Phase I Dose-Escalation Trial of Clofarabine Followed by Escalating Doses of Fractionated Cyclophosphamide in Children With Relapsed or Refractory Acute Leukemias (POE07-01)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified September 2010 by Sidney Kimmel Comprehensive Cancer Center.
Recruitment status was  Active, not recruiting
Sponsor:
Collaborator:
Genzyme, a Sanofi Company
Information provided by:
Sidney Kimmel Comprehensive Cancer Center
ClinicalTrials.gov Identifier:
NCT00852709
First received: February 26, 2009
Last updated: September 21, 2010
Last verified: September 2010
  Purpose

This is a Phase I study designed to determine the MTD and assess the toxicity associated with clofarabine followed by fractionated cyclophosphamide in patients > 1 year of age or < 21 years of age with relapsed or refractory acute leukemias. There will be 25 to 35 patients enrolled. Cohorts of 3 to 6 patients each will receive escalated doses of clofarabine followed by fractionated cyclophosphamide until the MTD is reached. There will be no intra-patient dose escalation. Single-agent cyclophosphamide will be administered by 2-hour IVI on Day 0 of cycle 1. On Days 1, 2, and 3 and Days 8, 9, and 10 clofarabine will be administered by IVI 2 hours before each dose of cyclophosphamide (see the treatment schema below). A cycle is defined as 28 days.


Condition Intervention Phase
Myelodysplastic Syndrome
Acute Myeloid Leukemia
Myeloproliferative Disorders
Acute Lymphocytic Leukemia
Acute Promyelocytic Leukemia
Acute Leukemia
Chronic Myelogenous Leukemia
Myelofibrosis
Chronic Myelomonocytic Leukemia
Juvenile Myelomonocytic Leukemia
Drug: Clofarabine
Drug: Cyclophosphamide
Phase 1

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: Phase I Dose-Escalation Trial of Clofarabine Followed by Escalating Doses of Fractionated Cyclophosphamide in Children With Relapsed or Refractory Acute Leukemias

Resource links provided by NLM:


Further study details as provided by Sidney Kimmel Comprehensive Cancer Center:

Primary Outcome Measures:
  • To determine the feasibility, tolerability, toxicities, and MTD of clofarabine followed by fractionated cyclophosphamide in pediatric patients with relapsed or refractory acute leukemias. [ Time Frame: 1 cycle ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To obtain preliminary descriptive data of the biologic and pharmacodynamic effects of clofarabine followed by fractionated cyclophosphamide on marrow and circulating leukemic blasts in pediatric patients with relapsed or refractory acute leukemias. [ Time Frame: 1 cycle ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 35
Study Start Date: September 2007
Estimated Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: Clofarabine
    On Days 1, 2, and 3 and Days 8, 9, and 10 clofarabine will be administered by IVI 2 hours before each dose of cyclophosphamide
    Drug: Cyclophosphamide
    Single-agent cyclophosphamide will be administered by 2-hour IVI on Day 0 of cycle 1. On Days 1, 2, and 3 and Days 8, 9, and 10 clofarabine will be administered by IVI 2 hours before each dose of cyclophosphamide
  Eligibility

Ages Eligible for Study:   1 Year to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 for adolescent/young adult patients.
  • Lansky Performance Index > 50 for pediatric patients less than age 10 years.
  • Laboratory values obtained < 7 days prior to receiving study treatment:
  • Total bilirubin < 1.5 mg/dL unless elevated due to hemolysis. The conjugated serum bilirubin prior to study entry must be within the normal range.
  • Aspartate transaminase (AST) and alanine transaminase (ALT) < 2.5 × upper limit of normal (ULN)
  • Serum creatinine < 1.0 mg/dL in adolescent/young adults (patients 12 to 17 years of age). For pediatric patients with serum creatinine above the ULN, creatinine clearance > 90 ml/min/1.73m2 calculated using the Schwartz formula may be enrolled. Collected creatinine clearance may be substituted.

Patients 18 years and older (Adult population): Serum creatinine <1.0 mg/dL; if serum creatinine >1.0 mg/dL, then the estimated glomerular filtration rate (GFR) must be >60 mL/min/1.73 m2

  • Cardiac function must be normal per the institution normal as measured by echocardiogram (ECHO) within 7 days.
  • Patients should have no evidence of myositis as detected by abnormal serum creatine kinase and/or myoglobin.

Exclusion Criteria:

  • No chemotherapy, radiation, or major surgery within 2 weeks prior to first dose of study drug except for 5-azacytidine, thalidomide, hydroxyurea, imatinib (Gleevec), and interferon which must be discontinued at least 3 days before study entry and the patient should have recovered from the toxic side effects of such therapy. In the instance of progressive disease, anti-leukemia therapy may have been administered within the 2-week period as long but the subject should have recovered from the toxic effects of that therapy. Also, intrathecal therapy may be administered within the 2-week period for subjects with CNS disease.
  • Patients who have had an allogeneic or autologous hematopoietic stem cell transplant.
  • Patients must have discontinued all growth factors, except Procrit (epoetin), at least 1 week before study.
  • Patients with known HIV positive status or AIDS.
  • Patients with known active Hepatitis B, Hepatitis C or cirrhosis.
  • History of severe coronary artery disease, including myocardial infarction within the previous 3 months, arrhythmias other than atrial flutter or fibrillation requiring medication, or uncontrolled congestive heart failure.
  • Patients with active uncontrolled infection, fever of infection, or evidence for progressive disease by CT scans of the lungs, sinuses, or abdomen. Patients who are on antimicrobial therapy and stable, CT scans must have been stable for 4 weeks, may be enrolled but there must be no evidence of an active infection. Patients with fever due to leukemia may be enrolled.
  • Pregnant or lactating patients. Female patients of childbearing potential must have a negative serum pregnancy test within 14 days before study entry.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00852709

Locations
United States, Arizona
Phoenix Children's Hospital
Phoenix, Arizona, United States, 85016-7710
United States, Colorado
University of Colorado Health Sciences Center and The Children's Hospital
Aurora, Colorado, United States, 80045
United States, Florida
Pediatrix Hematology/Oncology University of Florida College of Medicine
Gainesville, Florida, United States, 32610-0296
United States, Georgia
Children's Healthcare of Atlanta
Atlanta, Georgia, United States, 30322
United States, Tennessee
Vanderbilt Children's Hospital
Nashville, Tennessee, United States, 37232-6310
United States, Texas
M.D. Anderson Comprehensive Cancer Center
Houston, Texas, United States, 77030
Canada, Alberta
Southern Alberta Children's Cancer Program
Calgary, Alberta, Canada, T3B6A8
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center
Genzyme, a Sanofi Company
  More Information

No publications provided

Responsible Party: Robert J. Arceci, MD, PhD, The Sidney Kimmel Cancer Center at Johns Hopkins (SKCCJH)
ClinicalTrials.gov Identifier: NCT00852709     History of Changes
Other Study ID Numbers: J0715, POE07-01
Study First Received: February 26, 2009
Last Updated: September 21, 2010
Health Authority: United States: Institutional Review Board

Keywords provided by Sidney Kimmel Comprehensive Cancer Center:
Myelodysplastic syndrome that has transformed to AML (AML/MDS)
Treatment-related AML
AML evolving from myeloproliferative disorders (MPD)
Acute lymphocytic leukemia (ALL)
Acute promyelocytic leukemia (APL) refractory to arsenic therapy or retinoic acid therapy
Relapsed and/or refractory acute leukemia with progressive disease since last therapy
Chronic myelogenous leukemia (CML) in accelerated phase or blast crisis refractory to imatinib
High-risk MPD including myelofibrosis, chronic myelomonocytic leukemia (CMML, and relapsed or refractory juvenile myelomonocytic leukemia (JMML).

Additional relevant MeSH terms:
Primary Myelofibrosis
Leukemia
Leukemia, Lymphoid
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia, Myeloid, Acute
Leukemia, Myeloid
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myelomonocytic, Chronic
Leukemia, Promyelocytic, Acute
Myelodysplastic Syndromes
Preleukemia
Leukemia, Myelomonocytic, Acute
Myeloproliferative Disorders
Acute Disease
Leukemia, Myelomonocytic, Juvenile
Bone Marrow Diseases
Hematologic Diseases
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Myelodysplastic-Myeloproliferative Diseases
Precancerous Conditions
Disease Attributes
Pathologic Processes
Cyclophosphamide
Clofarabine
Immunosuppressive Agents

ClinicalTrials.gov processed this record on April 16, 2014