A Phase I Trial of Myeloablative Conditioning w/ Clofarabine and HD Busulfan for Pts w/ Refractory Heme Malignancies Undergoing Allo PBSCT

This study has been completed.
Sponsor:
Collaborator:
Genzyme, a Sanofi Company
Information provided by (Responsible Party):
Indiana University ( Indiana University School of Medicine )
ClinicalTrials.gov Identifier:
NCT00477542
First received: May 21, 2007
Last updated: March 30, 2012
Last verified: September 2011
  Purpose

This is a phase trial to determine the maximum tolerated dose (MTD) of clofarabine in a combination with a myeloablative dose of busulfan. This is an initial step in developing a novel myeloablative preparative regimen for allogeneic hematopoietic stem cell transplantation (HSCT). While this phase I trial will initially develop the regimen in patients with refractory disease, it is expected that it will find its best application in patients with less advanced disease


Condition Intervention Phase
Hematologic Malignancies
Drug: clofarabine
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Trial of Myeloablative Conditioning Using Clofarabine and High-Dose Busulfan for Patients With Refractory Hematological Malignancies Undergoing Allogeneic HSCT

Resource links provided by NLM:


Further study details as provided by Indiana University:

Primary Outcome Measures:
  • Determine the MTD of clofarabine in association with a myeloablative dose of busulfan as a preparative regimen in patients with refractory hematological malignancies undergoing allogeneic HSCT. [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • • Assessment of the toxicity of the combination of clofarabine and busulfan • Assess clofarabine and busulfan pharmacokinetics with combination therapy • Describe the response rate • Describe relapse rate and event-free survival [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

Enrollment: 18
Study Start Date: May 2007
Study Completion Date: November 2010
Primary Completion Date: November 2010 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: clofarabine

    Cohort- n- Clofarabine (mg/m2/day)

    -1 3-10 20

    1. 3-6 30
    2. 3-6 40
    3. 3-6 50
    4. 3-6 60
    5. 6-10 70
Detailed Description:

All patients will receive the same dose of busulfan. The dose of clofarabine will be escalated in successive cohorts of patients. Using a standard dose escalation design, successive cohorts of 3 patients will be treated with escalating doses of clofarabine. At the MTD (or highest dose-level if the MTD is not reached), the cohort will be expanded to 10 patients to better investigate correlative studies and give some preliminary idea of efficacy.

  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Documentation of disease. Patients must have one of the following disease types:

    • Acute myeloid leukemia (AML) with either:

      • Primary refractory to induction chemotherapy
      • Relapsed and refractory AML with >5% blasts in bone marrow or extramedullary disease (excluding active disease of the central nervous system).
      • Patients in second or subsequent complete remission (CR2, CR3, etc.).
    • Acute lymphoblastic leukemia (ALL) with one of the following criteria:

      • Primary refractory to induction chemotherapy.
      • Relapsed and refractory ALL with >5% blasts in bone marrow or extramedullary disease (excluding active disease of the central nervous system).
      • Patients in second or subsequent complete remission (CR2, CR3, etc.).
    • Myelodysplasia, refractory anemia with excess blasts with 11-20% blasts in the bone marrow (RAEB II).
    • Chronic myelogenous leukemia (CML) with one of the following criteria:

      • Accelerated phase.
      • Patients in blast crisis.
    • Patients with aggressive non-Hodgkin's lymphoma (NHL), including diffuse large cell lymphoma, mediastinal B-cell lymphoma, transformed lymphoma, mantle cell lymphoma, and peripheral T cell lymphoma, who also have one of the following criteria:

      • Failure to achieve complete remission to primary induction therapy
      • Relapsed NHL, refractory to at least one line of salvage systemic therapy
  • Patients who relapse < 6 months following autologous stem cell transplantation are not eligible.
  • Patient age 18-60 years
  • Availability of a consenting HLA-matched donor
  • Performance status ECOG 0-1
  • No active infection. Patients with active infections requiring oral or intravenous antibiotics are not eligible for enrollment until resolution of infection.
  • No HIV disease. Patients with immune dysfunction are at a significantly higher risk of infection from intensive immunosuppressive therapies.
  • Non-pregnant and non-nursing. Treatment under this protocol would expose a fetus to significant risks. Women of childbearing potential should have a negative pregnancy test prior to study entry. Women and men of reproductive potential should agree to use an appropriate method of birth control throughout their participation in this study due to the teratogenic potential of the therapy utilized in this trial. Appropriate methods of birth control include oral contraceptives, implantable hormonal contraceptives (Norplant®), or double barrier method (diaphragm plus condom).
  • Required baseline laboratory values:

    • LVEF > 45% corrected
    • DLCO > 50% of predicted value (corrected for hemoglobin)
    • Serum creatinine ≤ 2.0 mg/dl or estimated creatinine clearance of ≥60 ml/min
    • Bilirubin < 1 x upper limit of normal value
    • AST and ALT < 1 x upper limit of normal value
  • Signed written informed consent. Patient must be capable of understanding the investigational nature of the investigational nature, potential risks and benefits of the study, and able to provide valid informed consent.

Exclusion Criteria:

  • Patients who relapse < 6 months following autologous stem cell transplantation are not eligible
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00477542

Locations
United States, Indiana
Indiana University Cancer Center
Indianapolis, Indiana, United States, 46202
Sponsors and Collaborators
Indiana University School of Medicine
Genzyme, a Sanofi Company
Investigators
Principal Investigator: Sherif Farag, MD, PhD Indiana University
  More Information

No publications provided

Responsible Party: Indiana University ( Indiana University School of Medicine )
ClinicalTrials.gov Identifier: NCT00477542     History of Changes
Other Study ID Numbers: 0704-30 IUCRO-0186
Study First Received: May 21, 2007
Last Updated: March 30, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by Indiana University:
Clofarabine
allogeneic HSCT
refractory malignancies

Additional relevant MeSH terms:
Neoplasms
Hematologic Neoplasms
Neoplasms by Site
Hematologic Diseases
Busulfan
Clofarabine
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Myeloablative Agonists

ClinicalTrials.gov processed this record on July 26, 2014