Dasatinib, Cytarabine, and Idarubicin in Treating Patients With High-Risk Acute Myeloid Leukemia
Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities, Adult Acute Myeloid Leukemia With Del(5q), Adult Acute Myeloid Leukemia With Inv(16)(p13;q22)
About this trial
This is an interventional treatment trial for Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities
Eligibility Criteria
Inclusion Criteria:
Patients diagnosed with AML meeting one of the following criteria:
- Newly diagnosed, age 60 and older
- High risk cytogenetics and molecular abnormalities (National Comprehensive Cancer Network [NCCN] criteria)
- Relapsed or refractory to prior chemotherapy
- Secondary AML
Any prior chemotherapy must have been completed >= 2 weeks prior to day 1 of study treatment and the participant must have recovered to eligibility levels from prior toxicity
Only one prior regimen is allowed for relapsed AML patients; note one prior regimen is defined as follows:
- Induction chemotherapy followed by consolidation is considered one regimen
- Induction chemotherapy followed by re-induction in case of persistent disease followed by consolidation is considered one regimen
- Hydroxyurea is allowed prior to day 1 of study treatment to keep white blood cell (WBC) below 20 K
- Karnofsky performance status >= 60%
- Total bilirubin < 1.5 x institutional upper limit of normal
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional upper limit of normal
- Creatinine < 1.5 x institutional upper limit or normal OR creatinine clearance >= 60 mL/min for patients with creatinine levels above 1.5 x institutional upper limit of normal
- Ejection fraction (EF) >= 45%
- Ability to understand and sign a written informed consent document
- Patients should not be receiving any other investigational agents
Exclusion Criteria:
- Patients with clinically significant illness which would compromise participation in the study, including, but not limited to: active or uncontrolled infection, immune deficiencies or confirmed diagnosis of human immunodeficiency virus (HIV) infection, active hepatitis B, active hepatitis C, or uncontrolled diabetes, uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, myocardial infarction within the past 6 months, uncontrolled cardiac arrhythmias; or psychiatric illness/social situations that would limit compliance with study requirements
- Patients with additional (other than AML) currently active primary malignancy other than curatively treated carcinoma in situ (CIS) of the cervix, or basal or squamous cell carcinoma of the skin; patients are not considered to have a "currently active" malignancy if they have completed therapy for a prior malignancy and disease free from prior malignancies for > 2 years
- Patients with active central nervous system (CNS) disease
- Patients with Chronic Myelogenous Leukemia (CML) in Myeloid blasts crisis
- Active infections, including opportunistic infections
- Women of childbearing potential (WOCBP) who have a positive serum pregnancy test within 14 days of the first administration of oral dasatinib
Sites / Locations
- City of Hope Medical Center
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Dasatinib 100mg/day + Cytarabine 200mg/m2/day + Idarubicin 12mg/m2/day
Dasatinib 140mg/day + Cytarabine 200mg/m2/day + Idarubicin 12mg/m2/day
Patients receive cytarabine IV continuously over 168 hours on days 1-7, dasatinib PO QD on days 1-7, and idarubicin hydrochloride IV on days 1-3. Patients with non-responsive disease on day 30 may receive a second course of therapy (re-induction therapy) within 1 week in the absence of unacceptable toxicity.
Patients receive cytarabine IV continuously over 168 hours on days 1-7, dasatinib PO QD on days 1-7, and idarubicin hydrochloride IV on days 1-3. Patients with non-responsive disease on day 30 may receive a second course of therapy (re-induction therapy) within 1 week in the absence of unacceptable toxicity.