search
Back to results

CPX-351 Salvage Therapy Followed by Haplo-Cord Transplant for Relapsed/Refractory Leukemia or Myelodysplastic Syndrome

Primary Purpose

Myelodysplastic Syndromes, Leukemia, Myeloid, Acute, Leukemia, Relapsed Adult Acute Myeloid

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CPX-351
Fludarabine
Melphalan
Rabbit Anti-Human T-Lymphocyte Globulin
Haplo-Cord Stem Cell Transplantation
Sponsored by
Weill Medical College of Cornell University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndromes

Eligibility Criteria

18 Years - 89 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject must have refractory or relapsed Acute Myeloid Leukemia (AML) according to previously established criteria:

    1. Primary induction failure (PIF) after ≥ 2 cycles of chemotherapy
    2. First relapse
    3. Relapse refractory to salvage chemotherapy
    4. Second or subsequent relapse
  2. Subjects with Myelodysplastic Syndrome (MDS):

    (a) Either Refractory Anemia with Excess Blasts I or Refractory Anemia with Excess Blasts II (RAEB I or RAEB II)

  3. Karnofsky performance status ≥ 70
  4. Willing to participate as a research subject and sign an informed consent form
  5. Adequate physical function measured by:

    1. Cardiac: asymptomatic, or if symptomatic then Left Ventricular Ejection Fraction (LVEF) at rest must be ≥ 45% and must improve with exercise
    2. Hepatic: ≤3 x upper limit of normal (ULN) alanine aminotransferase (ALT) and ≤ 1.5 total serum bilirubin, unless liver is involved with the disease or there is congenital benign hyperbilirubinemia
    3. Renal: serum creatinine within normal range, or if serum creatinine is outside the normal range, then calculated creatinine clearance ≥ 60 ml/min
    4. Pulmonary: asymptomatic, or if symptomatic, diffusing capacity of the lungs for carbon monoxide (DLCO) ≥ 45% of predicted (corrected for hemoglobin)
  6. If subject has prior malignancy, must be without any evidence of disease of that prior malignancy for at least 2 years (excludes skin cancers that may have been excised within that 2 year period).

Exclusion Criteria:

  1. Serious active or uncontrolled infection or medical condition
  2. Women who are pregnant or breast feeding. Women of childbearing age must use adequate contraception and have a negative pregnancy test.
  3. Prior daunorubicin therapy with a cumulative dose of more than 368 mg/m2 or equivalent
  4. Other systemic anticancer therapy or ongoing clinically relevant toxicities from such therapy (at discretion of the investigator)
  5. History of and/or current evidence of myocardial impairment (e.g. cardiomyopathy, ischemic heart disease, significant valvular dysfunction, hypertensive heart disease, congestive heart failure), resulting in heart failure by New York Heart Association Class III or IV staging.
  6. Subjects with Wilson disease or other Copper-related disorders.

Sites / Locations

  • Weill Cornell Medical College

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CPX-351 Salvage Therapy and Transplant

Arm Description

Subjects will receive CPX-351 salvage chemotherapy on Day -21, -19, and -17 as a bridge to allogeneic stem cell transplantation using a Fludarabine/Melphalan/rATG conditioning regimen and a haplo-cord graft.

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Evaluated using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE)
Neutrophil Engraftment
Evaluate the time to neutrophil engraftment, defined as the first day in which absolute neutrophil count (ANC) >500/mm3 for three consecutive days
Overall Survival at Day 100, 6 months, and 1 year
Evaluate survival of subjects alive, with or without presence of disease, at the designated time points
Disease-Free Survival at Day 100, 6 months, and 1 year
Evaluate survival of subjects alive without disease at the designated time points

Secondary Outcome Measures

Non-Relapse Mortality
Death that cannot be explained by persistence, relapse, or progression of underlying disease
Relapse Rate
Time to first relapse or progression of underlying disease after initiation of protocol therapy

Full Information

First Posted
December 7, 2017
Last Updated
December 19, 2022
Sponsor
Weill Medical College of Cornell University
Collaborators
Jazz Pharmaceuticals
search

1. Study Identification

Unique Protocol Identification Number
NCT03393611
Brief Title
CPX-351 Salvage Therapy Followed by Haplo-Cord Transplant for Relapsed/Refractory Leukemia or Myelodysplastic Syndrome
Official Title
A Pilot Study of a Novel Sequential Treatment Utilizing CPX-351 as Salvage Chemotherapy Followed by Allogeneic Stem-Cell Transplantation (SCT) Utilizing a Haplo-cord Graft for Patients With Relapsed or Refractory Leukemia or Myelodysplastic Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
November 30, 2012 (Actual)
Primary Completion Date
August 30, 2021 (Actual)
Study Completion Date
November 18, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Weill Medical College of Cornell University
Collaborators
Jazz Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This pilot study is designed to evaluate outcomes with the combination of CPX-351 salvage therapy and haplo-cord graft stem cell transplantation for subjects with relapsed or refractory AML or myelodysplastic syndrome.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndromes, Leukemia, Myeloid, Acute, Leukemia, Relapsed Adult Acute Myeloid, Myelodysplastic Syndromes, Previously Treated

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CPX-351 Salvage Therapy and Transplant
Arm Type
Experimental
Arm Description
Subjects will receive CPX-351 salvage chemotherapy on Day -21, -19, and -17 as a bridge to allogeneic stem cell transplantation using a Fludarabine/Melphalan/rATG conditioning regimen and a haplo-cord graft.
Intervention Type
Drug
Intervention Name(s)
CPX-351
Other Intervention Name(s)
Cytarabine:Daunorubicin Liposome Injection
Intervention Description
Salvage Chemotherapy: CPX-351 at 120 u/m2 on Days -21, -19, and -17
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Other Intervention Name(s)
Fludara
Intervention Description
Fludarabine 150 mg/m2 (30 mg/m2/day x 5 days, Day -7 to Day -3)
Intervention Type
Drug
Intervention Name(s)
Melphalan
Other Intervention Name(s)
Alkeran
Intervention Description
Melphalan 140 mg/m2 (Day -2)
Intervention Type
Drug
Intervention Name(s)
Rabbit Anti-Human T-Lymphocyte Globulin
Other Intervention Name(s)
Thymoglobulin
Intervention Description
Rabbit ATG (rATG)-thymoglobulin 4.5 mg/kg (1.5 mg/kg/day x 3 days)
Intervention Type
Biological
Intervention Name(s)
Haplo-Cord Stem Cell Transplantation
Intervention Description
Allogeneic stem cell transplantation using a haploidentical donor and umbilical cord blood unit.
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Description
Evaluated using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE)
Time Frame
1 year
Title
Neutrophil Engraftment
Description
Evaluate the time to neutrophil engraftment, defined as the first day in which absolute neutrophil count (ANC) >500/mm3 for three consecutive days
Time Frame
100 days
Title
Overall Survival at Day 100, 6 months, and 1 year
Description
Evaluate survival of subjects alive, with or without presence of disease, at the designated time points
Time Frame
Day 100, 6 months, and 1 year post-transplant
Title
Disease-Free Survival at Day 100, 6 months, and 1 year
Description
Evaluate survival of subjects alive without disease at the designated time points
Time Frame
Day 100, 6 months, and 1 year post-transplant
Secondary Outcome Measure Information:
Title
Non-Relapse Mortality
Description
Death that cannot be explained by persistence, relapse, or progression of underlying disease
Time Frame
Day 100
Title
Relapse Rate
Description
Time to first relapse or progression of underlying disease after initiation of protocol therapy
Time Frame
Day 100, 6 months, 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject must have refractory or relapsed Acute Myeloid Leukemia (AML) according to previously established criteria: Primary induction failure (PIF) after ≥ 2 cycles of chemotherapy First relapse Relapse refractory to salvage chemotherapy Second or subsequent relapse Subjects with Myelodysplastic Syndrome (MDS): (a) Either Refractory Anemia with Excess Blasts I or Refractory Anemia with Excess Blasts II (RAEB I or RAEB II) Karnofsky performance status ≥ 70 Willing to participate as a research subject and sign an informed consent form Adequate physical function measured by: Cardiac: asymptomatic, or if symptomatic then Left Ventricular Ejection Fraction (LVEF) at rest must be ≥ 45% and must improve with exercise Hepatic: ≤3 x upper limit of normal (ULN) alanine aminotransferase (ALT) and ≤ 1.5 total serum bilirubin, unless liver is involved with the disease or there is congenital benign hyperbilirubinemia Renal: serum creatinine within normal range, or if serum creatinine is outside the normal range, then calculated creatinine clearance ≥ 60 ml/min Pulmonary: asymptomatic, or if symptomatic, diffusing capacity of the lungs for carbon monoxide (DLCO) ≥ 45% of predicted (corrected for hemoglobin) If subject has prior malignancy, must be without any evidence of disease of that prior malignancy for at least 2 years (excludes skin cancers that may have been excised within that 2 year period). Exclusion Criteria: Serious active or uncontrolled infection or medical condition Women who are pregnant or breast feeding. Women of childbearing age must use adequate contraception and have a negative pregnancy test. Prior daunorubicin therapy with a cumulative dose of more than 368 mg/m2 or equivalent Other systemic anticancer therapy or ongoing clinically relevant toxicities from such therapy (at discretion of the investigator) History of and/or current evidence of myocardial impairment (e.g. cardiomyopathy, ischemic heart disease, significant valvular dysfunction, hypertensive heart disease, congestive heart failure), resulting in heart failure by New York Heart Association Class III or IV staging. Subjects with Wilson disease or other Copper-related disorders.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sebastian Mayer, MD
Organizational Affiliation
Weill Medical College of Cornell University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Weill Cornell Medical College
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

Learn more about this trial

CPX-351 Salvage Therapy Followed by Haplo-Cord Transplant for Relapsed/Refractory Leukemia or Myelodysplastic Syndrome

We'll reach out to this number within 24 hrs