussels, België, 1200
- Cliniques universitaires Saint-Luc
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Leuven, België, B-3000
- U.Z. Gasthuisberg
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Montigny-le-Tilleul, België, 6110
- CHU Charleroi - Site Vesale
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 4E3
- Vancouver Hospital and Health Science Center
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New Brunswick
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Saint John, New Brunswick, Canada, E2L 4L2
- Saint John Regional Hospital
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Newfoundland and Labrador
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St. John's, Newfoundland and Labrador, Canada, A1B 3V6
- Memorial University of Newfoundland
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Nova Scotia
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Halifax, Nova Scotia, Canada, B3H 1V7
- Capital District Health Authority Center for Clinical Research
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Ontario
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Ottawa, Ontario, Canada, K1H 8L6
- Ottawa Hospital Regional Cancer Centre - General Campus
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Toronto, Ontario, Canada, M5G 2M9
- Princess Margaret Hospital
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Berlin, Duitsland, D-12200
- Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
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Cologne, Duitsland, D-50924
- Medizinische Universitaetsklinik I at the University of Cologne
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Frankfurt, Duitsland, D-60596
- Universitaetsfrauenklinik Frankfurt
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Heidelberg, Duitsland, D-69115
- Universitatsklinikum Heidelberg
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Muenster, Duitsland, D-48149
- Medizinische Klinik und Poliklinik A - Universitaetsklinikum Muenster
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Munich, Duitsland, D-81377
- Klinikum der Universitaet Muenchen - Grosshadern Campus
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Wurzburg, Duitsland, D-97070
- University Würzburg
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Besancon, Frankrijk, 25030
- Centre Hospitalier Regional de Besancon - Hopital Jean Minjoz
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Lyon, Frankrijk, 69437
- Hôpital Edouard Herriot
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Marseille, Frankrijk, 13273
- Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes
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Nantes, Frankrijk, 44093
- CHR Hotel Dieu
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Pessac, Frankrijk, 33604
- Hopital Haut Lévêque
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Athens, Griekenland, 10676
- Evaggelismos Hospital
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Rio Patras, Griekenland, GR-26500
- University of Patras Medical School
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Groningen, Nederland, 9713 GZ
- University Medical Center Groningen
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Gdansk, Polen, 80-211
- Medical University of Gdańsk
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Lodz, Polen, 90-419
- Medical University of Lodz
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Lublin, Polen, 20-954
- Centrum Onkologii Ziemi Lubelskiez
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Warsaw, Polen, 00-957
- Institute of Haematology and Blood Transfusion
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Warsaw, Polen, 00-909
- Wojskowy Instytut Medyczny
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Belgrade, Servië, 11000
- Clinical Centre of Serbia
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Nis, Servië, 18000
- Clinical Centre Nis
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Novi Sad, Servië, 21000
- Clinic Centre Novi Sad
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England
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Birmingham, England, Verenigd Koninkrijk, B9 5SS
- Birmingham Heartlands Hospital
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Cambridge, England, Verenigd Koninkrijk, CB2 2QQ
- Addenbrooke's Hospital at Cambridge University Hospitals NHS Foundation Trust
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Leicester, England, Verenigd Koninkrijk, LE1 5WW
- Leicester Royal Infirmary
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London, England, Verenigd Koninkrijk, SE5 9RS
- King's College Hospital
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Manchester, England, Verenigd Koninkrijk, M13 9WL
- Manchester Royal Infirmary
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Wales
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Cardiff, Wales, Verenigd Koninkrijk, CF14 4XW
- University Hospital of Wales
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California
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Los Angeles, California, Verenigde Staten, 90095-1781
- Jonsson Comprehensive Cancer Center at UCLA
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Los Angeles, California, Verenigde Staten, 90089-9181
- USC/Norris Comprehensive Cancer Center and Hospital
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Orange, California, Verenigde Staten, 92868
- Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
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San Francisco, California, Verenigde Staten, 94115
- UCSF Comprehensive Cancer Center
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Connecticut
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Hartford, Connecticut, Verenigde Staten, 06105
- Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
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Florida
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Miami, Florida, Verenigde Staten, 33136
- University of Miami Sylvester Comprehensive Cancer Center
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Tampa, Florida, Verenigde Staten, 33612
- Veterans Affairs Medical Center - Tampa (Haley)
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Illinois
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Chicago, Illinois, Verenigde Staten, 60637-1470
- University of Chicago Cancer Research Center
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Chicago, Illinois, Verenigde Staten, 60611-3013
- Robert H. Lurie Comprehensive Cancer Center at Northwestern University
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Indiana
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Indianapolis, Indiana, Verenigde Staten, 46260
- American Health Network - North Meridian
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Maryland
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Baltimore, Maryland, Verenigde Staten, 21201
- Greenebaum Cancer Center at University of Maryland Medical Center
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02115
- Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
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Nevada
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Las Vegas, Nevada, Verenigde Staten, 89135
- Nevada Cancer Institute
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New Mexico
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Albuquerque, New Mexico, Verenigde Staten, 87106
- New Mexico Cancer Care Alliance
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New York
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Buffalo, New York, Verenigde Staten, 14263-0001
- Roswell Park Cancer Institute
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Valhalla, New York, Verenigde Staten, 10595
- New York Medical College
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North Carolina
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Durham, North Carolina, Verenigde Staten, 27710
- Duke Comprehensive Cancer Center
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Greenville, North Carolina, Verenigde Staten, 27858
- Brody School of Medicine at East Carolina University
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Ohio
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Columbus, Ohio, Verenigde Staten, 43214-3998
- Riverside Methodist Hospital Cancer Care
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Pennsylvania
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Hershey, Pennsylvania, Verenigde Staten, 17033-0850
- Penn State Cancer Institute at Milton S. Hershey Medical Center
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Pittsburgh, Pennsylvania, Verenigde Staten, 15224
- Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital
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South Carolina
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Charleston, South Carolina, Verenigde Staten, 29425
- Hollings Cancer Center at Medical University of South Carolina
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Tennessee
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Nashville, Tennessee, Verenigde Staten, 37232-6838
- Vanderbilt-Ingram Cancer Center
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Texas
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Houston, Texas, Verenigde Staten, 77030-4009
- M.D. Anderson Cancer Center at University of Texas
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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:
Histologically confirmed acute myeloid leukemia (AML)
- Any WHO classification, excluding acute promyelocytic leukemia
- At least 10% blasts by bone marrow aspirate and/or biopsy
In first relapse after achieving a first complete response (CR) OR CR (with platelet count < 100,000/mm³ but ≥ 20,000/mm³ [transfusion independent for ≥ 7 consecutive days]) (CRp) that lasted ≥ 3 months but ≤ 24 months after completion of the initial induction regimen
- Relapse confirmed by recurrence of blasts in peripheral blood, bone marrow histopathology, and/or histologically confirmed CNS or extramedullary disease
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-2
Life expectancy
- Not specified
Hematopoietic
- See Disease Characteristics
Hepatic
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST ≤ 3 times ULN
- Chronic hepatitis allowed
Renal
- Creatinine ≤ 2.0 mg/dL
Cardiovascular
- No myocardial infarction within the past 3 months
- No uncontrolled arrhythmias
- No uncontrolled congestive heart failure
Pulmonary
- No severe chronic obstructive pulmonary disease
- No requirement for supplemental oxygen at rest
Immunologic
No uncontrolled active infection
- Infections that are controlled and under active treatment with antibiotics allowed
- No evidence of invasive fungal infection by blood or tissue cultures
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months after completion of study treatment
- No clinical evidence of another active malignancy by tumor marker, pathology, or radiologic studies
- No other severe medical condition that would preclude study treatment
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- At least 12 hours since prior hydroxyurea
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Not specified
Other
- No prior treatment while in first relapse except hydroxyurea
- No other concurrent standard or investigational treatment for AML
- No concurrent disulfiram (Antabuse®)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Induction therapy arm I
Patients receive cytarabine IV continuously on days 1-3 and VNP40101M IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
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IV gegeven
Given IV
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Actieve vergelijker: Induction therapy arm II
Patients receive cytarabine as in arm I and placebo IV over 30-60 minutes on day 2 (at least 12 hours after the start of cytarabine).
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IV gegeven
IV gegeven
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
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Algehele responspercentage
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Secundaire uitkomstmaten
Uitkomstmaat |
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Toxiciteit
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Duur van de reactie
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Algehele reactie
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Tijd tot tumorprogressie
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Bonny L. Johnson, RN, MSN, Vion Pharmaceuticals
Publicaties en nuttige links
Algemene publicaties
- Giles F, Vey N, DeAngelo D, Seiter K, Stock W, Stuart R, Boskovic D, Pigneux A, Tallman M, Brandwein J, Kell J, Robak T, Staib P, Thomas X, Cahill A, Albitar M, O'Brien S. Phase 3 randomized, placebo-controlled, double-blind study of high-dose continuous infusion cytarabine alone or with laromustine (VNP40101M) in patients with acute myeloid leukemia in first relapse. Blood. 2009 Nov 5;114(19):4027-33. doi: 10.1182/blood-2009-06-229351. Epub 2009 Aug 26.
- Giles FJ, Stock W, Vey N, et al.: A double blind placebo-controlled randomized phase III study of high dose continuous infusion cytosine arabinoside (araC) with or without cloretazine in patients with first relapse of acute myeloid leukemia (AML). [Abstract] Blood 108 (11): A-1970, 2006.
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
- volwassen acute myeloïde leukemie met 11q23 (MLL) afwijkingen
- volwassen acute myeloïde leukemie met inv(16)(p13;q22)
- volwassen acute myeloïde leukemie met t(16;16)(p13;q22)
- volwassen acute myeloïde leukemie met t(8;21)(q22;q22)
- recidiverende volwassen acute myeloïde leukemie
- volwassen acute megakaryoblastische leukemie (M7)
- volwassen acute minimaal gedifferentieerde myeloïde leukemie (M0)
- volwassen acute monoblastische leukemie (M5a)
- volwassen acute monocytische leukemie (M5b)
- volwassen acute myeloblastische leukemie met rijping (M2)
- volwassen acute myeloblastische leukemie zonder rijping (M1)
- volwassen acute myelomonocytische leukemie (M4)
- volwassen acute basofiele leukemie
- volwassen acute eosinofiele leukemie
- volwassen erytroleukemie (M6a)
- pure erytroïde leukemie bij volwassenen (M6b)
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per histologisch type
- Neoplasmata
- Leukemie
- Leukemie, myeloïde
- Leukemie, myeloïde, acuut
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Antivirale middelen
- Antimetabolieten, antineoplastische
- Antimetabolieten
- Antineoplastische middelen
- Immunosuppressieve middelen
- Immunologische factoren
- Cytarabine
Andere studie-ID-nummers
- CDR0000430677
- VION-CLI-037
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