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Study Summary
No. 2006-0069:.......Leukemia......Stefan Faderl......Leukemia
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Study Summary Title
Study Summary
Number:
2006-0069
Study Title:A Phase III Randomized, Double-Blind, Controlled Study Comparing Clofarabine and Cytarabine versus Cytarabine alone in Adult Patients 55 Years and Older with Acute Myeloid Leukemia (AML) who have Relapsed or are Refractory after Receiving up to Two Prior Induction Regimens
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Physician New Patient Referral
Name:Stefan FaderlPatients Call:800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Dept:LeukemiaReferring MD
Call:
800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Phone:713-745-4613
Contact us about clinical trials
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General Information
Disease Group:LeukemiaSupported By:N/A
Phase of Study:Phase IIIReturn
Visit:
Initial stay up to 4 weeks. Patients will be followed monthly for the first
year, every other month for the second year, and every 3 months therafter until
disease recurrence, death, or study termination.
Treatment
Agents:
Clofarabine
Cytarabine
Placebo
Home Care:Chemotherapy will be administered at MD Anderson Cancer Center. Further
evaluations following End of treatment visit are possible through referring MD.
Treatment Loc:Independent Multicenter Arrangements
Estimated
Length of Stay
in Houston:
Patients may be receiving therapy up to 5 days as inpatient.
Description/
Intervention:
The goal of this clinical research study is to find out of clofarabine given
with cytarabine is more effective than cytarabine alone for patients with AML.
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Study Objectives / Outcomes
Primary Objective:
  • To assess the efficacy of clofarabine in combination with cytarabine compared with cytarabine alone in adult patients 55 years and older with AML who have either relapsed or are refractory after receiving up to 2 prior regimens, as measured by overall survival.
Secondary Objectives:
  • To determine the overall remission (OR) rate (complete remission [CR]+complete remission with incomplete peripheral blood count recovery [CRi] of clofarabine in combination with cytarabine compared with cytarabine alone.
  • To determine the duration of remission and disease-free survival for each treatment group.
  • To compare treatment groups with respect to event-free survival and 4-month event-free survival.
  • To determine the safety and tolerability of clofarabine when used in combination with cytarabine compared with cytarabine alone and the duration, seriousness, severity and relationship of adverse events which occur during the treatment and follow-up period, including hospitalizations.
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Study Status Information
Study Activation / Registration Date:09/19/2006
IRB Review and Approval Date:04/19/2006
Study Type:Phase Iii
Recruitment Status:Closed
Projected Accrual:325
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Enrollment Eligibility
If you do not meet the enrollment eligibility, there may be other treatment options for you. Please Contact the Referral Office for more information.

Inclusion Criteria:1) Provide signed, written consent.

2) Have a diagnosis of AML according to the WHO classification. Acute promyelocytic leukemia with t(15;17)(q22;q12), (PML/RARalpha), or any other variant is excluded, unless the patient has received both all-trans retinoic acid and arsenic trioxide as prior therapy.

3) Have received not more than 2 prior induction regimens for treatment of AML according to the following definitions and qualifications: (a) Induction regimen: a drug or combination of drugs administered for a pre-specified number of cycles (usually note exceeding 2 cycles total) to patients with AML with the intent of achieving a CR or CRi; (b) at least 1 prior induction regimen must have included cytotoxic chemotherapy; (c) Hematopoietic stem cell transplantation (HSCT) (administered after induction therapy) is not considered a distinct induction regimen.

4) (continued) (d) consolidation or maintenance regimens (administered after CR or CRi documented) are not considered distinct induction regimens.

5) Are refractory or relapsed (requiring at least 5% leukemic blasts in the bone marrow, regardless of the presence of other features such as new or recurrent dysplastic changes or extramedullary disease) according to the following definitions: (a) relapsed (defined as >/= 5% leukemic blasts in the bone marrow), after receiving up to 2 prior induction regimens, (ie, first or second relapse);

6) (continued) (b) refractory (defined as >/= 5% leukemic blasts in the bone marrow) to not more than 1 prior induction regimen (defined as failure to achieve a CR or CRi following induction therapy), (ie, up to 1 induction failure).

7) Be 55 years of age or older at the time of signing the informed consent.

8) Have an ECOG performance status score of 0, 1, or 2.

9) Be able to comply with study procedures and follow-up examinations.

10) Be nonfertile or agree to use birth control (ie, condom, diaphragm, cervical cap, etc) during the study and for at least 90 days after the last dose of study drug.

11) Have adequate renal and hepatic function as indicated by the following laboratory values: estimated GFR >/= 60ml/min/1.73m2 (GFR as estimated by the Modification of Diet in Renal Disease [MDRD] equation; Serum bilirubin </= 1.5 x ULN; AST and ALT </= 2.5 x ULN; alkaline phosphatase </= 2.5 x ULN.

Exclusion Criteria:1) Received previous treatment with clofarabine

2) Received intermediate- or high-dose cytarbine (IDAC or HDAC, respectively) defined as a bolus administration schedule at >/= 500 mg/m^2/dose as a component of prior induction or consolidation therapy, unless both the following criteria are met: 1) the total duration of remission following the most recent IDAC- or HDAC-containing regimen exceeds 6 months, as measured from the time of documented remission (CR or CRi) with that regimen; and 2) the remission duration following the last day of IDAC or HDAC exposure exceeds 3 months.

3) Have received an HSCT within the previous 3 months prior to study entry.

4) Have >/= grade 2 acute graft versus host disease (GvHD).

5) Have either moderate or severe chronic GvHD, whether limited or extensive chronic GvHD. Patients with mild limited or extensive chronic GvHD may be included.

6) Are receiving any other systemic antileukemic therapy (standard or investigational). Patients must not have received previous therapy for at least 2 weeks prior to the first dose of study drug and must have recovered from any prior drug-related non-hematologic toxicity to </= grade 2, with the following exceptions: (a) hydroxyurea, which must not have been received < 24 hours prior to the first dose of study drug; (b) monoclonal antibodies, which must not have been received for 6 weeks prior to the first dose of study drug.

7) Have psychiatric disorders that would interfere with consent, study participation, or follow-up.

8) Have a systemic fungal, bacterial, viral, or other infection not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibioitics or other treatment).

9) Have been diagnosed with another malignancy, unless the patient has been disease free for at least 5 years following curative intent therapy, with the following exceptions: Patients with treated nonmelanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia, regardless of the disease-free duration, if definitive treatment for the condition has been completed; or patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on PSA values if hormonal therapy has been initiated or a radical prostatectomy has been performed.

10) Have clinical evidence suggestive of CNS involvement with leukemia unless a lumber puncture confirms the absence of leukemic blasts in the CSF.

11) Known HIV positivity.

12) Are pregnant or lactating.

13) Have any severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo induction therapy with either or both of these agents.

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Links
Registration Number: NCT00317642
Study Information on Clinical Trials Registry (clinicaltrials.gov)

Other Links:
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Results


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