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Hematologic MalignancyPhase 2NCT02718755

Phase II Study of Fludarabine, Cytarabine (ARA-C) and Erwinase IV in Patients With Relapsed or Refractory Hematologic Malignancies

A Phase 2 study testing Fludarabine, Cytarabine and Erwinase in people with Hematologic Malignancy, run by M.D. Anderson Cancer Center.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The goal of this clinical research study is to learn if fludarabine, cytarabine (ARA-C), and erwinase (also known as asparaginase [erwinia]) in combination can help to control relapsed or refractory hematologic malignancies. The safety of these drugs will also be studied. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Hematologic Malignancy
What is being tested?
Fludarabine, Cytarabine and Erwinase
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
May 2018to May 2022
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 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Patients with a diagnosis of relapsed or refractory hematologic malignancy including, but not limited to Acute myeloid leukemia (AML), Acute lymphoblastic leukemia (ALL), Burkitt's leukemia/lymphoma, Prolymphocytic leukemia, Biphenotypic acute leukemia, Blast-phase of chronic myeloid leukemia (CML), B-cell lymphoma, or Richter's transformation of chronic lymphocytic leukemia (CLL)
  • Age </= 60 years.
  • Adequate organ function as defined below: liver function (bilirubin < 2mg/dL, AST and/or ALT <2.5 x upper limits of normal (ULN)), kidney function (creatinine < 1.5 x ULN ), known cardiac ejection fraction of > or = 45% within the past 3 months
  • Eastern Cooperative Oncology Group (ECOG) performance status of </= 2.
  • 5) A negative urine pregnancy test is required within 1 week for all women of childbearing potential prior to enrolling on this trial.
  • 6) Patient must have the ability to understand the requirements of the study and signed informed consent. A signed informed consent by the patient or his legally authorized representative is required prior to their enrollment on the protocol.
  • 7) Patient must have the ability to understand the requirements of the study and signed informed consent. A signed informed consent by the patient or his legally authorized representative is required prior to their enrollment on the protocol.

Who cannot join

  • Pregnant women are excluded from this study because the agents used in this study have the potential for teratogenic or abortifacient effects. Because there is a potential risk for adverse events in nursing infants secondary to treatment of the mother with the chemotherapy agents, breastfeeding should also be avoided.
  • Uncontrolled intercurrent illness including, but not limited to active uncontrolled infection, symptomatic congestive heart failure (NYHA Class III or IV), unstable angina pectoris, clinically significant cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Patient with documented hypersensitivity to any of the components of the chemotherapy program.
  • Men and women of childbearing potential who do not practice contraception. Women of childbearing potential and men must agree to use contraception prior to study entry and for the duration of study participation.
  • Patients with history of clinically significant venous thromboembolism.

About this study

The goal of this clinical research study is to learn if fludarabine, cytarabine (ARA-C), and erwinase (also known as asparaginase [erwinia]) in combination can help to control relapsed or refractory hematologic malignancies. The safety of these drugs will also be studied.

Read the detailed description

Study Drug Administration:

Each cycle is 28 days.

If participant is found to be eligible to take part in this study, they will receive treatment in 2 phases: Induction and Consolidation.

All participants will receive the same dose level of fludarabine, cytarabine, and erwinase. If the doctor thinks it is needed, the study drug doses may be reduced.

Induction Phase:

Participant will receive 1-2 cycles during the Induction phase.

On Days 1-5, participant will receive fludarabine by vein over about 30 minutes and cytarabine by vein over about 2 hours.

On Days 1-7, participant will receive erwinase by vein over about 2 hours or as an injection into the muscle.

If the disease does not respond during Cycle 1, participant may be allowed to receive an additional Induction cycle. If the disease does respond to Induction, participant can move to the Consolidation phase.

Consolidation Phase:

Participant will receive up to 3 cycles during the Consolidation phase.

On Days 1-4, participant will receive fludarabine by vein over about 30 minutes and cytarabine by vein over about 2 hours. If the doctor thinks it is needed, this may be reduced to Days 1-3.

On Day 1 and then every other day for 15 days (3, 5, 7 and so on), participant will receive erwinase by vein over about 2 hours or as an injection into the muscle.

Study Visits:

On Day 1 (± 3 days) of every cycle, participant will have a physical exam.

Induction Cycle(s):

Every week, blood (about 2-3 teaspoons) will be drawn for routine tests.

On Days 1, 8, 9, and 12 of Cycle 1:

  • Blood (about 1-2 teaspoons) will be drawn for routine, biomarker, and pharmacodynamic (PD) testing. Biomarkers are found in the blood/tissue and may be related to how the leukemia reacts to the study drug. PD testing measures how the level of study drug in participant's body may affect the disease.
  • On Days 9 and 12 only, blood (about 1-2 teaspoons) will be drawn for pharmacokinetic (PK) testing. PK testing measures the amount of study drug in the body at different time points.

On Day 7 of Cycle 1, blood (about 1-2 teaspoons each time) will be drawn for PK testing before the dose and then 8 more times over the next 24 hours after the dose. Some of these blood samples will also be used for antibody testing. Antibodies are created by the immune system and may attack foreign cells or substances, such as the study drug.

On Day 21 of Cycle 1, participant will have a bone marrow aspiration/biopsy for biomarker and PD testing and to check the status of the disease. If the doctor thinks it is needed, participant may have additional bone marrow aspirations/biopsies while on study.

If participant has a second Induction Cycle and the doctor thinks it is needed, they will have a bone marrow aspirate/biopsy at the end of the second Induction Cycle for biomarker and PD testing and to check the status of the disease.

Consolidation Cycles:

Every 1-2 weeks, blood (about 2-3 teaspoons) will be drawn for routine tests.

On Day 1 of Cycle 1, blood (about 1-2 teaspoons) will be drawn for PK testing before the dose and then 8 more times over the next 24 hours after the dose. Some of this blood sample will also be used for antibody testing.

If participant did not have 2 induction cycles, at the end of Cycle 1 of Consolidation, if the doctor thinks it is needed, they will have a bone marrow aspirate/biopsy for biomarker and PD testing and to check the status of the disease.

Length of Treatment:

Participant may continue taking the study drugs for up to 3 cycles of Consolidation after Induction. Participant will no longer be able to take the study drug if the disease gets worse, if intolerable side effects occur, or if they are unable to follow study directions.

Patient's participation in the study will be over after the follow-up visits.

Follow-Up Visits:

Every 4-8 weeks after participant's last dose of study drugs, blood (about 2-3 teaspoons) will be drawn for routine tests.

Every 6-12 months after the last dose of study drugs, the study staff will check on how participant is doing. This will either be done by phone or during a regularly scheduled clinic visit. If participant is contacted by phone, the phone call should last about 10 minutes.

This follow-up will last until participant withdraws from the study or the study ends.

Long-Term Follow-Up:

After patient's participation in this study is over, they will be given the option to enroll in a long-term follow-up study (DR09-0223). Participant's doctor will explain this to them in more detail, and they will be required to sign a separate consent form.

This is an investigational study. Fludarabine and cytarabine are FDA approved and commercially available for the treatment of leukemia. Erwinase is FDA approved and commercially available for use in acute lymphoblastic leukemia. Its use in this study is investigational. The combination of these drugs is investigational. The study doctor can explain how the study drugs are designed to work.

Up to 20 participants will be enrolled in this study. All will take part at MD Anderson.

Being tested
Fludarabine, Cytarabine, Erwinase
Keywords
Hematologic malignancy, Relapsed and refractory hematologic malignancies, Acute myeloid leukemia, AML, Acute lymphoblastic leukemia, ALL, Burkitt's leukemia/lymphoma, Prolymphocytic leukemia, Biphenotypic acute leukemia, Blast-phase of chronic myeloid leukemia, CML, B-cell lymphoma, Richter's transformation of chronic lymphocytic leukemia, CLL, Fludarabine, Fludarabine phosphate, Fludara, Cytarabine, Ara-C, Cytosar
Medical subject headings
Hematologic Neoplasms, Recurrence, Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Burkitt Lymphoma, Lymphoma, Leukemia, Prolymphocytic, Leukemia, Biphenotypic, Acute

What participants receive

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

  • FludarabineDrug

    Also called Fludarabine Phosphate, Fludara

    Induction Phase:

    30 mg/m2 by vein over 15-30 minutes on Days 1 - 5 of a 28 day cycle.

    Consolidation Phase:

    30 mg/m2 by vein over 15-30 minutes on Days 1 - 4 of a 28 day cycle.

  • CytarabineDrug

    Also called Ara-C, Cytosar, DepoCyt, Cytosine Arabinosine Hydrochloride

    Induction Phase:

    2 grams/m2 by vein over approximately 2 hours on Days 1 - 5 of a 28 day cycle.

    Consolidation Phase:

    2 grams/m2 by vein over approximately 2 hours on Days 1 - 4 of a 28 day cycle.

  • ErwinaseDrug

    Also called L-asparaginase, Erwinia L-Asparaginase, Erwinia Chrysanthemi L-asparaginase

    Induction Phase:

    25,000 Units/m2 by vein (or intramuscularly) over 90-120 minutes on Days 1 - 7 of a 28 day cycle.

    Consolidation Phase:

    25,000 Units/m2 by vein (or intramuscularly) over 90-120 minutes every other day on Days 1, 3, 5, 7, 9, 11, 13, 15 of a 28 day cycle.

Study groups in NCT02718755
Study groupRoleWhat they receive
Fludarabine + Cytarabine + ErwinaseExperimentalInduction Phase: Participants receive 1-2 cycles during the Induction phase. Participants receive 1-2 cycles during the Induction phase. Participants receive Fludarabine by vein on Days 1-5 and Cytarabine by vein. Participants receive Erwinase by vein or as an injection into the muscle on Days 1-7. Consolidation Phase: Participants receive up to 3 cycles during the Consolidation phase. Participants receive Fludarabine by vein on Days 1-4 and Cytarabine by vein. On Day 1 and then every other day for 15 days (3, 5, 7 and so on), participant receives Erwinase by vein or as an injection into the muscle.
Receives: Drug: Fludarabine; Drug: Cytarabine; Drug: Erwinase

What is being measured

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

  1. Overall Response of Fludarabine, Cytarabine, and Erwinase in Refractory/Relapsed Hematologic Malignancies

    Response assessed according to the Revised Recommendations of the International Working Group Response Criteria in Acute Myeloid Leukemia.

    Measured: 56 days

Secondary outcomes (1)
  1. Disease-Free Survival (DFS) of Fludarabine, Cytarabine, and Erwinase in Refractory/Relapsed Hematologic Malignancies

    DFS calculated from date of remission until the date of first objective documentation of disease-relapse or death.

    Measured: 21 days

Timeline

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

  1. First posted24 Mar 2016 (estimated)
  2. Study startMay 2018 (estimated)
  3. Primary completionMay 2021 (estimated)
  4. Study completionMay 2022 (estimated)

Why it stopped: Problem with drug supply

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
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02718755
Sponsor's protocol ID
2015-0807
Other IDs
NCI-2016-00691
Status last verified
Jun 2018
First submitted
16 Mar 2016
Last updated
26 Jun 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Fludarabine, Cytarabine and Erwinase in people with Hematologic Malignancy, run by M.D. Anderson Cancer Center.

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 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: withdrawn, as of the sponsor's last update on 26 Jun 2018. Status can change between updates, so confirm with the study contact before making plans.

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 was withdrawn before enrolling participants, so there are no results.

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?

Overall Response of Fludarabine, Cytarabine, and Erwinase in Refractory/Relapsed Hematologic Malignancies (time frame: 56 days). 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 26 Jun 2018.

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