- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT06317662
Badanie możliwości dodania leku przeciwnowotworowego Venetoklaks i/lub przeciwnowotworowej immunoterapii Blinatumomab do zwykłej chemioterapii u niemowląt z nowo zdiagnozowaną białaczką z rearanżacją KMT2A lub bez rearanżacji KMT2A
Badanie II fazy dotyczące stosowania blinatumomabu w skojarzeniu z chemioterapią u niemowląt z nowo zdiagnozowaną ostrą białaczką limfoblastyczną z randomizacją pacjentów z rearanżacją KMT2A do dodania wenetoklaksu
This phase II trial tests the addition of venetoclax and/or blinatumomab to usual chemotherapy for treating infants with newly diagnosed acute lymphoblastic leukemia (ALL) with a KMT2A gene rearrangement (KMT2A-rearranged [R]) or without a KMT2A gene rearrangement (KMT2A-germline [G]). Venetoclax is in a class of medications called B-cell lymphoma-2 (Bcl-2) inhibitors. It may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Blinatumomab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. Chemotherapy drugs work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Adding venetoclax and/or blinatumomab to standard chemotherapy may be more effective at treating patients with ALL than standard chemotherapy alone, but it may also cause more side effects. This clinical trial evaluates the safety and effectiveness of adding venetoclax and/or blinatumomab to chemotherapy for the treatment of infants with KMT2A-R or KMT2A-G ALL.
Przegląd badań
Status
Interwencja / Leczenie
- Lek: Cyclophosphamide
- Lek: Doxorubicin
- Lek: Vincristine
- Procedura: Computed Tomography
- Procedura: Magnetic Resonance Imaging
- Procedura: Echocardiography Test
- Procedura: Multigated Acquisition Scan
- Biologiczny: Blinatumomab
- Procedura: Bone Marrow Aspiration
- Lek: Daunorubicin
- Procedura: Lumbar Puncture
- Lek: Methylprednisolone
- Procedura: Biospecimen Collection
- Lek: Calaspargase Pegol
- Lek: Therapeutic Hydrocortisone
- Lek: Asparaginase Erwinia chrysanthemi
- Lek: Cytarabine
- Lek: Dexamethasone
- Procedura: FDG-Positron Emission Tomography
- Lek: Leucovorin
- Lek: Levoleucovorin
- Lek: Mercaptopurine
- Lek: Methotrexate
- Lek: Thioguanine
- Lek: Venetoclax
- Lek: Prednisolone
- Lek: Prednisone
Szczegółowy opis
PRIMARY OBJECTIVES:
I. To evaluate the safety and tolerability of venetoclax in addition to a standard chemotherapy backbone and two cycles of blinatumomab in infants (aged 365 days or less at diagnosis) with newly diagnosed KMT2A-R ALL.
II. To determine in a randomized manner if the addition of venetoclax to induction chemotherapy improves end of induction minimal residual disease (MRD)-negative remission rates in infants with KMT2A-R ALL.
SECONDARY OBJECTIVES:
I. To estimate the MRD-negative remission rate for all eligible infants with KMT2A-R ALL treated with venetoclax at the recommended phase 2 dose (RP2D).
II. To compare event free survival (EFS) rates of infants with KMT2A-R ALL treated on arm B to those treated on arm A.
III. To compare 3-year EFS rates of infants with KMT2A-R ALL treated on arm A to historical controls.
IV. To determine the feasibility of treating infants with KMT2A-G ALL with a Children's Oncology Group (COG) high risk ALL chemotherapy backbone and two cycles of blinatumomab and estimate the 3-year EFS rate of infants with KMT2A-G ALL treated on arm C.
V. To characterize the pharmacokinetics (PK) of venetoclax in infants.
EXPLORATORY OBJECTIVES:
I. To describe 3-year EFS rate of infants with KMT2A-R ALL treated on arm B. II. To evaluate the use of high-throughput sequencing (HTS) for MRD detection in infant ALL compared to centralized flow cytometry.
III. To characterize the PK of calaspargase pegol in infants with ALL. IV. To report the incidence of CD19 negative relapse and myeloid switch relapse with protocol therapy.
V. To evaluate the impact of venetoclax in combination with chemotherapy on T-cell subsets and function.
VI. To describe the feasibility of T-cell collection and success of T-cell manufacturing for infants with KMT2A-R ALL who receive chimeric antigen receptor (CAR) T- cell therapy after coming off protocol therapy.
VII. To determine predictors of response and resistance to venetoclax and overall protocol therapy.
VIII. To evaluate the impact of subsequent anti-cancer therapy on overall survival after coming off protocol therapy.
IX. To compare overall survival (OS) rates of infants by arms and to historical OS rates.
OUTLINE:
STEROID PREPHASE: All patients receive prednisone or prednisolone orally (PO) or nasogastrically (NG) three times daily (TID) or methylprednisolone intravenously (IV) TID for 7 days prior to the start of induction therapy (on days 1-7).
Patients who are KMT2A gene rearrangement positive are assigned to the safety phase cohort during the safety phase of the study, or randomized between Arm A and Arm B during the expansion phase of the study. Patients who are KMT2A gene rearrangement negative are assigned to Arm C.
SAFETY PHASE COHORT (CLOSED TO ACCRUAL 06/03/2026):
INDUCTION: Patients receive venetoclax PO or NG once daily (QD) on days 1-7, 1-10, or 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy (methotrexate, hydrocortisone, cytarabine) intrathecally (IT) on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when absolute neutrophil counts (ANC) >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-central nervous system (CNS) extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine subcutaneously (SC) QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
EXPANSION PHASE: After completion of Safety phase, patients who are KMT2A gene rearrangement positive are randomized to Arm A or Arm B.
ARM A:
INDUCTION: Patients receive daunorubicin IV over 1-15 minutes on days 1 and 2, cytarabine SC or IV over 1-30 minutes on days 1-14, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29, or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
ARM B: Patients are assigned to 1 of 4 cohorts.
COHORT 1:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA + VENETOCLAX: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, venetoclax PO or NG QD on days 22-35, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
COHORT 2:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14 and 29-42, cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
COHORT 3:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14 and 29-42, cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA + VENETOCLAX: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, venetoclax PO or NG QD on days 22-35, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
COHORT 4:
INDUCTION + VENETOCLAX: Patients receive venetoclax PO or NG QD on days 1-14, daunorubicin IV over 1-15 minutes on days 1 and 2, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29 or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and intrathecal therapy IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, and intrathecal therapy IT on day 29. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to MARMA the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MARMA: Patients receive mercaptopurine PO or NG QD on days 1-14, high dose methotrexate IV over 24 hours on days 1 and 8, leucovorin PO, NG, or IV or levoleucovorin IV on days 3-4 and 10-11, intrathecal therapy IT on days 1 and 8, high dose cytarabine IV over 3 hours on days 22-23 and 29-30, and recombinant crisantaspase IM on days 23 and 30. At the end of MARMA (day 49), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28 and intrathecal therapy IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive calaspargase pegol IV over 1-2 hours on day 1, dexamethasone PO, NG, or IV TID on days 1-21, thioguanine PO or NG on days 1-28 and 36-49, vincristine IV on days 1, 8, 15, and 22, daunorubicin IV over 1-15 minutes on days 1, 8, 15, and 22, cytarabine SC or IV over 1-30 minutes on days 2-5, 9-12, 16-19, 23-26, 37-40, and 44-47, cyclophosphamide IV over 15-30 minutes on days 36 and 50, and intrathecal therapy IT on days 1 and 15. At the end of delayed intensification (day 63), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
MAINTENANCE: Patients receive mercaptopurine PO or NG on days 1-84 of each cycle, methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle, and intrathecal therapy IT on day 1 of cycles 1-3. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of MARMA in the absence of disease progression or unacceptable toxicity.
ARM C:
INDUCTION: Patients receive daunorubicin IV over 1-15 minutes on days 1 and 2, cytarabine SC or IV over 1-30 minutes on days 1-14, vincristine IV on days 1, 8, 15, and 22, dexamethasone PO, NG, or IV TID on days 1-28, calaspargase pegol IV over 1-2 hours on day 4, and intrathecal therapy IT on days 1, 15, and 29, or days 1, 8, 15, 22, and 29. Patients with < 5% blasts by morphology in the bone marrow at the end of induction (day 35) proceed directly to blinatumomab block 1 on the next day or when ANC >= 500/uL and platelets >= 50,000/uL. Patients with >= 5% blasts by morphology in the bone marrow at the end of induction proceed to blinatumomab block 1 as soon as marrow results are known, irrespective of ANC or platelet values.
BLINATUMOMAB BLOCK 1: Patients receive dexamethasone PO, NG, or IV on day 1 or days 1 and 8, blinatumomab IV on days 1-28, 1-7, or 8-28, and methotrexate IT on days 15 and 29. Patients who are MRD >= 1% or who have residual non-CNS extramedullary disease at the end of blinatumomab block 1 (day 35) discontinue protocol therapy. All other patients proceed directly to consolidation on the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
CONSOLIDATION: Patients receive cyclophosphamide IV over 30-60 minutes on days 1 and 29, cytarabine SC QD or IV over 1-30 minutes on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO or NG QD on days 1-14 and 29-42, methotrexate IT on days 8, 15, and 22, vincristine IV on days 15, 22, 43, and 50, and calaspargase pegol IV over 1-2 hours on days 15 and 43. Patients who are MRD >= 0.01% at the end of consolidation therapy (day 56) discontinue protocol therapy. All other patients proceed directly to interim maintenance 1 the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
INTERIM MAINTENANCE 1: Patients receive vincristine IV on days 1, 15, 29, and 43, high dose methotrexate IV over 24 hours on days 1, 15, 29, and 43, mercaptopurine PO or NG on days 1-14, 15-28, 29-42, and 43-56, methotrexate IT on days 1 and 29, and leucovorin PO or NG or IV or levoleucovorin IV on days 3-4, 17-18, 31-32, and 45-46. At the end of interim maintenance 1 (day 63), all patients proceed directly to blinatumomab block 2 the next day or when peripheral counts recover to ANC >= 500/uL and platelets >= 50,000/uL.
BLINATUMOMAB BLOCK 2: Patients receive blinatumomab IV on days 1-28, and methotrexate IT on days 1 and 15. At the end of blinatumomab block 2 (day 35), all patients proceed directly to delayed intensification the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
DELAYED INTENSIFICATION: Patients receive methotrexate IT on days 1, 29, and 36, dexamethasone PO, NG, or IV BID on days 1-7 and 15-21, vincristine IV on days 1, 8, 15, 43, and 50, doxorubicin IV over 3-15 minutes on days 1, 8, and 15, calaspargase pegol IV over 1-2 hours on days 4 and 43, cyclophosphamide IV over 30-60 minutes on day 29, thioguanine PO or NG on days 29-42, and cytarabine SC or IV over 1-30 minutes on days 29-32 and 36-39. At the end of delayed intensification (day 63), all patients proceed directly to interim maintenance 2 the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
INTERIM MAINTENANCE 2: Patients receive vincristine IV on days 1, 11, 21, 31, and 41, methotrexate IV push over 2-5 minutes or IV over 10-15 minutes on days 1, 11, 21, 31, and 41, methotrexate IT on days 1 and 31, and calaspargase pegol IV over 1-2 hours on days 2 and 23. At the end of interim maintenance 2 (day 56), all patients proceed directly to maintenance the next day or when peripheral counts recover to ANC >= 750/uL and platelets >= 75,000/uL.
MAINTENANCE: Patients receive methotrexate IT on day 1 of cycles 1-3, vincristine IV on day 1 of each cycle, prednisone or prednisolone PO or NG BID or methylprednisolone IV BID on days 1-5 of each cycle, mercaptopurine PO or NG on days 1-84 of each cycle, and methotrexate PO, NG, or IV on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 of each cycle. Cycles repeat every 12 weeks (84 days) for up to 2 years from the start of interim maintenance 1 in the absence of disease progression or unacceptable toxicity.
All patients undergo bone marrow aspiration, collection of blood samples and echocardiography (ECHO) or multigated acquisition scan (MUGA) throughout the trial. Patients may undergo computed tomography (CT), magnetic resonance imaging (MRI), fludeoxyglucose-positron emission tomography (FDG-PET), and/or lumbar puncture if clinically indicated.
After completion of study treatment, patients are followed up for up to 3 years.
Typ studiów
Zapisy (Szacowany)
Faza
- Faza 2
Kontakty i lokalizacje
Lokalizacje studiów
-
-
-
San Juan, Portoryko, 00926
- Rekrutacyjny
- University Pediatric Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 787-474-0333
-
Główny śledczy:
- Maria E. Echevarria
-
-
-
-
Alabama
-
Birmingham, Alabama, Stany Zjednoczone, 35233
- Rekrutacyjny
- Children's Hospital of Alabama
-
Kontakt:
- Site Public Contact
- Numer telefonu: 205-638-9285
- E-mail: oncologyresearch@peds.uab.edu
-
Główny śledczy:
- Matthew A. Kutny
-
-
Alaska
-
Anchorage, Alaska, Stany Zjednoczone, 99508
- Rekrutacyjny
- Providence Alaska Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 907-212-6871
- E-mail: AKPAMC.OncologyResearchSupport@providence.org
-
Główny śledczy:
- Brenda J. Wittman
-
-
Arizona
-
Mesa, Arizona, Stany Zjednoczone, 85202
- Rekrutacyjny
- Banner Children's at Desert
-
Kontakt:
- Site Public Contact
- Numer telefonu: 480-412-3100
-
Główny śledczy:
- Joseph C. Torkildson
-
-
Arkansas
-
Little Rock, Arkansas, Stany Zjednoczone, 72202-3591
- Rekrutacyjny
- Arkansas Children's Hospital
-
Główny śledczy:
- Michael W. Bishop
-
Kontakt:
- Site Public Contact
- Numer telefonu: 501-364-7373
-
-
California
-
Loma Linda, California, Stany Zjednoczone, 92354
- Rekrutacyjny
- Loma Linda University Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 909-558-4050
-
Główny śledczy:
- Albert Kheradpour
-
Long Beach, California, Stany Zjednoczone, 90806
- Rekrutacyjny
- Miller Children's and Women's Hospital Long Beach
-
Kontakt:
- Site Public Contact
- Numer telefonu: 562-933-5600
-
Główny śledczy:
- Jacqueline N. Casillas
-
Oakland, California, Stany Zjednoczone, 94611
- Rekrutacyjny
- Kaiser Permanente-Oakland
-
Kontakt:
- Site Public Contact
- Numer telefonu: 877-642-4691
- E-mail: Kpoct@kp.org
-
Główny śledczy:
- Aarati V. Rao
-
Oakland, California, Stany Zjednoczone, 94609
- Rekrutacyjny
- UCSF Benioff Children's Hospital Oakland
-
Główny śledczy:
- Anya Levinson
-
Kontakt:
- Site Public Contact
- Numer telefonu: 510-428-3264
- E-mail: PedOncRschOAK@ucsf.edu
-
Orange, California, Stany Zjednoczone, 92868
- Rekrutacyjny
- Children's Hospital of Orange County
-
Kontakt:
- Site Public Contact
- Numer telefonu: 714-509-8646
- E-mail: oncresearch@choc.org
-
Główny śledczy:
- Elyssa M. Rubin
-
Sacramento, California, Stany Zjednoczone, 95817
- Rekrutacyjny
- University of California Davis Comprehensive Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 916-734-3089
-
Główny śledczy:
- Marcio H. Malogolowkin
-
San Francisco, California, Stany Zjednoczone, 94158
- Rekrutacyjny
- UCSF Medical Center-Mission Bay
-
Główny śledczy:
- Anya Levinson
-
Kontakt:
- Site Public Contact
- Numer telefonu: 877-827-3222
- E-mail: cancertrials@ucsf.edu
-
-
Colorado
-
Aurora, Colorado, Stany Zjednoczone, 80045
- Rekrutacyjny
- Children's Hospital Colorado
-
Główny śledczy:
- Kelly E. Faulk
-
Kontakt:
- Site Public Contact
- Numer telefonu: 303-764-5056
- E-mail: josh.b.gordon@nsmtp.kp.org
-
-
Connecticut
-
Hartford, Connecticut, Stany Zjednoczone, 06106
- Rekrutacyjny
- Connecticut Children's Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 860-545-9981
-
Główny śledczy:
- Michael S. Isakoff
-
New Haven, Connecticut, Stany Zjednoczone, 06520
- Rekrutacyjny
- Yale University
-
Kontakt:
- Site Public Contact
- Numer telefonu: 203-785-5702
- E-mail: canceranswers@yale.edu
-
Główny śledczy:
- Farzana Pashankar
-
-
Delaware
-
Wilmington, Delaware, Stany Zjednoczone, 19803
- Rekrutacyjny
- Alfred I duPont Hospital for Children
-
Kontakt:
- Site Public Contact
- Numer telefonu: 302-651-5572
- E-mail: Allison.bruce@nemours.org
-
Główny śledczy:
- Emi H. Caywood
-
-
District of Columbia
-
Washington D.C., District of Columbia, Stany Zjednoczone, 20010
- Rekrutacyjny
- Children's National Medical Center
-
Główny śledczy:
- Jeffrey S. Dome
-
Kontakt:
- Site Public Contact
- Numer telefonu: 202-476-2800
- E-mail: OncCRC_OnCall@childrensnational.org
-
-
Florida
-
Gainesville, Florida, Stany Zjednoczone, 32610
- Rekrutacyjny
- UF Health Cancer Institute - Gainesville
-
Główny śledczy:
- Brian Stover
-
Kontakt:
- Site Public Contact
- Numer telefonu: 352-273-8010
-
Hollywood, Florida, Stany Zjednoczone, 33021
- Rekrutacyjny
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 954-265-1847
- E-mail: OHR@mhs.net
-
Główny śledczy:
- Iftikhar Hanif
-
Jacksonville, Florida, Stany Zjednoczone, 32207
- Rekrutacyjny
- Nemours Children's Clinic-Jacksonville
-
Kontakt:
- Site Public Contact
- Numer telefonu: 302-651-5572
- E-mail: Allison.bruce@nemours.org
-
Główny śledczy:
- Emi H. Caywood
-
Miami, Florida, Stany Zjednoczone, 33136
- Rekrutacyjny
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 305-243-2647
-
Główny śledczy:
- Julio C. Barredo
-
Orlando, Florida, Stany Zjednoczone, 32806
- Rekrutacyjny
- Arnold Palmer Hospital for Children
-
Kontakt:
- Site Public Contact
- Numer telefonu: 321-841-5357
- E-mail: Jennifer.spinelli@orlandohealth.com
-
Główny śledczy:
- Zhongbo Hu
-
Orlando, Florida, Stany Zjednoczone, 32827
- Rekrutacyjny
- Nemours Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 302-651-5572
- E-mail: Allison.bruce@nemours.org
-
Główny śledczy:
- Emi H. Caywood
-
Orlando, Florida, Stany Zjednoczone, 32803
- Rekrutacyjny
- AdventHealth Orlando
-
Kontakt:
- Site Public Contact
- Numer telefonu: 407-303-2090
- E-mail: FH.Cancer.Research@flhosp.org
-
Główny śledczy:
- Fouad M. Hajjar
-
Pensacola, Florida, Stany Zjednoczone, 32504
- Rekrutacyjny
- Nemours Children's Clinic - Pensacola
-
Kontakt:
- Site Public Contact
- E-mail: helpdesk@childrensoncologygroup.org
-
Główny śledczy:
- Jeffrey H. Schwartz
-
St. Petersburg, Florida, Stany Zjednoczone, 33701
- Rekrutacyjny
- Johns Hopkins All Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 727-767-4784
- E-mail: Ashley.Repp@jhmi.edu
-
Główny śledczy:
- Jennifer B. Dean
-
Tampa, Florida, Stany Zjednoczone, 33607
- Rekrutacyjny
- Saint Joseph's Hospital/Children's Hospital-Tampa
-
Kontakt:
- Site Public Contact
- Numer telefonu: 813-357-0849
- E-mail: jennifer.manns@baycare.org
-
Główny śledczy:
- Don E. Eslin
-
West Palm Beach, Florida, Stany Zjednoczone, 33407
- Rekrutacyjny
- Saint Mary's Medical Center
-
Główny śledczy:
- Matthew D. Ramirez
-
Kontakt:
- Site Public Contact
- Numer telefonu: 561-822-4745
-
-
Georgia
-
Atlanta, Georgia, Stany Zjednoczone, 30329
- Rekrutacyjny
- Children's Healthcare of Atlanta - Arthur M Blank Hospital
-
Główny śledczy:
- Melinda G. Pauly
-
Kontakt:
- Site Public Contact
- Numer telefonu: 404-785-0232
- E-mail: Olivia.Floyd@choa.org
-
-
Hawaii
-
Honolulu, Hawaii, Stany Zjednoczone, 96826
- Rekrutacyjny
- Kapiolani Medical Center for Women and Children
-
Kontakt:
- Site Public Contact
- Numer telefonu: 808-983-6090
-
Główny śledczy:
- Wade T. Kyono
-
-
Idaho
-
Boise, Idaho, Stany Zjednoczone, 83712
- Rekrutacyjny
- Saint Luke's Cancer Institute - Boise
-
Główny śledczy:
- Martha M. Pacheco
-
Kontakt:
- Site Public Contact
- Numer telefonu: 208-381-2774
- E-mail: eslinget@slhs.org
-
-
Illinois
-
Chicago, Illinois, Stany Zjednoczone, 60611
- Rekrutacyjny
- Lurie Children's Hospital-Chicago
-
Kontakt:
- Site Public Contact
- Numer telefonu: 773-880-4562
-
Główny śledczy:
- Sara Zarnegar-Lumley
-
Chicago, Illinois, Stany Zjednoczone, 60637
- Rekrutacyjny
- University of Chicago Comprehensive Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 773-702-8222
- E-mail: cancerclinicaltrials@bsd.uchicago.edu
-
Główny śledczy:
- Gabrielle Lapping-Carr
-
Oak Lawn, Illinois, Stany Zjednoczone, 60453
- Rekrutacyjny
- Advocate Children's Hospital-Oak Lawn
-
Kontakt:
- Site Public Contact
- Numer telefonu: 847-723-7570
-
Główny śledczy:
- Rebecca E. McFall
-
Park Ridge, Illinois, Stany Zjednoczone, 60068
- Rekrutacyjny
- Advocate Children's Hospital-Park Ridge
-
Kontakt:
- Site Public Contact
- E-mail: helpdesk@childrensoncologygroup.org
-
Główny śledczy:
- Rebecca E. McFall
-
Peoria, Illinois, Stany Zjednoczone, 61637
- Rekrutacyjny
- OSF Children's Hospital of Illinois
-
Główny śledczy:
- Prerna Kumar
-
Kontakt:
- Site Public Contact
- Numer telefonu: 309-624-4945
- E-mail: ChildrensHospitalofIllinois@osfhealthcare.org
-
Springfield, Illinois, Stany Zjednoczone, 62702
- Rekrutacyjny
- Southern Illinois University School of Medicine
-
Kontakt:
- Site Public Contact
- Numer telefonu: 217-545-7929
-
Główny śledczy:
- Gregory P. Brandt
-
-
Indiana
-
Indianapolis, Indiana, Stany Zjednoczone, 46202
- Rekrutacyjny
- Riley Hospital for Children
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-248-1199
-
Główny śledczy:
- Amanda Saraf
-
Indianapolis, Indiana, Stany Zjednoczone, 46260
- Rekrutacyjny
- Ascension Saint Vincent Indianapolis Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 317-338-2194
- E-mail: research@stvincent.org
-
Główny śledczy:
- Bassem I. Razzouk
-
-
Iowa
-
Des Moines, Iowa, Stany Zjednoczone, 50309
- Rekrutacyjny
- Blank Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 515-241-8912
- E-mail: samantha.mallory@unitypoint.org
-
Główny śledczy:
- Samantha L. Mallory
-
-
Kentucky
-
Lexington, Kentucky, Stany Zjednoczone, 40536
- Rekrutacyjny
- University of Kentucky/Markey Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 859-257-3379
-
Główny śledczy:
- James T. Badgett
-
Louisville, Kentucky, Stany Zjednoczone, 40202
- Rekrutacyjny
- Norton Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 502-629-5500
- E-mail: CancerResource@nortonhealthcare.org
-
Główny śledczy:
- Michael J. Ferguson
-
-
Louisiana
-
New Orleans, Louisiana, Stany Zjednoczone, 70118
- Rekrutacyjny
- Children's Hospital New Orleans
-
Główny śledczy:
- Maria C. Velez-Yanguas
-
Kontakt:
- Site Public Contact
- Numer telefonu: 504-894-5377
-
New Orleans, Louisiana, Stany Zjednoczone, 70121
- Rekrutacyjny
- Ochsner Medical Center Jefferson
-
Kontakt:
- Site Public Contact
- Numer telefonu: 504-842-8084
- E-mail: Elisemarie.curry@ochsner.org
-
Główny śledczy:
- Craig Lotterman
-
-
Maine
-
Scarborough, Maine, Stany Zjednoczone, 04074
- Rekrutacyjny
- Maine Children's Cancer Program
-
Główny śledczy:
- Sei-Gyung K. Sze
-
Kontakt:
- Site Public Contact
- Numer telefonu: 207-396-8670
- E-mail: clinicalresearch@mainehealth.org
-
-
Maryland
-
Baltimore, Maryland, Stany Zjednoczone, 21287
- Rekrutacyjny
- Johns Hopkins University/Sidney Kimmel Cancer Center
-
Główny śledczy:
- Stacy L. Cooper
-
Kontakt:
- Site Public Contact
- Numer telefonu: 410-955-8804
- E-mail: jhcccro@jhmi.edu
-
Baltimore, Maryland, Stany Zjednoczone, 21215
- Rekrutacyjny
- Sinai Hospital of Baltimore
-
Główny śledczy:
- Jason M. Fixler
-
Kontakt:
- Site Public Contact
- Numer telefonu: 410-601-9083
-
-
Massachusetts
-
Boston, Massachusetts, Stany Zjednoczone, 02215
- Rekrutacyjny
- Dana-Farber Cancer Institute
-
Główny śledczy:
- Melissa A. Burns
-
Kontakt:
- Site Public Contact
- Numer telefonu: 877-442-3324
-
Worcester, Massachusetts, Stany Zjednoczone, 01655
- Rekrutacyjny
- UMass Memorial Medical Center - University Campus
-
Kontakt:
- Site Public Contact
- Numer telefonu: 508-856-3216
- E-mail: cancer.research@umassmed.edu
-
Główny śledczy:
- Stefanie R. Lowas
-
-
Michigan
-
Ann Arbor, Michigan, Stany Zjednoczone, 48109
- Rekrutacyjny
- C S Mott Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-865-1125
-
Główny śledczy:
- Joshua W. Goldman
-
Grand Rapids, Michigan, Stany Zjednoczone, 49503
- Rekrutacyjny
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 616-391-1230
- E-mail: crcwm-regulatory@crcwm.org
-
Główny śledczy:
- Kathleen Y. Butler
-
Kalamazoo, Michigan, Stany Zjednoczone, 49007
- Rekrutacyjny
- Bronson Methodist Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 616-391-1230
- E-mail: crcwm-regulatory@crcwm.org
-
Główny śledczy:
- Kathleen Y. Butler
-
-
Minnesota
-
Minneapolis, Minnesota, Stany Zjednoczone, 55455
- Rekrutacyjny
- University of Minnesota/Masonic Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 612-624-2620
-
Główny śledczy:
- Peter M. Gordon
-
-
Mississippi
-
Jackson, Mississippi, Stany Zjednoczone, 39216
- Rekrutacyjny
- University of Mississippi Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 601-815-6700
-
Główny śledczy:
- Amanda Strobel
-
-
Missouri
-
Kansas City, Missouri, Stany Zjednoczone, 64108
- Rekrutacyjny
- Children's Mercy Hospitals and Clinics
-
Główny śledczy:
- Keith J. August
-
Kontakt:
- Site Public Contact
- Numer telefonu: 816-302-6808
- E-mail: COGResearchGroup@cmh.edu
-
St Louis, Missouri, Stany Zjednoczone, 63110
- Rekrutacyjny
- Washington University School of Medicine
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-600-3606
- E-mail: info@siteman.wustl.edu
-
Główny śledczy:
- Laura G. Schuettpelz
-
St Louis, Missouri, Stany Zjednoczone, 63141
- Rekrutacyjny
- Mercy Hospital Saint Louis
-
Kontakt:
- Site Public Contact
- Numer telefonu: 314-251-7066
-
Główny śledczy:
- Robin D. Hanson
-
-
Nebraska
-
Omaha, Nebraska, Stany Zjednoczone, 68114
- Rekrutacyjny
- Children's Hospital and Medical Center of Omaha
-
Kontakt:
- Site Public Contact
- Numer telefonu: 402-955-3949
-
Główny śledczy:
- Jill C. Beck
-
-
Nevada
-
Las Vegas, Nevada, Stany Zjednoczone, 89135
- Rekrutacyjny
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
-
Kontakt:
- Site Public Contact
- Numer telefonu: 702-384-0013
- E-mail: research@sncrf.org
-
Główny śledczy:
- Joseph L. Lasky
-
-
New Hampshire
-
Lebanon, New Hampshire, Stany Zjednoczone, 03756
- Rekrutacyjny
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
Główny śledczy:
- Angela Ricci
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-639-6918
- E-mail: cancer.research.nurse@dartmouth.edu
-
-
New Jersey
-
Hackensack, New Jersey, Stany Zjednoczone, 07601
- Rekrutacyjny
- Hackensack University Medical Center
-
Główny śledczy:
- Jing Chen
-
Kontakt:
- Site Public Contact
- Numer telefonu: 551-996-2897
-
Morristown, New Jersey, Stany Zjednoczone, 07960
- Rekrutacyjny
- Morristown Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 973-971-5900
-
Główny śledczy:
- Kathryn L. Laurie
-
New Brunswick, New Jersey, Stany Zjednoczone, 08903
- Rekrutacyjny
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
-
Główny śledczy:
- Marissa Botwinick
-
Kontakt:
- Site Public Contact
- Numer telefonu: 732-235-8675
-
Paterson, New Jersey, Stany Zjednoczone, 07503
- Rekrutacyjny
- Saint Joseph's Regional Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 973-754-2207
- E-mail: HallL@sjhmc.org
-
Główny śledczy:
- Alissa Kahn
-
-
New York
-
Albany, New York, Stany Zjednoczone, 12208
- Rekrutacyjny
- Albany Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 518-262-5513
-
Główny śledczy:
- Lauren R. Weintraub
-
Buffalo, New York, Stany Zjednoczone, 14263
- Rekrutacyjny
- Roswell Park Cancer Institute
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-767-9355
- E-mail: askroswell@roswellpark.org
-
Główny śledczy:
- Lisa Niswander
-
New Hyde Park, New York, Stany Zjednoczone, 11040
- Rekrutacyjny
- The Steven and Alexandra Cohen Children's Medical Center of New York
-
Kontakt:
- Site Public Contact
- Numer telefonu: 718-470-3460
-
Główny śledczy:
- Julie I. Krystal
-
New York, New York, Stany Zjednoczone, 10065
- Rekrutacyjny
- Memorial Sloan Kettering Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 212-639-7592
-
Główny śledczy:
- Kavitha Ramaswamy
-
New York, New York, Stany Zjednoczone, 10016
- Rekrutacyjny
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Główny śledczy:
- Elizabeth A. Raetz
-
Kontakt:
- Site Public Contact
- E-mail: CancerTrials@nyulangone.org
-
New York, New York, Stany Zjednoczone, 10065
- Rekrutacyjny
- NYP/Weill Cornell Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 212-746-1848
-
Główny śledczy:
- Jaclyn Rosenzweig
-
Rochester, New York, Stany Zjednoczone, 14642
- Rekrutacyjny
- University of Rochester
-
Kontakt:
- Site Public Contact
- Numer telefonu: 585-275-5830
-
Główny śledczy:
- Carol Fries Simpson
-
Syracuse, New York, Stany Zjednoczone, 13210
- Rekrutacyjny
- State University of New York Upstate Medical University
-
Kontakt:
- Site Public Contact
- Numer telefonu: 315-464-5476
-
Główny śledczy:
- Melanie A. Comito
-
The Bronx, New York, Stany Zjednoczone, 10467
- Rekrutacyjny
- Montefiore Medical Center - Moses Campus
-
Kontakt:
- Site Public Contact
- Numer telefonu: 718-379-6866
- E-mail: eskwak@montefiore.org
-
Główny śledczy:
- Alice Lee
-
Valhalla, New York, Stany Zjednoczone, 10595
- Rekrutacyjny
- New York Medical College
-
Kontakt:
- Site Public Contact
- Numer telefonu: 914-594-3794
-
Główny śledczy:
- Andrew J. Bellantoni
-
-
North Carolina
-
Chapel Hill, North Carolina, Stany Zjednoczone, 27599
- Rekrutacyjny
- UNC Lineberger Comprehensive Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 877-668-0683
- E-mail: cancerclinicaltrials@med.unc.edu
-
Główny śledczy:
- Thomas B. Alexander
-
Charlotte, North Carolina, Stany Zjednoczone, 28203
- Rekrutacyjny
- Carolinas Medical Center/Levine Cancer Institute
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-804-9376
-
Główny śledczy:
- Joel A. Kaplan
-
Durham, North Carolina, Stany Zjednoczone, 27710
- Rekrutacyjny
- Duke University Medical Center
-
Główny śledczy:
- Jessica M. Sun
-
Kontakt:
- Site Public Contact
- Numer telefonu: 888-275-3853
-
Greenville, North Carolina, Stany Zjednoczone, 27834
- Rekrutacyjny
- East Carolina University
-
Kontakt:
- Site Public Contact
- Numer telefonu: 252-744-1015
- E-mail: eubankss@ecu.edu
-
Główny śledczy:
- Andrea R. Whitfield
-
Winston-Salem, North Carolina, Stany Zjednoczone, 27157
- Rekrutacyjny
- Wake Forest University Health Sciences
-
Kontakt:
- Site Public Contact
- Numer telefonu: 336-713-6771
-
Główny śledczy:
- Sarah Supples
-
-
North Dakota
-
Fargo, North Dakota, Stany Zjednoczone, 58122
- Rekrutacyjny
- Sanford Broadway Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 701-323-5760
- E-mail: OncologyClinicalTrialsFargo@sanfordhealth.org
-
Główny śledczy:
- Samuel J. Milanovich
-
-
Ohio
-
Akron, Ohio, Stany Zjednoczone, 44308
- Rekrutacyjny
- Children's Hospital Medical Center of Akron
-
Kontakt:
- Site Public Contact
- Numer telefonu: 330-543-3193
-
Główny śledczy:
- Lauren R. Draper
-
Cincinnati, Ohio, Stany Zjednoczone, 45229
- Rekrutacyjny
- Cincinnati Children's Hospital Medical Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 513-636-2799
- E-mail: cancer@cchmc.org
-
Główny śledczy:
- Erin H. Breese
-
Cleveland, Ohio, Stany Zjednoczone, 44106
- Rekrutacyjny
- Rainbow Babies and Childrens Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 216-844-5437
-
Główny śledczy:
- Duncan S. Stearns
-
Dayton, Ohio, Stany Zjednoczone, 45404
- Rekrutacyjny
- Dayton Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-228-4055
-
Główny śledczy:
- Jordan M. Wright
-
Toledo, Ohio, Stany Zjednoczone, 43606
- Rekrutacyjny
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 419-824-1842
- E-mail: PCIOncResearch@promedica.org
-
Główny śledczy:
- Jamie L. Dargart
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Stany Zjednoczone, 73104
- Rekrutacyjny
- University of Oklahoma Health Sciences Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 405-271-8777
- E-mail: ou-clinical-trials@ouhsc.edu
-
Główny śledczy:
- Rene Y. McNall-Knapp
-
-
Pennsylvania
-
Allentown, Pennsylvania, Stany Zjednoczone, 18103
- Rekrutacyjny
- Lehigh Valley Hospital-Cedar Crest
-
Kontakt:
- Site Public Contact
- Numer telefonu: 610-402-9543
- E-mail: Morgan_M.Horton@lvhn.org
-
Główny śledczy:
- Jacob A. Troutman
-
Danville, Pennsylvania, Stany Zjednoczone, 17822
- Rekrutacyjny
- Geisinger Medical Center
-
Główny śledczy:
- Jagadeesh Ramdas
-
Kontakt:
- Site Public Contact
- Numer telefonu: 570-271-5251
- E-mail: cancerresearch@geisinger.edu
-
Hershey, Pennsylvania, Stany Zjednoczone, 17033
- Rekrutacyjny
- Penn State Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 717-531-6012
-
Główny śledczy:
- Lisa M. McGregor
-
Philadelphia, Pennsylvania, Stany Zjednoczone, 19104
- Rekrutacyjny
- Children's Hospital of Philadelphia
-
Kontakt:
- Site Public Contact
- Numer telefonu: 267-425-5544
- E-mail: CancerTrials@email.chop.edu
-
Główny śledczy:
- Kathrin M. Bernt
-
Pittsburgh, Pennsylvania, Stany Zjednoczone, 15224
- Rekrutacyjny
- Children's Hospital of Pittsburgh of UPMC
-
Kontakt:
- Site Public Contact
- Numer telefonu: 412-692-8570
- E-mail: jean.tersak@chp.edu
-
Główny śledczy:
- Jenny Ruiz
-
-
Rhode Island
-
Providence, Rhode Island, Stany Zjednoczone, 02903
- Rekrutacyjny
- Rhode Island Hospital
-
Główny śledczy:
- Bradley DeNardo
-
Kontakt:
- Site Public Contact
- Numer telefonu: 401-444-1488
-
-
South Carolina
-
Columbia, South Carolina, Stany Zjednoczone, 29203
- Rekrutacyjny
- Prisma Health Richland Hospital
-
Główny śledczy:
- Stuart L. Cramer
-
Kontakt:
- Site Public Contact
- Numer telefonu: 864-522-4317
- E-mail: Kim.Williams3@prismahealth.org
-
Greenville, South Carolina, Stany Zjednoczone, 29605
- Rekrutacyjny
- BI-LO Charities Children's Cancer Center
-
Główny śledczy:
- Aniket Saha
-
Kontakt:
- Site Public Contact
- Numer telefonu: 864-522-4317
- E-mail: Kim.Williams3@prismahealth.org
-
-
South Dakota
-
Sioux Falls, South Dakota, Stany Zjednoczone, 57117-5134
- Rekrutacyjny
- Sanford USD Medical Center - Sioux Falls
-
Kontakt:
- Site Public Contact
- Numer telefonu: 605-312-3320
- E-mail: OncologyClinicalTrialsSF@SanfordHealth.org
-
Główny śledczy:
- Jordan Fritch-Hanson
-
-
Tennessee
-
Knoxville, Tennessee, Stany Zjednoczone, 37916
- Rekrutacyjny
- East Tennessee Childrens Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 865-541-8266
-
Główny śledczy:
- Susan E. Spiller
-
Memphis, Tennessee, Stany Zjednoczone, 38105
- Rekrutacyjny
- Saint Jude Children's Research Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 888-226-4343
- E-mail: referralinfo@stjude.org
-
Główny śledczy:
- Matthew Rees
-
Nashville, Tennessee, Stany Zjednoczone, 37232
- Rekrutacyjny
- Vanderbilt University/Ingram Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-811-8480
-
Główny śledczy:
- Brianna N. Smith
-
Nashville, Tennessee, Stany Zjednoczone, 37203
- Rekrutacyjny
- The Children's Hospital at TriStar Centennial
-
Kontakt:
- Site Public Contact
- Numer telefonu: 615-342-1919
-
Główny śledczy:
- Clinton M. Carroll
-
-
Texas
-
Austin, Texas, Stany Zjednoczone, 78723
- Rekrutacyjny
- Dell Children's Medical Center of Central Texas
-
Kontakt:
- Site Public Contact
- Numer telefonu: 512-628-1902
- E-mail: TXAUS-DL-SFCHemonc.research@ascension.org
-
Główny śledczy:
- Shannon M. Cohn
-
Corpus Christi, Texas, Stany Zjednoczone, 78411
- Rekrutacyjny
- Driscoll Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 361-694-5311
- E-mail: Crystal.DeLosSantos@dchstx.org
-
Główny śledczy:
- Nkechi I. Mba
-
Dallas, Texas, Stany Zjednoczone, 75390
- Rekrutacyjny
- UT Southwestern/Simmons Cancer Center-Dallas
-
Kontakt:
- Site Public Contact
- Numer telefonu: 214-648-7097
- E-mail: canceranswerline@UTSouthwestern.edu
-
Główny śledczy:
- Caroline Smith
-
Dallas, Texas, Stany Zjednoczone, 75230
- Rekrutacyjny
- Medical City Dallas Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 972-566-5588
-
Główny śledczy:
- Maurizio L. Ghisoli
-
El Paso, Texas, Stany Zjednoczone, 79905
- Rekrutacyjny
- El Paso Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 915-298-5444
- E-mail: ranjan.bista@ttuhsc.edu
-
Główny śledczy:
- Benjamin Carcamo
-
Fort Worth, Texas, Stany Zjednoczone, 76104
- Rekrutacyjny
- Cook Children's Medical Center
-
Główny śledczy:
- Holly Pacenta
-
Kontakt:
- Site Public Contact
- Numer telefonu: 682-885-2103
- E-mail: CookChildrensResearch@cookchildrens.org
-
Houston, Texas, Stany Zjednoczone, 77030
- Rekrutacyjny
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Główny śledczy:
- Joanna S. Yi
-
Kontakt:
- Site Public Contact
- Numer telefonu: 713-798-1354
- E-mail: burton@bcm.edu
-
San Antonio, Texas, Stany Zjednoczone, 78207
- Rekrutacyjny
- Children's Hospital of San Antonio
-
Kontakt:
- Site Public Contact
- Numer telefonu: 210-704-2894
- E-mail: bridget.medina@christushealth.org
-
Główny śledczy:
- Julie Voeller
-
San Antonio, Texas, Stany Zjednoczone, 78229
- Rekrutacyjny
- Methodist Children's Hospital of South Texas
-
Kontakt:
- Site Public Contact
- Numer telefonu: 210-575-6240
- E-mail: Vinod.GidvaniDiaz@hcahealthcare.com
-
Główny śledczy:
- Jose M. Esquilin
-
Temple, Texas, Stany Zjednoczone, 76508
- Rekrutacyjny
- Scott and White Memorial Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 254-724-5407
-
Główny śledczy:
- Nicholas W. McGregor
-
-
Virginia
-
Charlottesville, Virginia, Stany Zjednoczone, 22908
- Rekrutacyjny
- University of Virginia Cancer Center
-
Kontakt:
- Site Public Contact
- Numer telefonu: 434-243-6303
- E-mail: uvacancertrials@hscmail.mcc.virginia.edu
-
Główny śledczy:
- Brian C. Belyea
-
Norfolk, Virginia, Stany Zjednoczone, 23507
- Rekrutacyjny
- Children's Hospital of The King's Daughters
-
Kontakt:
- Site Public Contact
- Numer telefonu: 757-668-7243
- E-mail: CCBDCresearch@chkd.org
-
Główny śledczy:
- Melissa S. Mark
-
Richmond, Virginia, Stany Zjednoczone, 23298
- Rekrutacyjny
- VCU Massey Comprehensive Cancer Center
-
Główny śledczy:
- Jordyn R. Griffin
-
Kontakt:
- Site Public Contact
- Numer telefonu: 804-628-6430
- E-mail: CTOclinops@vcu.edu
-
Roanoke, Virginia, Stany Zjednoczone, 24014
- Rekrutacyjny
- Carilion Children's
-
Kontakt:
- Site Public Contact
- Numer telefonu: 540-266-6238
- E-mail: wpmccarty@carilionclinic.org
-
Główny śledczy:
- Erwood G. Edwards
-
-
Washington
-
Seattle, Washington, Stany Zjednoczone, 98105
- Rekrutacyjny
- Seattle Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 866-987-2000
-
Główny śledczy:
- Sarah E. Leary
-
Spokane, Washington, Stany Zjednoczone, 99204
- Rekrutacyjny
- Providence Sacred Heart Medical Center and Children's Hospital
-
Kontakt:
- Site Public Contact
- Numer telefonu: 800-228-6618
- E-mail: HopeBeginsHere@providence.org
-
Główny śledczy:
- Judy L. Felgenhauer
-
-
Wisconsin
-
Green Bay, Wisconsin, Stany Zjednoczone, 54301
- Rekrutacyjny
- Saint Vincent Hospital Cancer Center Green Bay
-
Główny śledczy:
- Catherine A. Long
-
Kontakt:
- Site Public Contact
- Numer telefonu: 920-433-8889
- E-mail: WI_research_admin@hshs.org
-
Milwaukee, Wisconsin, Stany Zjednoczone, 53226
- Rekrutacyjny
- Children's Hospital of Wisconsin
-
Kontakt:
- Site Public Contact
- Numer telefonu: 414-955-4727
- E-mail: MACCCTO@mcw.edu
-
Główny śledczy:
- Zachary Graff
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
-
All patients must be enrolled on APEC14B1 and consented to eligibility screening (part A) prior to treatment and enrollment on AALL2321
-
Infants (aged 365 days or less) on the date of diagnosis are eligible; infants must be > 36 weeks gestational age (cumulative prenatal and postnatal age must be > 36 weeks) at the time of enrollment
-
Patients must have newly diagnosed B-acute lymphoblastic leukemia (B-ALL, 2017 World Health Organization [WHO] classification), also termed B-precursor ALL, or acute leukemia of ambiguous lineage (ALAL), which includes mixed phenotype acute leukemia. For patients with ALAL, the immunophenotype of the leukemia must comprise at least 50% B lineage
- Diagnostic immunophenotype: Leukemia cells must express CD19
Exclusion Criteria:
-
Patients with Down Syndrome
-
Patients with secondary B-ALL that developed after treatment of a prior malignancy with cytotoxic chemotherapy
-
Patients must not have received any cytotoxic chemotherapy for either the current diagnosis of infant ALL or for any cancer diagnosis prior to the initiation of protocol therapy, with the exception of:
-
Steroid pretreatment:
- PredniSONE, prednisoLONE, or methylPREDNISolone for ≤ 72 hours (3 days) in the 7 days prior to enrollment. The dose of predniSONE, prednisoLONE or methylPREDNISolone does not affect eligibility
- Inhaled and topical steroids are not considered pretreatment
- Note: Pretreatment with dexamethasone in the 28 days prior to initiation of protocol therapy is not allowed with the exception of a single dose of dexamethasone used during or within 6 hours prior to or after sedation to prevent or treat airway edema. However, prior exposure to ANY steroids that occurred > 28 days before enrollment does not affect eligibility
-
Intrathecal cytarabine or methotrexate:
- An intrathecal dose of cytarabine or methotrexate in the 7 days prior to enrollment does not affect eligibility
- Note: The preference is to defer the diagnostic lumbar puncture with intrathecal chemotherapy to day 1 of induction to allow for cytoreduction of circulating blasts and decrease the potential for central nervous system (CNS) contamination due to a traumatic tap. If done prior to day 1 of induction, these results will be used to determine CNS status
-
Hydroxyurea:
- Pretreatment with ≤ 72 hours (3 days) of hydroxyurea in the 7 days prior to enrollment does not affect eligibility
-
-
All patients and/or their parents or legal guardians must sign a written informed consent
-
All institutional, Food and Drug Administration (FDA) and National Cancer Institute (NCI) requirements for human studies must be met
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Zadanie sekwencyjne
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Eksperymentalny: Arm A
See Detailed Description for Arm A. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Given IV
Inne nazwy:
Undergo bone marrow aspiration Given IV
Inne nazwy:
Undergo lumbar puncture
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Given IV
Inne nazwy:
Given IT
Inne nazwy:
Given recombinant crisantaspase IM or crisantaspase IM or IV
Inne nazwy:
Given IT or IV
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO or NG
Inne nazwy:
Given IT or IV or PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
|
Eksperymentalny: Arm B, Cohort 1
See Detailed Description for Arm B, Cohort 1. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Given IV
Inne nazwy:
Undergo bone marrow aspiration Given IV
Inne nazwy:
Undergo lumbar puncture
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Given IV
Inne nazwy:
Given IT
Inne nazwy:
Given recombinant crisantaspase IM or crisantaspase IM or IV
Inne nazwy:
Given IT or IV
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO or NG
Inne nazwy:
Given IT or IV or PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
|
Eksperymentalny: Arm B, Cohort 2
See Detailed Description for Arm B, Cohort 2. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Given IV
Inne nazwy:
Undergo bone marrow aspiration Given IV
Inne nazwy:
Undergo lumbar puncture
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Given IV
Inne nazwy:
Given IT
Inne nazwy:
Given recombinant crisantaspase IM or crisantaspase IM or IV
Inne nazwy:
Given IT or IV
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO or NG
Inne nazwy:
Given IT or IV or PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
|
Eksperymentalny: Arm B, Cohort 3
See Detailed Description for Arm B, Cohort 3. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Given IV
Inne nazwy:
Undergo bone marrow aspiration Given IV
Inne nazwy:
Undergo lumbar puncture
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Given IV
Inne nazwy:
Given IT
Inne nazwy:
Given recombinant crisantaspase IM or crisantaspase IM or IV
Inne nazwy:
Given IT or IV
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO or NG
Inne nazwy:
Given IT or IV or PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
|
Eksperymentalny: Arm B, Cohort 4
See Detailed Description for Arm B, Cohort 4. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Given IV
Inne nazwy:
Undergo bone marrow aspiration Given IV
Inne nazwy:
Undergo lumbar puncture
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Given IV
Inne nazwy:
Given IT
Inne nazwy:
Given recombinant crisantaspase IM or crisantaspase IM or IV
Inne nazwy:
Given IT or IV
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO or NG
Inne nazwy:
Given IT or IV or PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
|
Eksperymentalny: Arm C
See Detailed Description for Arm C. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Given IV
Inne nazwy:
Undergo bone marrow aspiration Given IV
Inne nazwy:
Undergo lumbar puncture
Inne nazwy:
Given IV
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Given IV
Inne nazwy:
Given IT
Inne nazwy:
Given IT or IV
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO or NG
Inne nazwy:
Given IT or IV or PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
|
Eksperymentalny: Safety Phase Cohort
See Detailed Description for Safety Phase Cohort. (CLOSED TO ACCRUAL 06/03/2026) |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Given IV
Inne nazwy:
Undergo bone marrow aspiration Given IV
Inne nazwy:
Undergo lumbar puncture
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Given IV
Inne nazwy:
Given IT
Inne nazwy:
Given recombinant crisantaspase IM or crisantaspase IM or IV
Inne nazwy:
Given IT or IV
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG or IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO or NG
Inne nazwy:
Given IT or IV or PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
|
Eksperymentalny: Steroid Prephase(prednisone, prednisolone, methylprednisolone)
All patients receive prednisone or prednisolone PO or NG TID or methylprednisolone IV TID for 7 days prior to the start of induction therapy (on days 1-7). |
Undergo CT
Inne nazwy:
Undergo MRI
Inne nazwy:
Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Undergo bone marrow aspiration Undergo lumbar puncture
Inne nazwy:
Given IV
Inne nazwy:
Undergo collection of blood samples
Inne nazwy:
Undergo FDG-PET
Inne nazwy:
Given PO or NG
Inne nazwy:
Given PO or NG
Inne nazwy:
|
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Incidence of dose-limiting toxicities (DLTs) (safety phase)
Ramy czasowe: For the duration of the induction + venetoclax cycle
|
For the safety phase, DLTs of the induction + venetoclax cycle of KMT2A-rearranged (R) patients will be assessed. |
For the duration of the induction + venetoclax cycle
|
|
Incidence of DLTs (expansion phase)
Ramy czasowe: During the induction, consolidation, and MARMA cycles of Arm B
|
For the expansion phase, DLTs of Arm B will be assessed and monitored for the cycles that contain venetoclax (induction, consolidation, and MARMA cycles of Arm B). |
During the induction, consolidation, and MARMA cycles of Arm B
|
|
Minimal residual disease (MRD)-negative remission rate
Ramy czasowe: At the end of induction
|
The end of induction MRD-negative remission rate will be compared between Arm A and Arm B. MRD negativity is defined as achievement of complete remission and MRD < 0.01% by flow cytometry. The MRD-negative remission rate at the end of induction between Arm A and Arm B will be compared using a one-sided Z test of proportions with Type I error of 0.15. |
At the end of induction
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
MRD-negative remission rate
Ramy czasowe: At the end of induction
|
MRD-negative remission rate at the end of induction and the standard error or 95% confidence interval will be estimated among infants with KMT2A-R acute lymphoblastic leukemia (ALL) treated with venetoclax at the RP2D. This analysis will include eligible KMT2A-R patients treated with venetoclax at the RP2D in the safety phase, as well as patients randomized to Arm B and treated with venetoclax in the expansion phase. MRD negativity is defined as < 0.01% by flow cytometry. |
At the end of induction
|
|
Event free survival (EFS) rates of infants with KMT2A-R ALL
Ramy czasowe: From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
The EFS rates from date of randomization of Arm B will be compared to Arm A. Comparison of EFS rates between Arm A and Arm B will be based on a one-sided logrank test with Type I error of 0.15. In addition, EFS rates will be estimated using the Kaplan-Meier method with Greenwood standard errors. Hazard ratios and confidence intervals will be estimated based on Cox regression models as appropriate. Cumulative incidence rates of each EFS event type (relapse, treatment failure, secondary malignant neoplasm and death) will also be estimated and presented with cumulative incidence curves and compared between arms as appropriate. |
From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
3-year EFS of infants with KMT2A-R ALL
Ramy czasowe: From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
For Arm A, the 3-year EFS rate (representing a plateau rate based on the shape of EFS curves of historical data in this patient population) from the date of randomization will be compared to the stable historical 3-year EFS rate of 35% observed in AALL0631 and other international trials. |
From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
Proportion of KMT2A-germline (G) patients in Arm C who are able to receive all treatment cycles before maintenance
Ramy czasowe: Up to interim maintenance 2
|
The feasibility of treating KMT2A-G patients with a high-risk ALL backbone and two cycles of blinatumomab (Arm C) will be assessed. Arm C treatment will be considered feasible for KMT2A-G patients if the proportion of KMT2A-G patients in Arm C who are able to receive all treatment cycles before maintenance (i.e., up to interim maintenance 2) is more than 76.8%. The proportion of patients receiving all cycles before Maintenance will be compared to 76.8% with a one-sample exact test of proportion with Type I error of 0.15. |
Up to interim maintenance 2
|
|
3-year EFS of infants with KMT2A-G ALL treated on Arm C
Ramy czasowe: From date of enrollment to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
The 3-year EFS rate from date of enrollment of KMT2A-G patients in Arm C will be estimated with the Kaplan-Meier method. |
From date of enrollment to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
Pharmacokinetics (PK) of venetoclax in infants
Ramy czasowe: On days 7, 10, and 14 of induction
|
PK samples will be collected from patients enrolled in the safety phase of the study as well as from patients randomized to Arm B in the expansion phase who consent to participate, to determine the major secondary objective of characterizing the PK of venetoclax in infants. PK samples will be evaluated in batches and standard nonlinear mixed effect modeling will be used for model building and refinement of time-concentration data. After model refinement, a non-parametric bootstrap analysis will be performed reporting the 95% confidence intervals for each PK parameter. |
On days 7, 10, and 14 of induction
|
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
3-year EFS of infants with KMT2A-R ALL treated on Arm B
Ramy czasowe: From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
Arm B, the 3-year EFS rate from date of randomization will be estimated, and will be compared to Arm A as described in the secondary objective, and to historical 3-year EFS. Comparison to historical rate will be based on a one-sample test of proportion with one-sided Type I error of 0.15. |
From date of randomization to treatment failure, first documented relapse following achievement of remission-1, occurrence of a second or secondary malignant neoplasm, or death, assessed up to 3 years
|
|
Use of high-throughput sequencing (HTS) for MRD detection in infant ALL compared to centralized flow cytometry
Ramy czasowe: Up to 3 years
|
Pre-treatment HTS clonality and HTS MRD tracking results will be collected and compared to the required centralized flow cytometry-based MRD data to evaluate the feasibility and prognostic utility of HTS MRD evaluation in the infant ALL population. |
Up to 3 years
|
|
PK of calaspargase pegol in infants with ALL
Ramy czasowe: At completion of the trial, up to 3 years
|
PK of calaspargase pegol will be analyzed by monitoring asparaginase activity levels. Once a PK model is developed for calaspargase pegol, standard regression analysis will be used to describe the relationship between drug exposure and asparaginase activity. Additionally, asparaginase-associated toxicities will be described for the entire study population and correlated with activity levels when possible. The result of this analysis will be an estimation of potential optimal exposure expected to yield the maximum efficacy while limiting toxicity. These analyses will be exploratory and descriptive. |
At completion of the trial, up to 3 years
|
|
Incidence of CD19-negative relapse and myeloid switch relapse with protocol therapy
Ramy czasowe: At the time of relapse, up to 3 years
|
For patients who experience relapse, will collect information regarding the immunophenotype of the leukemic blasts at time of relapse. Will report on the rate of CD19 negative relapse as well as myeloid switch relapse for all patients enrolled on study. This analysis will be exploratory and descriptive. |
At the time of relapse, up to 3 years
|
|
Impact of venetoclax in combination with chemotherapy on T-cell subsets and function
Ramy czasowe: Prior to and following the first course of venetoclax
|
BCL-2 inhibition is reported to alter T-cell subsets, including increased activation, enhanced cytotoxicity against leukemia cells and heightened resistance to cell death. Peripheral blood and bone marrow samples will be collected prior to and following the first course of venetoclax to evaluate effects on T-cell subsets and function following venetoclax exposure. |
Prior to and following the first course of venetoclax
|
|
Feasibility of T-cell collection and success of T-cell manufacturing for infants with KMT2A-R ALL who receive chimeric antigen receptor (CAR) T-cell therapy
Ramy czasowe: After coming off protocol therapy
|
For patients that undergo T-cell collection, will collect data regarding the feasibility of T-cell collection in the context of protocol therapy. Additionally, for patients who proceed with CAR T-cell therapy after coming off protocol therapy, will collect data regarding the success of T-cell manufacturing, infusion and response to therapy in this young population, as the success of this subsequent therapy may be heavily impacted by the effect of protocol therapy on T-cell function. These analyses will be exploratory and descriptive. |
After coming off protocol therapy
|
|
Predictors of response and resistance to venetoclax and overall protocol therapy
Ramy czasowe: Before and after venetoclax exposure, up to 3 years
|
Will study the inter- and intra- patient variability in the expression of apoptotic proteins (e.g., BCL-2, MCL-1, BCL-XL) and apoptotic priming at diagnosis and identify changes that occur during induction therapy in relationship to venetoclax exposure. Will then determine whether the state of BCL-2 specific apoptotic priming correlates with outcome. Will also integrate genomic and molecular features (such as developmental state, signaling, epigenomic, transcriptomic, proteomic and metabolomic states) before and after venetoclax exposure, for those assays where this type of analysis is feasible, to determine biomarkers of response and resistance to therapy for infants with ALL. |
Before and after venetoclax exposure, up to 3 years
|
|
Impact of subsequent anti-cancer therapy on overall survival
Ramy czasowe: After coming off protocol therapy
|
For all patients who remain in study follow-up after coming off protocol therapy, data will be collected regarding subsequent cancer directed therapies received as well as relapse and survival status in order to evaluate the impact of subsequent cancer directed therapy on the overall survival of patients enrolled on this study. These analyses will be exploratory and descriptive. |
After coming off protocol therapy
|
|
Overall survival (OS) rates
Ramy czasowe: From randomization to death due to any cause, up to 3 years
|
Will compare OS rates of infants by arms and to historical OS rates. The OS rates from the date of randomization of patients with KMT2A-R ALL will be compared between Arm A and Arm B. Comparison of OS rates between Arm A and Arm B will be based on a one-sided logrank test with Type I error of 0.15. In addition, OS rates of KMT2A-R patients in Arm A and Arm B will be compared to historical rates observed in similar patients in completed studies such as AALL0631 or AALL15P1. In addition, OS from enrollment of KMT2A-G patients will be compared to historical rates. OS rates will be estimated using the Kaplan-Meier method with Greenwood standard errors. Hazard ratios and confidence intervals will be estimated based on Cox regression models as appropriate. These analyses will be largely exploratory. |
From randomization to death due to any cause, up to 3 years
|
Współpracownicy i badacze
Sponsor
Śledczy
- Główny śledczy: Erin H Breese, Children's Oncology Group
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
- Nowotwory
- Choroby układu odpornościowego
- Infekcje
- Choroby wirusowe
- Nowotwory według typu histologicznego
- Choroby hematologiczne
- Infekcje wirusami DNA
- Choroby limfatyczne
- Zaburzenia limfoproliferacyjne
- Zaburzenia immunoproliferacyjne
- Chłoniak nieziarniczy
- Chłoniak z komórek B
- Chłoniak
- Białaczka, układ limfatyczny
- Białaczka
- Zakażenia wirusem Epsteina-Barra
- Infekcje Herpesviridae
- Zakażenia wirusem nowotworowym
- Choroby hemowe i limfatyczne
- Chłoniak Burkitta
- Białaczka, dwufenotypowa, ostra
- Hormony
- Hormony, substytuty hormonów i antagoniści hormonów
- Związki siarki
- Organiczne chemikalia
- Związki heterocykliczne, 1-ring
- Związki heterocykliczne
- Związki heterocykliczne, 2-ring
- Związki heterocykliczne, sterowanie stopieniem
- Techniki śledcze
- Lecznictwo
- Techniki laboratoryjne kliniczne
- Techniki i procedury diagnostyczne
- Diagnoza
- Nakłucia
- Procedury chirurgiczne, operacyjny
- Kwasy nukleinowe, nukleotydy i nukleozydy
- Biopsja
- Węglowodory
- Węglowodory, cykliczne
- Węglowodany
- Alkaloidy
- Policykliczne aromatyczne węglowodory
- Węglowodory, aromatyczne
- Związki policykliczne
- Glikozydy
- Hydrolazy
- Enzymy
- Enzymy i koenzymy
- Indole
- Puryny
- Cytydyna
- Nukleozydy pirymidynowe
- Pirymidyn
- Ciąży
- Ciężarne
- Steroidy
- Związki sterownika
- Sterydy, fluorowane
- Pochodne benzenu
- Techniki chemii, analityczne
- Kwasy sulfonowe
- Kwasy siarkowe
- Analiza widma
- Mostki fosforamidu
- Związki musztardy azotu
- Związki musztardy
- Węglowodory, uboczne
- Fosforamidy
- Związki okorosfosforowe
- Nukleozydy
- FormylTetrahydrofolates
- Tetrahydrofolety
- Kwas foliowy
- Pterins
- Perydyny
- Ciąży
- Ciąży
- Amidohydrolazy
- Vinca alkaloidy
- Sesologanina alkaloidy tryptaminy
- Alkaloidy indole
- Indolizicyny
- Indolizyny
- Arabinonukleozydy
- Aminopterina
- Antracykliny
- Naftaceny
- Aminoglikozydy
- Koenzymy
- Ciążone
- Pusta
- 11-hydroksykortykosteroidy
- Hydroksykortykosteroidy
- Hormony kory nadnerczy
- 17-hydroksykortykosteroidy
- Techniki diagnostyczne, neurologiczne
- Benzenezulfoniany
- Arylosulfoniany
- Kwasy arylosulfonowe
- Związki sulfhydrylowe
- Deksametazon
- Metotreksat
- Prednizon
- Prednizolon
- Cyklofosfamid
- Cytarabina
- Leukoworyna
- Lewoleukoworyna
- Doksorubicyna
- Winkrystyna
- Metyloprednizolon
- Daunorubicyna
- Hydrokortyzon
- Asparaginaza
- Merkaptopuryna
- Tioguanina
- Dobesylan wapnia
- Prowadzenie okazów
- Spektroskopia rezonansu magnetycznego
- Venetoclax
- Blinatumomab
- Kłucie kręgosłupa
- 21-fosforan deksametazonu
- Deltacortene
- prednielidene
- N, N-dicykloheksylo-izoborneol-10-sulfonamid
- Calaspargaza Pegol
- azathiopuryna
- Merphos
- Auricularum
- octan deksametazonu
- asparaginaza Erwinia chryzanthemi rekombinowana
- exifone
- Medrol Veriderm
Inne numery identyfikacyjne badania
- NCI-2024-01994
- U10CA180886 (Grant/umowa NIH USA)
- NCI-2024-01994 (Identyfikator rejestru: CTRP (Clinical Trial Reporting Program))
- AALL2321 (Inny identyfikator: CTEP)
- AALL2321 (Inny identyfikator: Children's Oncology Group)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .