Volasertib and Vincristine Sulfate Liposome in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
Recurrent Adult Acute Lymphoblastic Leukemia, Refractory Adult Acute Lymphoblastic Leukemia
About this trial
This is an interventional treatment trial for Recurrent Adult Acute Lymphoblastic Leukemia
Eligibility Criteria
Inclusion Criteria:
- Patients must have histologically confirmed diagnosis of Philadelphia-negative ALL by bone marrow biopsy or aspirate
- Patients must have >= 5% blasts in the bone marrow
Patients must have refractory disease, disease relapse or progression after at least two prior systemic chemotherapy or immunotherapy regimens
- Note: Exceptions may be made if a patient is deemed unfit for first-line salvage therapy by the treating physician; such cases should be clearly documented
- Patients with a history of CNS (central nervous system) leukemia are eligible if they are not symptomatic from current CNS involvement; if there is CNS involvement that is known prior to enrollment or identified subsequently, it will be treated accordingly with intrathecal chemotherapy per the treating physician
- Patients must exhibit an Eastern Cooperative Oncology Group (ECOG) performance status of =< 2
- Patients must have adequate organ function within 14 days prior to registration, as defined below:
- Total bilirubin =< 2 x institutional upper limit of normal (ULN)
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/aspartate aminotransferase (ALT) (serum glutamic pyruvic transaminase [SPGT]) =< 3 x ULN
- Creatinine =< 2 X ULN
Females of child-bearing potential (FOCBP) and males must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 6 months following completion of therapy; should a female patient become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
NOTE: A FOCBP is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
- Has not undergone a hysterectomy or bilateral oophorectomy
- Has had menses at any time in the preceding 12 consecutive months (and therefore has not been naturally postmenopausal for > 12 months)
- FOCBP must have a negative pregnancy test within 14 days prior to registration on study
- Patients must have the ability to understand and the willingness to sign a written informed consent prior to registration on study
Exclusion Criteria:
- Patients who have had chemotherapy, immunotherapy, or radiotherapy within 2 weeks prior to entering the study or those who have not recovered from adverse events (=< grade 1 or patient's baseline) due to agents administered more than 2 weeks earlier are not eligible
- Patients may not be receiving any other investigational agents within 7 days of registration
- Patients may not be receiving any medications that are known to prolong QT interval unless reviewed and approved by the principal investigator (PI)
- Patients who have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to volasertib or VSLI are not eligible
Subject may not have had hematopoietic stem cell transplant (HSCT) meeting any of the following:
- Is within 2 months of transplant from cycle 1 day 1 (C1D1)
- Has clinically significant graft-versus-host disease requiring treatment
- Has >= grade 2 persistent non-hematological toxicity related to the transplant
- Donor lymphocyte infusion (DLI) is not permitted < 30 days prior to study registration
- Patients with >= grade 2 sensory or motor neuropathy are not eligible
Fridericia's corrected QT (QTcF) prolongation > 470 ms or QT prolongation deemed clinically relevant by the investigator (e.g., congenital long QT syndrome); the QTcF will be calculated as the mean of the 3 electrocardiograms (ECGs) taken at screening
- NOTE: The formula used to calculate QTcF can be physician's choice, but it must be used consistently throughout the study
Patients who have an uncontrolled intercurrent illness including, but not limited to any of the following, are not eligible:
- Ongoing or active infection requiring systemic treatment
- Symptomatic congestive heart failure (>= class 3)
- Unstable angina pectoris
- Cardiac arrhythmia
- Psychiatric illness/social situations that would, in the investigator's opinion, limit compliance with study requirements
- Known human immunodeficiency virus (HIV) infection
- Known John Cunningham virus (JC) virus infection and/or progressive multifocal leukoencephalopathy (PML)
Known clinically active hepatitis A, B, or C infections
- NOTE: Patients with chronic hepatitis C virus (HCV) or hepatitis B virus (HBV) infection may enroll if other laboratory criteria are met; those with HBV surface antigen positivity may enroll only if maintained on appropriate suppressive antiviral therapy for the duration of enrollment in the trial
- Second malignancy that requires active treatment
- Any other illness or condition that the treating investigator feels would interfere with study compliance or would compromise the patient's safety or study endpoints
- Female patients who are pregnant or nursing are not eligible
Sites / Locations
- Stanford University
- Johns Hopkins University/Sidney Kimmel Cancer Center
Arms of the Study
Arm 1
Experimental
Treatment (volasertib, vincristine sulfate liposome)
Patients receive volasertib IV over 1 hour on day 1 and vincristine sulfate liposome IV over 1 hour on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression, development of an inter-current illness that prevents further administration of treatment, unacceptable toxicity, patient decides to withdraw or treating investigator determines that the patient should be taken off treatment for any reason.