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iCare4: Genomic Signatures With Midostaurin in Acute Myeloid Leukemia (UF-HEM-004)

Primary Purpose

Acute Myeloid Leukemia

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Midostaurin
Cytarabine
Sponsored by
University of Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring acute myeloid leukemia, genomic signatures, midostaurin, relapsed, refractory, PKC412

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Written informed consent obtained from the subject prior to registration on the study and the ability for the subject to adhere to the study visit schedule and all the study-related procedures.
  • A diagnosis of relapsed or refractory AML. For the purpose of this study, refractory AML is defined as failure to achieve CR after one cycle of induction chemotherapy and relapsed AML is defined as any evidence of disease recurrence after achieving CR of any duration.
  • Both males and females ≥ eighteen years of age
  • Karnofsky Performance Status of ≥ 70% or Eastern Cooperative Oncology Group (ECOG) performance status < 2 (unless poor performance status is related to the disease).
  • Adequate organ function defined as:
  • AST and ALT < 2.5 times the upper limit of normal (ULN),
  • Serum bilirubin < 2.5 x ULN, and
  • Serum creatinine < 1.5 mg/dL or creatinine clearance > 50 mL/min.
  • Laboratory values can be outside of this range if secondary to AML disease.
  • An ejection fraction of > 45% confirmed by echocardiogram.
  • Life expectancy of greater than one month.
  • Subjects who previously received midostaurin are allowed if the last dose of midostaurin was given ≥ six months prior to disease relapse.
  • Females who are non-pregnant and non-nursing.
  • Females of reproductive age and males must agree to avoid getting pregnant or to father a child while on therapy and for five months after the last dose of chemotherapy.
  • Women of child-bearing potential (WOCBP) must either agree to continued abstinence from heterosexual intercourse or begin one of the following acceptable methods of birth control: IUD, tubal ligation, or partner must use a latex condom during any sexual contact, even if the partner has undergone a successful vasectomy. Hormonal contraception is an inadequate method of birth control.
  • Males must use a latex condom during any sexual contact with WOCBP, even if they have undergone a successful vasectomy (while on therapy and for five months after the last dose of chemotherapy)

Exclusion Criteria:

  • Age ≥ of seventy-six years.
  • Subjects with the inability to swallow oral medications.
  • Clinical evidence of active CNS leukemia.
  • A medical history of receiving an allogeneic hematopoietic stem cell transplantation (HSCT).
  • Subjects must not have any uncontrolled or intercurrent illness including, but not limited to,
  • ongoing or active infection,
  • symptomatic congestive heart failure,
  • unstable angina pectoris,
  • cardiac arrhythmia,
  • myocardial infarction within three months,
  • poorly controlled hypertension,
  • uncontrolled diabetes, or psychiatric illness/social situation that would limit compliance with protocol requirements.
  • Females or males of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for at least five months after the last dose of chemotherapy.
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of PKC412.
  • Previous therapy with midostaurin within six months prior to relapse.
  • History of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications, in the opinion of the treating physician.
  • Prisoners or subjects who are involuntarily incarcerated.
  • Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.
  • Subjects demonstrating an inability to comply with the study and/or follow-up procedures.

Sites / Locations

  • University of Florida

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Midostaurin and Cytarabine

Arm Description

Treatment will consist of 3 phases: induction (a 28-42 day cycle), followed by consolidation (up to 4 cycles). Each cycle in the consolidation phase will last 28 days. Subjects will proceed from one phase to the next if they have achieved or maintained a complete remission or complete remission with incomplete blood count recovery by International Working Group 2003 response criteria. Patients may receive a allogeneic hematopoietic stem cell transplant between the end of the induction phase.

Outcomes

Primary Outcome Measures

Progression Free Survival
Compare the progression free survival of patients receiving midostaurin and cytarabine to that historically achieved in patients receiving cytarabine alone

Secondary Outcome Measures

Number of participants with treatment-related adverse events as assessed by National Cancer Institute (NCI) Common Terminology for Adverse Events(CTCAE) v4.0
Assess the incidence and severity of toxicities of midostaurin and cytarabine using CTCAE v4.0
Overall survival
Compare the overall survival of patients receiving midostaurin and cytarabine to that historically achieved in patients receiving cytarabine alone
Morphologic response rate
Compare the morphologic response rate (using International Working Group 2003 criteria) of patients receiving midostaurin and cytarabine to that historically achieved in patients receiving cytarabine alone

Full Information

First Posted
June 26, 2017
Last Updated
October 18, 2018
Sponsor
University of Florida
Collaborators
Novartis Pharmaceuticals
search

1. Study Identification

Unique Protocol Identification Number
NCT03207334
Brief Title
iCare4: Genomic Signatures With Midostaurin in Acute Myeloid Leukemia (UF-HEM-004)
Official Title
A Phase II, Open-Label Clinical Efficacy Study Defining Genomic Signatures That Correlate With Midostaurin Response in Relapsed or Refractory Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Insufficient funding
Study Start Date
November 2018 (Anticipated)
Primary Completion Date
January 2021 (Anticipated)
Study Completion Date
January 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Florida
Collaborators
Novartis Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is an open label, single arm study of midostaurin in patients with relapsed or refractory AML.
Detailed Description
Clinical trials have shown that the multi-kinase inhibitor midostaurin improves survival in patients with AML. The main objective of this study is to investigate its effect (in conjunction with cytarabine) on progression free survival, as well as overall survival and morphologic response rate in patients with relapsed or refractory AML. This study will also attempt to identify specific populations of patients with relapsed or refractory AML who best respond to treatment with midostaurin to enhance treatment planning.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
acute myeloid leukemia, genomic signatures, midostaurin, relapsed, refractory, PKC412

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
All patients will receive midostaurin and cytarabine.
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Midostaurin and Cytarabine
Arm Type
Experimental
Arm Description
Treatment will consist of 3 phases: induction (a 28-42 day cycle), followed by consolidation (up to 4 cycles). Each cycle in the consolidation phase will last 28 days. Subjects will proceed from one phase to the next if they have achieved or maintained a complete remission or complete remission with incomplete blood count recovery by International Working Group 2003 response criteria. Patients may receive a allogeneic hematopoietic stem cell transplant between the end of the induction phase.
Intervention Type
Drug
Intervention Name(s)
Midostaurin
Other Intervention Name(s)
PKC412, Rydapt
Intervention Description
Induction Phase: 50 mg orally twice daily beginning on day 7 and ending 48 hours prior to beginning the consolidation phase Consolidation Phase: 50 mg orally twice daily beginning on Day 6 and ending 48 hours prior to either the start of the next cycle or beginning conditioning therapy for allogenic stem cell transplant.
Intervention Type
Drug
Intervention Name(s)
Cytarabine
Other Intervention Name(s)
Depocyt
Intervention Description
Induction Phase: 3 g/m2 (patients 18-65 years old) or 1 g/m2 (patients > 65 years old or those with co-morbidities precluding a higher dose) by vein over 3 hours every 12 hours on Days 1-6. Consolidation Phase: 3 g/m2 (patients 18-65 years old) or 1 g/m2 (patients > 65 years old or those with co-morbidities precluding a higher dose) by vein over 3 hours every 12 hours on Days 1, 3, and 5 of each cycle.
Primary Outcome Measure Information:
Title
Progression Free Survival
Description
Compare the progression free survival of patients receiving midostaurin and cytarabine to that historically achieved in patients receiving cytarabine alone
Time Frame
Up to 6 months
Secondary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by National Cancer Institute (NCI) Common Terminology for Adverse Events(CTCAE) v4.0
Description
Assess the incidence and severity of toxicities of midostaurin and cytarabine using CTCAE v4.0
Time Frame
Up to 2.5 years
Title
Overall survival
Description
Compare the overall survival of patients receiving midostaurin and cytarabine to that historically achieved in patients receiving cytarabine alone
Time Frame
Up to 3.5 years
Title
Morphologic response rate
Description
Compare the morphologic response rate (using International Working Group 2003 criteria) of patients receiving midostaurin and cytarabine to that historically achieved in patients receiving cytarabine alone
Time Frame
Up to 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent obtained from the subject prior to registration on the study and the ability for the subject to adhere to the study visit schedule and all the study-related procedures. A diagnosis of relapsed or refractory AML. For the purpose of this study, refractory AML is defined as failure to achieve CR after one cycle of induction chemotherapy and relapsed AML is defined as any evidence of disease recurrence after achieving CR of any duration. Both males and females ≥ eighteen years of age Karnofsky Performance Status of ≥ 70% or Eastern Cooperative Oncology Group (ECOG) performance status < 2 (unless poor performance status is related to the disease). Adequate organ function defined as: AST and ALT < 2.5 times the upper limit of normal (ULN), Serum bilirubin < 2.5 x ULN, and Serum creatinine < 1.5 mg/dL or creatinine clearance > 50 mL/min. Laboratory values can be outside of this range if secondary to AML disease. An ejection fraction of > 45% confirmed by echocardiogram. Life expectancy of greater than one month. Subjects who previously received midostaurin are allowed if the last dose of midostaurin was given ≥ six months prior to disease relapse. Females who are non-pregnant and non-nursing. Females of reproductive age and males must agree to avoid getting pregnant or to father a child while on therapy and for five months after the last dose of chemotherapy. Women of child-bearing potential (WOCBP) must either agree to continued abstinence from heterosexual intercourse or begin one of the following acceptable methods of birth control: IUD, tubal ligation, or partner must use a latex condom during any sexual contact, even if the partner has undergone a successful vasectomy. Hormonal contraception is an inadequate method of birth control. Males must use a latex condom during any sexual contact with WOCBP, even if they have undergone a successful vasectomy (while on therapy and for five months after the last dose of chemotherapy) Exclusion Criteria: Age ≥ of seventy-six years. Subjects with the inability to swallow oral medications. Clinical evidence of active CNS leukemia. A medical history of receiving an allogeneic hematopoietic stem cell transplantation (HSCT). Subjects must not have any uncontrolled or intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, myocardial infarction within three months, poorly controlled hypertension, uncontrolled diabetes, or psychiatric illness/social situation that would limit compliance with protocol requirements. Females or males of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for at least five months after the last dose of chemotherapy. Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of PKC412. Previous therapy with midostaurin within six months prior to relapse. History of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications, in the opinion of the treating physician. Prisoners or subjects who are involuntarily incarcerated. Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness. Subjects demonstrating an inability to comply with the study and/or follow-up procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maxim Norkin, MD, PhD
Organizational Affiliation
University of Florida
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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iCare4: Genomic Signatures With Midostaurin in Acute Myeloid Leukemia (UF-HEM-004)

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