LeukemiaPhase 2NCT02419469
Augmented Berlin-Frankfurt-Munster Therapy Plus Ofatumumab for Young Adults With Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma
A Phase 2 study testing Cytarabine, Daunorubicin and Vincristine in people with Leukemia and Precursor-B Acute Lymphoblastic Leukemia, run by M.D. Anderson Cancer Center at 1 site in United States.
Trial summary
The goal of this clinical research study is to learn if a chemotherapy combination called augmented Berlin-Frankfurt-Munster (BFM), when also combined with ofatumumab or rituximab, can help to control precursor-B ALL or LL in patients who are 12-30 years of age. Read more about this study
- Who is it for?
- Ages 12 to 30 years
- Conditions the study is for
- Leukemia, Precursor-B Acute Lymphoblastic Leukemia, Lymphoblastic Lymphoma
- What is being tested?
- Cytarabine, Daunorubicin and Vincristine
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1 participants
- Where
- 1 siteUnited States
- Study dates
- 13 Nov 2015to 22 Jun 2017
- 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 12 to 30 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Patients must have precursor-B lymphoblastic leukemia or lymphoma.
- Patients must be untreated or have had only one prior chemotherapy regimen for ALL or LL . Previously treated patients will be analyzed separately.
- Age between 12 to 30 years old
- Patients with central nervous system (CNS) disease or testicular disease are eligible.
- Intrathecal therapy with cytarabine is allowed prior to registration for patient convenience. This is usually done at the time of the diagnostic bone marrow or venous line placement to avoid a second lumbar puncture. Systemic chemotherapy must begin within 72 hours of the first intrathecal treatment.
- Signed informed consent prior to the start of systemic therapy. In the event of enrollment of a minor patient, an attempt to obtain assent from the patient must be documented, and parental consent must be signed.
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- Echocardiogram should be done within 7 days of starting therapy if there are cardiac risk factors (e.g., history of hypertension or of myocardial infarction)
- Creatinine should be < 3 mg/dL bilirubin < 3 mg/dl unless due to disease
- Zubrod Performance status of <3
- Patients who received steroids more than 72 hours prior to study enrollment are eligible but will be analyzed separately.
- Lymphoblasts may have any positive expression of cluster of differentiation antigen 20 (CD20) for ofatumumab administration.
Who cannot join
- Age less than twelve years of age or greater than 30 years.
- More than one prior treatment regimen for ALL or LL.
- The patient is pregnant or unwilling to practice appropriate birth control.
- Presence of the Philadelphia chromosome t(9;22)
- Laboratory or clinical evidence of active infectious hepatitis.
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Texas MD Anderson Cancer Center
Houston, Texas, 77030
About this study
The goal of this clinical research study is to learn if a chemotherapy combination called augmented Berlin-Frankfurt-Munster (BFM), when also combined with ofatumumab or rituximab, can help to control precursor-B ALL or LL in patients who are 12-30 years of age. The safety of these drug combinations will also be studied.
Augmented BFM is made up of daunorubicin, vincristine, prednisone, dexamethasone, PEG asparaginase, and methotrexate.
Read the detailed description
Study Drug Administration:
If you are found to be eligible to take part in this study, on Day 1 or during the spinal tap procedure, you will be given cytarabine as an injection in your spinal fluid.
You will then receive the study drugs in Induction, Consolidation, and Maintenance Courses. Induction Therapy is designed to remove the signs of leukemia that can be seen and to allow normal blood cells to be restored. This is called remission. Consolidation and Maintenance Therapies are designed to cause the disease to stay in remission.
The study drugs will be given the following ways:
- Daunorubicin by vein over about 30 minutes
- Vincristine by vein over 15-30 minutes
- PEG asparaginase by vein over 15-60 minutes
- Methotrexate either by mouth or as an injection into your spinal fluid (intrathecal), depending on the course. When given through the spinal fluid, cerebrospinal fluid (CSF) will be collected with each spinal tap to test the fluid for leukemia. If there is disease in your spinal fluid before starting the treatment, you will be given additional methotrexate doses each week until there is no disease present.
- Ofatumumab as an injection or by vein. If given by vein, the length of the infusion will depend on how well you tolerate the drug. If ofatumumab is not available, you will be given rituximab by vein over several (about 4-6) hours.
- Cyclophosphamide by vein over about 1 hour
- Cytarabine as an injection under the skin or by vein. If given by vein, the length of the infusion will depend on how well you tolerate the drug.
- Doxorubicin by vein. If given by vein, the length of the infusion will depend on how well you tolerate the drug.
- Prednisone, 6-Mercaptopurine, dexamethasone, and 6-Thioguanine are all taken by mouth
Within 3 days after you receive cytarabine, you will begin the Induction Course, which will last for 4 weeks. In the Induction Course, you will receive:
- Daunorubicin and vincristine on Days 1, 8, 15, and 22
- PEG asparaginase 1 time during Week 1
- Prednisone each day on Days 1-28.
- Intrathecal methotrexate at Weeks 2 and 5 during a spinal tap. If the is disease in your spinal fluid before starting the treatment, you will be given additional methotrexate doses each week until there is no disease present.
- Ofatumumab or rituximab on Days 2 and 15
Depending on how you respond to Induction, you may begin the Consolidation Courses 1-4 weeks after Induction.
You will then receive Consolidation Course 1. This course will last 8 weeks, and you will receive:
- Cyclophosphamide at Weeks 1 and 5
- Cytarabine on or around Days 1-4 and Days 8-11 of each 4-week cycle
- 6-Mercaptopurine on Days 1-14 of each 4-week cycle
- Vincristine at Weeks 3 and 4 of each 4-week cycle
- PEG Asparaginase at Weeks 3 and 7
- Intrathecal methotrexate weekly during Month 1 only
- Ofatumumab or rituximab at Weeks 1 and 5
You will then receive 2 courses of Consolidation Course 2. Each course will last about 7 weeks, and you will receive:
- Vincristine and methotrexate every 10 (+/- 2) days for up to 5 doses
- PEG Asparaginase at Weeks 1 and 4
- Intrathecal methotrexate at Weeks 1 and 5
- Ofatumumab or rituximab at Weeks 1 and 5
You will then receive Consolidation 3 (Part A). This course will last for 4 weeks, and you will receive:
- Vincristine and doxorubicin at Weeks 1, 2, and 3
- Dexamethasone on Days 1-7 and Days 15-21
- PEG asparaginase at Week 1
- Intrathecal methotrexate at Week 1
- Ofatumumab or rituximab on Weeks 1 and 3
You will then receive Consolidation 3 (Part B). This course will last for 4 weeks, and you will receive:
- Cyclophosphamide at Week 1
- Cytarabine for 4 days in a row during Weeks 1-2
- 6-Thioguanine every day for the first 2 weeks.
- Intrathecal methotrexate at Weeks 1 and 2
- Vincristin at Weeks 3 and 4
- PEG Asparaginase at Week 3
Once you finish Consolidation, you will then receive 24 months of Maintenance Therapy.
- Vincristine every month.
- Dexamethasone for 5 days every month.
- 6-Mercaptopurine 1 time a day
- Methotrexate by mouth every week.
- If you have ALL, you will also receive intrathecal methotrexate every 3 months for the first 12 months of maintenance.
Study Tests/Procedures:
Induction:
- Blood (about 3 teaspoons) will be drawn about 2 times each week during the Induction Period for routine tests.
- You will have a bone marrow aspirate or biopsy on Days 15 and 29 and then as needed to check the status of the disease.
- About 7 days after you receive your first dose of PEG asparaginase, blood (about 1 tablespoon) will be drawn to check the activity of the drug in your blood. If the drug does not seem to be working well, your dose may be changed.
- If you have LL and bone marrow was not found to be involved with the disease at screening, you will have a chest x-ray, CT scans, and positron emission tomography (PET) scans to measure the disease. These scans will be done after about 28 days of therapy.
Consolidation 1:
- Blood (about 3 teaspoons) will be drawn for routine tests about 2 times each week.
- You will have a spinal tap during each intrathecal methotrexate dose. The spinal fluid will be checked for leukemia cells.
- You will have a bone marrow aspiration at the end of Month 2 to check the status of the disease.
Consolidation 2:
- Blood (about 3 teaspoons) will be drawn every 2 weeks for routine tests.
- You will have a spinal tap during each intrathecal methotrexate doses. The spinal fluid will be checked for leukemia cells.
Consolidation 3 (Part A and B):
- Blood (about 3 teaspoons) will be drawn at least weekly for routine tests.
- You will have a spinal tap during each intrathecal methotrexate dose. The spinal fluid will be checked for leukemia cells.
Maintenance:
- You will have a spinal tap during each intrathecal methotrexate dose. The spinal fluid will be checked for leukemia cells.
- You will have a bone marrow aspiration at least every 3-6 months to check the status of the disease.
Length of Study:
You may remain on study for as long as the study doctor thinks it is in your best interest. If the disease does not appear to be improving after Induction, you will be taken off study. You may be taken off study if the disease gets worse or comes back during treatment, if intolerable side effects occur, if your doctor thinks it is in your best interest, or if you cannot follow the study instructions.
Follow-up Visits:
Your study doctor will inform you of your follow-up visit schedule in the clinic. At each follow-up visit there will be a physical exam and blood (about 1 tablespoon) will be drawn for routine tests. You will be followed-up for the next 3 years after your the last dose of your chemotherapy.
This is an investigational study. The chemotherapy drugs used in this study are all FDA approved and commercially available for the treatment of various types of leukemia. The use of ofatumumab/rituximab in this drug combination, as well as the drug combination's use in pediatric patients, is investigational.
Up to 100 participants will be enrolled in this study. All will take part at MD Anderson.
- Being tested
- Cytarabine, Daunorubicin, Vincristine, Prednisone, PEG asparaginase
- Keywords
- Leukemia, Precursor-B acute lymphoblastic leukemia, ALL, Lymphoblastic lymphoma, LL, Lymphoma, Cytarabine, Ara-C, Cytosar, DepoCyt, Cytosine Arabinosine Hydrochloride, Daunorubicin, Daunorubicin Hydrochloride, Cerubidine, Daunomycin, DNR, Vincristine, Prednisone, PEG asparaginase, Pegaspargase
- Medical subject headings
- Leukemia, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Lymphoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CytarabineDrug
Also called Ara-C, Cytosar, DepoCyt, Cytosine Arabinosine Hydrochloride
Participants initially receive intrathecal treatment using Cytarabine 100 mg on Day 1. Induction chemotherapy must begin within 3 days of the intrathecal Cytarabine dose.
Consolidation Therapy 1: Cytarabine 75 mg/m2 subcutaneously Days 1 - 4 and 8 - 11.
Consolidation Therapy 3B: Cytarabine 75 mg/m2 subcutaneously Days 1 - 4 and Days 8 - 11.
DaunorubicinDrug
Also called Daunorubicin Hydrochloride, Cerubidine, Daunomycin, DNR
Induction Therapy: Daunorubicin 25 mg/m2 by vein weekly for 4 doses.
VincristineDrug
Induction Therapy: Vincristine 1.5 mg/m2 by vein weekly for 4 doses.
Consolidation Therapy 1: Vincristine 1.5 mg/m2 by vein Week 3 and Week 4.
Consolidation Therapy 2: Vincristine 1.5 mg/m2 by vein every 10 days for 5 doses.
Consolidation Therapy 3A: Vincristine 1.5 mg/m2 by vein weekly for 3 doses.
Consolidation Therapy 3B: Vincristine 1.5 mg/m2 by vein Weeks 3 and 4.
Maintenance Therapy (24 months): Vincristine 1.5 mg/m2 by vein every 28 days.
PrednisoneDrug
Induction Therapy: Prednisone 60 mg/m2/day by mouth for 28 days.
PEG asparaginaseDrug
Also called Pegaspargase, Oncaspar, Polyethylene Glycol Conjugated Lasparaginase-H
Induction Therapy: PEG asparaginase 2000 IU/m2 by vein on Day 4 of induction.
Consolidation Therapy 1: PEG-asparaginase 2000 IU/m2 by vein Week 3 and Week 7.
Consolidation Therapy 2: PEG-asparaginase 2000 IU/m2 by vein Weeks 1 and 4.
Consolidation Therapy 3A: PEG-asparaginase 2000 IU/m2 by vein in Week 1.
Consolidation Therapy 3B: PEG-asparaginase 2000 IU/m2 by vein Week 3.
OfatumumabDrug
Also called Arzerra
Induction Therapy: Ofatumumab 300 mg by injection or vein on Day 2 and Ofatumumab 2000 mg by injection or vein on Day 15.
Consolidation Therapy 1: Ofatumumab 2000 mg by injection or vein Week 1 and Week 5.
Consolidation Therapy 2: Ofatumumab 2000 mg by injection or vein Week 1 and Week 5.
Consolidation Therapy 3A: Ofatumumab 2000 mg by injection or vein Week 1 and Week 3.
RituximabDrug
Also called Rituxan
Induction Therapy: If Ofatumumab not available, Rituximab 375 mg/m2 by vein on Day 1 and on Day 15.
Consolidation Therapy 1: If Ofatumumab not available, Rituximab 375 mg/m2 by vein Week 1 and Week 5.
Consolidation Therapy 2: If Ofatumumab not available, Rituximab 375 mg/m2 by vein Week 1 and Week 5.
Consolidation Therapy 3A: If Ofatumumab not available, Rituximab 375 mg/m2 by vein Week 1 and Week 3.
MethotrexateDrug
Induction Therapy: Intrathecal methotrexate 12 mg on Day 8 and Day 29.
Consolidation Therapy 1: Intrathecal methotrexate 12 mg Weekly, Weeks 1 - 4.
Consolidation Therapy 2: Methotrexate by vein every 10 days starting at 100 mg/m2 and increasing by 50 mg/m2 as tolerated. and Intrathecal methotrexate 12 mg Week 1.
Consolidation Therapy 3A: Intrathecal methotrexate 12 mg in Week 1.
Consolidation Therapy 3B: Intrathecal methotrexate 12 mg Week 1 and 2.
Maintenance Therapy (24 months): Methotrexate 20 mg/m2 by mouth weekly, hold on days of intrathecal methotrexate.
Maintenance Therapy (24 months): Intrathecal methotrexate 12 mg every 3 months for 4 doses.
CyclophosphamideDrug
Also called Cytoxan, Neosar
Consolidation Therapy 1: Cyclophosphamide 1 gram/m2 by vein Week 1 and Week 5.
Consolidation Therapy 3B: Cyclophosphamide 1 gram/m2 by vein Week 1.
MercaptopurineDrug
Also called 6-Mercaptopurine, Purinethol, 6-MP
Consolidation Therapy 1: Mercaptopurine 60 mg/m2/day by mouth Days 1 - 14.
Maintenance Therapy (24 months): Mercaptopurine 75 mg/m2 by mouth nightly.
DoxorubicinDrug
Also called Doxorubicin Hydrochloride, Adriamycin PFS, Adriamycin RDF, Adriamycin
Consolidation Therapy 3A: Doxorubicin 25 mg/m2 by vein weekly for 3 doses.
Dexamethasone acetateDrug
Also called Decadron
Consolidation Therapy 3A: Dexamethasone 10 mg/m2 by mouth on Days 1 - 7 and Days 15 - 21.
Maintenance Therapy (24 months): Dexamethasone 6 mg/m2/day by mouth Days 1 - 5 every 28 days.
ThioguanineDrug
Also called 6-thioguanine
Consolidation Therapy 3B: Thioguanine 60 mg/m2/day by mouth for 14 days.
| Study group | Role | What they receive |
|---|---|---|
| Augmented BFM Therapy + Ofatumumab or Rituximab | Experimental | Participants receive the study drugs in Induction, Consolidation, and Maintenance Courses. Receives: Drug: Cytarabine; Drug: Daunorubicin; Drug: Vincristine; Drug: Prednisone; Drug: PEG asparaginase; Drug: Ofatumumab; Drug: Rituximab; Drug: Methotrexate; Drug: Cyclophosphamide; Drug: Mercaptopurine; Drug: Doxorubicin; Drug: Dexamethasone acetate; Drug: Thioguanine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Event Free Survival (EFS)
Event free survival defined as the time from treatment to relapse of leukemia or death for any reason or lost to follow-up. Study regimen considered successful if it exhibits a 3-year EFS rate greater than 65% and response rate no less than 90% with Grade III-IV infectious toxicity rate in induction no more than 33%.
Measured: 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Apr 2015 (estimated)
- Study start13 Nov 2015
- Primary completion22 Jun 2017
- Study completion22 Jun 2017
Why it stopped: Slow Accrual
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for LeukemiaStudies of the same condition, open and under way.
- More trials run by M.D. Anderson Cancer CenterThe 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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 1 participants (actual)
Sponsor and investigators
- Lead sponsor
- M.D. Anderson Cancer Center
- Sponsor type
- University, hospital or other
- Collaborators
- Jazz Pharmaceuticals
- Responsible party
- Sponsor
- Investigators
- Michael E. Rytting, MD, Principal investigator, M.D. Anderson Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02419469
- Sponsor's protocol ID
- 2014-0396
- Other IDs
- NCI-2015-00967
- Status last verified
- May 2018
- First submitted
- 14 Apr 2015
- Last updated
- 11 Jun 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 Jun 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Augmented Berlin-Frankfurt-Munster Therapy Plus Ofatumumab for Young Adults With Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma
- ClinicalTrials.gov ID
- NCT02419469
- Acronym / sponsor ID
- 2014-0396
- Keywords
- Leukemia, Precursor-B acute lymphoblastic leukemia, ALL, Lymphoblastic lymphoma, LL, Lymphoma, Cytarabine, Ara-C
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Slow Accrual
- Enrolment
- 1 participants (actual)
- Lead sponsor
- M.D. Anderson Cancer CenterUniversity, hospital or other
- Collaborators
- Jazz Pharmaceuticals
- Study start
- 13 Nov 2015 (actual)
- Primary completion
- 22 Jun 2017 (actual)
- Study completion
- 22 Jun 2017 (actual)
- First posted
- 17 Apr 2015 (estimated)
- Results
- Posted 11 Jun 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical research study is to learn if a chemotherapy combination called augmented Berlin-Frankfurt-Munster (BFM), when also combined with ofatumumab or rituximab, can help to control precursor-B ALL or LL in patients who are 12-30 years of age. The safety of these drug combinations will also be studied.
Augmented BFM is made up of daunorubicin, vincristine, prednisone, dexamethasone, PEG asparaginase, and methotrexate.
Detailed description
Study Drug Administration:
If you are found to be eligible to take part in this study, on Day 1 or during the spinal tap procedure, you will be given cytarabine as an injection in your spinal fluid.
You will then receive the study drugs in Induction, Consolidation, and Maintenance Courses. Induction Therapy is designed to remove the signs of leukemia that can be seen and to allow normal blood cells to be restored. This is called remission. Consolidation and Maintenance Therapies are designed to cause the disease to stay in remission.
The study drugs will be given the following ways:
- Daunorubicin by vein over about 30 minutes
- Vincristine by vein over 15-30 minutes
- PEG asparaginase by vein over 15-60 minutes
- Methotrexate either by mouth or as an injection into your spinal fluid (intrathecal), depending on the course. When given through the spinal fluid, cerebrospinal fluid (CSF) will be collected with each spinal tap to test the fluid for leukemia. If there is disease in your spinal fluid before starting the treatment, you will be given additional methotrexate doses each week until there is no disease present.
- Ofatumumab as an injection or by vein. If given by vein, the length of the infusion will depend on how well you tolerate the drug. If ofatumumab is not available, you will be given rituximab by vein over several (about 4-6) hours.
- Cyclophosphamide by vein over about 1 hour
- Cytarabine as an injection under the skin or by vein. If given by vein, the length of the infusion will depend on how well you tolerate the drug.
- Doxorubicin by vein. If given by vein, the length of the infusion will depend on how well you tolerate the drug.
- Prednisone, 6-Mercaptopurine, dexamethasone, and 6-Thioguanine are all taken by mouth
Within 3 days after you receive cytarabine, you will begin the Induction Course, which will last for 4 weeks. In the Induction Course, you will receive:
- Daunorubicin and vincristine on Days 1, 8, 15, and 22
- PEG asparaginase 1 time during Week 1
- Prednisone each day on Days 1-28.
- Intrathecal methotrexate at Weeks 2 and 5 during a spinal tap. If the is disease in your spinal fluid before starting the treatment, you will be given additional methotrexate doses each week until there is no disease present.
- Ofatumumab or rituximab on Days 2 and 15
Depending on how you respond to Induction, you may begin the Consolidation Courses 1-4 weeks after Induction.
You will then receive Consolidation Course 1. This course will last 8 weeks, and you will receive:
- Cyclophosphamide at Weeks 1 and 5
- Cytarabine on or around Days 1-4 and Days 8-11 of each 4-week cycle
- 6-Mercaptopurine on Days 1-14 of each 4-week cycle
- Vincristine at Weeks 3 and 4 of each 4-week cycle
- PEG Asparaginase at Weeks 3 and 7
- Intrathecal methotrexate weekly during Month 1 only
- Ofatumumab or rituximab at Weeks 1 and 5
You will then receive 2 courses of Consolidation Course 2. Each course will last about 7 weeks, and you will receive:
- Vincristine and methotrexate every 10 (+/- 2) days for up to 5 doses
- PEG Asparaginase at Weeks 1 and 4
- Intrathecal methotrexate at Weeks 1 and 5
- Ofatumumab or rituximab at Weeks 1 and 5
You will then receive Consolidation 3 (Part A). This course will last for 4 weeks, and you will receive:
- Vincristine and doxorubicin at Weeks 1, 2, and 3
- Dexamethasone on Days 1-7 and Days 15-21
- PEG asparaginase at Week 1
- Intrathecal methotrexate at Week 1
- Ofatumumab or rituximab on Weeks 1 and 3
You will then receive Consolidation 3 (Part B). This course will last for 4 weeks, and you will receive:
- Cyclophosphamide at Week 1
- Cytarabine for 4 days in a row during Weeks 1-2
- 6-Thioguanine every day for the first 2 weeks.
- Intrathecal methotrexate at Weeks 1 and 2
- Vincristin at Weeks 3 and 4
- PEG Asparaginase at Week 3
Once you finish Consolidation, you will then receive 24 months of Maintenance Therapy.
- Vincristine every month.
- Dexamethasone for 5 days every month.
- 6-Mercaptopurine 1 time a day
- Methotrexate by mouth every week.
- If you have ALL, you will also receive intrathecal methotrexate every 3 months for the first 12 months of maintenance.
Study Tests/Procedures:
Induction:
- Blood (about 3 teaspoons) will be drawn about 2 times each week during the Induction Period for routine tests.
- You will have a bone marrow aspirate or biopsy on Days 15 and 29 and then as needed to check the status of the disease.
- About 7 days after you receive your first dose of PEG asparaginase, blood (about 1 tablespoon) will be drawn to check the activity of the drug in your blood. If the drug does not seem to be working well, your dose may be changed.
- If you have LL and bone marrow was not found to be involved with the disease at screening, you will have a chest x-ray, CT scans, and positron emission tomography (PET) scans to measure the disease. These scans will be done after about 28 days of therapy.
Consolidation 1:
- Blood (about 3 teaspoons) will be drawn for routine tests about 2 times each week.
- You will have a spinal tap during each intrathecal methotrexate dose. The spinal fluid will be checked for leukemia cells.
- You will have a bone marrow aspiration at the end of Month 2 to check the status of the disease.
Consolidation 2:
- Blood (about 3 teaspoons) will be drawn every 2 weeks for routine tests.
- You will have a spinal tap during each intrathecal methotrexate doses. The spinal fluid will be checked for leukemia cells.
Consolidation 3 (Part A and B):
- Blood (about 3 teaspoons) will be drawn at least weekly for routine tests.
- You will have a spinal tap during each intrathecal methotrexate dose. The spinal fluid will be checked for leukemia cells.
Maintenance:
- You will have a spinal tap during each intrathecal methotrexate dose. The spinal fluid will be checked for leukemia cells.
- You will have a bone marrow aspiration at least every 3-6 months to check the status of the disease.
Length of Study:
You may remain on study for as long as the study doctor thinks it is in your best interest. If the disease does not appear to be improving after Induction, you will be taken off study. You may be taken off study if the disease gets worse or comes back during treatment, if intolerable side effects occur, if your doctor thinks it is in your best interest, or if you cannot follow the study instructions.
Follow-up Visits:
Your study doctor will inform you of your follow-up visit schedule in the clinic. At each follow-up visit there will be a physical exam and blood (about 1 tablespoon) will be drawn for routine tests. You will be followed-up for the next 3 years after your the last dose of your chemotherapy.
This is an investigational study. The chemotherapy drugs used in this study are all FDA approved and commercially available for the treatment of various types of leukemia. The use of ofatumumab/rituximab in this drug combination, as well as the drug combination's use in pediatric patients, is investigational.
Up to 100 participants will be enrolled in this study. All will take part at MD Anderson.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Augmented BFM Therapy + Ofatumumab or Rituximab | Experimental | Drug: Cytarabine, Drug: Daunorubicin, Drug: Vincristine, Drug: Prednisone, Drug: PEG asparaginase, Drug: Ofatumumab, Drug: Rituximab, Drug: Methotrexate, Drug: Cyclophosphamide, Drug: Mercaptopurine, Drug: Doxorubicin, Drug: Dexamethasone acetate, Drug: ThioguanineParticipants receive the study drugs in Induction, Consolidation, and Maintenance Courses. |
Who may qualify
- Ages
- 12 to 30 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (11 listed)
- Patients must have precursor-B lymphoblastic leukemia or lymphoma.
- Patients must be untreated or have had only one prior chemotherapy regimen for ALL or LL . Previously treated patients will be analyzed separately.
- Age between 12 to 30 years old
- Patients with central nervous system (CNS) disease or testicular disease are eligible.
- Intrathecal therapy with cytarabine is allowed prior to registration for patient convenience. This is usually done at the time of the diagnostic bone marrow or venous line placement to avoid a second lumbar puncture. Systemic chemotherapy must begin within 72 hours of the first intrathecal treatment.
Key exclusion criteria (5 listed)
- Age less than twelve years of age or greater than 30 years.
- More than one prior treatment regimen for ALL or LL.
- The patient is pregnant or unwilling to practice appropriate birth control.
- Presence of the Philadelphia chromosome t(9;22)
- Laboratory or clinical evidence of active infectious hepatitis.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CytarabineAlso: Ara-C, Cytosar, DepoCyt, Cytosine Arabinosine HydrochlorideParticipants initially receive intrathecal treatment using Cytarabine 100 mg on Day 1. Induction chemotherapy must begin within 3 days of the intrathecal Cytarabine dose. Consolidation Therapy 1: Cytarabine 75 mg/m2 subcutaneously Days 1 - 4 and 8 - 11. Consolidation Therapy 3B: Cytarabine 75 mg/m2 subcutaneously Days 1 - 4 and Days 8 - 11. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| DaunorubicinAlso: Daunorubicin Hydrochloride, Cerubidine, Daunomycin, DNRInduction Therapy: Daunorubicin 25 mg/m2 by vein weekly for 4 doses. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| VincristineInduction Therapy: Vincristine 1.5 mg/m2 by vein weekly for 4 doses. Consolidation Therapy 1: Vincristine 1.5 mg/m2 by vein Week 3 and Week 4. Consolidation Therapy 2: Vincristine 1.5 mg/m2 by vein every 10 days for 5 doses. Consolidation Therapy 3A: Vincristine 1.5 mg/m2 by vein weekly for 3 doses. Consolidation Therapy 3B: Vincristine 1.5 mg/m2 by vein Weeks 3 and 4. Maintenance Therapy (24 months): Vincristine 1.5 mg/m2 by vein every 28 days. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| PrednisoneInduction Therapy: Prednisone 60 mg/m2/day by mouth for 28 days. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| PEG asparaginaseAlso: Pegaspargase, Oncaspar, Polyethylene Glycol Conjugated Lasparaginase-HInduction Therapy: PEG asparaginase 2000 IU/m2 by vein on Day 4 of induction. Consolidation Therapy 1: PEG-asparaginase 2000 IU/m2 by vein Week 3 and Week 7. Consolidation Therapy 2: PEG-asparaginase 2000 IU/m2 by vein Weeks 1 and 4. Consolidation Therapy 3A: PEG-asparaginase 2000 IU/m2 by vein in Week 1. Consolidation Therapy 3B: PEG-asparaginase 2000 IU/m2 by vein Week 3. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| OfatumumabAlso: ArzerraInduction Therapy: Ofatumumab 300 mg by injection or vein on Day 2 and Ofatumumab 2000 mg by injection or vein on Day 15. Consolidation Therapy 1: Ofatumumab 2000 mg by injection or vein Week 1 and Week 5. Consolidation Therapy 2: Ofatumumab 2000 mg by injection or vein Week 1 and Week 5. Consolidation Therapy 3A: Ofatumumab 2000 mg by injection or vein Week 1 and Week 3. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| RituximabAlso: RituxanInduction Therapy: If Ofatumumab not available, Rituximab 375 mg/m2 by vein on Day 1 and on Day 15. Consolidation Therapy 1: If Ofatumumab not available, Rituximab 375 mg/m2 by vein Week 1 and Week 5. Consolidation Therapy 2: If Ofatumumab not available, Rituximab 375 mg/m2 by vein Week 1 and Week 5. Consolidation Therapy 3A: If Ofatumumab not available, Rituximab 375 mg/m2 by vein Week 1 and Week 3. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| MethotrexateInduction Therapy: Intrathecal methotrexate 12 mg on Day 8 and Day 29. Consolidation Therapy 1: Intrathecal methotrexate 12 mg Weekly, Weeks 1 - 4. Consolidation Therapy 2: Methotrexate by vein every 10 days starting at 100 mg/m2 and increasing by 50 mg/m2 as tolerated. and Intrathecal methotrexate 12 mg Week 1. Consolidation Therapy 3A: Intrathecal methotrexate 12 mg in Week 1. Consolidation Therapy 3B: Intrathecal methotrexate 12 mg Week 1 and 2. Maintenance Therapy (24 months): Methotrexate 20 mg/m2 by mouth weekly, hold on days of intrathecal methotrexate. Maintenance Therapy (24 months): Intrathecal methotrexate 12 mg every 3 months for 4 doses. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| CyclophosphamideAlso: Cytoxan, NeosarConsolidation Therapy 1: Cyclophosphamide 1 gram/m2 by vein Week 1 and Week 5. Consolidation Therapy 3B: Cyclophosphamide 1 gram/m2 by vein Week 1. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| MercaptopurineAlso: 6-Mercaptopurine, Purinethol, 6-MPConsolidation Therapy 1: Mercaptopurine 60 mg/m2/day by mouth Days 1 - 14. Maintenance Therapy (24 months): Mercaptopurine 75 mg/m2 by mouth nightly. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| DoxorubicinAlso: Doxorubicin Hydrochloride, Adriamycin PFS, Adriamycin RDF, AdriamycinConsolidation Therapy 3A: Doxorubicin 25 mg/m2 by vein weekly for 3 doses. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| Dexamethasone acetateAlso: DecadronConsolidation Therapy 3A: Dexamethasone 10 mg/m2 by mouth on Days 1 - 7 and Days 15 - 21. Maintenance Therapy (24 months): Dexamethasone 6 mg/m2/day by mouth Days 1 - 5 every 28 days. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
| ThioguanineAlso: 6-thioguanineConsolidation Therapy 3B: Thioguanine 60 mg/m2/day by mouth for 14 days. | Drug | Augmented BFM Therapy + Ofatumumab or Rituximab |
Primary outcome
Event Free Survival (EFS)
Time frame: 3 years
Event free survival defined as the time from treatment to relapse of leukemia or death for any reason or lost to follow-up. Study regimen considered successful if it exhibits a 3-year EFS rate greater than 65% and response rate no less than 90% with Grade III-IV infectious toxicity rate in induction no more than 33%.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jun 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- University of Texas MD Anderson Cancer Center WebsiteLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michael E. Rytting, MD principal investigator
M.D. Anderson Cancer Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Cytarabine, Daunorubicin and Vincristine in people with Leukemia and Precursor-B Acute Lymphoblastic Leukemia, run by M.D. Anderson Cancer Center at 1 site in United States.
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 11 inclusion and 5 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 11 Jun 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. 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 11 Jun 2018). 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?
Event Free Survival (EFS) (time frame: 3 years). 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 11 Jun 2018.