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A Study Being Conducted at Multiple Locations to Compare Safety and Efficacy of Three Different Regimens; (1) High-Dose Lenalidomide; (2) Lenalidomide + Azacitidine; or (3) Azacitidine in Subjects ≥ 65 Years With Newly-Diagnosed Acute Myeloid Leukemia

2019年6月17日 更新者:Celgene

A Phase 2, Multicenter, Randomized, Open-label, Parallel-group Study of a Lenalidomide (Revlimid®) Regimen or a Sequential Azacitidine (Vidaza®) Plus Lenalidomide (Revlimid®) Regimen Versus an Azacitidine (Vidaza®) Regimen for Therapy of Older Subjects With Newly Diagnosed Acute Myeloid Leukemia

The study aim is to compare safety and efficacy of high-dose lenalidomide regimen, sequential azacitidine and lenalidomide and an azacitidine in persons ≥65 years with newly-diagnosed acute myeloid leukemia (AML).

研究概览

详细说明

On September 11, 2013, randomization into the continuous 50 mg lenalidomide only arm was temporarily suspended based on review of the data from the first 13 participants and a high rate of discontinuation (11/13 participants). The Data Monitoring Committee assessed the study data on September 20, 2013 and reported no safety concerns. The high rate of early discontinuation is inconsistent with the treatment duration required for testing the study primary endpoint of survival at one year. Consequently, Celgene has decided not to reopen the lenalidomide only arm.

研究类型

介入性

注册 (实际的)

88

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Alberta
      • Calgary、Alberta、加拿大、T2N 4N2
        • (402) Tom Baker Cancer Centre
      • Edmonton、Alberta、加拿大、T6G 1Z1
        • (405) University of Alberta Hospital
    • Manitoba
      • Winnipeg、Manitoba、加拿大、R3E 0V9
        • (401) Cancer Care Manitoba
    • Nova Scotia
      • Halifax、Nova Scotia、加拿大、B3H 2Y9
        • (403) Queen Elizabeth II Health Sciences Centre - VG Site
    • Ontario
      • Ottawa、Ontario、加拿大、K1H 8L6
        • (404) The Ottawa Hospital
      • Toronto、Ontario、加拿大、M5G 2M9
        • (400) Princess Margaret Hospital
    • Arizona
      • Tucson、Arizona、美国、85724
        • (210) University of Arizona Cancer Center
    • California
      • La Jolla、California、美国、92093-0960
        • (180) University of California, San Diego
      • Los Angeles、California、美国、90048
        • (240) Cedars-Sinai Medical Center
      • Orange、California、美国、92868
        • (215) Hematology Oncology Medical Group
      • Sacramento、California、美国、95857
        • (130) UC Davis Medical Center
      • San Luis Obispo、California、美国、93401
        • (200) Coastal Integrative Cancer Care
      • Stanford、California、美国、94305
        • (125) University of Stanford
    • Colorado
      • Aurora、Colorado、美国、80045
        • (115) University of Colorado Anschultz Cancer Center
    • Florida
      • Miami Beach、Florida、美国、33140
        • (145) Mount Sinai Comprehensive Cancer Center
    • Illinois
      • Chicago、Illinois、美国、60612
        • (140) Rush University Medical Center
    • Kansas
      • Westwood、Kansas、美国、66205
        • (185) The University of Kansas Cancer Center
    • Kentucky
      • Louisville、Kentucky、美国、40202
        • (175) University Lousiville
    • Louisiana
      • New Orleans、Louisiana、美国、70072
        • (195) Tulane University Hospital Tulane Cancer Center
    • Minnesota
      • Minneapolis、Minnesota、美国、55455
        • (235) University of Minnesota
    • Missouri
      • Saint Louis、Missouri、美国、63110-1093
        • (100) Washington University School of Medicine
    • Montana
      • Billings、Montana、美国、59101
        • (150) Billings Clinic
    • New York
      • New York、New York、美国、10029-65749
        • (165) Mount Sinai Medical Center New York
    • Pennsylvania
      • Pittsburgh、Pennsylvania、美国、15224-1791
        • (160) The Western Pennsylvania Hospital- Cancer Institute
    • South Carolina
      • Greenville、South Carolina、美国、29605
        • (205) Greenville Hospital System
    • South Dakota
      • Sioux Falls、South Dakota、美国、57105
        • (120) Avera Cancer Institute
    • Tennessee
      • Nashville、Tennessee、美国、37203
        • (230) Tennessee Oncology, PLLC
    • Texas
      • Dallas、Texas、美国、75390-9179
        • (105) University of Texas Southwestern Medical Center Simmons Comprehensive Cancer Center
      • San Antonio、Texas、美国、78229
        • (155) Cancer Care Centers of South Texas
    • Wisconsin
      • Madison、Wisconsin、美国、53792
        • (135) University of Wisconsin

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

65年 及以上 (年长者)

接受健康志愿者

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Newly diagnosed acute myeloid leukemia (AML), AML with antecedent hematologic disorder or therapy-related AML
  • Male or female subjects aged ≥ 65
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
  • White blood cell (WBC) count ≤ 10 x 10⁹/L at screening

Exclusion Criteria:

  • Previous treatment with azacitidine, decitabine, cytarabine or lenalidomide
  • Previous cytotoxic or biologic treatment of any kind for AML or prior use of targeted therapy agents.
  • Suspected or proven acute promyelocytic leukemia
  • Prior bone marrow or stem cell transplantation
  • Candidate for allogeneic bone marrow or stem cell transplantation
  • AML antecedent hematologic disorder such as chronic myelogenous leukemia or myeloproliferative neoplasms
  • Presence of malignant disease within the previous 12 months with exceptions

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:Lenalidomide in combination with azacitidine
Repeated cycles of azacitidine 75 mg/m^2/day subcutaneous (SC) on Days 1-7 and lenalidomide 50 mg/day by mouth (PO) on Days 8-28 followed by a 14-day break plus best supportive care
Azacitidine at 75 mg/m^2/day subcutaneous on Days 1-7
其他名称:
  • 维达扎
Lenalidomide 50 mg PO daily x 28 days for the first 2 cycles then 25 mg PO daily x 28 days for the next 2 cycles followed by continuous 28-day cycles of lenalidomide 10 mg PO daily
其他名称:
  • CC-5013
  • 来复美®

The use of BSC was considered as concomitant treatment and must be documented as concomitant medication.

BSC includes, but is not limited to, treatment with Red Blood Celll (RBC) or whole blood transfusions, fresh frozen plasma transfusions, platelet transfusions, antibiotic or antifungal therapy, and nutritional support

实验性的:Lenalidomide - single agent
Lenalidomide 50 mg PO daily for 28 days for the first 2 cycles and lenalidomide 25 mg daily for 28 days for the next 2 cycles followed by continuous 28-day cycles of lenalidomide 10 mg daily PO plus best supportive care
Lenalidomide 50 mg PO daily x 28 days for the first 2 cycles then 25 mg PO daily x 28 days for the next 2 cycles followed by continuous 28-day cycles of lenalidomide 10 mg PO daily
其他名称:
  • CC-5013
  • 来复美®

The use of BSC was considered as concomitant treatment and must be documented as concomitant medication.

BSC includes, but is not limited to, treatment with Red Blood Celll (RBC) or whole blood transfusions, fresh frozen plasma transfusions, platelet transfusions, antibiotic or antifungal therapy, and nutritional support

实验性的:Azacitidine-single agent
Repeated cycles of azacitidine 75mg/m^2/day subcutaneous on Days 1-7 followed by a 21-day break plus best supportive care
Azacitidine at 75 mg/m^2/day subcutaneous on Days 1-7
其他名称:
  • 维达扎

The use of BSC was considered as concomitant treatment and must be documented as concomitant medication.

BSC includes, but is not limited to, treatment with Red Blood Celll (RBC) or whole blood transfusions, fresh frozen plasma transfusions, platelet transfusions, antibiotic or antifungal therapy, and nutritional support

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Kaplan Meier Estimates for One Year Survival
大体时间:Up to 24 months
One-year survival rate was defined as all deaths within one year from the date of randomization. All others censored at the at year 1 or date of discontinuation
Up to 24 months
Overall Survival
大体时间:From date of randomization until the date of the first documented date of progression or date of death of any cause; the overall median follow-up for survivng participants was 4.1 months (range 0.2 to 54.8 months)
Overall Survival reported at the end of the study are for those participants who were alive at the end of the study
From date of randomization until the date of the first documented date of progression or date of death of any cause; the overall median follow-up for survivng participants was 4.1 months (range 0.2 to 54.8 months)

次要结果测量

结果测量
措施说明
大体时间
Percentage of Participants With a Complete Response or Morphologic Incomplete Response.
大体时间:Complete Response or Morphologic Incomplete Response data not analyzed.

Based on IWG response criteria for AML. Complete remission (CR), morphologic complete remission (CR) was defined as < 5% bone marrow blasts, an absolute neutrophil count ≥ 1 x 10^9/L, platelets ≥100 x 10^9/L, and transfusion independence (no transfusions for 1 week prior to each assessment). No duration of these findings is required for confirmation of this response.

Morphologic CR with incomplete blood count recovery (CRi) was defined as a morphologic complete remission but the ANC count may be <1 x 10^9/L and/or the platelet count may be <100 x 10^9/L. Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.

Complete Response or Morphologic Incomplete Response data not analyzed.
Duration of Remission (DoR)
大体时间:Duration of Remission (DoR) time frame not analyzed.
Duration of remission was defined as the time from the date of CR or CRi until relapse. Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
Duration of Remission (DoR) time frame not analyzed.
Cytogenetic Complete Remission Rate (CRc)
大体时间:Cytogenetic Complete Remission timeframe was not analyzed.
The CRc response category is comprised of the subset of participants who had abnormal cytogenetics at baseline and subsequently achieved CR during treatment in conjunction with a reversion to a normal karyotype. For the primary definition of CRc, a normal karyotype is defined as no clonal abnormalities after review of at least 10 metaphases using conventional cytogenetic techniques. Cytogenetic complete remission rate (CRc) 1) CR criteria met AND 2) Abnormal karyotype present at baseline AND 3) Reversion to normal karyotype at time of CR (based on ≥ 10 metaphases), where date of cytogenetic sample = date of BM sample used for the CR assessment. Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
Cytogenetic Complete Remission timeframe was not analyzed.
Percentage of Participants With an Overall Response Rate (CR +CRi+ PR)
大体时间:Overall response rate time frame was not analyzed.
Morphologic complete remission (CR) is defined as a leukemia-free state defined as less than 5% blasts in a one marrow aspirate with spicules and with at least 200 nucleated cells (there should be no blasts with auer rods) and ANC of ≥ 1 x 10^9/L, a platelet count ≥ 100 x 10^9/L, no transfusions for 1 week prior to each assessment. No duration of these findings is required for confirmation of this response. Morphologic complete remission with incomplete blood count recovery was defined as a morphologic complete remission but the ANC may be < 1 x 10^9/L and/or the platelet count may be < 100 x 10^9/L. Partial remission was defined as an ANC > 1 x 10^9/L and platelet count ≥ 100 x 10^9/L with a > 50% decrease in the percentage of bone marrow blasts to 5% to 25% (a blast count value of ≤ 5% may also be considered a partial remission if auer rods are present). Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
Overall response rate time frame was not analyzed.
Progression-Free Survival (PFS)
大体时间:Progression-Free survival data and time frame was not analyzed.
PFS is defined as the time from randomization to the first observation of documented disease progression or death from any cause whichever occurred first. Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
Progression-Free survival data and time frame was not analyzed.
Event-Free Survival (EFS)
大体时间:Event-Free survival time was not analyzed.
EFS was defined as the interval from the date of randomization to the date of treatment failure, progressive disease, relapse after CR or CRi, or death from any cause, whichever occurred first. Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
Event-Free survival time was not analyzed.
Relapse-Free Survival (RFS)
大体时间:Relapse-Free survival time frame was not analyzed.
RFS is defined only for subjects that achieve CR and CRi and is measured as the interval from that date to the date of disease relapse, death from any cause, whichever occurs first, censoring at the last visit date for subjects alive in continuous CR/CRi. Because of a high rate of discontinuation in one of the investigational cohorts, secondary endpoints were not analyzed.
Relapse-Free survival time frame was not analyzed.
Percentage of Participants With 30-Day Treatment-Related Mortality
大体时间:30 days
30-day mortality rate was defined as death from any cause within 30 days after first dose.
30 days
Number of Participants With Treatment Emergent Adverse Events (TEAE)
大体时间:From the first dose of study drug up to 28 days after the last dose of study drug; up to 15 May 2018
TEAEs were defined as those events that started on or after the first day of study drug up until 28 days after the last dose of study drug; Serious AE (SAE) = any AE which results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability; is a congenital anomaly/birth defect; constitutes an important medical event. Severity of AEs were graded based upon the participants symptoms according to the Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0); and according to the scale: Grade (Gr) 1 = Mild - transient or mild discomfort; no medical intervention required; Grade 2 = Moderate - mild to moderate limitation in activity; Grade 3 = Severe; Grade 4 = Life threatening; Grade 5 = Death
From the first dose of study drug up to 28 days after the last dose of study drug; up to 15 May 2018
Number of Participants With a Second Primary Malignancy
大体时间:From randomization of the last participant up to a minimum of 4 years following discontinuation
Second primary malignancies were monitored as events of interest and reported as serious adverse events regardless of the treatment arm the participant was enrolled in.
From randomization of the last participant up to a minimum of 4 years following discontinuation

其他结果措施

结果测量
措施说明
大体时间
Percentage of Participants Alive at One Year
大体时间:Up to 12 months
Defined as the percentage of participants who survived at one year
Up to 12 months

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

调查人员

  • 研究主任:Robert Gale, MD、Celgene

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2012年4月27日

初级完成 (实际的)

2015年5月19日

研究完成 (实际的)

2018年5月15日

研究注册日期

首次提交

2011年5月19日

首先提交符合 QC 标准的

2011年5月20日

首次发布 (估计)

2011年5月24日

研究记录更新

最后更新发布 (实际的)

2019年6月25日

上次提交的符合 QC 标准的更新

2019年6月17日

最后验证

2019年6月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

急性髓性白血病的临床试验

  • Shenzhen Second People's Hospital
    招聘中
    白血病 | 骨髓的 | 慢性的 | BCR-ABL (Breakpoint Cluster Region-abelson Murine Leukemia) | 积极的
    中国

Azacitidine的临床试验

3
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