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Tipifarnib in Treating Older Patients With Acute Myeloid Leukemia
Phase 2 Trial of R115777 in Previously Untreated Older Adults With AML and Baseline Presence of a Specific 2-Gene Expression Signature Ratio
Studie Overzicht
Toestand
Conditie
- Secundaire acute myeloïde leukemie
- Onbehandelde volwassen acute myeloïde leukemie
- Volwassen acute monoblastische leukemie
- Volwassen acute monocytische leukemie
- Acute myeloïde leukemie bij volwassenen met Inv(16)(p13.1q22); CBFB-MYH11
- Volwassen acute myeloïde leukemie met rijping
- Volwassen acute myeloïde leukemie met minimale differentiatie
- Acute myeloïde leukemie bij volwassenen met t(16;16)(p13.1;q22); CBFB-MYH11
- Volwassen acute myeloïde leukemie zonder rijping
- Volwassen acute myelomonocytaire leukemie
- Aan alkyleringsmiddel gerelateerde acute myeloïde leukemie
- Volwassen acute megakaryoblastische leukemie
- Erythroleukemie bij volwassenen
- Volwassen pure erytroïde leukemie
- Acute myeloïde leukemie bij volwassenen met t(9;11)(p22;q23); MLLT3-MLL
- Acute myeloïde leukemie bij volwassenen met t(8;21)(q22;q22); RUNX1-RUNX1T1
Interventie / Behandeling
Gedetailleerde beschrijving
PRIMARY OBJECTIVES:
I. To determine the complete remission (CR) rate in acute myeloid leukemia (AML) patients prospectively selected for tipifarnib (ZARNESTRA) treatment on the basis of a 2-gene signature (RASGRP1:APTX ratio) in bone marrow aspirates.
SECONDARY OBJECTIVES:
I. To determine the median overall and 1-year survival of patients treated with this regimen II. To determine the median relapse-free survival of patients treated with this regimen.
III. To determine the safety of this regimen in these patients IV. To determine the immunophenotypic expression of RASGRP1 on baseline bone marrow blasts and assess correlation with PCR-based detection.
OUTLINE: This is a multicenter study.
Patients receive tipifarnib orally twice daily on days 1-21. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Bone marrow aspirate and/or biopsy are collected at baseline and on day 28 of course 1 and 2 for RasGRP1 protein expression analysis by qRT-PCR.
After completion of study therapy, patients are followed up every 30 days.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
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Florida
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Tampa, Florida, Verenigde Staten, 33612
- Moffitt Cancer Center
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Georgia
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Atlanta, Georgia, Verenigde Staten, 30342
- Blood and Marrow Transplant Group of Georgia
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Atlanta, Georgia, Verenigde Staten, 30322
- Emory University/Winship Cancer Institute
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Maryland
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Baltimore, Maryland, Verenigde Staten, 21287
- Johns Hopkins University/Sidney Kimmel Comprehensive Cancer Center
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New York
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New York, New York, Verenigde Staten, 10065
- Memorial Sloan-Kettering Cancer Center
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New York, New York, Verenigde Staten, 10065
- Weill Medical College of Cornell University
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North Carolina
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Chapel Hill, North Carolina, Verenigde Staten, 27599
- University of North Carolina
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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
Inclusion Criteria:
Previously untreated acute myeloid leukemia (AML) (de novo or secondary)
- No diagnosis of acute promyelocytic leukemia (APL)
- Deemed unsuitable for or refuses standard induction chemotherapy
- RASGRP1:APTX ratio >= 5, through bone marrow screening
- No patients with known leukemic involvement of the central nervous system
- ECOG performance status =< 2
- No WBC >= 30,000/uL (hydroxyurea permitted up to 24 hours prior to initiation of therapy)
- Serum creatinine less than 1.5 times the upper limit of the normal range (ULN) (National Cancer Institute [NCI] Common Toxicity Criteria [CTC] Grade 1)
- Total bilirubin less than 1.5 times ULN (unless the increase is unequivocally due to hemolysis or Gilbert syndrome)
- ALT and AST less than 2.5 times ULN (NCI CTC Grade 1)
- Men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation
- No symptomatic neuropathy of grade 2 or worse
- No uncompensated disseminated intravascular coagulation (DIC) or uncontrolled bleeding
- No history of allergic reactions attributed to compounds of similar chemical or biologic composition to tipifarnib (R115777), such as the imidazole drugs, including clotrimazole, ketoconazole, miconazole, econazole, fenticonazole, isoconazole, sulconazole, ticonazole, or terconazole
- No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Known HIV-positive patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with R115777; in addition, these patients are at increased risk of lethal infections when treated with marrow-suppressive therapy; known HIV-positive patients NOT on antiretroviral therapy AND with a CD4 cell count >= 400/mm^3 are eligible
- No other concurrent cytotoxic or biologic antileukemic therapy
- No patients who are receiving any other investigational agents
Use of enzyme-inducing anticonvulsants (e.g., phenytoin, fosphenytoin, phenobarbital, primidone, carbamazepine, oxcarbazepine) while taking tipifarnib (R115777) is contraindicated
- If clinically indicated, subjects may use non-enzyme-inducing anticonvulsants during treatment with R115777
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Treatment (tipifarnib)
Patients receive tipifarnib orally twice daily on days 1-21.
Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
|
Correlatieve studies
Gegeven PO
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Complete Remission (CR) Rate
Tijdsspanne: From first treatment through follow up period, an expected average of 12 months
|
Complete Remission (CR) rate in Acute Myelogenous Leukemia (AML) patients prospectively selected for R115777R115777 (ZARNESTRA) treatment on the basis of a 2-gene signature (RASGRP1:APTX ratio) in bone marrow aspirates.
AML Complete Remission: Bone marrow aspiration - Less than 5% leukemic blasts, Auer rods not detected; Peripheral blood counts - Absolute neutrophil count >/= 1,000/mm^3, Platelet count >/= 100,000/mm^3, Leukemic blasts not present; Blood-product transfusion independence; Absence of extramedullary leukemia.
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From first treatment through follow up period, an expected average of 12 months
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Median Overall Survival (OS)
Tijdsspanne: From first treatment through follow up period, an expected average of 12 months
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Overall survival is calculated from the first day of R115777 treatment and lasts until the date of death recorded on the case report form (CRF).
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From first treatment through follow up period, an expected average of 12 months
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Median 1-Year Survival Rate
Tijdsspanne: 1 year
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Prior to the early discontinuation of the study (for not meeting the primary endpoint of at least 3 CR/CRi after 2 cycles), investigators had planned to calculate one year survival from Kaplan Meier estimates.
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1 year
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Number of Participants With Relapse Free Survival
Tijdsspanne: 7 months
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Relapse-free survival is calculated from the date of documentation of complete remission/morphologic complete remission with incomplete blood count recovery (CR/CRi) until disease relapse or death from any cause.
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7 months
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Jeffrey Lancet, Moffitt Cancer Center
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
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per histologisch type
- Neoplasmata
- Beenmergziekten
- Hematologische ziekten
- Myeloproliferatieve aandoeningen
- Leukemie
- Leukemie, myeloïde
- Leukemie, myeloïde, acuut
- Leukemie, myelomonocytische, acuut
- Leukemie, monocytisch, acuut
- Leukemie, megakaryoblastisch, acuut
- Leukemie, erytroblastisch, acuut
- Antineoplastische middelen
- Tipifarnib
Andere studie-ID-nummers
- NCI-2011-02589 (Register-ID: CTRP (Clinical Trial Reporting Program))
- U01CA070095 (Subsidie/contract van de Amerikaanse NIH)
- N01CM00071 (Subsidie/contract van de Amerikaanse NIH)
- P30CA076292 (Subsidie/contract van de Amerikaanse NIH)
- N01CM00100 (Subsidie/contract van de Amerikaanse NIH)
- 16572
- CDR0000699713
- 8977 (Andere identificatie: CTEP)
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