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Tipifarnib, Cytarabine, and Daunorubicin in Treating Older Patients With Acute Myeloid Leukemia

Primary Purpose

Leukemia

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
cytarabine
daunorubicin hydrochloride
tipifarnib
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia focused on measuring adult acute basophilic leukemia, adult acute eosinophilic leukemia, adult acute megakaryoblastic leukemia (M7), adult acute minimally differentiated myeloid leukemia (M0), adult acute monoblastic leukemia (M5a), adult acute monocytic leukemia (M5b), adult acute myeloblastic leukemia with maturation (M2), adult acute myeloblastic leukemia without maturation (M1), adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), adult acute myelomonocytic leukemia (M4), adult erythroleukemia (M6a), adult pure erythroid leukemia (M6b), untreated adult acute myeloid leukemia

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Diagnosis of acute myeloid leukemia (AML) All subtypes, except acute promyelocytic leukemia, are allowed At least 20% bone marrow or peripheral blood blasts OR biopsy-confirmed extramedullary disease No cerebrospinal fluid involvement PATIENT CHARACTERISTICS: Age 56 and over Performance status ECOG 0-2 OR Karnofsky 60-100% Life expectancy Not specified Hematopoietic See Disease Characteristics WBC < 100,000/mm^3 (treatment with hydroxyurea allowed) Hepatic Bilirubin ≤ 1.25 times upper limit of normal (ULN) AST and ALT ≤ 2.0 times ULN Renal Creatinine < 1.7 mg/dL OR Creatinine clearance ≥ 60 mL/min Cardiovascular LVEF ≥ 50% No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Immunologic HIV negative No history of allergic reaction attributed to compounds of similar chemical or biologic composition to tipifarnib or imidazole drugs (e.g., ketoconazole, clotrimazole, or miconazole) No ongoing or active infection Other Not pregnant Fertile patients must use effective contraception Able to swallow oral medications No other uncontrolled illness No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy No prior chemotherapy for AML except hydroxyurea for cytoreduction More than 4 weeks since prior chemotherapy except hydroxyurea (6 weeks for nitrosoureas or mitomycin) and recovered At least 24 hours since prior hydroxyurea Endocrine therapy No concurrent dexamethasone Radiotherapy More than 4 weeks since prior radiotherapy and recovered No prior radiotherapy > 3,000 cGy to marrow-producing areas Surgery Not specified Other No other concurrent investigational agents No other concurrent antileukemic agents No concurrent treatment with any of the following: Ketoconazole Itraconazole Voriconazole Clarithromycin Erythromycin Phenytoin Carbamazepine Barbiturates Cyclosporine Pimozide Warfarin Grapefruit juice Simvastatin Lovastatin Atorvastatin No concurrent magnesium- or aluminum-containing antacids within 2 hours before or after tipifarnib administration

Sites / Locations

  • McMaster Children's Hospital at Hamilton Health Sciences
  • London Regional Cancer Program at London Health Sciences Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Tipifarnib with conventional induction and consolidation

Arm Description

Outcomes

Primary Outcome Measures

Maximum tolerated dose of tipifarnib when administered with cytarabine and daunorubicin
Toxicity
Pharmacokinetics

Secondary Outcome Measures

Full Information

First Posted
January 7, 2005
Last Updated
July 22, 2015
Sponsor
University Health Network, Toronto
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00101153
Brief Title
Tipifarnib, Cytarabine, and Daunorubicin in Treating Older Patients With Acute Myeloid Leukemia
Official Title
A Phase I Study Of Therapy With The Farnesyl Transferase Inhibitor R115777 (Zarnestra) Combined With Conventional Induction And Consolidation Chemotherapy For Previously Untreated Patients Over Age 55 With Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2015
Overall Recruitment Status
Completed
Study Start Date
April 2007 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Tipifarnib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cytarabine and daunorubicin, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving tipifarnib together with cytarabine and daunorubicin may kill more cancer cells. PURPOSE: This phase I trial is studying the side effects and best dose of tipifarnib when given with cytarabine and daunorubicin in treating older patients with acute myeloid leukemia.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of tipifarnib when administered with cytarabine and daunorubicin in older patients with previously untreated acute myeloid leukemia. Determine the toxicity of this regimen in these patients. Determine the pharmacokinetics of this regimen in these patients. OUTLINE: This is a multicenter, dose-escalation study of tipifarnib. Induction therapy (1 course): Patients receive cytarabine IV continuously on days 1-7, daunorubicin IV on days 6-8, and oral tipifarnib twice daily on days 6-15 in the absence of unacceptable toxicity. Patients achieving complete remission proceed to consolidation therapy. Consolidation therapy (1 course): After hematologic recovery, patients begin consolidation therapy 35-60 days after the start of induction therapy. Patients receive cytarabine, daunorubicin, and tipifarnib as in induction therapy. Cohorts of 3-6 patients receive escalating doses of tipifarnib 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. A total of 10 patients are treated at the recommended phase II dose. Patients are followed every 3 months. PROJECTED ACCRUAL: A total of 3-28 patients will be accrued for this study within 1.5-22 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia
Keywords
adult acute basophilic leukemia, adult acute eosinophilic leukemia, adult acute megakaryoblastic leukemia (M7), adult acute minimally differentiated myeloid leukemia (M0), adult acute monoblastic leukemia (M5a), adult acute monocytic leukemia (M5b), adult acute myeloblastic leukemia with maturation (M2), adult acute myeloblastic leukemia without maturation (M1), adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), adult acute myelomonocytic leukemia (M4), adult erythroleukemia (M6a), adult pure erythroid leukemia (M6b), untreated adult acute myeloid leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Tipifarnib with conventional induction and consolidation
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
cytarabine
Intervention Type
Drug
Intervention Name(s)
daunorubicin hydrochloride
Intervention Type
Drug
Intervention Name(s)
tipifarnib
Primary Outcome Measure Information:
Title
Maximum tolerated dose of tipifarnib when administered with cytarabine and daunorubicin
Time Frame
minimum of 30 days per treatment cycle
Title
Toxicity
Time Frame
All cycles
Title
Pharmacokinetics
Time Frame
Day 6

10. Eligibility

Sex
All
Minimum Age & Unit of Time
56 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of acute myeloid leukemia (AML) All subtypes, except acute promyelocytic leukemia, are allowed At least 20% bone marrow or peripheral blood blasts OR biopsy-confirmed extramedullary disease No cerebrospinal fluid involvement PATIENT CHARACTERISTICS: Age 56 and over Performance status ECOG 0-2 OR Karnofsky 60-100% Life expectancy Not specified Hematopoietic See Disease Characteristics WBC < 100,000/mm^3 (treatment with hydroxyurea allowed) Hepatic Bilirubin ≤ 1.25 times upper limit of normal (ULN) AST and ALT ≤ 2.0 times ULN Renal Creatinine < 1.7 mg/dL OR Creatinine clearance ≥ 60 mL/min Cardiovascular LVEF ≥ 50% No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Immunologic HIV negative No history of allergic reaction attributed to compounds of similar chemical or biologic composition to tipifarnib or imidazole drugs (e.g., ketoconazole, clotrimazole, or miconazole) No ongoing or active infection Other Not pregnant Fertile patients must use effective contraception Able to swallow oral medications No other uncontrolled illness No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy No prior chemotherapy for AML except hydroxyurea for cytoreduction More than 4 weeks since prior chemotherapy except hydroxyurea (6 weeks for nitrosoureas or mitomycin) and recovered At least 24 hours since prior hydroxyurea Endocrine therapy No concurrent dexamethasone Radiotherapy More than 4 weeks since prior radiotherapy and recovered No prior radiotherapy > 3,000 cGy to marrow-producing areas Surgery Not specified Other No other concurrent investigational agents No other concurrent antileukemic agents No concurrent treatment with any of the following: Ketoconazole Itraconazole Voriconazole Clarithromycin Erythromycin Phenytoin Carbamazepine Barbiturates Cyclosporine Pimozide Warfarin Grapefruit juice Simvastatin Lovastatin Atorvastatin No concurrent magnesium- or aluminum-containing antacids within 2 hours before or after tipifarnib administration
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph Brandwein, MD
Organizational Affiliation
Princess Margaret Hospital, Canada
Official's Role
Study Chair
Facility Information:
Facility Name
McMaster Children's Hospital at Hamilton Health Sciences
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada
Facility Name
London Regional Cancer Program at London Health Sciences Centre
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 465
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
19092853
Citation
Brandwein JM, Leber BF, Howson-Jan K, Schimmer AD, Schuh AC, Gupta V, Yee KW, Wright J, Moore M, MacAlpine K, Minden MD; NCI CTEP Protocol 6670. A phase I study of tipifarnib combined with conventional induction and consolidation therapy for previously untreated patients with acute myeloid leukemia aged 60 years and over. Leukemia. 2009 Apr;23(4):631-4. doi: 10.1038/leu.2008.341. Epub 2008 Dec 18.
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Tipifarnib, Cytarabine, and Daunorubicin in Treating Older Patients With Acute Myeloid Leukemia

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