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Aezea® (Cenersen) and Chemotherapy for AML Subjects ≥ 55 Years of Age With No Response to Frontline Induction Course

Primary Purpose

Acute Myelogenous Leukemia

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
cenersen
placebo
idarubicin, cytarabine
Sponsored by
Eleos, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myelogenous Leukemia focused on measuring Oligonucleotides, Antisense, Tumor Suppressor Protein p53, idarubicin, cytarabine

Eligibility Criteria

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

Inclusion Criteria:

  • In response to their first course of frontline treatment, patients who did not achieve a response (CR, CRi, or PR) and have ≥ 15% bone marrow blasts in a BM specimen between day 14 - 42 from the initiation of a single frontline course. If within that timeframe the BM is hypoplastic, the BM assessment can be repeated within a subsequent two-week period and the patient entered into the study if there is ≥ 15% blasts in the bone marrow.
  • ≥ 55 years old
  • Have an understanding of the importance of not taking paracetamol (acetaminophen) or high dose antioxidants from 1 day before through 1 day after treatment during any given course
  • Have a life expectancy of more than 4 weeks following initiation of treatment
  • Secondary AML is allowed as are antecedent hematologic disorders
  • Zubrod performance status ≤ 2
  • Have recovered from acute toxicities of prior chemotherapy (≤ Grade 2)
  • Have signed an informed consent
  • Total bilirubin ≤ 1.5 x upper normal limit (UNL) and Alanine Amino Transferase [ALT (Serum Glutamic-pyruvic Transaminase (SGPT))] ≤ 2.5 x UNL
  • Creatinine ≤ 1.5 x UNL
  • Serum magnesium should be within the normal range (Mg replacement being acceptable)
  • Left Ventricular Ejection Fraction (LVEF) of >50% as determined by multiple-gated acquisition scan (MUGA) or Echocardiogram (ECHO)
  • Ability to receive all courses of therapy, as outlined in the treatment schedules at the investigative site
  • Willingness to comply with scheduled follow-up as required by the protocol
  • Use of adequate contraceptive techniques if premenopausal and sexually active; examples include implantable, injectable or oral contraceptives, intrauterine devices (IUD), sterilization, or sexual abstinence
  • If premenopausal, have negative pregnancy tests at screening

Exclusion Criteria:

  • Presence of any pneumonia regardless of severity or other life-threatening illness including, but not limited to, ongoing infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, high blood pressure, history of labile hypertension, history of poor compliance with an antihypertensive regimen, myocardial infarction less than or equal to 6 months prior to registration, diabetes, or extensive and symptomatic interstitial fibrosis of lung, chronic liver disease or psychiatric illness/social situations that limits compliance with study requirements
  • Acute promyelocytic leukemia (APL [FAB classification M3])
  • Requirement for transplant before Course 2 is complete
  • Concurrent use of other experimental agents (i.e., drugs not approved for clinical indications) or having received other investigational agents within the 30 days prior to the start of Course 1
  • Pregnancy (includes a positive pregnancy test at the screening visit) or lactation
  • Known HIV infection
  • Active hepatitis B or C or other active liver disease
  • Presence of dyspnea at rest or with minimal exertion after correction for anemia
  • Known or suspected hypersensitivity or allergy to idarubicin or ara-C
  • Occurrence of major surgery within two weeks of the start of Course 1
  • Chemotherapy within two weeks prior to initiation of therapy under this protocol, or hydroxyurea within 7 days
  • Patients who, with appropriate explanation, are not prepared to exclude the use of paracetamol (acetaminophen) or paracetamol-containing medications from 1 day before through 1 day after treatment during any course
  • Patients who are not prepared to commit to the exclusion of high dose antioxidants from 1 day before through 1 day after treatment during any given course
  • Medical or psychiatric conditions that compromise the ability to give informed consent, to comply with the protocol or to complete the study
  • Inability, in the opinion of the principal investigator or clinical staff, to comply with protocol requirements for the duration of the study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    cenersen, idarubicin, cytarabine

    placebo, idarubicin, cytarabine

    Arm Description

    cenersen, idarubicin, cytarabine

    placebo, idarubicin, cytarabine

    Outcomes

    Primary Outcome Measures

    Complete Remission Rate

    Secondary Outcome Measures

    Overall Survival
    Safety Profile
    Complete Remission + Complete Remission with Incomplete Blood Count Recovery Rate
    Morphologic Leukemia-Free State Rate
    Partial Remission Rate
    Remission Duration
    Early deaths measured as deaths at 30, 60 and 90 days of the start of treatment
    Time to Neutrophil and Platelet Recovery
    Death in Complete Remission
    Zubrod Score

    Full Information

    First Posted
    August 26, 2009
    Last Updated
    September 16, 2014
    Sponsor
    Eleos, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00967512
    Brief Title
    Aezea® (Cenersen) and Chemotherapy for AML Subjects ≥ 55 Years of Age With No Response to Frontline Induction Course
    Official Title
    Aezea (Cenersen) in Combination With Chemotherapy for Treatment of Acute Myelogenous Leukemia Subjects ≥55 Years of Age With No Response to Single Frontline Induction Course in a Randomized Double-Blind Placebo-Controlled Multi-Center Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2014
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Study Was Terminated due to lack of Funding.
    Study Start Date
    January 2012 (undefined)
    Primary Completion Date
    January 2012 (Anticipated)
    Study Completion Date
    January 2012 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Eleos, Inc.

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to assess whether treatment with cenersen in combination with 4 cycles of high and low-dose chemotherapy (idarubicin and cytarabine) improves the complete response rate in acute myelogenous leukemia (AML) patients ≥ 55 years of age who did not show a response (CR, CRi, or PR) to a single aggressive frontline induction course.
    Detailed Description
    Cenersen is a phosphorothioate antisense oligonucleotide of sequence 5'-CCCTG5-CTCCC10-CCCTG15-GCTCC20-3'. For AML, cenersen is specific for blocking p53 expression in the stem cells. When AML stem cells are dividing, cenersen sensitizes them to even low-level DNA damage of the type caused by idarubicin, etoposide and possibly ara-C. Because AML stem cells are not all dividing at any given time, this protocol is designed to treat patients with a total of four cycles of cenersen plus chemotherapy within a two to three month period. For a limited period of time, proliferating non-stem cells can be expected to maintain or even expand the tumor while the stem cells are being depleted. If the proliferating non-stem cells are not resupplied by the stem cells, they will all become end stage blasts after a few divisions and undergo elimination.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Acute Myelogenous Leukemia
    Keywords
    Oligonucleotides, Antisense, Tumor Suppressor Protein p53, idarubicin, cytarabine

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    cenersen, idarubicin, cytarabine
    Arm Type
    Experimental
    Arm Description
    cenersen, idarubicin, cytarabine
    Arm Title
    placebo, idarubicin, cytarabine
    Arm Type
    Placebo Comparator
    Arm Description
    placebo, idarubicin, cytarabine
    Intervention Type
    Drug
    Intervention Name(s)
    cenersen
    Other Intervention Name(s)
    Aezea®, cenersen sodium, EL625
    Intervention Description
    solution for injection, intravenous infusion, 0.1 mg/kg/h x 24h x 4 days, and 0.4 mg/kg/h x 3h x 4 days
    Intervention Type
    Drug
    Intervention Name(s)
    placebo
    Other Intervention Name(s)
    saline
    Intervention Description
    solution for injection, intravenous infusion, 0.1 mg/kg/h x 24h x 4 days, and 0.4 mg/kg/h x 3h x 4 days
    Intervention Type
    Drug
    Intervention Name(s)
    idarubicin, cytarabine
    Other Intervention Name(s)
    idamycin, Ara-C
    Intervention Description
    idarubicin, cytarabine
    Primary Outcome Measure Information:
    Title
    Complete Remission Rate
    Time Frame
    within day 28-42 of Course 1, and within day 28-42 of Course 2
    Secondary Outcome Measure Information:
    Title
    Overall Survival
    Time Frame
    2 years
    Title
    Safety Profile
    Time Frame
    up to 2 years
    Title
    Complete Remission + Complete Remission with Incomplete Blood Count Recovery Rate
    Time Frame
    within day 28-42 of Course 1, and within day 28-42 of Course 2
    Title
    Morphologic Leukemia-Free State Rate
    Time Frame
    within day 28-42 of Course 1, and within day 28-42 of Course 2
    Title
    Partial Remission Rate
    Time Frame
    within day 28-42 of Course 1, and within day 28-42 of Course 2
    Title
    Remission Duration
    Time Frame
    2 years
    Title
    Early deaths measured as deaths at 30, 60 and 90 days of the start of treatment
    Time Frame
    30, 90, and 90 days from start of treatment
    Title
    Time to Neutrophil and Platelet Recovery
    Time Frame
    within day 28-42 of Course 1, and within day 28-42 of Course 2
    Title
    Death in Complete Remission
    Time Frame
    2 years
    Title
    Zubrod Score
    Time Frame
    during Frontline Assessment (screening); Course 1: on days 6, 15, 18, and within day 28-42; Course 2: on days 1, 7, 15, 18, and within day 28-42; Course 3: on days 1 and 6; and Course 4: on days 1 and 6

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    55 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: In response to their first course of frontline treatment, patients who did not achieve a response (CR, CRi, or PR) and have ≥ 15% bone marrow blasts in a BM specimen between day 14 - 42 from the initiation of a single frontline course. If within that timeframe the BM is hypoplastic, the BM assessment can be repeated within a subsequent two-week period and the patient entered into the study if there is ≥ 15% blasts in the bone marrow. ≥ 55 years old Have an understanding of the importance of not taking paracetamol (acetaminophen) or high dose antioxidants from 1 day before through 1 day after treatment during any given course Have a life expectancy of more than 4 weeks following initiation of treatment Secondary AML is allowed as are antecedent hematologic disorders Zubrod performance status ≤ 2 Have recovered from acute toxicities of prior chemotherapy (≤ Grade 2) Have signed an informed consent Total bilirubin ≤ 1.5 x upper normal limit (UNL) and Alanine Amino Transferase [ALT (Serum Glutamic-pyruvic Transaminase (SGPT))] ≤ 2.5 x UNL Creatinine ≤ 1.5 x UNL Serum magnesium should be within the normal range (Mg replacement being acceptable) Left Ventricular Ejection Fraction (LVEF) of >50% as determined by multiple-gated acquisition scan (MUGA) or Echocardiogram (ECHO) Ability to receive all courses of therapy, as outlined in the treatment schedules at the investigative site Willingness to comply with scheduled follow-up as required by the protocol Use of adequate contraceptive techniques if premenopausal and sexually active; examples include implantable, injectable or oral contraceptives, intrauterine devices (IUD), sterilization, or sexual abstinence If premenopausal, have negative pregnancy tests at screening Exclusion Criteria: Presence of any pneumonia regardless of severity or other life-threatening illness including, but not limited to, ongoing infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, high blood pressure, history of labile hypertension, history of poor compliance with an antihypertensive regimen, myocardial infarction less than or equal to 6 months prior to registration, diabetes, or extensive and symptomatic interstitial fibrosis of lung, chronic liver disease or psychiatric illness/social situations that limits compliance with study requirements Acute promyelocytic leukemia (APL [FAB classification M3]) Requirement for transplant before Course 2 is complete Concurrent use of other experimental agents (i.e., drugs not approved for clinical indications) or having received other investigational agents within the 30 days prior to the start of Course 1 Pregnancy (includes a positive pregnancy test at the screening visit) or lactation Known HIV infection Active hepatitis B or C or other active liver disease Presence of dyspnea at rest or with minimal exertion after correction for anemia Known or suspected hypersensitivity or allergy to idarubicin or ara-C Occurrence of major surgery within two weeks of the start of Course 1 Chemotherapy within two weeks prior to initiation of therapy under this protocol, or hydroxyurea within 7 days Patients who, with appropriate explanation, are not prepared to exclude the use of paracetamol (acetaminophen) or paracetamol-containing medications from 1 day before through 1 day after treatment during any course Patients who are not prepared to commit to the exclusion of high dose antioxidants from 1 day before through 1 day after treatment during any given course Medical or psychiatric conditions that compromise the ability to give informed consent, to comply with the protocol or to complete the study Inability, in the opinion of the principal investigator or clinical staff, to comply with protocol requirements for the duration of the study
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Larry J Smith, PhD
    Organizational Affiliation
    Eleos, Inc.
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Learn more about this trial

    Aezea® (Cenersen) and Chemotherapy for AML Subjects ≥ 55 Years of Age With No Response to Frontline Induction Course

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