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Advancing Chemical and Genomic Strategies for Relapsed/Refractory T-ALL and ETP-ALL

Primary Purpose

T Acute Lymphoblastic Leukemia, Early T Acute Lymphoblastic Leukemia, T-lymphoblastic Lymphoma

Status
Recruiting
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
bone marrow and/or peripheral blood samples withdrawal
Sponsored by
Gruppo Italiano Malattie EMatologiche dell'Adulto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for T Acute Lymphoblastic Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Patients to be enrolled in this study must have T-cell ALL or T-cell lymphoblastic lymphoma (LL) in the first relapse or must have failed primary induction chemotherapy (i.e., never attained a complete remission following an initial course of standard therapy for T-ALL/LBL or have a diagnosis of ETP-ALL [T-ALL with the following phenotype: Negative: CD1a-, CD8-, CD4-, CD5 (less than 75% of blasts); CD13+, CD33+, CD34+, CD117+, HLA-DR+, CD11b+, and/or CD65+ -in at least 25% of lymphoblasts
  • Ages Eligible for Study: over 18 years
  • Patients with T-ALL/LBL must have greater than 5% blasts in the bone marrow with or without extramedullary disease
  • Patients with T-ALL/LBL must have recurrent disease, documented by clinical or radiographic criteria, as well as histologic verification of the malignancy at original diagnosis
  • Patients may have CNS 1 (WBC count in CSF <5 and having no blasts) or CNS 2 (WBC count in CSF <5 and having blasts) disease but not CNS 3 (WBC count in CSF ≥5 and having blasts)
  • ECOG 0-2 or Karnofsky ≥ 50%
  • Patients may be enrolled on study regardless of the timing of prior Intrathecal therapy; however, they may not begin treatment on this protocol until a minimum of 7 days has elapsed since prior intrathecal therapy
  • Adequate renal function defined as serum creatinine ≤ 1.5x upper limit of normal (ULN) for age. If the serum creatinine is above these values, the calculated creatinine clearance or radioisotope GFR must be ≥ 70 mL/min/1.73m2
  • Total bilirubin ≤ 1.5x ULN for age. If the total bilirubin is elevated, patient will still be eligible if the conjugated (direct) serum bilirubin ≤ ULN for age
  • ALT ≤ 5x ULN of normal for age
  • Adequate cardiac function defined as shortening fraction of ≥ 27% by echocardiogram or ejection fraction ≥ 45% by gated radionuclide study
  • No evidence of dyspnea at rest
  • No exercise intolerance
  • A pulse oximetry ≥ 94% at sea level (≥ 90% at altitude ≥ 5000 feet) if there is clinical indication for determination
  • Patients must be capable of understanding the investigational nature, potential risks and benefits of the study. All patients must sign a written informed consent

Exclusion Criteria:

  • Significant organ compromise that will increase risk of toxicity or mortality
  • Active serious infection not controlled by oral or intravenous antibiotics
  • Active secondary malignancy other than skin cancer (e.g., basal cell carcinoma or squamous cell carcinoma) that in the investigator's opinion will shorten survival to less than 1 year
  • Known hepatitis B or C infection, or known seropositivity for human immunodeficiency virus (HIV)
  • Active grade III-V cardiac failure as defined by the New York Heart Association Criteria
  • Patients with a cardiac ejection fraction (as measured by either multigated acquisition [MUGA] or echocardiogram) < 40%

Sites / Locations

  • Aou Ospedali Riuniti "Umberto I - G.M. Lancisi - G. Salesi"- Ancona - Sod Clinica EmatologicaRecruiting
  • Asst Papa Giovanni Xxiii - Ospedale Di Bergamo - Sc EmatologiaRecruiting
  • Aou Di Bologna - Policlinico S. Orsola-Malpighi - Uoc EmatologiaRecruiting
  • Asst Degli Spedali Civili Di Brescia - Uo EmatologiaRecruiting
  • Asl Lecce, Ospedale 'V. Fazzi' - Uo EmatologiaRecruiting
  • Aulss 3 Serenissima, Ospedale Dell'Angelo - Mestre - Uo EmatologiaRecruiting
  • Ematologia ed Immunologia ClinicaRecruiting
  • Fondazione Policlinico Universitario Agostino Gemelli Irccs - Roma - Area EmatologicaRecruiting
  • Aou Senese - Uoc Ematologia E TrapiantiRecruiting
  • Aulss 8 Berica - Ospedale Di Vicenza - Uoc EmatologiaRecruiting

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Biological evaluation

Arm Description

A combined approach of Drug Sensitivity and Resistance Profiling (DSRP) and molecular-cytogenetic findings is used in order to prioritize compounds for tailored therapies.

Outcomes

Primary Outcome Measures

Drug sensitivity profile
Frequencies of alternative therapies identified for T-ALL patients

Secondary Outcome Measures

Full Information

First Posted
September 24, 2020
Last Updated
November 24, 2022
Sponsor
Gruppo Italiano Malattie EMatologiche dell'Adulto
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1. Study Identification

Unique Protocol Identification Number
NCT04582487
Brief Title
Advancing Chemical and Genomic Strategies for Relapsed/Refractory T-ALL and ETP-ALL
Official Title
Advancing Chemical and Genomic Strategies for Relapsed/Refractory T-ALL and ETP-ALL
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 19, 2021 (Actual)
Primary Completion Date
May 2024 (Anticipated)
Study Completion Date
May 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gruppo Italiano Malattie EMatologiche dell'Adulto

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a biological study for R/R T-ALL/LBL or ETP-ALL patients. Bone marrow and/or peripheral blood samples will be subjected to genomic, DSRP profiling and phosphoproteomic screening to identify novel potential therapeutic approach and thus, eligibility for treatment based on molecular and DSRP data. As soon as genomic and DSRP profiling are made available, local Investigator can submit to local ethic committee a request for clinical use of identified compound.
Detailed Description
This is a biological study for R/R T-ALL/LBL or ETP-ALL patients. Bone marrow and/or peripheral blood samples will be subjected to genomic, DSRP profiling and phosphoproteomic screening to identify novel potential therapeutic approach and thus, eligibility for treatment based on molecular and DSRP data. Genomic studies include karyotyping, CI-FISH and sequencing of 72 selected genes recurrently involved in T-ALL (by NGS). A panel of 80 compounds has been choosen for DSRP profile. As soon as genomic and DSRP profiling are made available, local Investigator can submit to local ethic committee a request for clinical use of compound hits. Meanwhile, in case of leukocytosis and uncontrolled disease, patients will be treated with cytoreductive therapies and best supportive care according to guidelines and scientific consensus. Every patient will receive a molecularly and functionally informed therapy following the therapeutic schedule already defined by in other tumors. Treatment will be selected on the basis of integration of genomic and small response data.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
T Acute Lymphoblastic Leukemia, Early T Acute Lymphoblastic Leukemia, T-lymphoblastic Lymphoma, Etp All

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Biological evaluation
Arm Type
Other
Arm Description
A combined approach of Drug Sensitivity and Resistance Profiling (DSRP) and molecular-cytogenetic findings is used in order to prioritize compounds for tailored therapies.
Intervention Type
Other
Intervention Name(s)
bone marrow and/or peripheral blood samples withdrawal
Intervention Description
bone marrow and/or peripheral blood samples evaluation
Primary Outcome Measure Information:
Title
Drug sensitivity profile
Description
Frequencies of alternative therapies identified for T-ALL patients
Time Frame
baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients to be enrolled in this study must have T-cell ALL or T-cell lymphoblastic lymphoma (LL) in the first relapse or must have failed primary induction chemotherapy (i.e., never attained a complete remission following an initial course of standard therapy for T-ALL/LBL or have a diagnosis of ETP-ALL [T-ALL with the following phenotype: Negative: CD1a-, CD8-, CD4-, CD5 (less than 75% of blasts); CD13+, CD33+, CD34+, CD117+, HLA-DR+, CD11b+, and/or CD65+ -in at least 25% of lymphoblasts Ages Eligible for Study: over 18 years Patients with T-ALL/LBL must have greater than 5% blasts in the bone marrow with or without extramedullary disease Patients with T-ALL/LBL must have recurrent disease, documented by clinical or radiographic criteria, as well as histologic verification of the malignancy at original diagnosis Patients may have CNS 1 (WBC count in CSF <5 and having no blasts) or CNS 2 (WBC count in CSF <5 and having blasts) disease but not CNS 3 (WBC count in CSF ≥5 and having blasts) ECOG 0-2 or Karnofsky ≥ 50% Patients may be enrolled on study regardless of the timing of prior Intrathecal therapy; however, they may not begin treatment on this protocol until a minimum of 7 days has elapsed since prior intrathecal therapy Adequate renal function defined as serum creatinine ≤ 1.5x upper limit of normal (ULN) for age. If the serum creatinine is above these values, the calculated creatinine clearance or radioisotope GFR must be ≥ 70 mL/min/1.73m2 Total bilirubin ≤ 1.5x ULN for age. If the total bilirubin is elevated, patient will still be eligible if the conjugated (direct) serum bilirubin ≤ ULN for age ALT ≤ 5x ULN of normal for age Adequate cardiac function defined as shortening fraction of ≥ 27% by echocardiogram or ejection fraction ≥ 45% by gated radionuclide study No evidence of dyspnea at rest No exercise intolerance A pulse oximetry ≥ 94% at sea level (≥ 90% at altitude ≥ 5000 feet) if there is clinical indication for determination Patients must be capable of understanding the investigational nature, potential risks and benefits of the study. All patients must sign a written informed consent Exclusion Criteria: Significant organ compromise that will increase risk of toxicity or mortality Active serious infection not controlled by oral or intravenous antibiotics Active secondary malignancy other than skin cancer (e.g., basal cell carcinoma or squamous cell carcinoma) that in the investigator's opinion will shorten survival to less than 1 year Known hepatitis B or C infection, or known seropositivity for human immunodeficiency virus (HIV) Active grade III-V cardiac failure as defined by the New York Heart Association Criteria Patients with a cardiac ejection fraction (as measured by either multigated acquisition [MUGA] or echocardiogram) < 40%
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Paola Fazi
Phone
0670390528
Email
p.fazi@gimema.it
First Name & Middle Initial & Last Name or Official Title & Degree
Enrico Crea
Phone
0670390514
Email
e.crea@gimema.it
Facility Information:
Facility Name
Aou Ospedali Riuniti "Umberto I - G.M. Lancisi - G. Salesi"- Ancona - Sod Clinica Ematologica
City
Ancona
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Attilio Olivieri
Phone
3289558821
Email
a.olivieri@univpm.it
Facility Name
Asst Papa Giovanni Xxiii - Ospedale Di Bergamo - Sc Ematologia
City
Bergamo
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alessandro Rambaldi
Phone
3484526901
Email
arambaldi@asst-pg23.it
Facility Name
Aou Di Bologna - Policlinico S. Orsola-Malpighi - Uoc Ematologia
City
Bologna
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cristina Papayannidis
Phone
3496484441
Email
cristina.papayannidis@unibo.it
Facility Name
Asst Degli Spedali Civili Di Brescia - Uo Ematologia
City
Brescia
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Erika Borlenghi
Phone
3402526539
Email
erika.borlenghi@gmail.com
Facility Name
Asl Lecce, Ospedale 'V. Fazzi' - Uo Ematologia
City
Lecce
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nicola Di Renzo
Phone
3388178577
Email
direnzo.ematolecce@gmail.com
Facility Name
Aulss 3 Serenissima, Ospedale Dell'Angelo - Mestre - Uo Ematologia
City
Mestre
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Renato Bassan
Email
Renato.Bassan@aulss3.veneto.it
Facility Name
Ematologia ed Immunologia Clinica
City
Perugia
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cristina Mecucci
Email
cristina.mecucci@unipg.it
First Name & Middle Initial & Last Name & Degree
Roberta La Starza
Facility Name
Fondazione Policlinico Universitario Agostino Gemelli Irccs - Roma - Area Ematologica
City
Roma
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Simona Sica
Phone
3355952379
Email
simona.sica@Unicatt.it
Facility Name
Aou Senese - Uoc Ematologia E Trapianti
City
Siena
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Monica Bocchia
Phone
3495792804
Email
bocchia@unisi.it
Facility Name
Aulss 8 Berica - Ospedale Di Vicenza - Uoc Ematologia
City
Vicenza
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Albana Lico
Email
albana.lico@aulss8.veneto.it

12. IPD Sharing Statement

Learn more about this trial

Advancing Chemical and Genomic Strategies for Relapsed/Refractory T-ALL and ETP-ALL

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