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Alvocidib, Cytarabine, and Mitoxantrone Hydrochloride or Cytarabine and Daunorubicin Hydrochloride in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia

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ClinicalTrials.gov Identifier: NCT01349972
Recruitment Status : Completed
First Posted : May 9, 2011
Results First Posted : June 6, 2017
Last Update Posted : July 31, 2017
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: None (Open Label);   Primary Purpose: Treatment
Conditions Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome
Adult Acute Minimally Differentiated Myeloid Leukemia (M0)
Adult Acute Monoblastic Leukemia (M5a)
Adult Acute Monocytic Leukemia (M5b)
Adult Acute Myeloblastic Leukemia With Maturation (M2)
Adult Acute Myeloblastic Leukemia Without Maturation (M1)
Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities
Adult Acute Myeloid Leukemia With Del(5q)
Adult Acute Myeloid Leukemia With Inv(16)(p13;q22)
Adult Acute Myeloid Leukemia With t(16;16)(p13;q22)
Adult Acute Myeloid Leukemia With t(8;21)(q22;q22)
Adult Acute Myelomonocytic Leukemia (M4)
Adult Erythroleukemia (M6a)
Adult Pure Erythroid Leukemia (M6b)
Secondary Acute Myeloid Leukemia
Untreated Adult Acute Myeloid Leukemia
Interventions Drug: alvocidib
Drug: daunorubicin hydrochloride
Drug: mitoxantrone hydrochloride
Drug: cytarabine
Enrollment 172
Recruitment Details  
Pre-assignment Details  
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Period Title: Overall Study
Started 114 58
Completed 109 56
Not Completed 5 2
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride) Total
Hide Arm/Group Description

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Total of all reporting groups
Overall Number of Baseline Participants 114 58 172
Hide Baseline Analysis Population Description
[Not Specified]
Age, Categorical  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 114 participants 58 participants 172 participants
<=18 years
0
   0.0%
0
   0.0%
0
   0.0%
Between 18 and 65 years
79
  69.3%
43
  74.1%
122
  70.9%
>=65 years
35
  30.7%
15
  25.9%
50
  29.1%
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 114 participants 58 participants 172 participants
Female
53
  46.5%
27
  46.6%
80
  46.5%
Male
61
  53.5%
31
  53.4%
92
  53.5%
1.Primary Outcome
Title Complete Response Rate
Hide Description Bone marrow showing less than 5% myeloblasts with normal maturation of all cell lines, an ANC of at least 1000/cu mm and a platelet count of 100,000/cu mm, absence of blast in peripheral blood, absence of identifiable leukemic cells in the bone marrow, clearance of disease-associated cytogenetic abnormalities, and clearance of any previously existing extramedullary disease. These criteria are taken from Dohner H, Estey EH, Amadori S, et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood 2010;115:453-474
Time Frame 3 years
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description:

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Overall Number of Participants Analyzed 109 56
Measure Type: Number
Unit of Measure: participants
76 24
2.Secondary Outcome
Title Incidence of Toxicities, Characterized by Number of Events by Treatment and Grade
Hide Description The descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be utilized for AE reporting.
Time Frame Up to 14 days after completion of study treatment
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Hide Analysis Population Description
Number of evaluable subjects
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description:

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Overall Number of Participants Analyzed 109 56
Measure Type: Number
Unit of Measure: Number of events
156 77
3.Secondary Outcome
Title Disease-free Survival
Hide Description Probabilities will be estimated with the Kaplan-Meier estimate. Survival estimates at two years will be estimated. Disease-free survival Overall survival was defined from date of randomization to death or last known follow-up. Event free survival was defined as date of randomization to the first occurrence of persistent AML after 1 cycle of induction, relapse or death. Patients were censored for event free survival if they had received non-protocol therapy or a stem cell transplant.
Time Frame Time from randomization until death from any cause or relapse or recurrence, assessed up to 2 years
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description:

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Overall Number of Participants Analyzed 114 58
Median (Full Range)
Unit of Measure: years
1.46
(1.06 to 2.11)
1.85
(1.35 to 3.33)
4.Secondary Outcome
Title Overall Survival
Hide Description Probabilities will be estimated with the Kaplan-Meier estimate. Survival estimates at two years will be estimated.
Time Frame 4 years
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description:

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Overall Number of Participants Analyzed 109 56
Median (95% Confidence Interval)
Unit of Measure: years
1.46
(0.09 to 2.12)
1.850
(1.35 to 3.33)
5.Secondary Outcome
Title Number of Patients With Minimal Residual Disease
Hide Description Comparisons of the treatments with respect to MRD will be based on the number of patients with MRD at day 14 after the start of treatment.
Time Frame From study start to 14 days after the start of treatment
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description:

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Overall Number of Participants Analyzed 102 55
Measure Type: Count of Participants
Unit of Measure: Participants
26
  25.5%
24
  43.6%
6.Secondary Outcome
Title Progression-free Survival
Hide Description Probabilities will be estimated with the Kaplan-Meier estimate. Survival estimates at two years will be estimated.
Time Frame 4 years
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description:

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

Overall Number of Participants Analyzed 76 26
Median (95% Confidence Interval)
Unit of Measure: years
0.81
(0.42 to 0.98)
0.28
(0.11 to 1.11)
Time Frame [Not Specified]
Adverse Event Reporting Description [Not Specified]
 
Arm/Group Title Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Hide Arm/Group Description

Patients receive alvocidib IV over 1 hour on days 1-3, cytarabine IV over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Patients who achieve complete or partial response to the first course (completion of all doses) may receive a second course of treatment or high-dose cytarabine after 21-63 days following blood count recovery, and/or undergo allogeneic bone marrow transplant.

alvocidib: Given IV

mitoxantrone hydrochloride: Given IV

cytarabine: Given IV

Patients receive cytarabine IV continuously on days 1-7 and daunorubicin hydrochloride IV on days 1-3. Patients who have residual disease on day 14 may receive additional cytarabine for 5 days and daunorubicin hydrochloride for 2 days.

daunorubicin hydrochloride: Given IV

cytarabine: Given IV

All-Cause Mortality
Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Affected / at Risk (%) Affected / at Risk (%)
Total   --/--      --/--    
Show Serious Adverse Events Hide Serious Adverse Events
Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   53/114 (46.49%)      21/58 (36.21%)    
Blood and lymphatic system disorders     
bone marrow hypocellular   1/114 (0.88%)  1 0/58 (0.00%)  0
Disseminated Intravascular Coagulation  1  2/114 (1.75%)  2 1/58 (1.72%)  1
febrile neutropenia   1/114 (0.88%)  1 0/58 (0.00%)  0
Cardiac disorders     
atrial fibrillation   1/114 (0.88%)  1 2/58 (3.45%)  2
cardiac chest pain   1/114 (0.88%)  1 0/58 (0.00%)  0
heart failure   2/114 (1.75%)  2 0/58 (0.00%)  0
left ventricular systolic dysfunction   5/114 (4.39%)  5 0/58 (0.00%)  0
myocardial infarction   2/114 (1.75%)  2 0/58 (0.00%)  0
pericardial effusion   1/114 (0.88%)  1 0/58 (0.00%)  0
pericarditis   1/114 (0.88%)  1 1/58 (1.72%)  1
Endocrine disorders     
thyrotoxicosis   1/114 (0.88%)  1 0/58 (0.00%)  0
Gastrointestinal disorders     
ileal perforation   1/114 (0.88%)  1 0/58 (0.00%)  0
peritoneal necrosis   1/114 (0.88%)  1 0/58 (0.00%)  0
small intestinal obstruction   1/114 (0.88%)  1 0/58 (0.00%)  0
gastrointestinal hemmorrhage   1/114 (0.88%)  1 1/58 (1.72%)  1
General disorders     
death   1/114 (0.88%)  1 0/58 (0.00%)  0
fever   2/114 (1.75%)  2 0/58 (0.00%)  0
Immune system disorders     
cytokine release syndrome   3/114 (2.63%)  3 2/58 (3.45%)  2
sogt tissue infection   1/114 (0.88%)  1 0/58 (0.00%)  0
Infections and infestations     
appendicitis   1/114 (0.88%)  1 0/58 (0.00%)  0
lung infection  2  2/114 (1.75%)  2 0/58 (0.00%)  0
sepsis   1/114 (0.88%)  1 0/58 (0.00%)  0
Investigations     
blood bilirubin increased   2/114 (1.75%)  2 0/58 (0.00%)  0
creatinine increased   1/114 (0.88%)  1 0/58 (0.00%)  0
QTc prolonged   1/114 (0.88%)  1 0/58 (0.00%)  0
alkaline phosphatase increased   0/114 (0.00%)  0 1/58 (1.72%)  1
Metabolism and nutrition disorders     
dehydration   1/114 (0.88%)  1 0/58 (0.00%)  0
hyperglycemia   1/114 (0.88%)  1 1/58 (1.72%)  1
hypokalemia   0/114 (0.00%)  0 1/58 (1.72%)  1
hyponatremia   1/114 (0.88%)  1 1/58 (1.72%)  1
hypocalcemia   1/114 (0.88%)  1 0/58 (0.00%)  0
hypophosphatemia   2/114 (1.75%)  2 2/58 (3.45%)  2
tumor lysis syndrome   4/114 (3.51%)  4 1/58 (1.72%)  1
Nervous system disorders     
seizure   1/114 (0.88%)  1 0/58 (0.00%)  0
Renal and urinary disorders     
acute kidney injury   2/114 (1.75%)  2 2/58 (3.45%)  2
chronic kidney disease   0/114 (0.00%)  0 1/58 (1.72%)  1
renal insufficiency   1/114 (0.88%)  1 0/58 (0.00%)  0
necrotic bladder   1/114 (0.88%)  1 0/58 (0.00%)  0
Respiratory, thoracic and mediastinal disorders     
adult respiratory distress syndrome   0/114 (0.00%)  0 1/58 (1.72%)  1
hypoxia   0/114 (0.00%)  0 1/58 (1.72%)  1
Vascular disorders     
thrombotic event   1/114 (0.88%)  1 0/58 (0.00%)  0
capillary leak syndrome   0/114 (0.00%)  0 1/58 (1.72%)  1
hypertension   0/114 (0.00%)  0 1/58 (1.72%)  1
Indicates events were collected by systematic assessment
1
Term from vocabulary, DIC
2
Term from vocabulary, pneumonia
Show Other (Not Including Serious) Adverse Events Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 0%
Arm I (Alvocidib, Cytarabine, Mitoxantrone Hydrochloride) Arm II (Cytarabine, Daunorubicin Hydrochloride)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   32/114 (28.07%)      21/58 (36.21%)    
Blood and lymphatic system disorders     
Febril eNeutropenia   5/114 (4.39%)  5 7/58 (12.07%)  7
Cardiac disorders     
Mypocardial Infarction   0/114 (0.00%)  0 1/58 (1.72%)  1
Sinus Tachycardia   1/114 (0.88%)  1 0/58 (0.00%)  0
Gastrointestinal disorders     
mucositis   1/114 (0.88%)  1 3/58 (5.17%)  3
Nausea   2/114 (1.75%)  2 0/58 (0.00%)  0
Vomiting   2/114 (1.75%)  2 0/58 (0.00%)  0
Diarrhea   4/114 (3.51%)  4 0/58 (0.00%)  0
General disorders     
Fatigue   2/114 (1.75%)  2 0/58 (0.00%)  0
Multi-organ failure   2/114 (1.75%)  2 0/58 (0.00%)  0
Edema   2/114 (1.75%)  2 0/58 (0.00%)  0
Immune system disorders     
Cytokine release syndrome   1/114 (0.88%)  1 0/58 (0.00%)  0
Infections and infestations     
Sepsis   4/114 (3.51%)  4 1/58 (1.72%)  1
Catheter Related Infection   0/114 (0.00%)  0 1/58 (1.72%)  1
Bacteremia   2/114 (1.75%)  2 0/58 (0.00%)  0
Pneumonia   0/114 (0.00%)  0 1/58 (1.72%)  1
Infectious Enterocolitis   2/114 (1.75%)  2 0/58 (0.00%)  0
Investigations     
Hypokalemia   1/114 (0.88%)  1 0/58 (0.00%)  0
Hypophosphatemia   0/114 (0.00%)  0 1/58 (1.72%)  1
Aspartate aminotransferase increased *  3/114 (2.63%)  3 1/58 (1.72%)  1
Alanine aminotransferase increased *  4/114 (3.51%)  4 0/58 (0.00%)  0
Hypocalcemia *  1/114 (0.88%)  1 1/58 (1.72%)  1
GGT increased *  1/114 (0.88%)  1 0/58 (0.00%)  0
Ejection fraction decreased *  0/114 (0.00%)  0 1/58 (1.72%)  1
Creatinine increased *  1/114 (0.88%)  1 1/58 (1.72%)  1
Blood bilirubin increased *  3/114 (2.63%)  3 0/58 (0.00%)  0
INR increased *  1/114 (0.88%)  1 0/58 (0.00%)  0
Metabolism and nutrition disorders     
Tumor Lysis Syndrome   1/114 (0.88%)  1 3/58 (5.17%)  3
Hyperkalemia *  1/114 (0.88%)  1 0/58 (0.00%)  0
Respiratory, thoracic and mediastinal disorders     
Dyspnea   1/114 (0.88%)  1 0/58 (0.00%)  0
Adult respiratory distress syndrome   1/114 (0.88%)  1 0/58 (0.00%)  0
Hypoxia   1/114 (0.88%)  1 0/58 (0.00%)  0
Pulmonary Edema   1/114 (0.88%)  1 0/58 (0.00%)  0
Skin and subcutaneous tissue disorders     
Pruritis   0/114 (0.00%)  0 1/58 (1.72%)  1
Rash maculo-papular   1/114 (0.88%)  1 2/58 (3.45%)  2
Vascular disorders     
Hypotension   1/114 (0.88%)  1 1/58 (1.72%)  1
Indicates events were collected by systematic assessment
*
Indicates events were collected by non-systematic assessment
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: Joshua Zeidner
Organization: University of North Carolina, Lineberger Comprehensive Cancer Center
Phone: (919) 962-5164
EMail: Joshua_Zeidner@med.unc.edu
Layout table for additonal information
Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01349972     History of Changes
Obsolete Identifiers: NCT01413880
Other Study ID Numbers: NCI-2011-02587
NCI-2011-02587 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
JHOC-J1101
CDR0000699421
J1101 ( Other Identifier: Johns Hopkins University/Sidney Kimmel Comprehensive Cancer Center )
8972 ( Other Identifier: CTEP )
U01CA070095 ( U.S. NIH Grant/Contract )
N01CM00100 ( U.S. NIH Grant/Contract )
P30CA006973 ( U.S. NIH Grant/Contract )
First Submitted: May 6, 2011
First Posted: May 9, 2011
Results First Submitted: September 4, 2015
Results First Posted: June 6, 2017
Last Update Posted: July 31, 2017