Intravenous (IV) Decitabine and Oral Bexarotene for Acute Myelogenous Leukemia (AML)
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Purpose
The main objective is to determine the safety and tolerability of combination decitabine and bexarotene during four cycles of therapy.
| Condition | Intervention | Phase |
|---|---|---|
|
Leukemia, Myeloid, Acute |
Drug: Decitabine Drug: Bexarotene |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase I Dose Escalation Study of Intravenous Decitabine in Combination With Oral Bexarotene in Patients With Acute Myeloid Leukemia (AML) |
- Toxicity of combination decitabine and bexarotene during four cycles of therapy [ Time Frame: After 4 cycles of therapy ] [ Designated as safety issue: Yes ]
- To determine the complete remission (CR) and partial remission (PR) rate after four cycles of therapy. [ Time Frame: After 4 cycles of therapy ] [ Designated as safety issue: No ]
- To determine the rates of hematological improvement, transfusion independence, time to progression, cytogenetic response, and survival. [ Time Frame: Every 2 months for 2 years after first dose of study drug ] [ Designated as safety issue: No ]
- To perform correlative studies defining transcriptional response to bexarotene in primary AML bone marrow cells. [ Time Frame: Baseline, C1D3, Day 25 of even cycles, and End of Study treatment ] [ Designated as safety issue: No ]
- To perform correlative studies examining the clonality of morphologically differentiated neutrophils by fluorescence in situ hybridization (FISH) in patients with improved neutrophil counts. [ Time Frame: Baseline, C1D3, Day 25 of even cycles, and End of Study treatment ] [ Designated as safety issue: No ]
- To perform correlative studies comparing the self-renewal of morphologically differentiated neutrophils and leukemic blasts by colony forming assays in patients with improved neutrophil counts. [ Time Frame: Baseline, C1D3, Day 25 of even cycles, and End of Study treatment ] [ Designated as safety issue: No ]
- To perform correlative studies of platelet function by PFA100 in patients with platelet counts improved to >100,000/microliter [ Time Frame: Baseline, C1D3, Day 25 of even cycles, and End of Study treatment ] [ Designated as safety issue: No ]
| Enrollment: | 19 |
| Study Start Date: | March 2010 |
| Estimated Study Completion Date: | March 2015 |
| Estimated Primary Completion Date: | May 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Dose Level 1
Decitabine 20 mg/m2 IV days 3-7 of cycle 1 and days 1-5 of subsequent cycles. Each cycle is 28 days. Bexarotene 100 mg/m2 PO daily for each 28 day cycle. |
Drug: Decitabine
Other Name: Dacogen®
Drug: Bexarotene
Other Name: Targretin®
|
|
Experimental: Dose Level 2
Decitabine 20 mg/m2 IV days 3-7 of cycle 1 and days 1-5 of subsequent cycles. Each cycle is 28 days. Bexarotene 200 mg/m2 PO daily for each 28 day cycle. |
Drug: Decitabine
Other Name: Dacogen®
Drug: Bexarotene
Other Name: Targretin®
|
|
Experimental: Dose Level 3
Decitabine 20 mg/m2 IV days 3-7 of cycle 1 and days 1-5 of subsequent cycles. Each cycle is 28 days. Bexarotene 300 mg/m2 PO daily for each 28 day cycle. |
Drug: Decitabine
Other Name: Dacogen®
Drug: Bexarotene
Other Name: Targretin®
|
Detailed Description:
The investigators are seeking to study the combination of decitabine and bexarotene. These two agents have each shown efficacy in decreasing leukemic blast counts and restoring normal hematopoiesis via different mechanisms of action and with non-overlapping side-effect profiles. By combining these agents, the investigators hope to improve overall response rates. The investigators further hope to improve platelet and neutrophil counts in an even greater number of patients, thus treating two of the most important sources of morbidity and mortality in this patient population.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- AML with bone marrow blasts ≥ 20%.
- Relapsed disease after 1 or more lines of prior salvage chemotherapy and any FAB-AML, or
- Diagnosis of AML and age ≥ 60 and not a candidate for cytotoxic chemotherapy and any FAB-AML except FAB-M3.
- Performance status ≤ 2.
- Age ≥ 18 years.
Exclusion Criteria:
- Peripheral white blood cell count (WBC) > 10,000/microliter.
- Total bilirubin > 1.5 x normal.
- AST/ALT > 2.5 x normal.
- Serum creatinine > 2 x normal.
- Fasting serum triglyceride > 1,000 mg/dL.
- Active or poorly controlled graft vs host disease (GVHD).
- Pregnant or nursing.
- Known CNS leukemia.
- History of positive HIV serology.
- History of positive Hepatitis C serology.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, congestive heart failure of NYHA class 3 or 4, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situation that would limit compliance with study requirements.
- Chemotherapy within 21 days of enrollment.
- Radiation therapy within 14 days of enrollment.
Contacts and Locations| United States, Missouri | |
| Washington University School of Medicine | |
| St. Louis, Missouri, United States, 63110 | |
| Principal Investigator: | Amanda Cashen, M.D. | Washington University School of Medicine |
More Information
Additional Information:
No publications provided
| Responsible Party: | Washington University School of Medicine |
| ClinicalTrials.gov Identifier: | NCT01001143 History of Changes |
| Other Study ID Numbers: | 09-1661 / 201012801 |
| Study First Received: | October 19, 2009 |
| Last Updated: | April 12, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Myeloid, Acute Leukemia, Myeloid Neoplasms by Histologic Type Neoplasms Decitabine Bexarotene Antimetabolites, Antineoplastic Antimetabolites |
Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antineoplastic Agents Therapeutic Uses Enzyme Inhibitors Anticarcinogenic Agents Protective Agents Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on June 17, 2013