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Acute Myeloid Leukemia (AML)Phase 2azacitidineNCT01180322

Trial Evaluating Induction Therapy With Idarubicin and Etoposide Plus Sequential or Concurrent Azacitidine and Maintenance Therapy With Azacitidine

A Phase 2 study testing Cytarabine, Idarubicin and Etoposide in people with Acute Myeloid Leukemia (AML), run by University of Ulm at 44 sites in 2 countries.

Completed

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

Official record
Search all trials

Trial summary

This is a randomized phase II, four-arm, open-label, multi-center study in adult patients with acute myeloid leukemia (AML) as defined in inclusion/exclusion criteria. The primary efficacy objective is to evaluate the impact of sequential or concurrent addition of 5-azacytidine to intensive induction chemotherapy with… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Acute Myeloid Leukemia (AML)
What is being tested?
Cytarabine, Idarubicin and Etoposide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
277 participants
Where
44 sitesin 2 countries
Study dates
Nov 2010to 2 Oct 2016
Phase
Phase 2
Are there results?
None posted in the registry

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

  • Patients with suspected diagnosis of acute myeloid leukemia or related precursor neoplasm, or acute leukemia of ambiguous lineage (classified according to the World Health Organization (WHO) classification)
  • Patients considered eligible for intensive chemotherapy
  • WHO performance status of ≤ 2
  • Age ≥ 18 years. There is no upper age limit.
  • No prior chemotherapy for leukemia except hydroxyurea to control hyperleukocytosis
  • Non-pregnant and non-nursing. Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test within a sensitivity of at least 25 mIU/mL within 72 hours prior to registration. "Women of childbearing potential" is defined as a sexually active mature woman who has not undergone a hysterectomy or who has had menses at any time in the preceding 24 consecutive months.
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  • Female patients in the reproductive age and male patients must agree to avoid getting pregnant or to father a child while on therapy and for 3 month after the last dose of chemotherapy.
  • Women of child-bearing potential must either commit to continued abstinence from heterosexual intercourse or begin one acceptable method of birth control (IUD, tubal ligation, or partner's vasectomy). Hormonal contraception is an inadequate method of birth control.
  • Men must use a latex condom during any sexual contact with women of childbearing potential, even if they have undergone a successful vasectomy. (while on therapy and for 3 month after the last dose of chemotherapy)
  • Signed written informed consent.

Who cannot join

  • -AML with other recurrent genetic abnormalities (according to WHO 2008): AML with t(8;21)(q22;q22); RUNX1-RUNX1T1 AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBFB-MYH11 AML with t(15;17)(q22;q12); PML-RARA (or variant translocations with other RARA gene fusions)
  • AML with NPM1 mutation
  • AML with FLT3 mutation
  • Performance status WHO >2
  • Patients with ejection fraction < 50% by Multi Gated Acquisition Scan (MUGA) or echocardiogram (ECHO scan) within 14 days of day 1
  • Organ insufficiency (creatinine >1.5x upper normal serum level; bilirubin, AST or ALP >2.5x upper normal serum level, not attributable to AML; heart failure NYHA III/IV; severe obstructive or restrictive ventilation disorder)
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  • Uncontrolled infection
  • Severe neurological or psychiatric disorder interfering with ability of giving an informed consent
  • Patients with a "currently active" second malignancy other than non-melanoma skin cancers. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are considered by their physician to be at less than 30% risk of relapse within one year.
  • Known positive for Human immunodeficiency virus (HIV)
  • Bleeding disorder independent of leukemia
  • No consent for registration, storage and processing of the individual disease-characteristics and course as well as information of the family physician and/or other physicians involved in the treatment of the patient about study participation.
  • No consent for biobanking.

Trial locations and contacts

44 sites in 2 countries.

44 sites in 2 countries

Germany39 sites
  • Universitätsklinikum Charité Berlin

    Berlin, 13353

  • Knappschaftskrankenhaus Bochum-Langendreer

    Bochum, 44892

  • Universitätsklinikum Bonn

    Bonn, 53111

  • Städtisches Klinikum Braunschweig

    Braunschweig, 38114

  • Klinikum Bremen-Mitte

    Bremen, 28177

  • Klinikum Darmstadt

    Darmstadt, 64283

  • Universitätsklinikum Düsseldorf

    Düsseldorf, 40225

  • Kliniken Essen Süd, Evangelischs Krankenhaus

    Essen, 45239

  • Klinikum Esslingen

    Esslingen am Neckar, 73730

  • Klinikum Frankfurt-Höchst

    Frankfurt, 65929

  • Medizinisches Versorgungszentrum Fulda

    Fulda, 36043

  • Universitätsklinikum Gießen

    Giessen, 35392

  • Wilhelm-Anton-Hospital Goch

    Goch, 47574

  • Universitätsklinikum Göttingen

    Göttingen, 37075

  • Sklepios Klinik Hamburg-Altona

    Hamburg, 22763

  • Evangelisches Krankenhaus Hamm

    Hamm, 59063

  • Klinikum Hanau

    Hanau, 63450

  • KRH Klinikum Hannover-Siloah

    Hanover, 30449

  • Medizinische Hochschule Hannover

    Hanover, 30625

  • SLK-Kliniken Heilbronn

    Heilbronn, 74078

  • Städtisches Klinikum Karlsruhe

    Karlsruhe, 76133

  • Universitätsklinikum Schleswig-Holstein

    Kiel, 24116

  • Caritas-Krankenhaus Lebach

    Lebach, 66822

  • Klinikum Lippe

    Lemgo, 32657

  • Klinikum Lüdenscheid

    Lüdenscheid, 58515

  • Klinikum der Johannes-Guttenberg-Universität

    Mainz, 55131

  • Johannes Wesling Klinikum Minden

    Minden, 32429

  • Klinikum rechts der Isar

    München, 81675

  • Stauferklinikum Schwäbisch-Gmünd

    Mutlangen, 73557

  • Klinikum Passau

    Passau, 94032

  • Krankenhaus der Barmherzigen Brüder

    Regensburg, 93049

  • Caritas-Klinik St. Theresia

    Saarbrücken, 66113

  • Klinikum Stuttgart

    Stuttgart, 70174

  • Diakonie-Klinikum Stuttgart

    Stuttgart, 70176

  • Krankenhaus der Barmherzigen Brüder

    Trier, 54292

  • Universitätsklinikum Tübingen

    Tübingen, 72076

  • Universitätsklinikum Ulm

    Ulm, 89081

  • Schwarzwald-Baar-Klinikum

    Villingen-Schwenningen, 78050

  • Helios Klinikum

    Wuppertal, 42283

Other trials in Germany

Austria5 sites
  • Universitätsklinikum Innsbruck

    Innsbruck, 6020

  • Krankenhaus der Barmherzigen Schwestern

    Linz, 4010

  • Elisabethinen Krankenhaus Linz

    Linz, 4020

  • Landeskliniken Salzburg

    Salzburg, 5020

  • Hanuschkrankenhaus

    Vienna, 1140

Other trials in Austria

About this study

Official title: Randomized Phase-II Trial Evaluating Induction Therapy With Idarubicin and Etoposide Plus Sequential or Concurrent Azacitidine and Maintenance Therapy With Azacitidine

This is a randomized phase II, four-arm, open-label, multi-center study in adult patients with acute myeloid leukemia (AML) as defined in inclusion/exclusion criteria.

The primary efficacy objective is to evaluate the impact of sequential or concurrent addition of 5-azacytidine to intensive induction chemotherapy with idarubicin and etoposide on the complete remission (CR) rate

Read more

Sample size: 336 patients

The treatment duration of an individual patient randomized into one of the three experimental arms (Arm B, C, D) (in case of application of induction, consolidation and maintenance therapy with Azacitidine) is about 30 months.

The treatment duration for patients randomized into the standard arm of the study (Arm A) is about 7 months (in case of application of induction, consolidation and 2-yrs observation as maintenance (without treatment with Azacitidine)).

In case of induction followed by consolidation with allogeneic Stem cell transplantation (SCT) the treatment duration per patient is about 6 months.

Every patient will be followed until month 54 after inclusion into the study. Duration of the study for an individual patient including treatment (induction, consolidation [chemotherapy or allogeneic SCT], maintenance [experimental arm with Azacitidine or observation]) and follow-up period: 54 months

Being tested
Cytarabine, Idarubicin, Etoposide, Azacitidine, Lenograstim
Keywords
azacitidine, Acute myeloid Leukemia (AML)
Medical subject headings
Leukemia, Myeloid, Acute

What participants receive

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

  • CytarabineDrug

    Induction therapy:100 mg/m2/day by continuous intravenous (IV) infusion on days 1-7 (total dose 700 mg/m2)

    Consolidation therapy:

    Younger adults (18 to 65 years): 3 g/m2/day by IV infusion over 3 hours every 12 hours on days 1, 2, and 3 (total dose 18 g/m2).

    Elderly patients (>65 years): 1 g/m2/day by IV infusion over 3 hours every 12 hours on days 1, 2, and 3 (total dose 6 g/m2).

  • IdarubicinDrug

    First induction therapy:

    Arm A, C, D:

    12 mg/m2/day by IV push on days 1,3,5 (total dose 36 mg/m2). For elderly (>65 yrs) patients only two doses of idarubicin are foreseen on days 1+3.

    Arm B:

    12 mg/m2/day by IV push on days 6, 8 10 (total dose 36 mg/m2). For elderly (>65 yrs) patients only two doses of idarubicin are foreseen on days 6+8.

    Second induction therapy:

    Arm A, C, D:

    12 mg/m2/day by IV push on days 1 and 3 (total dose 24 mg/m2; for all age groups)

    Arm B:

    12 mg/m2/day by IV push on days 6 and 8 (total dose 24 mg/m2; for all age groups).

  • EtoposideDrug

    Induction therapy:

    Arm A, C, D:

    100 mg/m²/day by 1-hour IV infusion on days 1,2,3 (total dose 300 mg/m2). On days 1 and 3 start after idarubicin push. For elderly (>65 yrs) patients only two doses of etoposide are foreseen on days 1+3.

    Arm B:

    100 mg/m²/day by 1-hour IV infusion on days 6,7,8 (total dose 300 mg/m2). On days 6 and 8 start after idarubicin push. For elderly (>65 yrs) patients only two doses of etoposide are foreseen on days 6+8.

  • AzacitidineDrug

    Induction therapy:

    Arm B and C:

    100 mg/m2/day by subcutaneous (SC) injection or 15-minute IV infusion on day 1 to day 5 (total dose 500 mg/m2). Azacitidine is always given prior to idarubicin and etoposide.

    Arm D:

    100 mg/m2/day by SC injection or 15-minute IV infusion on days 4-8 (total dose 500 mg/m2). Azacitidine is always given prior to idarubicin and etoposide.

    Maintenance therapy:

    Arm B, C, D:

    50 mg/m2/day by SC injection on days 1-5 (total dose 250 mg/m2) every 4 weeks. (Maintenance therapy is scheduled for a total duration of 2 years in patients with continuous CR)

  • LenograstimDrug

    Consolidation therapy:

    subcutaneously daily beginning on day 10 until neutrophil count > 0.5 x 109/l.

Study groups in NCT01180322
Study groupRoleWhat they receive
Arm AActive comparatorStandard Therapy
Receives: Drug: Cytarabine; Drug: Idarubicin; Drug: Etoposide; Drug: Lenograstim
Arm BExperimentalInvestigational Therapy "Azacitidine Prior"
Receives: Drug: Cytarabine; Drug: Idarubicin; Drug: Etoposide; Drug: Azacitidine; Drug: Lenograstim
Arm CExperimentalInvestigational Therapy "Azacitidine Concurrent"
Receives: Drug: Cytarabine; Drug: Idarubicin; Drug: Etoposide; Drug: Azacitidine; Drug: Lenograstim
Arm DExperimentalInvestigational Therapy "Azacitidine After"
Receives: Drug: Cytarabine; Drug: Idarubicin; Drug: Etoposide; Drug: Azacitidine; Drug: Lenograstim

What is being measured

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

  1. Rates of complete remission (CR) after induction therapy

    To evaluate the impact of sequential or concurrent addition of 5-azacytidine to intensive induction chemotherapy with idarubicin and etoposide on the CR rate

    Measured: 56 days

Secondary outcomes (13)
  1. Event-free survival

    Measured: after two years of follow-up

  2. Relapse-free survival

    Measured: after two years of follow-up

  3. overall survival

    Measured: after two years of follow-up

  4. days in hospital during each cycle and during the whole intervention

    Measured: 6 months

  5. Rate of early deaths or hypoplastic deaths (ED/HD)

    Measured: 56 days

  6. type, frequency, severity (graded using the National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] Version 3.0), timing and relatedness of non-hematological toxicity observed during different treatment cycles

    Measured: 6 months

  7. quality of life assessed by the EORTC Quality of Life Core Questionnaire (QLQ-C30)

    quality of life assessed by the EORTC Quality of Life Core Questionnaire (QLQ-C30), supplemented by information on self-assessed concomitant diseases, late treatment effects, and demographics according to Messerer et al [35].

    Measured: at the end of therapy (in average 6 months) and once a year in the follow-up

  8. duration of leukopenia after each consolidation cycle

    Measured: 42 days

  9. duration of neutropenia after each consolidation cycle

    Measured: 42 days

  10. duration of thrombocytopenia after each consolidation cycle

    Measured: 42 days

  11. duration of leukopenia after each induction cycle

    Measured: 28 days

  12. duration of neutropenia after each induction cycle

    Measured: 28 days

  13. duration of thrombocytopenia after each induction cycle

    Measured: 28 days

Timeline

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

  1. First posted12 Aug 2010 (estimated)
  2. Study startNov 2010
  3. Primary completionJun 2012
  4. Study completion2 Oct 2016

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
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
277 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01180322
Sponsor's protocol ID
AMLSG 12-09
Acronym
azacitidine
Status last verified
Dec 2020
First submitted
2 Aug 2010
Last updated
31 Dec 2020
Results posted
No
Data monitoring committee
Yes

Publications

  • Schmutz M, Zucknick M, Schlenk RF, Mertens D, Benner A, Weichenhan D, Mucke O, Dohner K, Plass C, Bullinger L, Claus R. Predictive value of DNA methylation patterns in AML patients treated with an azacytidine containing induction regimen. Clin Epigenetics. 2023 Oct 26;15(1):171. doi: 10.1186/s13148-023-01580-z.

    PubMed 37885041

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Cytarabine, Idarubicin and Etoposide in people with Acute Myeloid Leukemia (AML), run by University of Ulm at 44 sites in 2 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 10 inclusion and 13 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 31 Dec 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 44 sites in Germany, Austria. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Rates of complete remission (CR) after induction therapy (time frame: 56 days). 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 NCT01180322, which also lists 1 linked publication.

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 31 Dec 2020.

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