Phase I Study of Lenalidomide in Patients With Acute Leukemia

This study is currently recruiting participants. (see Contacts and Locations)
Verified February 2014 by University of California, Davis
Sponsor:
Collaborator:
Celgene Corporation
Information provided by (Responsible Party):
University of California, Davis
ClinicalTrials.gov Identifier:
NCT01615042
First received: June 6, 2012
Last updated: February 28, 2014
Last verified: February 2014
  Purpose

Lenalidomide is a drug that alters the immune system and it may also be directly toxic to tumor. Therefore, in theory, it may reduce or prevent the growth of cancer cells or directly kill them. We will be studying how lenalidomide can be used to decrease bone marrow blast cells in preparation for a bone transplant.


Condition Intervention Phase
Acute Leukemia
Drug: Lenalidomide
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase I Trial of High Dose Lenalidomide in Patients With Refractory/Relapsed Acute Leukemia as a Bridge to Bone Marrow Transplant

Resource links provided by NLM:


Further study details as provided by University of California, Davis:

Primary Outcome Measures:
  • Maximum Tolerated Dose (measured by NCI Common Toxicity Criteria for Adverse Effects (CTCAE) version 4.0) [ Time Frame: One Cycle (21 days) ] [ Designated as safety issue: Yes ]
    All patients who receive the study drug will be followed closely and evaluated for toxicity.


Secondary Outcome Measures:
  • Rates of complete response (CR) and complete response without platelet recovery (CRi) [ Time Frame: One Cycle (21 days) ] [ Designated as safety issue: No ]
    Patients will be assessed for the efficacy (CR or CRi) if they have received at least 7 continuous days of study drug.

  • Pharmacokinetics of high-dose lenalidomide cell activity. [ Time Frame: At 0.25, 0.5, 1, 2, 3, 4, 6, 8, and 24 hours after dose on day 1, as well as before morning dosing on days 8, 15, and 21 during the clinical therapy ] [ Designated as safety issue: No ]
    Plasma concentrations of lenalidomide will be studied

  • Define the effects of lenalidomide on T and Natural Killer (NK) cell activity. [ Time Frame: Baseline and at two weeks after therapy ] [ Designated as safety issue: No ]
    Blood samples will be drawn and will be tested for NK cell and T cell activity.


Estimated Enrollment: 18
Study Start Date: August 2012
Estimated Study Completion Date: August 2015
Estimated Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Dose Escalation/High Dose Lenalidomide
Subjects are given a single dose of the drug while they are observed and tested for a period of time. If they do not exhibit any adverse side effects the dose is escalated, and a new group of subjects is then given a higher dose.
Drug: Lenalidomide
Oral capsule, daily, 50mg-100mg, one cycle (21 days)
Other Name: Revlimid

Detailed Description:

We hypothesize that lenalidomide in high doses can be used to decrease bone marrow blast count in patients with relapsed or refractory acute myeloid leukemia in preparation for an allogeneic stem cell transplant with acceptable toxicities that are no worse than current cytotoxic chemotherapeutic agents. The known dose-limiting toxicity at 75 mg was excessive fatigue in a previous phase I trial which in this study may be irrelevant as all study participants will have an in-patient status.

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Understand and voluntarily sign an informed consent form.
  • Between 18 and 80 years of age at the time of signing the informed consent form.
  • Able to adhere to the study visit schedule and other protocol requirements.
  • Non-M3 Acute Myeloid Leukemia with the presence of residual disease in the bone marrow on day 14-28 post induction (or re-induction) chemotherapy. Day 14-28 residual disease is defined in this study as the presence of more than 10 % blasts in the marrow, presence of between 5-10% blasts cells that are not in cluster in hypocellular marrow is ambiguous and bone marrow biopsy should be repeated in 5-7 days.
  • Patient should have an already identified sibling, matched unrelated donor or cord blood donor at the time of enrollment to this clinical trial.
  • Eastern Cooperative Oncology Group (ECOG) performance status of equal or less than 3 at study entry (this patient population is typically admitted and is in the hospital)
  • Laboratory test results within defined ranges
  • Disease free of other malignancies beside the acute myeloid leukemia (AML) for greater than or equal to 2 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast.
  • All study participants must be registered into the mandatory RevAssist® program, and be willing and able to comply with the requirements of RevAssist®.
  • Females of childbearing potential (FCBP)must have a negative serum or urine pregnancy test with a sensitivity of at least 50 milli-International unit (mIU)/mL within 10 - 14 days and again within 24 hours prior to prescribing lenalidomide prescriptions must be filled within 7 days as required by RevAssist) and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or breast feeding females (Lactating females must agree not to breast feed while taking lenalidomide).
  • Patients younger than 50 years old, after first induction of chemotherapy, who are able to safely tolerate re-induction therapy with high dose chemotherapy are not eligible for this study.
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Use of any other experimental drug or therapy within 14 days of baseline.
  • Known hypersensitivity to thalidomide or lenalidomide (if applicable).
  • The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
  • Known sero-positive for active viral infection with human immunodeficiency virus, hepatitis B virus or hepatitis C virus. Patients who are sero-positive because of hepatitis B virus vaccine are eligible.
  • Patients who are not able to swallow the lenalidomide capsule as a whole are excluded from this study.
  • Patients with impaired gastrointestinal absorption
  • Symptomatic congestive heart failure
  • Unstable angina pectoris or cardiac arrhythmia
  • History of adrenal insufficiency
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01615042

Contacts
Contact: Corinne Turrell 916-734-3089

Locations
United States, California
University of California Comprehensive Cancer Center Recruiting
Sacramento, California, United States, 95817
Principal Investigator: Mehrdad Abedi, MD         
Sponsors and Collaborators
University of California, Davis
Celgene Corporation
Investigators
Principal Investigator: Mehrdad Abedi, MD University of California, Davis
  More Information

Additional Information:
No publications provided

Responsible Party: University of California, Davis
ClinicalTrials.gov Identifier: NCT01615042     History of Changes
Other Study ID Numbers: UCDCC#228, RV_AML_PI_0696
Study First Received: June 6, 2012
Last Updated: February 28, 2014
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by University of California, Davis:
Acute Leukemia
Bone Marrow Transplant
High Dose Lenalidomide

Additional relevant MeSH terms:
Leukemia
Acute Disease
Neoplasms by Histologic Type
Neoplasms
Disease Attributes
Pathologic Processes
Lenalidomide
Thalidomide
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Antineoplastic Agents
Therapeutic Uses
Immunosuppressive Agents
Leprostatic Agents
Anti-Bacterial Agents
Anti-Infective Agents

ClinicalTrials.gov processed this record on August 28, 2014