LeukemiaPhase 2NCT00077116
Idarubicin, Cytarabine, and Gemtuzumab Ozogamicin in Treating Patients With Previously Untreated High-Risk Myelodysplastic Syndrome or Acute Myeloid Leukemia Secondary to Myelodysplastic Syndrome
A Phase 2 study testing busulfan, cyclophosphamide and cytarabine in people with Leukemia and Myelodysplastic Syndromes, run by European Organisation for Research and Treatment of Cancer - EORTC at 9 sites in 4 countries.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as idarubicin and cytarabine, work in different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies, such as gemtuzumab ozogamicin, can locate cancer cells and either kill them or deliver cancer-killing substances to them without… Read more about this study
- Who is it for?
- Ages 16 to 70 years
- Conditions the study is for
- Leukemia, Myelodysplastic Syndromes
- What is being tested?
- busulfan, cyclophosphamide and cytarabine
- Type of treatment
- Surgery or procedure
- How many people
- 31 participants
- Where
- 9 sitesin 4 countries
- Study dates
- Nov 2003to Nov 2006
- Phase
- Phase 2
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 to 70 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically confirmed diagnosis of 1 of the following:
- High-risk myelodysplastic syndromes (MDS), including any of the following:
- Refractory anemia with excess blasts (RAEB) with > 10% blast cells in the bone marrow
- RAEB in transformation
- Other forms of MDS with multiple (3 or more) chromosomal abnormalities or chromosome 7 abnormalities AND/OR profound cytopenias, defined as neutrophil count < 500/mm^3 and/or platelet count < 20,000/mm^3
- Chronic myelomonocytic leukemia with > 5% blast cells in the bone marrow
- Chronic myelomonocytic leukemia with neutrophil count > 16,000/mm^3 OR monocyte count > 2,600/mm^3
- Secondary acute myeloid leukemia supervening after overt MDS of more than 6 months in duration
- Patients with or without an HLA-identical sibling
- No active CNS leukemia
PATIENT CHARACTERISTICS:
Age
- 16 to 70
Performance status
- WHO 0-2
Life expectancy
- Not specified
Hematopoietic
- See Disease Characteristics
Hepatic
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
Renal
- Creatinine ≤ 1.5 times ULN
Cardiovascular
- No severe cardiovascular disease
- No arrhythmias requiring chronic treatment
- No congestive heart failure
- No symptomatic ischemic heart disease
Pulmonary
- No severe lung disease
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No HIV positivity
- No other concurrent malignant disease
- No active uncontrolled infection
- No history of alcohol abuse (i.e., averaged less than 5 alcoholic consumptions daily for the past year)
- No concurrent severe neurological or psychiatric disease
- No other psychological, familial, sociological, or geographical condition that would preclude study compliance
PRIOR CONCURRENT THERAPY:
Biologic therapy
- More than 6 weeks since prior growth factors
Chemotherapy
- No prior intensive chemotherapy
- More than 6 weeks since prior low-dose chemotherapy or hydroxyurea
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Not specified
Other
- More than 6 weeks since prior immunosuppressants
- No prior participation in this clinical study
Trial locations and contacts
9 sites in 4 countries.
9 sites in 4 countries
Belgium4 sites
AZ Sint-Jan
Bruges, 8000
Institut Jules Bordet
Brussels, 1000
Cliniques Universitaires Saint-Luc
Brussels, 1200
H. Hartziekenhuis - Roeselaere.
Roeselare, 8800
Netherlands3 sites
Onze Lieve Vrouwe Gasthuis
Amsterdam, 1091 HA
Leiden University Medical Center
Leiden, 2300 CA
Universitair Medisch Centrum St. Radboud - Nijmegen
Nijmegen, NL-6500 HB
About this study
Official title: Idarubicin and Ara-C in Combination With Gemtuzumab-Ozogamicin (IAGO) for Young Untreated Patients, Without an HLA Identical Sibling, With High Risk MDS or AML Developing After a Preceding Period With MDS During 6 Months Duration: A Phase II Study
RATIONALE: Drugs used in chemotherapy, such as idarubicin and cytarabine, work in different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies, such as gemtuzumab ozogamicin, can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Giving monoclonal antibody therapy together with chemotherapy may kill more cancer cells. Giving healthy stem cells from a donor whose blood closely resembles the patient's blood will help the patient's bone marrow make new stem cells that become red blood cells, white blood cells, and platelets.
PURPOSE: This phase II trial is studying how well giving idarubicin and cytarabine together with gemtuzumab ozogamicin works in treating patients with previously untreated high-risk myelodysplastic syndrome or acute myeloid leukemia secondary to myelodysplastic syndrome.
Read the detailed description
OBJECTIVES:
Primary
- Determine the feasibility of combining gemtuzumab ozogamicin with idarubicin and cytarabine with or without cyclophosphamide with total body irradiation vs busulfan followed by allogeneic stem cell transplantation in patients with previously untreated high-risk myelodysplastic syndromes (MDS) or acute myeloid leukemia secondary to MDS.
- Determine the toxicity profile of this regimen in these patients.
- Determine the antileukemic/anti-MDS activity of this regimen in these patients.
Secondary
- Determine the hepatotoxicity of this regimen, in terms of veno-occlusive disease, in these patients.
- Determine the severity of pancytopenia and duration of recovery in patients treated with this regimen.
OUTLINE: This is a multicenter study. Patients are assigned to 1 of 2 treatment groups.
- Group 1 (for patients with no HLA-matched sibling donor): Patients receive remission-induction chemotherapy comprising idarubicin IV over 5 minutes on days 1, 3, and 5; cytarabine IV continuously over 24 hours on days 1-10; and gemtuzumab ozogamicin IV over 2 hours on day 7. Treatment continues for a second course in the absence of unacceptable toxicity.
- Group 2 (for patients with an HLA-matched sibling donor): Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive myeloablative consolidation chemotherapy comprising cyclophosphamide on days -6 and -5 and total body irradiation twice daily on days -4 to -2.
- Arm II: Patients receive myeloablative consolidation chemotherapy comprising busulfan on days -8 to -5 and cyclophosphamide on days -4 and -3.
Patients in both arms may alternatively undergo T-cell depletion and/or a reduced-intensity conditioning regimen.
Approximately 4-8 weeks after completion of consolidation chemotherapy, all patients in group 2 undergo allogeneic bone marrow transplantation or allogeneic peripheral blood stem cell transplantation. Patients in group 2 then proceed to remission-induction chemotherapy as in group 1.
Patients achieving complete remission are recommended for consolidation therapy off study.
Patients are followed monthly for 6 months, every 2 months for 6 months, and then every 3 months thereafter.
PROJECTED ACCRUAL: A total of 28 patients will be accrued for this study within 10 months.
- Conditions
- Leukemia, Myelodysplastic Syndromes
- Being tested
- busulfan, cyclophosphamide, cytarabine, gemtuzumab ozogamicin, idarubicin
- Keywords
- untreated adult acute myeloid leukemia, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, chronic myelomonocytic leukemia, de novo myelodysplastic syndromes, secondary myelodysplastic syndromes, adult acute myeloid leukemia with t(8;21)(q22;q22), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with t(15;17)(q22;q12), childhood myelodysplastic syndromes
- Medical subject headings
- Leukemia, Myelodysplastic Syndromes, Anemia, Refractory, with Excess of Blasts, Leukemia, Myelomonocytic, Chronic, Congenital Abnormalities
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
busulfanDrug
cyclophosphamideDrug
cytarabineDrug
gemtuzumab ozogamicinDrug
idarubicinDrug
allogeneic bone marrow transplantationProcedure or surgery
peripheral blood stem cell transplantationProcedure or surgery
radiation therapyRadiation
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of complete remission (CR) or complete remission with incomplete recovery of platelets (CRp) as measured by Cheson response criteria after the start of treatment
Severe toxicity after the start of treatment
Secondary outcomes (3)
Disease-free survival from CR/CRp
Duration of overall survival
Severity of pancytopenia and duration of recovery in patients who reached CR/CRp after the start of treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Feb 2004 (estimated)
- Study startNov 2003
- Primary completionNov 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for LeukemiaStudies of the same condition, open and under way.
- More trials run by European Organisation for Research and Treatment of Cancer - EORTCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Masking
- None (open label)
- Enrolment
- 31 participants (actual)
Sponsor and investigators
- Sponsor type
- Research network
- Responsible party
- Sponsor
- Investigators
- Theo De Witte, MD, PhD, Study chair, Universitair Medisch Centrum St. Radboud - Nijmegen
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00077116
- Sponsor's protocol ID
- EORTC-06013
- Other IDs
- EORTC-06013
- Status last verified
- Jul 2012
- First submitted
- 10 Feb 2004
- Last updated
- 16 Jul 2012
- Results posted
- No