AzTrials
AzTrials

Acute Myeloid LeukemiaPhase 1/2NCT01853228

A Study of Decitabine (DACOGEN) in Sequential Administration With Cytarabine in Children With Relapsed or Refractory Acute Myeloid Leukemia

A Phase 1/2 study testing Phase1 and Phase 2: decitabine, Phase 1: cytarabine and Phase 2: cytarabine in people with Acute Myeloid Leukemia, run by Janssen Research & Development, LLC at 17 sites in 7 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

The purpose of this study is to examine the safety and efficacy of decitabine in sequential administration with cytarabine in children with relapsed or refractory acute myeloid leukemia (AML). Read more about this study

Who is it for?
Ages 1 month to 18 years
Conditions the study is for
Acute Myeloid Leukemia
What is being tested?
Phase1 and Phase 2: decitabine, Phase 1: cytarabine and Phase 2: cytarabine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
17 participants
Where
17 sitesin 7 countries
Study dates
22 Oct 2013to 28 Aug 2017
Phase
Phase 1/2
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 1 month to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Histological diagnosis of acute myeloid leukemia (AML) according to the World Health Organization (WHO) classification
  • Diagnosis of AML which has relapsed or is refractory to standard of care and no curative therapy exists
  • Karnofsky or Lansky score of at least 50
  • Must be recovered from acute toxicity of any prior treatment
  • Must have adequate organ function according to protocol-defined criteria
  • Agrees to protocol-defined use of effective contraception
  • Female participants of childbearing potential must have a negative serum or urine pregnancy test at Day 1 of Cycle 1

Who cannot join

  • Prior treatment with decitabine or azacitidine
  • Acute promyelocytic leukemia (M3 subtype in the French-American-British [FAB] classification system)
  • CNS3 disease
  • acute myeloid leukemia (AML) associated with congenital syndromes such as Down syndrome, Fanconi anemia, Bloom syndrome, Kostmann syndrome or Diamond-Blackfan anemia, or bone marrow failure associated with inherited syndromes
  • White blood cell count greater than 40x10^9 cells/liter(L)
  • Known allergies, hypersensitivity, or intolerance to decitabine or cytarabine or their excipients
Show all 14Show fewer
  • Contraindications to the use of cytarabine per local prescribing information or prior adverse reactions to cytarabine which would prevent further use
  • Currently enrolled in the treatment phase of an interventional investigational study
  • Female who is pregnant, or breast-feeding, or planning to become pregnant while enrolled in this study or within 3 months after the last dose of study drug (however, the period after which it becomes safe to become pregnant after the last dose of treatment is not known)
  • Male who plans to father a child while enrolled in this study or within 3 months after the last dose of study drug
  • Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the patient or that could prevent, limit, or confound the protocol-specified assessments
  • Any social or medical condition that in the investigator's opinion renders the participant unfit for study participation
  • History of hepatitis B surface antigen (HBsAg) or hepatitis C antibody (anti-HCV) positive, or other clinically active liver disease
  • History of human immunodeficiency virus (HIV) antibody positive

Trial locations and contacts

17 sites in 7 countries.

17 sites in 7 countries

Germany4 sites
  • Study site

    Essen

  • Study site

    Hamburg

  • Study site

    Hanover

  • Study site

    Stuttgart

Other trials in Germany

United Kingdom4 sites
  • Study site

    Birmingham

  • Study site

    Cambridge

  • Study site

    Glasgow

  • Study site

    Sutton

Other trials in United Kingdom

France3 sites
  • Study site

    Paris

  • Study site

    Toulouse

  • Study site

    Vandœuvre-lès-Nancy

Other trials in France

Spain3 sites
  • Study site

    Barcelona

  • Study site

    Madrid

  • Study site

    Valencia

Other trials in Spain

Belgium1 site
  • Study site

    Ghent

Other trials in Belgium

Denmark1 site
  • Study site

    Copenhagen Ø

Other trials in Denmark

Netherlands1 site
  • Study site

    Rotterdam

Other trials in Netherlands

About this study

Official title: Phase 1-2 Safety and Efficacy Study of DACOGEN in Sequential Administration With Cytarabine in Children With Relapsed or Refractory Acute Myeloid Leukemia

The purpose of this study is to examine the safety and efficacy of decitabine in sequential administration with cytarabine in children with relapsed or refractory acute myeloid leukemia (AML).

Read the detailed description

This is an open-label (identity of assigned study drug will be known) study to evaluate safety, efficacy, and pharmacokinetics (study of what the body does to a drug) of decitabine in sequential administration with cytarabine in children with relapsed or refractory AML. The study will determine the maximum tolerated dose of cytarabine that can be given following decitabine (Phase 1) and the response rate to this combination (Phase 2). Participants may enter a continuation phase of single agent-decitabine infusions for as long as such treatment would be considered beneficial. Serial pharmacokinetic samples will be collected and safety and efficacy will be monitored throughout the study.

Being tested
Phase1 and Phase 2: decitabine, Phase 1: cytarabine, Phase 2: cytarabine
Keywords
Acute myeloid leukemia, Relapsed or refractory acute myeloid leukemia, Children, Decitabine, DACOGEN, Cytarabine
Medical subject headings
Leukemia, Myeloid, Acute, Recurrence

What participants receive

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

  • Phase1 and Phase 2: decitabineDrug

    20 mg/m2 administered by intravenous infusion over 1 hour once daily for 5 consecutive days (Day 1 to Day 5 of 28-day cycle)

  • Phase 1: cytarabineDrug

    1 g/m2, 2 g/m2, and 1.5 g/m2 dose levels administered by intravenous infusion over 4 hours daily for 5 consecutive days (Day 8 to Day 12 of 28-day cycle) for the determination of the maximum tolerated dose

  • Phase 2: cytarabineDrug

    Phase 1 maximum tolerated dose administered by intravenous infusion over 4 hours daily for 5 consecutive days (Day 8 to Day 12 of 28-day cycle)

Study groups in NCT01853228
Study groupRoleWhat they receive
Decitabine and cytarabineExperimentalNot described
Receives: Drug: Phase1 and Phase 2: decitabine; Drug: Phase 1: cytarabine; Drug: Phase 2: cytarabine

What is being measured

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

  1. Phase 1: Maximum Tolerated Dose (MTD) of Cytarabine

    The maximum tolerated dose (MTD) for cytarabine was based on the number of participants experiencing a dose-limiting toxicity (DLT) by the end of Cycle 1. A non-hematological DLT was defined as: any Grade >=3 toxicity that persists for greater than (>) 5 days or any Grade 2 toxicity that persists for >7 days and that is intolerable to the participant. A hematological DLT was defined as Grade 4 neutropenia or thrombocytopenia due to a hypoplastic bone marrow at Day 42, in the absence of malignant infiltration. The nominal duration of each cycle was 28 days. However, participants who had not experienced bone marrow recovery at Day 28 were followed up to Day 42. Failure of marrow recovery (improvement to Grade 3) by Day 42 was considered a DLT. The maximum duration of Cycle 1 was therefore 42 days.

    Measured: Cycle 1 (42 days)

  2. Phase 1 and 2: Total Clearance of Decitabine

    Total clearance of drug after intravenously administration was calculated as: dose/area under the plasma concentration-time curve.

    Measured: Cycle 1 (28 days) Day 5: pre-infusion, 0.5 hour during infusion, end of infusion and at 5 minute (min), 0.5 hour, 1 hour, and 2 hour after end of infusion

  3. Phase 1 and 2: Volume of Distribution at Steady-State (Vss) of Decitabine

    Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired blood concentration of a drug.

    Measured: Cycle 1 (28 days) Day 5: pre-infusion, 0.5 hour during infusion, end of infusion and at 5 min, 0.5 hour, 1 hour, and 2 hour after end of infusion

  4. Phase 2: Percentage of Participants Who Achieved CR or CRi at Cycle 1 Day 28

    Response rate (percentage of participants who achieved CR or CRi) was measured using international working group (IWG) criteria. Response rate is defined as complete remission (CR) or complete remission with incomplete blood count recovery (CRi) in children with relapsed or refractory acute myeloid leukemia. CRi is defined as morphologic CR with residual neutropenia (less than [<] 1,000/microliter) or thrombocytopenia <100,000/ microliter). CR is defined as morphologic leukemia-free state, with less than 5 percentage (%) blasts in aspirate sample with marrow spicules and with a count of greater than or equal to (>=) 200 nucleated cells, plus absolute neutrophil count (ANC) greater than (>) 1,000/ microliter, platelet count of >100,000/microliter and participant must be independent of transfusions for a minimum of 1 week before each marrow assessment.

    Measured: Cycle 1 (28 days) Day 28

  5. Phase 2: Percentage of Participants Who Achieved CR or CRi at Cycle 2 Day 28

    Response rate (percentage of participants who achieved CR or CRi) was measured using international working group (IWG) criteria. Response rate is defined as complete remission (CR) or complete remission with incomplete blood count recovery (CRi) in children with relapsed or refractory acute myeloid leukemia. CRi is defined as morphologic CR with residual neutropenia (less than [<] 1,000/microliter) or thrombocytopenia <100,000/ microliter). CR is defined as morphologic leukemia-free state, with less than 5 percentage (%) blasts in aspirate sample with marrow spicules and with a count of greater than or equal to (>=) 200 nucleated cells, plus absolute neutrophil count (ANC) greater than (>) 1,000/ microliter, platelet count of >100,000/microliter and participant must be independent of transfusions for a minimum of 1 week before each marrow assessment.

    Measured: Cycle 2 (28 days) Day 28

  6. Phase 2: Percentage of Participants Who Achieved CR or CRi at End of Study Treatment

    Response rate (percentage of participants who achieved CR or CRi) was measured using international working group (IWG) criteria. Response rate is defined as complete remission (CR) or complete remission with incomplete blood count recovery (CRi) in children with relapsed or refractory acute myeloid leukemia. CRi is defined as morphologic CR with residual neutropenia (less than [<] 1,000/microliter) or thrombocytopenia <100,000/ microliter). CR is defined as morphologic leukemia-free state, with less than 5 percentage (%) blasts in aspirate sample with marrow spicules and with a count of greater than or equal to (>=) 200 nucleated cells, plus absolute neutrophil count (ANC) greater than (>) 1,000/ microliter, platelet count of >100,000/microliter and participant must be independent of transfusions for a minimum of 1 week before each marrow assessment.

    Measured: End of study treatment (approximately 3 years)

Secondary outcomes (7)
  1. Phase 1 and 2: Maximum Plasma Concentration (Cmax) of Decitabine

    Cmax is the maximum observed plasma concentration of Decitabine.

    Measured: Cycle 1 (28 days) Day 5: pre-infusion, 0.5 hour during infusion, end of infusion and at 5 min, 0.5 hour, 1 hour, and 2 hour after end of infusion

  2. Phase 1 and 2: Area Under the Plasma Concentration-Time Curve (AUC) of Decitabine

    AUC is the area under the plasma concentration-time curve of decitabine.

    Measured: Cycle 1 (28 days) Day 5: pre-infusion, 0.5 hour during infusion, end of infusion and at 5 min, 0.5 hour, 1 hour, and 2 hour after end of infusion

  3. Phase 2: Duration of Response

    Duration of response is defined as weeks from date of first response to date of first relapse or date of death.

    Measured: From time of response to relapse, study completion/withdrawal, or death, whichever comes first, for up to approximately 3 years 10 months

  4. Phase 2: Overall Response Rate

    Overall response rate is defined as percentage of participants with complete remission (CR) +complete remission with incomplete blood count recovery (CRi)+partial remission (PR) per IWG Criteria. CRi: morphologic CR with residual neutropenia (less than [<] 1,000/microliter) or thrombocytopenia <100,000/microliter). CR is defined as morphologic leukemia-free state, with less than 5 percentage (%) blasts in aspirate sample with marrow spicules and with a count of greater than or equal to (>=) 200 nucleated cells, plus absolute neutrophil count (ANC) greater than (>) 1,000/ microliter platelet count of >100,000/microliter and participant must be independent of transfusions for a minimum of 1 week before each marrow assessment. PR: all the same hematologic values of a CR, but with a decrease of >=50% of the percentage of blasts to 5% to 25% in the bone marrow aspirate.

    Measured: Up to approximately 3 years 10 months

  5. Phase 1 and 2: Overall Survival (OS)

    OS is defined as the time from the date of first dose of study drug to date of death from any cause. If the participant is alive or the vital status is unknown, the participant will be censored at the date the participant will be last known to be alive.

    Measured: From enrollment to death or withdrawal, whichever comes first, for up to approximately 3 years 10 months

  6. Phase 1 and 2: Event-Free Survival

    Event free survival is defined as the time from first dose of study drug to relapse from CR, death, or second malignancy for participants who achieved CR. CR is defined as morphologic leukemia-free state, with less than 5 percentage (%) blasts in aspirate sample with marrow spicules and with a count of greater than or equal to (>=) 200 nucleated cells, plus absolute neutrophil count (ANC) greater than (>) 1,000/ microliter platelet count of >100,000/microliter and participant must be independent of transfusions for a minimum of 1 week before each marrow assessment.

    Measured: From enrollment to progression/relapse, death, or withdrawal, whichever comes first, for up to approximately 3 years 10 months

  7. Phase 1 and 2: Number of Participants Reporting Treatment-Emergent Adverse Events (TEAEs)

    TEAEs are defined as adverse events with onset or worsening on or after date of first dose of study treatment. An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.

    Measured: Approximately 3 years 10 months

Timeline

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

  1. First posted14 May 2013 (estimated)
  2. Study start22 Oct 2013
  3. Primary completion28 Aug 2017
  4. Study completion28 Aug 2017

Why it stopped: EMA/PDCO acknowledged that available results from this study do not support further clinical studies in relapsed/refractory AML paediatric patients.

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 1/2
Primary purpose
Treatment
Intervention model
Sequential
Masking
None (open label)
Enrolment
17 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01853228
Sponsor's protocol ID
CR102071
Other IDs
DACOGENAML2004, 2013-000390-70
Status last verified
Mar 2019
First submitted
10 May 2013
Last updated
17 Jun 2019
Data monitoring committee
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Phase1 and Phase 2: decitabine, Phase 1: cytarabine and Phase 2: cytarabine in people with Acute Myeloid Leukemia, run by Janssen Research & Development, LLC at 17 sites in 7 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 7 inclusion and 14 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: stopped early, as of the sponsor's last update on 17 Jun 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in Germany, United Kingdom, France, Spain, Belgium and 2 more countries. 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 combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 17 Jun 2019). 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?

Phase 1: Maximum Tolerated Dose (MTD) of Cytarabine (time frame: Cycle 1 (42 days)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 17 Jun 2019.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in