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Phase I/II Trial: BIBF 1120 Added to Low-dose Cytarabine in Elderly Patients With Acute Myeloid Leukemia (AML)

Primary Purpose

Acute Myeloid Leukemia

Status
Unknown status
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
triple kinase inhibitor BIBF1120
Sponsored by
University Hospital Muenster
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with newly diagnosed AML (except APL) according to the FAB or WHO classification, including AML evolving from MDS or other hematological diseases and AML after previous cytotoxic therapy or radiation (secondary AML), with medical contraindications against or not willing to receive a standard induction and consolidation therapy.
  • Bone marrow aspirate or biopsy must contain > 20% blasts of all nucleated cells. In AML FAB M6 ≥ 30% of non-erythroid cells in the bone marrow must be leukemic blasts. In patients with 20-30% blasts, the indication for a treatment with hypomethylating agents (5-azacitidine or decitabine) should be considered prior to inclusion into the trial.
  • Age ≥ 60 years
  • Informed consent, personally signed and dated to participate in the study
  • Male patients enrolled in this trial must use adequate barrier birth control measures during the course of treatment and for at least 3 months after the last administration of study therapy (low-dose cytarabine and/or BIBF 1120).

Exclusion Criteria:

  • Patients with 20-30% bone marrow blasts which are qualifying for and consenting into a therapy with hypomethylating agents
  • Patients who are eligible for and consenting into a standard chemotherapy
  • Known central nervous system manifestation of AML
  • Inadequate liver function (ALT and AST ≥ 2.5 x ULN) if not caused by leukemic infiltration
  • Known chronically active hepatitis C infection or acute hepatitis
  • Chronically impaired renal function (creatinin clearance < 30 ml/min)
  • Uncontrolled hypertension with a resting pressure systolic > 160 mmHg or diastolic > 95 mmHg despite adequate treatment
  • severe trauma or surgery within 4 weeks of study entry
  • severe, non-healing wounds, ulcer or fracture
  • Uncontrolled active infection
  • Concurrent malignancies other than AML or other severe diseases which in the opinion of the investigator are likely to influence the endpoint assessment
  • Hypersensitivity to cytarabine (not including drug fever or exanthema)
  • Previous treatment of AML except hydroxyurea up to 24 hours before study medication
  • Previous therapy with tyrosine kinase inhibitors or angiogenesis inhibitors
  • Parallel participation in another clinical trial for the same indication. Eligibility of patients with investigational drug therapy outside of this trial during or within 4 weeks of study entry should be discussed with the study office prior to study entry
  • Any severe concomitant condition, which makes it undesirable for the patient to participate in the study or which could jeopardize compliance with the protocol

Sites / Locations

  • Universitätsklinikum Münster, Medizinische Klinik und Poliklinik A

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

BIBF 1120

Arm Description

Outcomes

Primary Outcome Measures

Phase I: defining maximum tolerated dose (MTD)
Phase II: overall response rate (ORR)

Secondary Outcome Measures

Complete remission (CR) rate
overall survival (OS)
relapse-free survival (RFS)of the responding patients
number of participants with adverse events as a measure of safety and tolerability
ORR rate of the Flt3-mutated patients versus the Flt3-wildtype patients
CR rate of the Flt3-mutated patients versus the Flt3-wildtype patients
OS of the Flt3-mutated patients versus the Flt3-wildtype patients
time to response (CR, CRp, CRi) of the responding patients
CRp = complete remission with incomplete platelet recovery CRi = complete remission with incomplete neutrophil recovery

Full Information

First Posted
November 15, 2011
Last Updated
December 10, 2013
Sponsor
University Hospital Muenster
Collaborators
Boehringer Ingelheim
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1. Study Identification

Unique Protocol Identification Number
NCT01488344
Brief Title
Phase I/II Trial: BIBF 1120 Added to Low-dose Cytarabine in Elderly Patients With Acute Myeloid Leukemia (AML)
Official Title
A Single-arm, Open Label, Multi-center Phase I/II Trial to Assess the Safety and Efficacy of BIBF 1120 Added to Low-dose Cytarabine in Elderly Patients With AML Unfit for an Intensive Induction Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Unknown status
Study Start Date
March 2012 (undefined)
Primary Completion Date
November 2014 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital Muenster
Collaborators
Boehringer Ingelheim

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Low-dose cytarabine works in a minority of elderly patients with an acute myeloid leukemia unfit for intensive induction therapy by killing of leukemia cells. Addition of BIBF1120 to low-dose cytarabine might enhance the killing of leukemia cells. PURPOSE: This phase I / II trial is studying how safe BIBF1120 can be combined with low-dose cytarabine (phase I) and how well the combination of low-dose cytarabine and BIBF1120 works in elderly patients with acute myeloid leukemia unfit for intensive chemotherapy (phase II).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
140 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
BIBF 1120
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
triple kinase inhibitor BIBF1120
Intervention Description
triple kinase inhibitor BIBF1120 is given in addition to low-dose cytarabine
Primary Outcome Measure Information:
Title
Phase I: defining maximum tolerated dose (MTD)
Time Frame
4 weeks
Title
Phase II: overall response rate (ORR)
Time Frame
up to 6 month
Secondary Outcome Measure Information:
Title
Complete remission (CR) rate
Time Frame
up to 12 month
Title
overall survival (OS)
Time Frame
up to 12 month
Title
relapse-free survival (RFS)of the responding patients
Time Frame
up to 12 month
Title
number of participants with adverse events as a measure of safety and tolerability
Time Frame
up to 12 month
Title
ORR rate of the Flt3-mutated patients versus the Flt3-wildtype patients
Time Frame
up to 12 month
Title
CR rate of the Flt3-mutated patients versus the Flt3-wildtype patients
Time Frame
up to 12 month
Title
OS of the Flt3-mutated patients versus the Flt3-wildtype patients
Time Frame
up to 12 month
Title
time to response (CR, CRp, CRi) of the responding patients
Description
CRp = complete remission with incomplete platelet recovery CRi = complete remission with incomplete neutrophil recovery
Time Frame
up to 12 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with newly diagnosed AML (except APL) according to the FAB or WHO classification, including AML evolving from MDS or other hematological diseases and AML after previous cytotoxic therapy or radiation (secondary AML), with medical contraindications against or not willing to receive a standard induction and consolidation therapy. Bone marrow aspirate or biopsy must contain > 20% blasts of all nucleated cells. In AML FAB M6 ≥ 30% of non-erythroid cells in the bone marrow must be leukemic blasts. In patients with 20-30% blasts, the indication for a treatment with hypomethylating agents (5-azacitidine or decitabine) should be considered prior to inclusion into the trial. Age ≥ 60 years Informed consent, personally signed and dated to participate in the study Male patients enrolled in this trial must use adequate barrier birth control measures during the course of treatment and for at least 3 months after the last administration of study therapy (low-dose cytarabine and/or BIBF 1120). Exclusion Criteria: Patients with 20-30% bone marrow blasts which are qualifying for and consenting into a therapy with hypomethylating agents Patients who are eligible for and consenting into a standard chemotherapy Known central nervous system manifestation of AML Inadequate liver function (ALT and AST ≥ 2.5 x ULN) if not caused by leukemic infiltration Known chronically active hepatitis C infection or acute hepatitis Chronically impaired renal function (creatinin clearance < 30 ml/min) Uncontrolled hypertension with a resting pressure systolic > 160 mmHg or diastolic > 95 mmHg despite adequate treatment severe trauma or surgery within 4 weeks of study entry severe, non-healing wounds, ulcer or fracture Uncontrolled active infection Concurrent malignancies other than AML or other severe diseases which in the opinion of the investigator are likely to influence the endpoint assessment Hypersensitivity to cytarabine (not including drug fever or exanthema) Previous treatment of AML except hydroxyurea up to 24 hours before study medication Previous therapy with tyrosine kinase inhibitors or angiogenesis inhibitors Parallel participation in another clinical trial for the same indication. Eligibility of patients with investigational drug therapy outside of this trial during or within 4 weeks of study entry should be discussed with the study office prior to study entry Any severe concomitant condition, which makes it undesirable for the patient to participate in the study or which could jeopardize compliance with the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Utz Krug, MD
Organizational Affiliation
University Hospital Münster, Medizinische Klinik und Poliklinik A
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsklinikum Münster, Medizinische Klinik und Poliklinik A
City
Münster
ZIP/Postal Code
48149
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
36399194
Citation
Berdel AF, Koch R, Gerss J, Hentrich M, Peceny R, Bartscht T, Steffen B, Bischoff M, Spiekermann K, Angenendt L, Mikesch JH, Kewitz T, Butterfass-Bahloul T, Serve H, Lenz G, Berdel WE, Krug U, Schliemann C. A randomized phase 2 trial of nintedanib and low-dose cytarabine in elderly patients with acute myeloid leukemia ineligible for intensive chemotherapy. Ann Hematol. 2023 Jan;102(1):63-72. doi: 10.1007/s00277-022-05025-0. Epub 2022 Nov 18.
Results Reference
derived
PubMed Identifier
27716819
Citation
Schliemann C, Gerss J, Wiebe S, Mikesch JH, Knoblauch N, Sauer T, Angenendt L, Kewitz T, Urban M, Butterfass-Bahloul T, Edemir S, Vehring K, Muller-Tidow C, Berdel WE, Krug U. A Phase I Dose Escalation Study of the Triple Angiokinase Inhibitor Nintedanib Combined with Low-Dose Cytarabine in Elderly Patients with Acute Myeloid Leukemia. PLoS One. 2016 Oct 7;11(10):e0164499. doi: 10.1371/journal.pone.0164499. eCollection 2016.
Results Reference
derived

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Phase I/II Trial: BIBF 1120 Added to Low-dose Cytarabine in Elderly Patients With Acute Myeloid Leukemia (AML)

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