search
Back to results

Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia

Primary Purpose

Recurrent Adult Acute Lymphoblastic Leukemia, Recurrent Adult Acute Myeloid Leukemia, Secondary Acute Myeloid Leukemia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
cytarabine
mitoxantrone hydrochloride
alvocidib
pharmacological study
laboratory procedure
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Adult Acute Lymphoblastic Leukemia

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Established diagnoses of poor-risk hematologic malignancies will be considered eligible for this Phase I/II study Pathological confirmation of the diagnosis of AML or ALL ECOG performance status 0,1,2 Patients must be able to give informed consent Female patients of childbearing age must have negative pregnancy test AST and ALT =< 2.5 x normal Alkaline phosphatase =< 2.5 x normal Bilirubin =< 1.5 x normal Serum creatinine =< 2.0 mg/dl Left ventricular ejection fraction must >= 45% by MUGA or Echocardiogram Acute Myelogenous Leukemia (AML) AML arising from MDS Secondary AML Relapsed or refractory AML, including primary induction failure Acute Lymphoblastic Leukemia (ALL) Relapsed or refractory ALL, including primary induction failure Patients who fail primary induction therapy or who relapse after achieving complete remission (CR) are eligible if they have undergone no more than 3 prior courses of induction/reinduction There should be an interval of at least 4 weeks from any previous intensive chemotherapy before beginning flavopiridol, with the exceptions non-aplasia producing treatments (i.e. hydroxyurea, interferon, imatinib, 6MP, thalidomide); patients should have recovered completely from any treatment-related toxicities; patients may have received hematopoietic growth factors previously, but must be off all growth factors (including EPO, G-CSF, GM-CSF, IL-3, IL-11) for at least 4 days prior to beginning flavopiridol Patients who have undergone stem cell transplantation (SCT), autologous or allogeneic, are eligible provided that they are >= 4 weeks from stem cell infusion, have no active GVHD, and meet other eligibility criteria Exclusion Criteria: Hyperleukocytosis with >= 50,000 leukemic blasts/mm^3 Active, uncontrolled infection Disseminated intravascular coagulation Active CNS leukemia Concomitant chemotherapy, radiation therapy or immunotherapy Intrinsic impaired cardiac function (MI within the preceding 3 months or history of severe coronary artery disease, cardiomyopathy, CHF > Class II) History of congestive heart disease, or arrhythmia without regard to time, severity or resolution Women who are pregnant or lactating will not be eligible for this trial, as the investigational agent may be harmful to the developing fetus or nursing infant

Sites / Locations

  • Johns Hopkins University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (flavopiridol, cytarabine, mitoxantrone)

Arm Description

Patients receive flavopiridol IV over 1 hour on days 1-3 and cytarabine IV continuously on days 6-9 followed by mitoxantrone IV over 30-150 minutes on day 9. Patients achieving a partial or complete response after the first course of therapy may receive an additional course of therapy beginning 35 ± 7 days after blood count recovery.

Outcomes

Primary Outcome Measures

Dose-limiting toxicity (DLT) as assessed by NCI CTC version 2.0
Complete remission (CR)

Secondary Outcome Measures

Full Information

First Posted
May 6, 2001
Last Updated
October 7, 2013
Sponsor
National Cancer Institute (NCI)
search

1. Study Identification

Unique Protocol Identification Number
NCT00016016
Brief Title
Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia
Official Title
A Phase I/II Study of Flavopiridol (NSC 649890, IND 46,211) in Timed Sequential Combination With Cytosine Arabinoside (Ara-C) and Mitoxantrone for Adults With Poor-Risk Acute Leukemias
Study Type
Interventional

2. Study Status

Record Verification Date
October 2013
Overall Recruitment Status
Completed
Study Start Date
February 2001 (undefined)
Primary Completion Date
November 2006 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Phase II trial to study the effectiveness of combining flavopiridol and cytarabine with mitoxantrone in treating patients who have acute leukemia. Drugs used in chemotherapy work in different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells.
Detailed Description
PRIMARY OBJECTIVES: I. To determine the toxicities of escalating doses of flavopiridol administered in a timed sequence with ara-C and mitoxantrone in adults with refractory or relapsed acute leukemias or high-risk myelodysplasias (MDS). II. To determine if flavopiridol administered in a timed sequence with ara-C and Mitoxantrone will induce clinical responses in adults with refractory or relapsed acute leukemias or MDS. III. To determine if flavopiridol is directly cytotoxic to leukemic blasts in vivo. IV. To determine if flavopiridol can recruit and synchronize residual leukemic blasts to proliferate in vivo. OUTLINE: This is a dose-escalation study of flavopiridol. (Phase I closed to accrual effective10/24/2003). Patients receive flavopiridol IV over 1 hour on days 1-3 and cytarabine IV continuously on days 6-9 followed by mitoxantrone IV over 30-150 minutes on day 9. Patients achieving a partial or complete response after the first course of therapy may receive an additional course of therapy beginning 35 ± 7 days after blood count recovery. Cohorts of 3-6 patients receive escalating doses of flavopiridol until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. (Phase I closed to accrual effective 10/24/2003). Once the MTD is reached, additional patients are accrued to receive flavopiridol at the recommended phase II dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Adult Acute Lymphoblastic Leukemia, Recurrent Adult Acute Myeloid Leukemia, Secondary Acute Myeloid Leukemia, Untreated Adult Acute Lymphoblastic Leukemia, Untreated Adult Acute Myeloid Leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
53 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment (flavopiridol, cytarabine, mitoxantrone)
Arm Type
Experimental
Arm Description
Patients receive flavopiridol IV over 1 hour on days 1-3 and cytarabine IV continuously on days 6-9 followed by mitoxantrone IV over 30-150 minutes on day 9. Patients achieving a partial or complete response after the first course of therapy may receive an additional course of therapy beginning 35 ± 7 days after blood count recovery.
Intervention Type
Drug
Intervention Name(s)
cytarabine
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
mitoxantrone hydrochloride
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
alvocidib
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
pharmacological study
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
laboratory procedure
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Dose-limiting toxicity (DLT) as assessed by NCI CTC version 2.0
Time Frame
Up to 35 days
Title
Complete remission (CR)
Time Frame
Up to 6 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Established diagnoses of poor-risk hematologic malignancies will be considered eligible for this Phase I/II study Pathological confirmation of the diagnosis of AML or ALL ECOG performance status 0,1,2 Patients must be able to give informed consent Female patients of childbearing age must have negative pregnancy test AST and ALT =< 2.5 x normal Alkaline phosphatase =< 2.5 x normal Bilirubin =< 1.5 x normal Serum creatinine =< 2.0 mg/dl Left ventricular ejection fraction must >= 45% by MUGA or Echocardiogram Acute Myelogenous Leukemia (AML) AML arising from MDS Secondary AML Relapsed or refractory AML, including primary induction failure Acute Lymphoblastic Leukemia (ALL) Relapsed or refractory ALL, including primary induction failure Patients who fail primary induction therapy or who relapse after achieving complete remission (CR) are eligible if they have undergone no more than 3 prior courses of induction/reinduction There should be an interval of at least 4 weeks from any previous intensive chemotherapy before beginning flavopiridol, with the exceptions non-aplasia producing treatments (i.e. hydroxyurea, interferon, imatinib, 6MP, thalidomide); patients should have recovered completely from any treatment-related toxicities; patients may have received hematopoietic growth factors previously, but must be off all growth factors (including EPO, G-CSF, GM-CSF, IL-3, IL-11) for at least 4 days prior to beginning flavopiridol Patients who have undergone stem cell transplantation (SCT), autologous or allogeneic, are eligible provided that they are >= 4 weeks from stem cell infusion, have no active GVHD, and meet other eligibility criteria Exclusion Criteria: Hyperleukocytosis with >= 50,000 leukemic blasts/mm^3 Active, uncontrolled infection Disseminated intravascular coagulation Active CNS leukemia Concomitant chemotherapy, radiation therapy or immunotherapy Intrinsic impaired cardiac function (MI within the preceding 3 months or history of severe coronary artery disease, cardiomyopathy, CHF > Class II) History of congestive heart disease, or arrhythmia without regard to time, severity or resolution Women who are pregnant or lactating will not be eligible for this trial, as the investigational agent may be harmful to the developing fetus or nursing infant
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Judith Karp
Organizational Affiliation
Johns Hopkins University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287-8936
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia

We'll reach out to this number within 24 hrs