Dasatinib Followed by Stem Cell Transplant in Treating Older Patients With Newly Diagnosed Acute Lymphoblastic Leukemia
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Purpose
This phase II clinical trial is studying how well dasatinib followed by stem cell transplant works in treating older patients with newly diagnosed acute lymphoblastic leukemia. Dasatinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving chemotherapy before a stem cell transplant stops the growth of cancer cells by stopping them from dividing or killing them. Monoclonal antibodies, such as alemtuzumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Giving more than one drug (combination chemotherapy) and giving dasatinib together with chemotherapy may kill more cancer cells.
| Condition | Intervention | Phase |
|---|---|---|
|
Philadelphia Chromosome Positive Adult Precursor Acute Lymphoblastic Leukemia Untreated Adult Acute Lymphoblastic Leukemia |
Biological: alemtuzumab Drug: dasatinib Drug: daunorubicin hydrochloride Drug: fludarabine phosphate Procedure: allogeneic hematopoietic stem cell transplantation Procedure: autologous hematopoietic stem cell transplantation Procedure: in vitro-treated peripheral blood stem cell transplantation Drug: dexamethasone Drug: cyclophosphamide Biological: filgrastim Biological: pegfilgrastim Drug: methotrexate Drug: leucovorin calcium Drug: melphalan Drug: tacrolimus Drug: etoposide phosphate Drug: cytarabine Drug: mercaptopurine Drug: vincristine sulfate Other: pharmacological study Other: laboratory biomarker analysis |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Study of Dasatinib (Sprycel®) (IND #73969, NSC #732517) as Primary Therapy Followed by Transplantation for Adults >/= 18 Years With Newly Diagnosed Ph+ Acute Lymphoblastic Leukemia by CALGB, ECOG and SWOG |
- Disease-free survival (DFS) [ Time Frame: 3 years ] [ Designated as safety issue: No ]Estimated using the Kaplan-Meier estimator. Proportions will be estimated using point as well as interval estimators. All interval estimators will be constructed using the finite sample size sampling distribution at the unadjusted two-sided level of 0.05.
- Probability of being BCR-ABL negative in the bone marrow and peripheral blood at the completion of the CNS prophylaxis course (restricted to those patients achieving a complete response [CR]) [ Time Frame: Up to 10 years ] [ Designated as safety issue: No ]Proportions will be estimated based on the combined and individual cohorts.
- Feasibility of maintenance therapy in this patient population (restricted to those patients achieving a CR) [ Time Frame: Up to 10 years ] [ Designated as safety issue: No ]Proportions will be estimated based on the combined and individual cohorts.
- Overall survival [ Time Frame: Up to 10 years ] [ Designated as safety issue: No ]Estimated using the Kaplan-Meier estimator. Proportions will be estimated using point as well as interval estimators. All interval estimators will be constructed using the finite sample size sampling distribution at the unadjusted two-sided level of 0.05.
- DFS [ Time Frame: Up to 10 years ] [ Designated as safety issue: No ]Estimated using the Kaplan-Meier estimator. Proportions will be estimated using point as well as interval estimators. All interval estimators will be constructed using the finite sample size sampling distribution at the unadjusted two-sided level of 0.05.
- Response [ Time Frame: Up to 10 years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 66 |
| Study Start Date: | December 2010 |
| Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Treatment (chemotherapy, transplant)
See Detailed Description
|
Biological: alemtuzumab
Given IV
Other Names:
Drug: dasatinib
Given PO
Other Names:
Drug: daunorubicin hydrochloride
Given IV
Other Names:
Drug: fludarabine phosphate
Given IV
Other Names:
Procedure: allogeneic hematopoietic stem cell transplantation
Undergo peripheral blood allogeneic HCT
Procedure: autologous hematopoietic stem cell transplantation
Undergo peripheral blood autologous HCT
Procedure: in vitro-treated peripheral blood stem cell transplantation
Undergo peripheral blood autologous or allogeneic HCT
Other Names:
Drug: dexamethasone
Given PO or IV
Other Names:
Drug: cyclophosphamide
Given IV
Other Names:
Biological: filgrastim
Given SC
Other Names:
Biological: pegfilgrastim
Given SC
Other Names:
Drug: methotrexate
Given IT, IV, or PO
Other Names:
Drug: leucovorin calcium
Given IV or PO
Other Names:
Drug: melphalan
Given IV
Other Names:
Drug: tacrolimus
Given IV or PO
Other Names:
Drug: etoposide phosphate
Given IV
Other Names:
Drug: cytarabine
Given IV
Other Names:
Drug: mercaptopurine
Given PO
Other Names:
Drug: vincristine sulfate
Given IV
Other Names:
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies
Other: laboratory biomarker analysis
Correlative studies
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 50 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Unequivocal histologic diagnosis of ALL
- Detection of the t(9;22)(q34;q11) or 3-way variant by metaphase cytogenetics or BCR-ABL positive status by molecular analysis (Q-PCR or FISH) in a CLIA-approved laboratory
- No prior therapy except up to one week of corticosteroids and/or hydroxyurea to enable time for the detection of t(9;22)(q34;q11) or BCR/ABL
- Enrolled on required companion study CALGB-8461 (Cytogenetic Studies in Acute Leukemia)
- Non-pregnant and non-nursing; treatment under this protocol would expose an unborn child to significant risks; women and men of reproductive potential should agree to use an effective means of birth control and contraception should continue for three months after the last dose of dasatinib to allow complete clearance of drug and its principal metabolites from the body; in women of childbearing potential, a pregnancy test will be required at study entry
- Left ventricular ejection fraction >= lower limit of institutional normal
- No myocardial infarction within 6 months
- No ventricular tachyarrhythmia within 6 months
- No major conduction abnormality (unless a cardiac pacemaker is present)
Contacts and Locations
Show 55 Study Locations| Principal Investigator: | Meir Wetzler | Cancer and Leukemia Group B |
More Information
No publications provided
| Responsible Party: | National Cancer Institute (NCI) |
| ClinicalTrials.gov Identifier: | NCT01256398 History of Changes |
| Other Study ID Numbers: | NCI-2011-02621, CALGB 10701, CDR0000690286, CALGB-10701, CALGB 10701/CTSU C10701, U10CA031946 |
| Study First Received: | December 7, 2010 |
| Last Updated: | May 6, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Lymphoid Precursor Cell Lymphoblastic Leukemia-Lymphoma Philadelphia Chromosome Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Translocation, Genetic Chromosome Aberrations Pathologic Processes 6-Mercaptopurine Cytarabine |
Methotrexate Fludarabine monophosphate Vidarabine Cyclophosphamide Melphalan Tacrolimus Campath 1G Etoposide phosphate Fludarabine Alemtuzumab Daunorubicin Dexamethasone Etoposide Vincristine BB 1101 |
ClinicalTrials.gov processed this record on May 23, 2013