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Phase II Study of Azacitidine and Sargramostim as Maintenance Treatment for Poor-Risk AML or MDS
A Phase II Study of 5-Azacitidine (5AC) in Combination With Sargramostim (GM-CSF) as Maintenance Treatment, After Definitive Therapy With Either Stem Cell Transplant (SCT) or Cytarabine-based Chemotherapy, in Patients With Poor-risk Acute Myeloid Leukemia (AML) or Myelodysplastic Syndrome (MDS)
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
We propose a phase II study to determine the impact of maintenance therapy with 5-azacytidine and GM-CSF in patients with poor-risk AML or MDS, who are in remission after definitive treatment with either stem cell transplant or cytarabine-based consolidation chemotherapy.
In order to precede relapse and to avoid lead time bias, treatment would need to commence within 185 days of definitive therapy. Furthermore, approximately 50% of relapses occur within the first year and up to 80% within two years after SCT, therefore we would limit the duration of maintenance therapy to one year, followed by two years of follow-up.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
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Maryland
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Baltimore, Maryland, Verenigde Staten, 21287
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
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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:
- Age > 6 months
- Initial diagnosis of poor -risk AML or MDS (defined in section 3.2), treated with either stem cell transplant or cytarabine-based consolidation chemotherapy, within the past 60-185 days
- ECOG performance status 0-2
- No morphologic evidence of leukemia or active MDS as determined by JHH Hematopathologist independent review of a bone marrow aspirate and biopsy done following the completion of therapy and within 14 days prior to enrollment
- Peripheral blood count recovery: Neutrophil count ≥ 1000 /µL, platelet count ≥ 50x 109 /µL without platelet transfusions, and adequate hematocrit independent of red cell transfusions .
- No evidence of extramedullary leukemia, such as CNS or soft tissue involvement
- Adequate end organ function as measured by the following: AST and ALT < 4 x normal, total serum bilirubin < 2 x upper limit normal (unless due to hemolysis, Gilbert's syndrome, or ineffective erythropoiesis), creatinine < 2 x upper limit of normal
- Ability to give informed consent
- In agreement to use an effective barrier method of birth control to avoid pregnancy during the study and for a minimum of 30 days after study treatment, for all male and female patients who are fertile
Exclusion Criteria:
- Patients with untreated or uncontrolled infections
- Patients with untreated or uncontrolled grade 3 or 4 GVHD
- Pregnancy and lactation
- Concurrent use of any other investigational agents.
- Known HIV-positive patients.
- Known hypersensitivity to 5AC or GM-CSF
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Myeloablative BMT
Azacitidine and sargramostim after myeloablative stem cell transplant
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Azacitidine will be administered days 1-5 of a 28 day cycle.
Treatment is planned for a total of 12 cycles.
Andere namen:
Sargramostim will be administered days 1-10 of a 28 day cycle.
Treatment is planned for a total of 12 cycles.
Andere namen:
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Experimenteel: Non-myeloablative BMT
Azacitidine and sargramostim after non-myeloablative stem cell transplant
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Azacitidine will be administered days 1-5 of a 28 day cycle.
Treatment is planned for a total of 12 cycles.
Andere namen:
Sargramostim will be administered days 1-10 of a 28 day cycle.
Treatment is planned for a total of 12 cycles.
Andere namen:
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Experimenteel: Standard consolidation
Azacitidine and sargramostim after standard consolidation
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Azacitidine will be administered days 1-5 of a 28 day cycle.
Treatment is planned for a total of 12 cycles.
Andere namen:
Sargramostim will be administered days 1-10 of a 28 day cycle.
Treatment is planned for a total of 12 cycles.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Two-year Relapse Free Survival of Patients
Tijdsspanne: 2 year
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To evaluate the two-year relapse-free survival (RFS) of patients with poor-risk Acute Myeloid Leukemia (AML) or Myelodysplasia (MDS), who receive maintenance treatment with 5-Azacytidine (5AC) in combination with sargramostim (GM-CSF) during remission, following definitive therapy with either a stem cell transplant (SCT) or cytarabine-based consolidation chemotherapy.
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2 year
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Hematologic Toxicity as Determined by Anemia
Tijdsspanne: 1 year
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Percentage of patients with anemia, the most commonly reported hematologic toxicity, after receiving the combination of Azacitidine and sargramostim
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1 year
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One-year RFS
Tijdsspanne: 1 year
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We will report the number of participants with one year RFS
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1 year
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Overall Survival
Tijdsspanne: 2 years
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Percentage of participants with overall survival at 2 years.
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2 years
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Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Studie stoel: Margaret Showel, MD, JHU
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
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 (Werkelijk)
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
- Voorstadia van kanker
- Myelodysplastische syndromen
- Leukemie
- Leukemie, myeloïde
- Leukemie, myeloïde, acuut
- Preleukemie
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Enzymremmers
- Antimetabolieten, antineoplastische
- Antimetabolieten
- Antineoplastische middelen
- Immunologische factoren
- Azacitidine
- Sargramostim
Andere studie-ID-nummers
- J1240
- P01CA015396 (Subsidie/contract van de Amerikaanse NIH)
- NA_00072223 (Andere identificatie: JHMIRB)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
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