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Bortezomib in Treating Young Patients With Refractory or Recurrent Leukemia

Primary Purpose

Blastic Phase Chronic Myelogenous Leukemia, Childhood Acute Promyelocytic Leukemia (M3), Recurrent Childhood Acute Lymphoblastic Leukemia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
bortezomib
pharmacological study
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Blastic Phase Chronic Myelogenous Leukemia

Eligibility Criteria

1 Year - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically confirmed leukemia of 1 of the following types: Acute lymphoblastic leukemia Acute myeloid leukemia Chronic myelogenous leukemia in blast crisis Relapsed or refractory disease Immunophenotypically confirmed disease, either at initial diagnosis or relapse More than 25% blasts in the bone marrow (M3 bone marrow) Active extramedullary disease (except leptomeningeal disease) allowed No known curative therapy or therapy proven to prolong survival with an acceptable quality of life available Performance status - Karnofsky 50-100% (for patients age 11 to 21) Performance status - Lansky 50-100% (for patients age 10 and under) Platelet count ≥ 20,000/mm^3* Hemoglobin ≥ 8.0 g/dL* WBC < 20,000/mm^3** (hydroxyurea for cytoreduction allowed) No hyperleukocytosis (i.e., WBC > 100,000/mm^3) Bilirubin ≤ 1.5 times upper limit of normal (ULN) ALT ≤ 5 times ULN Albumin ≥ 2 g/dL Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min Creatinine based on age as follows: ≤ 0.8 mg/dL for patients age 5 and under ≤ 1.0 mg/dL for patients age 6 to 10 ≤ 1.2 mg/dL for patients age 11 to 15 ≤ 1.5 mg/dL for patients age 16 to 21 Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No uncontrolled infection Recovered from prior immunotherapy At least 7 days since prior filgrastim (G-CSF) or sargramostim (GM-CSF) At least 7 days since prior biologic agents At least 3 months since prior stem cell transplantation or rescue and no evidence of active graft-versus-host disease No concurrent prophylactic G-CSF during course 1 of study No concurrent immunotherapy No concurrent biologic therapy Recovered from prior chemotherapy At least 24 hours since prior hydroxyurea for cytoreduction At least 6 weeks since prior nitrosoureas No concurrent chemotherapy At least 7 days since prior steroids (except as premedication prior to blood product transfusion) Recovered from prior radiotherapy At least 2 weeks since prior small port local palliative radiotherapy At least 3 months since prior total body irradiation, craniospinal irradiation, or irradiation to more than 50% of the pelvis At least 6 weeks since other prior substantial bone marrow radiotherapy No concurrent radiotherapy At least 7 days since prior retinoids No other concurrent investigational agents No other concurrent anticancer agents No concurrent anticonvulsant medications known to activate the cytochrome p450 system (e.g., phenytoin, carbamazepine, or phenobarbital) Concurrent benzodiazepines and gabapentin are allowed

Sites / Locations

  • COG Phase I Consortium

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm I

Arm Description

Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Maximum tolerated dose and recommended phase II dose
Toxicity as assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) 3.0
Pharmacokinetics as assessed by confidence intervals (CI), area under the curve (AUC), and half-life (T ½)

Secondary Outcome Measures

Antitumor activity
Correlate apoptosis and NF-kB activation

Full Information

First Posted
February 10, 2004
Last Updated
June 4, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00077467
Brief Title
Bortezomib in Treating Young Patients With Refractory or Recurrent Leukemia
Official Title
A Phase I Study of PS-341 (Velcade, Bortezomib) in Pediatric Patients With Refractory/Recurrent Leukemias
Study Type
Interventional

2. Study Status

Record Verification Date
June 2013
Overall Recruitment Status
Completed
Study Start Date
January 2004 (undefined)
Primary Completion Date
March 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
This phase I trial is studying the side effects and best dose of bortezomib in treating young patients with refractory or recurrent leukemia. Bortezomib may stop the growth of cancer cells by blocking the enzymes necessary for their growth.
Detailed Description
OBJECTIVES: Primary I. Determine the maximum tolerated dose and recommended phase II dose of bortezomib in children with refractory or recurrent leukemia. II. Determine the toxic effects of this drug in these patients. III. Determine the pharmacokinetics of this drug in these patients. Secondary I. Determine, preliminarily, the antitumor activity of this drug in these patients. II. Determine, preliminarily, the biologic activity of this drug in these patients. OUTLINE: This is a dose-escalation, open-label, multicenter study. Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. PROJECTED ACCRUAL: A total of 3-36 patients will be accrued for this study within 1.5-36 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Blastic Phase Chronic Myelogenous Leukemia, Childhood Acute Promyelocytic Leukemia (M3), Recurrent Childhood Acute Lymphoblastic Leukemia, Recurrent Childhood Acute Myeloid Leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
bortezomib
Other Intervention Name(s)
LDP 341, MLN341, VELCADE
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Maximum tolerated dose and recommended phase II dose
Time Frame
Up to 21 days
Title
Toxicity as assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) 3.0
Time Frame
Up to 2 years
Title
Pharmacokinetics as assessed by confidence intervals (CI), area under the curve (AUC), and half-life (T ½)
Time Frame
Pretreatment, days 1, 8, 18-22 of course 1
Secondary Outcome Measure Information:
Title
Antitumor activity
Time Frame
Up to 2 years
Title
Correlate apoptosis and NF-kB activation
Time Frame
Prestudy, days 8 and 18

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed leukemia of 1 of the following types: Acute lymphoblastic leukemia Acute myeloid leukemia Chronic myelogenous leukemia in blast crisis Relapsed or refractory disease Immunophenotypically confirmed disease, either at initial diagnosis or relapse More than 25% blasts in the bone marrow (M3 bone marrow) Active extramedullary disease (except leptomeningeal disease) allowed No known curative therapy or therapy proven to prolong survival with an acceptable quality of life available Performance status - Karnofsky 50-100% (for patients age 11 to 21) Performance status - Lansky 50-100% (for patients age 10 and under) Platelet count ≥ 20,000/mm^3* Hemoglobin ≥ 8.0 g/dL* WBC < 20,000/mm^3** (hydroxyurea for cytoreduction allowed) No hyperleukocytosis (i.e., WBC > 100,000/mm^3) Bilirubin ≤ 1.5 times upper limit of normal (ULN) ALT ≤ 5 times ULN Albumin ≥ 2 g/dL Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min Creatinine based on age as follows: ≤ 0.8 mg/dL for patients age 5 and under ≤ 1.0 mg/dL for patients age 6 to 10 ≤ 1.2 mg/dL for patients age 11 to 15 ≤ 1.5 mg/dL for patients age 16 to 21 Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No uncontrolled infection Recovered from prior immunotherapy At least 7 days since prior filgrastim (G-CSF) or sargramostim (GM-CSF) At least 7 days since prior biologic agents At least 3 months since prior stem cell transplantation or rescue and no evidence of active graft-versus-host disease No concurrent prophylactic G-CSF during course 1 of study No concurrent immunotherapy No concurrent biologic therapy Recovered from prior chemotherapy At least 24 hours since prior hydroxyurea for cytoreduction At least 6 weeks since prior nitrosoureas No concurrent chemotherapy At least 7 days since prior steroids (except as premedication prior to blood product transfusion) Recovered from prior radiotherapy At least 2 weeks since prior small port local palliative radiotherapy At least 3 months since prior total body irradiation, craniospinal irradiation, or irradiation to more than 50% of the pelvis At least 6 weeks since other prior substantial bone marrow radiotherapy No concurrent radiotherapy At least 7 days since prior retinoids No other concurrent investigational agents No other concurrent anticancer agents No concurrent anticonvulsant medications known to activate the cytochrome p450 system (e.g., phenytoin, carbamazepine, or phenobarbital) Concurrent benzodiazepines and gabapentin are allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Terzah Horton
Organizational Affiliation
COG Phase I Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
COG Phase I Consortium
City
Arcadia
State/Province
California
ZIP/Postal Code
91006-3776
Country
United States

12. IPD Sharing Statement

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Bortezomib in Treating Young Patients With Refractory or Recurrent Leukemia

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