CLAG Gleevec in Relapsed or Refractory Acute Myeloid Leukemia (AML)
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Purpose
The purpose of this study is to evaluate the safety of combined chemotherapy treatment regimen with cladribine (2-CDA), cytarabine, and granulocyte colony-stimulating factor (G-CSF) [CLAG] with Gleevec® (imatinib mesylate).
| Condition | Intervention | Phase |
|---|---|---|
|
Leukemia |
Drug: CLAG Regimen Drug: Gleevec® |
Phase 2 |
| 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 II Study of CLAG Regimen in Combination With Imatinib Mesylate (Gleevec) in Relapsed or Refractory Acute Myeloid Leukemia |
- Participants' Overall Response (OR) [ Time Frame: 12 weeks per patient ] [ Designated as safety issue: No ]The primary endpoint is to determine the overall response rate as well as toxicity of CLAG-Gleevec combination regimen (Cladribine, cytarabine, G-CSF, and Imatinib Mesylate) in treatment of refractory or relapsed acute myeloid leukemia.
- Number of Participants With Progression Free Survival (PFS) [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- Number of Participants With Overall Survival (OS) [ Time Frame: 2 years ] [ Designated as safety issue: No ]
| Enrollment: | 38 |
| Study Start Date: | August 2009 |
| Estimated Study Completion Date: | September 2014 |
| Estimated Primary Completion Date: | September 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: CLAG Regimen with Gleevec®
Combined chemotherapy treatment (CLAG regimen) with Gleevec® (imatinib mesylate).
|
Drug: CLAG Regimen
Combination of chemotherapy drugs. Cladribine, Days 2 - 6, 2 hour infusion. Cytarabine, Days 2 - 6, 4 hour infusion. Neupogen, Days 1 - 6, Given 12 - 24 hours before 1st dose of cladribine.
Other Names:
Drug: Gleevec®
Days 2 - 15, Pill taken twice a day
Other Name: imatinib mesylate
|
Detailed Description:
In relapsed or resistant acute myeloid leukemia (a type of blood cancer where immature blood cells are increased, blocking normal blood cell production), different types of chemotherapy are used for treatment. Patients responded to all the chemotherapies in similar ways, but most of the responses did not last long if further stem cell transplantation was not done. Gleevec is believed to work by interfering with the abnormal protein by blocking it from telling the body to keep making more white blood cells that are abnormal.
The CLAG regimen is the standard chemotherapy used for relapsed AML (Acute Myeloid Leukemia). This study will add Gleevec® to the regimen for a period of 14 days. Gleevec® is approved by the Food and Drug Administration (FDA) for the treatment of chronic myeloid leukemia (CML) and some types of acute lymphoblastic leukemia (ALL). Its use in combination with CLAG regimen is considered experimental for the treatment of Acute Myeloid Leukemia/CML blast crisis.
The goal of the study is to find out what effects (good and bad) Gleevec® (Imatinib mesylate) combined with chemotherapy has on you and your acute myeloid leukemia.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Men and Women of all ethnic groups whose age is ≥ 18 years old.
- Diagnosis of AML or CML blast crisis, according to World Health Organization (WHO) criteria, except acute promyelocytic leukemia AML-M3 French-American-British (FAB) subgroup. A documentation of relapse is required by a bone marrow/aspirate within 4 weeks of registration.
- Refractory or Relapsed AML. Refractory AML is defined as failure to achieve CR after 2 cycles of induction chemotherapy or persistent (>40%) bone marrow blasts after one cycle of chemotherapy induction.
- Relapsed AML is defined as any evidence of disease recurrence after achieving complete response (CR) (more than 5% myeloblasts). Early relapse is defined as that occurring within 12 months and late relapse is defines as that occurring after 12 months.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Patients must sign a written informed consent.
- Females of childbearing potential (FOCP) must not be pregnant or actively nursing a child. They must have a negative pregnancy test 7 days before initiation of study drug administration
- Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential.
- Male and females of reproductive potential must agree to employ an effective barrier method of birth control throughout the duration of the trial and for 3 months following study medication discontinuation.
- Prior allogeneic or autologous stem cell transplantation is allowed.
Exclusion Criteria:
- Abnormal Kidney Functions: creatinine ≥2.5mg/dL.
- Abnormal Liver Functions: Bilirubin more 3 mg/dL, transaminases (AST/ALT) more that 2.5 times the institutional upper limits of normal (IULN).
- Systemic active infection, unless controlled on active therapy.
- Patients with Grade III/IV cardiac problems as defined by the New York Heart Association (NYHA) Criteria ( i.e., congestive heart failure, myocardial infarction within 6 months of the study), or ejection fraction (EF)< 30%.
- Patient has known chronic liver disease (i.e., chronic active hepatitis, hepatitis B, hepatitis C, and cirrhosis).
- Patient has known diagnosis of human immunodeficiency virus (HIV) infection.
- History of other malignancy, except non-melanotic skin cancers or no disease recurrence/progression for more than 2 years.
- Patients that have received investigational agents within 1 month of study entry.
- History of allergic reaction attributed to compounds of similar chemical or biologic composition to Gleevec or any component of the CLAG regimen
- Prior therapy with CLAG chemotherapy regimen
- Any adverse event attributable to previous chemotherapy regimen must be resolved to grade 1 or less at time of registration.
Contacts and Locations| United States, Florida | |
| H. Lee Moffitt Cancer Center and Research Institute | |
| Tampa, Florida, United States, 33612 | |
| Principal Investigator: | Rami Komrokji, M.D. | H. Lee Moffitt Cancer Center and Research Institute |
More Information
Additional Information:
No publications provided
| Responsible Party: | H. Lee Moffitt Cancer Center and Research Institute |
| ClinicalTrials.gov Identifier: | NCT00955916 History of Changes |
| Other Study ID Numbers: | MCC-15787, CSTI571AUS235 |
| Study First Received: | August 5, 2009 |
| Last Updated: | April 26, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
|
relapsed refractory acute myeloid |
AML CML blast crisis |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Myeloid, Acute Leukemia, Myeloid Neoplasms by Histologic Type Neoplasms Cytarabine Cladribine Imatinib 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 Protein Kinase Inhibitors Enzyme Inhibitors |
ClinicalTrials.gov processed this record on May 23, 2013