Fludarabine, Cytarabine, Filgrastim and Idarubicin in Core Binding Factor (CBF) Leukemias - Full Text View

Sponsor:	M.D. Anderson Cancer Center
Information provided by (Responsible Party):	M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier:	NCT00801489

Purpose

The goal of this clinical research study is to learn if idarubicin can be added to the combination of fludarabine, cytarabine, and Neupogen (Filgrastim) without increasing the risk of side effects. This study will also look at whether the addition of idarubicin will increase the long-term chances of patients remaining disease free.

Condition	Intervention	Phase
Acute Myelogenous Leukemia	Drug: Fludarabine Drug: Cytarabine Drug: G-CSF (Filgrastim, Neupogen) Drug: Idarubicin	Phase II

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	A Phase 2 Study of Fludarabine, Cytarabine, Filgrastim and Idarubicin in Newly Diagnosed Core Binding Factor Associated Acute Myelogenous Leukemia

Resource links provided by NLM:

MedlinePlus related topics: Acute Myeloid Leukemia Cancer Leukemia

Drug Information available for: Cytarabine hydrochloride Fludarabine Idarubicin hydrochloride Idarubicin Fludarabine monophosphate Filgrastim Lenograstim Granulocyte colony-stimulating factor Cytarabine

U.S. FDA Resources

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:

Complete Response (CR) Rate and Toxicity Rate [ Time Frame: Weekly blood tests, bone marrow aspirate Days 18-24 and at 4 + 7 months, blood tests every 2-3 months for 2 years ] [ Designated as safety issue: Yes ]

Estimated Enrollment:	102
Study Start Date:	April 2007
Estimated Study Completion Date:	April 2014
Estimated Primary Completion Date:	April 2014 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Fludarabine + Cytarabine + Idarubicin + G-CSF G-CSF = Filgrastim or Neupogen	Drug: Fludarabine 30 mg/m^2 intravenously days 1, 2, 3, 4, and 5 (infusion time approximately 30 minutes). Post-Remission Therapy will consist of 3 days rather than 5 days. Other Name: Fludara® Drug: Cytarabine 2 g/m^2 intravenously over 4 hours daily days 1, 2, 3, 4, and 5; each infusion begins 3.5 hours after completion of that day's fludarabine infusion - Post-Remission Therapy will consist of 3 days rather than 5 days. Other Names: Cytosar-U Ara-C Drug: G-CSF (Filgrastim, Neupogen) 5 mcg/kg body weight (rounded off to the nearest number) starting day-1 till recovery of absolute neutrophil count (ANC) to 1.0 x 109/L or above. (G-CSF will be started on day 2 for patients with presenting WBC count > 10 x 109/L. Post-Remission Therapy will consist of 4 days rather than 5 days. Other Names: Neupogen Granulocyte Colony-Stimulating Factor G-CSF Drug: Idarubicin 6 mg/m2 by vein over 30 minutes to be given immediately after fludarabine administration on Days 3 and 4. Idarubicin will be administered as in induction cycle, in one post-remission cycle (from cycle 3-6). Idarubicin will be given immediately after fludarabine administration on Days 2 and 3. Other Name: Idamycin

Arms

Assigned Interventions

Experimental: Fludarabine + Cytarabine + Idarubicin + G-CSF

G-CSF = Filgrastim or Neupogen

Drug: Fludarabine

30 mg/m^2 intravenously days 1, 2, 3, 4, and 5 (infusion time approximately 30 minutes). Post-Remission Therapy will consist of 3 days rather than 5 days.

Other Name: Fludara®

Drug: Cytarabine

2 g/m^2 intravenously over 4 hours daily days 1, 2, 3, 4, and 5; each infusion begins 3.5 hours after completion of that day's fludarabine infusion - Post-Remission Therapy will consist of 3 days rather than 5 days.

Other Names:

Cytosar-U
Ara-C

Drug: G-CSF (Filgrastim, Neupogen)

5 mcg/kg body weight (rounded off to the nearest number) starting day-1 till recovery of absolute neutrophil count (ANC) to 1.0 x 109/L or above. (G-CSF will be started on day 2 for patients with presenting WBC count > 10 x 109/L. Post-Remission Therapy will consist of 4 days rather than 5 days.

Other Names:

Neupogen
Granulocyte Colony-Stimulating Factor
G-CSF

Drug: Idarubicin

6 mg/m2 by vein over 30 minutes to be given immediately after fludarabine administration on Days 3 and 4. Idarubicin will be administered as in induction cycle, in one post-remission cycle (from cycle 3-6). Idarubicin will be given immediately after fludarabine administration on Days 2 and 3.

Other Name: Idamycin

Show Detailed Description

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Patients must have untreated AML, or high-risk MDS [refractory anemia with excess blasts, (RAEB), or RAEB "in transformation" (RAEB-t)] characterized by t(8;21), inv(16), or t(16;16).The presence of additional abnormalities is irrelevant.
Age equal to or greater than 18 years (the safety of GO in patients <18 years is not determined and advantage of fludarabine, cytarabine, idarubicin-based regimen in CBF leukemias in children is not demonstrated).
Patients must provide written consent.
Because of the high possibility of CR in CBF leukemias, participants will not be excluded based on performance status.For patients with Eastern Co-operative Oncology Group (ECOG) performance status >/= to 3 the dosing schedule will be discussed with study chairman.
Patients with organ dysfunction will not be excluded from the study. For patients with evidence of organ dysfunction (creatinine >/= 1.5, cardiac ejection fraction </= 50%, total bilirubin >/=2 and AST/ALT >/= 3 times ULN, dose adjustments/omissions will be made.
Up to one cycle of prior induction therapy will be permitted to include patients in whom presence of "good-risk" cytogenetics was initially missed. If the patient is in remission from induction therapy, he/she will receive post-remission therapy. If the patient is not in remission then he/she will receive induction therapy.
Patients of child bearing potential should practice effective methods of contraception.

Exclusion Criteria:

1) Pregnant and lactating females will be excluded since the safety of GO or FLAG + Ida in pregnancy and lactation is unknown.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00801489

Contacts

Contact: Gautam Borthakur, MD

713-563-1586

Locations

United States, Texas
The University of Texas M.D. Anderson Cancer Center	Recruiting
Houston, Texas, United States, 77030
Contact: Gautam Borthakur, MD 713-563-1586
Principal Investigator: Gautam Borthakur, MD

Sponsors and Collaborators

M.D. Anderson Cancer Center

Investigators

Principal Investigator:

Gautam Borthakur, MD

M.D. Anderson Cancer Center

More Information

Additional Information:

M.D. Anderson Cancer Center's website This link exits the ClinicalTrials.gov site

No publications provided

Responsible Party:	M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier:	NCT00801489 History of Changes
Other Study ID Numbers:	2007-0147
Study First Received:	December 2, 2008
Last Updated:	November 18, 2011
Health Authority:	United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:

Leukemia
Acute Myelogenous Leukemia
AML

Additional relevant MeSH terms:

Leukemia
Leukemia, Myeloid, Acute
Leukemia, Myeloid
Neoplasms by Histologic Type
Neoplasms
Cytarabine
Fludarabine monophosphate
Vidarabine
Fludarabine
Idarubicin
Lenograstim
Antimetabolites, Antineoplastic

Antimetabolites
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Antineoplastic Agents
Therapeutic Uses
Antiviral Agents
Anti-Infective Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antibiotics, Antineoplastic
Adjuvants, Immunologic

ClinicalTrials.gov processed this record on February 09, 2012