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Induction, Consolidation and Intensification Therapy for Patients Younger Than 66 Years With Previously Untreated CD33 Positive Acute Myeloid Leukemia (AML) (MYFLAI07)

Primary Purpose

Acute Myeloid Leukemia

Status
Completed
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
FLAIMy - Fluda, Ida, Ara-C, Mylotarg
Sponsored by
University Hospital, Udine, Italy
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring Induction chemotherapy, Fludarabine, Gemtuzumab Ozogamicin

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 18-65 years.
  • WHO PS grade 0-2 (Appendix B) or Karnofsky > 70.
  • AML according to the new WHO criteria, i.e., % of BM blasts ≥ 20%. NB. this % should be assessed on a BM aspiration or on a BM biopsy
  • All FAB subtypes except M3.
  • CD33 positivity (> 20%). It is mandatory to perform an immunotyping of the BM blasts in particular the determination of CD33 positivity, which will be used as a inclusion factor.
  • Previously untreated (except ≤ 14 days of Hydroxyurea) primary or secondary AML (including AML after MDS).
  • Adequate renal and liver function, i.e., creatinine < 2 mg/dl and bilirubin, ALT/AST ≤ 3 times the upper limit of normal.
  • Written informed consent

Exclusion Criteria:

  • Blast crisis of chronic myeloid leukemia.
  • AML supervening after other myeloproliferative diseases.
  • AML de novo or secondary previously pretreated.
  • Concomitant malignant disease.
  • Active central nervous system (CNS) leukemia.
  • Active uncontrolled infection [NB severe systemic infection should be excluded].
  • Concomitant severe cardiovascular disease, i.e., arrhythmias requiring chronic treatment, congestive heart failure or symptomatic ischemic heart disease.
  • Cardiac ejection fraction of 50% or less.
  • Severe pulmonary dysfunction (CTC grade 3-4).
  • Severe concomitant neurological or psychiatric disease.
  • History of alcohol abuse.
  • HIV positivity.
  • Pregnancy.
  • Man and woman not agreeing to the adequate contraceptive precautions during study period and for at last 24 months after stop of therapy.
  • Any psychological, familiar, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.

Sites / Locations

  • University Hospital, Udine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Efficacy of FLAIMy

Arm Description

Outcomes

Primary Outcome Measures

Feasibility, Efficacy (CR+PR rate) and Toxicity of FLAI + Gemtuzumab-Ozogamicin.
RFS, DFS and OS.

Secondary Outcome Measures

Evaluation of Minimal Residual Disease by WT1 (and other biologic markers) expression and monitoring.
Evaluation of prognostic clinical relevance of biological features at onset.
Feasibility and outcome of consolidation with BMT.

Full Information

First Posted
May 26, 2009
Last Updated
May 5, 2014
Sponsor
University Hospital, Udine, Italy
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1. Study Identification

Unique Protocol Identification Number
NCT00909168
Brief Title
Induction, Consolidation and Intensification Therapy for Patients Younger Than 66 Years With Previously Untreated CD33 Positive Acute Myeloid Leukemia (AML)
Acronym
MYFLAI07
Official Title
Induction, Consolidation and Intensification Therapy for Patients Younger Than 66 Years With Previously Untreated CD33 Positive Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2014
Overall Recruitment Status
Completed
Study Start Date
March 2008 (undefined)
Primary Completion Date
May 2009 (Actual)
Study Completion Date
March 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Hospital, Udine, Italy

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, open, non-randomized, non-controlled, phase II, clinical trial for treatment of newly diagnosed AML patients, younger than 66 years. Trial is based on: INDUCTION: FLAI + Gemtuzumab-Ozogamicin (FLAI-GO). CONSOLIDATION: Intermediate dose AraC + IDA (IDAC+IDA) +/- one course of high dose AraC (HDAC) INTENSIFICATION: Allo-BMT, ASCT MAINTENANCE: AraC a) Primary endpoints: Feasibility, Efficacy (CR+PR rate) and Toxicity of FLAI + Gemtuzumab-Ozogamicin. RFS, DFS and OS. b) Secondary endpoints: Evaluation of Minimal Residual Disease by WT1 (and other biologic markers) expression and monitoring. Evaluation of prognostic clinical relevance of biological features at onset. Feasibility and outcome of consolidation with BMT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
Induction chemotherapy, Fludarabine, Gemtuzumab Ozogamicin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
130 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Efficacy of FLAIMy
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
FLAIMy - Fluda, Ida, Ara-C, Mylotarg
Intervention Description
FLUDARABINE: 25 mg/m2/day, 250 FS in 30', start h 9 - 1, 2, 3, 4, 5 ARABINOSYL-CYTOSINE (Cytarabine): 2 g/m2/day, 500 FS in 3 h, start h 13 - 1, 2, 3, 4, 5 IDARUBICIN: 10 mg/m2/day, 100 FS in 1 h, start h 16 - 1, 3, 5 GEMTUZUMAB OZOGAMICIN (Mylotarg): 5 mg, single dose 500 FS in 4 h - 6
Primary Outcome Measure Information:
Title
Feasibility, Efficacy (CR+PR rate) and Toxicity of FLAI + Gemtuzumab-Ozogamicin.
Time Frame
one year
Title
RFS, DFS and OS.
Time Frame
one year
Secondary Outcome Measure Information:
Title
Evaluation of Minimal Residual Disease by WT1 (and other biologic markers) expression and monitoring.
Time Frame
one year
Title
Evaluation of prognostic clinical relevance of biological features at onset.
Time Frame
one year
Title
Feasibility and outcome of consolidation with BMT.
Time Frame
one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-65 years. WHO PS grade 0-2 (Appendix B) or Karnofsky > 70. AML according to the new WHO criteria, i.e., % of BM blasts ≥ 20%. NB. this % should be assessed on a BM aspiration or on a BM biopsy All FAB subtypes except M3. CD33 positivity (> 20%). It is mandatory to perform an immunotyping of the BM blasts in particular the determination of CD33 positivity, which will be used as a inclusion factor. Previously untreated (except ≤ 14 days of Hydroxyurea) primary or secondary AML (including AML after MDS). Adequate renal and liver function, i.e., creatinine < 2 mg/dl and bilirubin, ALT/AST ≤ 3 times the upper limit of normal. Written informed consent Exclusion Criteria: Blast crisis of chronic myeloid leukemia. AML supervening after other myeloproliferative diseases. AML de novo or secondary previously pretreated. Concomitant malignant disease. Active central nervous system (CNS) leukemia. Active uncontrolled infection [NB severe systemic infection should be excluded]. Concomitant severe cardiovascular disease, i.e., arrhythmias requiring chronic treatment, congestive heart failure or symptomatic ischemic heart disease. Cardiac ejection fraction of 50% or less. Severe pulmonary dysfunction (CTC grade 3-4). Severe concomitant neurological or psychiatric disease. History of alcohol abuse. HIV positivity. Pregnancy. Man and woman not agreeing to the adequate contraceptive precautions during study period and for at last 24 months after stop of therapy. Any psychological, familiar, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
ANNA CANDONI, MD
Organizational Affiliation
UUNIVERSITY HOSPITAL, UDINE, ITALY
Official's Role
Study Director
Facility Information:
Facility Name
University Hospital, Udine
City
Udine
ZIP/Postal Code
33100
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
29396857
Citation
Candoni A, Papayannidis C, Martinelli G, Simeone E, Gottardi M, Iacobucci I, Gherlinzoni F, Visani G, Baccarani M, Fanin R. Flai (fludarabine, cytarabine, idarubicin) plus low-dose Gemtuzumab Ozogamicin as induction therapy in CD33-positive AML: Final results and long term outcome of a phase II multicenter clinical trial. Am J Hematol. 2018 May;93(5):655-663. doi: 10.1002/ajh.25057. Epub 2018 Mar 2.
Results Reference
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Induction, Consolidation and Intensification Therapy for Patients Younger Than 66 Years With Previously Untreated CD33 Positive Acute Myeloid Leukemia (AML)

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