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Lenalidomide Maintenance Therapy in Patients With Myelodysplastic Syndromes (MDS) or Acute Myelogenous Leukemia (AML) (LENAMAINT)

Primary Purpose

Myelodysplastic Syndromes, Acute Myelogenous Leukemia

Status
Terminated
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
lenalidomide
Sponsored by
Technische Universität Dresden
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndromes focused on measuring MDS, AML, Lenalidomide, monosomy 5, monosomy del5q

Eligibility Criteria

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

Inclusion Criteria:

  • Understand and voluntarily sign an informed consent form.
  • Age >=18 years at the time of signing the informed consent form.
  • Able to adhere to the study visit schedule and other protocol requirements.
  • AML (>/= 20% blasts) including secondary (s)AML (after radio-chemotherapy) with karyotype abnormalities involving monosomy 5 or del5q or MDS and sMDS RAEB-1 and RAEB-2 with karyotype abnormalities involving monosomy 5 or del5q or MDS and sMDS type RA(+/-RS) or RCMD(+/-RS) only with complex karyotype abnormalities involving monosomy 5 or del5q
  • in complete hematological remission documented by bone marrow aspiration within 8-12 weeks after allogeneic HSCT
  • All previous cancer therapy, including radiation, hormonal therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study.
  • ECOG performance status of </= 2 at study entry.
  • Laboratory test results within these ranges:

    • Absolute neutrophil count >= 1.0 x 10 9/L
    • Platelet count >= 100 x 10 9/L
    • Serum creatinine <= 2.0 mg/dL
    • Total bilirubin <= 1.5 mg/dL
    • AST (SGOT) and ALT (SGPT) <= 5 x ULN
  • Females of childbearing potential (FCBP)† must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) for at least 28 days before starting study drug; 2) while participating in the study; and 3) for at least 28 days after discontinuation from the study. The two methods of reliable contraception must include one highly effective method (i.e. intrauterine device (IUD), hormonal [birth control pills, injections, or implants], tubal ligation, partner's vasectomy) and one additional effective (barrier) method (i.e. latex condom, diaphragm, cervical cap). FCBP must be referred to a qualified provider of contraceptive methods if needed.
  • Disease free of prior malignancies for >= 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast
  • Able to take aspirin (ASA) 100mg daily as prophylactic anticoagulation in case of concomitant steroid treatment (patients intolerant to ASA may use low molecular weight heparin).

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • active uncontrolled acute GVHD overall grade 3-4
  • Pregnant or breast feeding females. (Lactating females must agree not to breast feed while taking lenalidomide).
  • History of arterial or venous embolism or stroke
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Use of any other experimental drug or therapy to treat MDS or AML within 28 days of baseline (patients within a clinical trial evaluating new conditioning regimens are allowed to participate in the LENAMAINT study)
  • Known hypersensitivity to thalidomide or lenalidomide.
  • history of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
  • Known positive for HIV or infectious hepatitis, type A, B or C.

Sites / Locations

  • Dresden University of Technology, Medizinische Klinik und Poliklinik 1
  • Universitätsklinikum Düsseldorf, Medizinische Klinik und Poliklinik, Klinik für Hämatologie, Onkologie und klinische Immunologie
  • Universitätsklinikum Essen, Klinik für Knochenmarktransplantation
  • Universitätsklinikum Hamburg-Eppendorf, Onkologisches Zentrum
  • Medizinische Hochschule Hannover, Zentrum Innere Medizin, Hämatologie
  • Universitätsklinikum Ulm, Klinik für Innere Medizin III
  • Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

lenalidomide

Arm Description

lenalidomide therapy p.o. 10 mg/d for 21 days every 4 weeks for 1 year (12 cycles) after HSCT

Outcomes

Primary Outcome Measures

Cumulative incidence of relapse rate

Secondary Outcome Measures

Overall survival, Incidence and severity of acute and chronic GVHD, Safety

Full Information

First Posted
July 17, 2008
Last Updated
September 26, 2013
Sponsor
Technische Universität Dresden
Collaborators
Celgene Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT00720850
Brief Title
Lenalidomide Maintenance Therapy in Patients With Myelodysplastic Syndromes (MDS) or Acute Myelogenous Leukemia (AML)
Acronym
LENAMAINT
Official Title
Lenalidomide Maintenance Therapy in Patients With MDS or AML With Cytogenetic Abnormalities Involving Monosomy 5 or del5q After Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2013
Overall Recruitment Status
Terminated
Why Stopped
Low recruitment, scientific rationale not applicable anymore to all patients and possible induction of GvHD by the study drug
Study Start Date
April 2008 (undefined)
Primary Completion Date
January 2011 (Actual)
Study Completion Date
January 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Technische Universität Dresden
Collaborators
Celgene Corporation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The hypothesis of this study is that lenalidomide can be an effective drug in preventing relapse of MDS and AML patients with chromosomal abnormalities involving monosomy 5 or del5q after allogeneic HSCT. Due to its immunomodulatory action it might also be able to enhance a T - or NK cell mediated graft versus leukemia (GVL) effects. Nevertheless, one has to keep in mind a possible, yet unknown influence on modulation of clinical GVHD.
Detailed Description
Cytogenetics are main predictors of outcome in patients with MDS and AML. In fact, a monosomy 5 (-5) or del5q (excluding typical 5q-syndrome) are mostly poor prognostic markers also because being frequently part of a complex karyotype. Together, these patients often do not respond to conventional chemotherapy and can only be cured by allogeneic HSCT. Nevertheless, even after transplantation the relapse rate is considerably high and in the majority of patient's relapses occur within the first year after HSCT. Lenalidomide has been successfully used in MDS patients with del5q, irrespective of additional cytogenetic abnormalities. Furthermore, in vitro studies have demonstrated also impressive anti-proliferative effects of the compound in cell lines harbouring a monosomy 5. Therefore, it seems to be a promising compound in preventing relapse of high-risk MDS or AML patients with chromosomal abnormalities involving del5q or -5 after allogeneic HSCT. Due to its immunomodulatory action it might also be able to enhance T - or NK cell mediated graft versus leukemia effects. Nevertheless, it is unknown whether lenalidomide could modulate or enhance clinical graft versus host disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndromes, Acute Myelogenous Leukemia
Keywords
MDS, AML, Lenalidomide, monosomy 5, monosomy del5q

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
lenalidomide
Arm Type
Experimental
Arm Description
lenalidomide therapy p.o. 10 mg/d for 21 days every 4 weeks for 1 year (12 cycles) after HSCT
Intervention Type
Drug
Intervention Name(s)
lenalidomide
Other Intervention Name(s)
Revlimid
Intervention Description
p.o. 10 mg/d for 21 days every 4 weeks for 1 year (12 cycles) after HSCT
Primary Outcome Measure Information:
Title
Cumulative incidence of relapse rate
Time Frame
1 year post transplantation
Secondary Outcome Measure Information:
Title
Overall survival, Incidence and severity of acute and chronic GVHD, Safety
Time Frame
1 year post transplantation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Understand and voluntarily sign an informed consent form. Age >=18 years at the time of signing the informed consent form. Able to adhere to the study visit schedule and other protocol requirements. AML (>/= 20% blasts) including secondary (s)AML (after radio-chemotherapy) with karyotype abnormalities involving monosomy 5 or del5q or MDS and sMDS RAEB-1 and RAEB-2 with karyotype abnormalities involving monosomy 5 or del5q or MDS and sMDS type RA(+/-RS) or RCMD(+/-RS) only with complex karyotype abnormalities involving monosomy 5 or del5q in complete hematological remission documented by bone marrow aspiration within 8-12 weeks after allogeneic HSCT All previous cancer therapy, including radiation, hormonal therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study. ECOG performance status of </= 2 at study entry. Laboratory test results within these ranges: Absolute neutrophil count >= 1.0 x 10 9/L Platelet count >= 100 x 10 9/L Serum creatinine <= 2.0 mg/dL Total bilirubin <= 1.5 mg/dL AST (SGOT) and ALT (SGPT) <= 5 x ULN Females of childbearing potential (FCBP)† must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) for at least 28 days before starting study drug; 2) while participating in the study; and 3) for at least 28 days after discontinuation from the study. The two methods of reliable contraception must include one highly effective method (i.e. intrauterine device (IUD), hormonal [birth control pills, injections, or implants], tubal ligation, partner's vasectomy) and one additional effective (barrier) method (i.e. latex condom, diaphragm, cervical cap). FCBP must be referred to a qualified provider of contraceptive methods if needed. Disease free of prior malignancies for >= 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast Able to take aspirin (ASA) 100mg daily as prophylactic anticoagulation in case of concomitant steroid treatment (patients intolerant to ASA may use low molecular weight heparin). Exclusion Criteria: Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form. active uncontrolled acute GVHD overall grade 3-4 Pregnant or breast feeding females. (Lactating females must agree not to breast feed while taking lenalidomide). History of arterial or venous embolism or stroke Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study. Use of any other experimental drug or therapy to treat MDS or AML within 28 days of baseline (patients within a clinical trial evaluating new conditioning regimens are allowed to participate in the LENAMAINT study) Known hypersensitivity to thalidomide or lenalidomide. history of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs. Known positive for HIV or infectious hepatitis, type A, B or C.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Uwe Platzbecker, PD Dr. med.
Organizational Affiliation
Dresden University of Technology, Medizinische Klinik und Poliklinik 1
Official's Role
Study Chair
Facility Information:
Facility Name
Dresden University of Technology, Medizinische Klinik und Poliklinik 1
City
Dresden
State/Province
Saxony
ZIP/Postal Code
01307
Country
Germany
Facility Name
Universitätsklinikum Düsseldorf, Medizinische Klinik und Poliklinik, Klinik für Hämatologie, Onkologie und klinische Immunologie
City
Düsseldorf
ZIP/Postal Code
40225
Country
Germany
Facility Name
Universitätsklinikum Essen, Klinik für Knochenmarktransplantation
City
Essen
ZIP/Postal Code
45122
Country
Germany
Facility Name
Universitätsklinikum Hamburg-Eppendorf, Onkologisches Zentrum
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Medizinische Hochschule Hannover, Zentrum Innere Medizin, Hämatologie
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Universitätsklinikum Ulm, Klinik für Innere Medizin III
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II
City
Würzburg
ZIP/Postal Code
97080
Country
Germany

12. IPD Sharing Statement

Links:
URL
http://www.mk1dd.de
Description
Dresden University Hospital C. G. Carus, Medizinische Klinik und Poliklinik 1

Learn more about this trial

Lenalidomide Maintenance Therapy in Patients With Myelodysplastic Syndromes (MDS) or Acute Myelogenous Leukemia (AML)

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