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Acute Lymphoblastic Leukemia (ALL)Phase 2NCT00495079

Safety and Efficacy of Marqibo in Relapsed Acute Lymphoblastic Leukemia

A Phase 2 study testing Marqibo® (vincristine sulfate liposomes injection) in people with Acute Lymphoblastic Leukemia (ALL), run by Spectrum Pharmaceuticals, Inc at 33 sites in 5 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This was a Phase 2, international, multicenter, open-label, single-arm trial evaluating Marqibo (VSLI) in adult subjects with: 1) Ph- ALL or lymphoblastic lymphoma in second or greater relapse; or 2) Ph- ALL or lymphoblastic lymphoma who failed 2 or greater treatment lines of anti-leukemia chemotherapy. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Acute Lymphoblastic Leukemia (ALL)
What is being tested?
Marqibo® (vincristine sulfate liposomes injection)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
65 participants
Where
33 sitesin 5 countries
Study dates
May 2007to 8 Aug 2010
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years.
  • Had Ph- ALL or lymphoblastic lymphoma and was in second relapse, or had failed 2 treatment lines of anti-leukemia chemotherapy.
  • Had histologically or cytologically proven ALL and ≥ 10% bone marrow blasts. If < 10% bone marrow blasts, subject must have had histologically or cytologically proven ALL and evaluable extramedullary disease. Sponsor approval was obtained prior to enrolling subjects who had < 10% bone marrow blasts with evaluable extramedullary disease.
  • Had achieved a CR to at least 1 prior anti-leukemia therapy as defined by a leukemia-free interval of ≥ 90 days.
  • For subjects with a prior history of stem cell transplantation, had ≤ Grade 1 active skin graft-versus-host disease (GVHD). No active gastrointestinal or liver graft-versus-host disease.
  • Had an Eastern Cooperative Oncology Group (ECOG) performance status 0 to 3.
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  • Had normal renal and liver function as defined below within 14 days, inclusive, prior to first dose of VSLI, unless the abnormality was considered attributable to leukemia:
  • Total bilirubin ≤ 2.0 × institutional upper limit of normal, unless the subject had a known diagnosis of Gilbert's disease. If a subject had Gilbert's disease, he/she could have participated in this study, however must have been monitored closely during the study.
  • Aspartate transaminase (AST) or alanine transaminase (ALT) ≤ 3 × institutional upper limit of normal.
  • Serum creatinine ≤ 2.0 g/dL or calculated estimated creatinine clearance ≥ 50 mL/minute/1.73 m2 based on Cockcroft and Gault formula, unless renal dysfunction was considered due to hematologic malignancy.
  • Had never received prior VSLI treatment.
  • For women of childbearing potential, had a negative serum or urine pregnancy test within 14 days prior to enrollment.
  • If female, the subject was postmenopausal, surgically sterilized, or willing to use acceptable methods of birth control (e.g., hormonal contraceptive, intra-uterine device, diaphragm with spermicide, and condom with spermicide or abstinence) from the Screening visit through 30 days after the last dose of VSLI.
  • If male, the subject agreed to use an acceptable barrier method for contraception from the Screening visit through 30 days after the last dose of VSLI.
  • Before enrollment, the subject was capable of understanding and complying with parameters as outlined in the protocol and able to sign a written informed consent according to ICH/GCP and national/local regulations.

Who cannot join

  • Had Burkitt's lymphoma or Burkitt's leukemia.
  • Had a history of Philadelphia chromosome-positive (Ph+) ALL and/or BCR/ABL rearrangements documented by fluorescent in situ hybridization or polymerase chain reaction.
  • Had a history of Philadelphia chromosome-positive (Ph+) ALL and/or BCR/ABL rearrangements documented by fluorescent in situ hybridization or polymerase chain reaction.
  • Had active CNS disease. History of treated CNS disease was allowable. The CNS disease must have resolved in order for the subject to be eligible.
  • Was eligible for stem cell transplantation. This implied that a suitable donor was readily available, the subject was willing to undergo stem cell transplantation, and the Investigator believed this was a better treatment option than VSLI. This was at the Investigator's discretion.
  • Was treated with any investigational agents or chemotherapy agents in the last 21 days before the first dose of VSLI, unless full recovery from side effects had occurred or the subject had rapidly progressing disease judged to be life threatening by the Investigator.
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  • Was receiving any other standard or investigational treatment for the subject's leukemia.
  • Intrathecal chemotherapy for CNS prophylaxis was allowable.
  • The use of hydroxyurea (Hydrea®) to control leukocytosis was allowable but must have been tapered off by Day 14 of Course 1. From Day 15 of Course 1 on through the end of study participation, hydroxyurea (Hydrea®) was not allowed.
  • Systemic corticosteroids must have been tapered off, preferably before the start of study treatment, but no later than by Day 5 of Course 1. From Day 6 of Course 1 on through the end of study participation, systemic corticosteroids were not allowed.
  • Had persistent chronic clinically significant toxicities from prior chemotherapy ≥ Grade 2 (National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] version 3.0).
  • Had persistent ≥ Grade 2 active neuropathy (NCI CTCAE v3.0).
  • Had a history of persistent ≥ Grade 2 active neurologic disorders unrelated to chemotherapy (including demyelinating form of Charcot-Marie-Tooth syndrome, acquired demyelinating disorders, or other demyelinating condition).
  • Had a history of allergic reactions or sensitivity attributed to compounds of similar chemical or biologic composition to vincristine or components of study drug.
  • Was female who was pregnant or breast-feeding.
  • Had active serious infection not controlled by oral or intravenous antibiotics or antifungals.
  • Had human immunodeficiency virus positive status.
  • Had any medical condition which in the opinion of the investigator placed the subject at an unacceptably high risk for toxicities.
  • Had any condition or circumstance which in the opinion of the investigator would significantly interfere with the subject's protocol compliance and put the subject at increased risk.

Trial locations and contacts

33 sites in 5 countries.

33 sites in 5 countries

United States18 sites
  • Emory University - Winship Cancer Institute

    Atlanta, Georgia, 30322

  • Roswell Park Cancer Institute

    Buffalo, New York, 14263

  • Loyola University Medical Center

    Chicago, Illinois, 60153

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • University of Chicago Medical Center

    Chicago, Illinois, 60637

  • Rocky Mountain Cancer Center

    Denver, Colorado, 80218

  • Henry Ford Health System

    Detroit, Michigan, 48202

  • Hackensack University Medical Center

    Hackensack, New Jersey, 07601

  • University of Texas M.D. Anderson Cancer Center

    Houston, Texas, 77030

  • Univesity of Iowa - Hospitals and Clinica

    Iowa City, Iowa, 52242

  • USC - Norris Cancer Center

    Los Angeles, California, 90033

  • UCLA Medical Center

    Los Angeles, California, 90095

  • University of Nebraska Medical Center

    Omaha, Nebraska, 68198

  • Western Pennsylvania Allegheny Health System

    Pittsburgh, Pennsylvania, 15224

  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15232

  • University of California Medical Center

    San Francisco, California, 94143

  • Stanford Hospitals and Clinics

    Stanford, California, 94305

  • New York Medical College

    Valhalla, New York, 10595

Other trials in United States

Germany9 sites
  • Dresden University Hospital

    Dresden, 01307

  • University of Essen

    Essen, 45122

  • J.W. Goethe University

    Frankfurt, 60325

  • University of Leipzig

    Leipzig

  • University of Muenster

    Münster, 48149

  • University of Rostock

    Rostock, 18057

  • Diakonie-Klinikum Stuttgart

    Stuttgart, 70176

  • Robert Bosch Hospital

    Stuttgart

  • University of Ulm

    Ulm, 89070

Other trials in Germany

Israel4 sites
  • Rambam Medical Center

    Haifa, 31096

  • Hadassah Medical Center - Ein Karem

    Jerusalem, 91120

  • Rabin Medical Center Campus

    Petah Tikva, 49100

  • The Chaim Sheba Medical Center

    Tel HaShomer

Other trials in Israel

Canada1 site
  • Princess Margaret Hospital

    Toronto, Ontario, M5G 2M9

Other trials in Canada

United Kingdom1 site
  • Derriford Hospital

    Plymouth, PL6 8DH

Other trials in United Kingdom

About this study

Official title: A Phase 2 Study to Evaluate the Safety and Efficacy of Weekly Doses of Marqibo® (Vincristine Sulfate Liposomes Injection) in Adult Patients With Philadelphia Chromosome-negative Acute Lymphoblastic Leukemia (ALL) in Second Relapse or Adult Patients With Philadelphia Chromosome-negative ALL Who Failed Two Treatment Lines of Anti-leukemia Chemotherapy

This was a Phase 2, international, multicenter, open-label, single-arm trial evaluating Marqibo (VSLI) in adult subjects with: 1) Ph- ALL or lymphoblastic lymphoma in second or greater relapse; or 2) Ph- ALL or lymphoblastic lymphoma who failed 2 or greater treatment lines of anti-leukemia chemotherapy. The original enrollment target for this study was approximately 56 subjects. Per a protocol amendment, enrollment was increased from 56 to 65.

The primary objective of this study was to evaluate:

  • The efficacy of the study treatment as determined by the rate of CR plus CR with incomplete blood count recovery (CRi) in adult subjects with Philadelphia chromosome-negative (Ph-) ALL in second relapse or adult subjects with (Ph-) ALL who failed 2 treatment lines of anti-leukemia chemotherapy. Subjects must have achieved a CR to at least 1 prior anti-leukemia therapy as defined by a leukemia-free interval of ≥ 90 days.
Read the detailed description

The secondary objectives of this study were to evaluate:

  • Duration of CR plus CRi
  • Overall survival
  • Safety and tolerability
Being tested
Marqibo® (vincristine sulfate liposomes injection)
Keywords
acute, lymphoblastic, lymphocytic, leukemia, leukaemia, lukemia, leukimia, ALL, Marqibo, Hana Biosciences, vincristine, liposomal, liposome, optisome, hematology, malignancy, hematological, relapsed, anti-leukemia, adult
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma, Leukemia, Neoplasms, Recurrence

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Marqibo® (vincristine sulfate liposomes injection)Drug

    Also called VSLI, Vincristine Sulfate Liposomes Injection

    Dosing was done every 7 days (± 3 days) on Days 1, 8, 15, and 22 with no less than 4 days between dosing days. Dose calculations were based on body surface area using the subject's height (from Screening) and actual weight for each course.

Study groups in NCT00495079
Study groupRoleWhat they receive
MarqiboExperimentalEligible subjects received study drug at 2.25 mg/m^2 intravenously via peripheral or central venous access over 60 minutes (± 10 minutes).
Receives: Drug: Marqibo® (vincristine sulfate liposomes injection)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Complete Remission Plus Complete Remission Without Full Platelet Recovery (CR + CRi)

    CR is defined as no evidence of ALL: ANC>or=1x10^9/L or platelet count>100x10^9/L, absence of leukemia blast cells in blood and marrow (<5% blasts), resolution of all sites of extramedullary disease (EMD). CR with incomplete blood count recovery (CRi): As per CR but platelet count< 100x10^9/L or ANC< 1x10^9/L. Partial remission(PR):CR with>5-25% abnormal cells in the marrow or 50% decrease in bone marrow blasts. Reduction in EMD by at least 50%. Hematologic Improvement. Bone marrow blast(BMB) response: BMB<5% in the absence of HI. Stable disease(SD):No significant hematological and extramedullary change from baseline.

    Measured: Response assessment performed at the end of each 28 day course.

  2. Clinical Response Assessment Per Independent Response Review Committee (IRRC) Evaluation

    Number of subjects who achieved Complete Remission (CR)as assessed by the IRRC. CR is defined as no evidence of ALL. ANC>=1X10^9/L or Platelet count>=100x10^9/L, absence of blasts in blood and morrow (<5%), resolution of all sites of extramedullary disease (EMD). CR with incomplete blood count recovery(CRi)is defined as per CR but platelet count <100x10^9/L or ANC<1x10^9/L.

    Measured: Response assessment at the end of each 28 days course

Secondary outcomes (2)
  1. Duration of CR + CRi

    Duration of response for those subjects who achieved CR or CRi

    Measured: CR + CRi duration was calculated from the date the subject first met the definition of CR or CRi until the date of relapse

  2. Overall Survival

    Time, in days, from informed consent date until the date of death or date of last contact

    Measured: unlimited

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jul 2007 (estimated)
  2. Study startMay 2007
  3. Primary completion8 Aug 2010
  4. Study completion8 Aug 2010

Resources

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
65 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00495079
Sponsor's protocol ID
HBS407
Status last verified
Feb 2021
First submitted
28 Jun 2007
Last updated
5 Mar 2021

Publications

  • Schiller GJ, Damon LE, Coutre SE, Hsu P, Bhat G, Douer D. High-Dose Vincristine Sulfate Liposome Injection, for Advanced, Relapsed, or Refractory Philadelphia Chromosome-Negative Acute Lymphoblastic Leukemia in an Adolescent and Young Adult Subgroup of a Phase 2 Clinical Trial. J Adolesc Young Adult Oncol. 2018 Oct;7(5):546-552. doi: 10.1089/jayao.2018.0041. Epub 2018 Sep 21.

    PubMed 30239252
  • Silverman JA, Reynolds L, Deitcher SR. Pharmacokinetics and pharmacodynamics of vincristine sulfate liposome injection (VSLI) in adults with acute lymphoblastic leukemia. J Clin Pharmacol. 2013 Nov;53(11):1139-45. doi: 10.1002/jcph.155. Epub 2013 Aug 17.

    PubMed 23907766
  • O'Brien S, Schiller G, Lister J, Damon L, Goldberg S, Aulitzky W, Ben-Yehuda D, Stock W, Coutre S, Douer D, Heffner LT, Larson M, Seiter K, Smith S, Assouline S, Kuriakose P, Maness L, Nagler A, Rowe J, Schaich M, Shpilberg O, Yee K, Schmieder G, Silverman JA, Thomas D, Deitcher SR, Kantarjian H. High-dose vincristine sulfate liposome injection for advanced, relapsed, and refractory adult Philadelphia chromosome-negative acute lymphoblastic leukemia. J Clin Oncol. 2013 Feb 20;31(6):676-83. doi: 10.1200/JCO.2012.46.2309. Epub 2012 Nov 19.

    PubMed 23169518

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Marqibo® (vincristine sulfate liposomes injection) in people with Acute Lymphoblastic Leukemia (ALL), run by Spectrum Pharmaceuticals, Inc at 33 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 33 sites in United States, Germany, Israel, Canada, United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 29 Nov 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Complete Remission Plus Complete Remission Without Full Platelet Recovery (CR + CRi) (time frame: Response assessment performed at the end of each 28 day course.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00495079, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Mar 2021.

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