CPX-351 as a Novel Approach for the Treatment of Older Patients With AML and MDS
Primary Purpose
Refractory Acute Myeloid Leukemia, Relapsed Acute Myelomonocytic Leukemia, Myelodysplastic Syndromes
Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CPX-351
Sponsored by
About this trial
This is an interventional treatment trial for Refractory Acute Myeloid Leukemia
Eligibility Criteria
Inclusion Criteria:
Primary refractory or relapsed AML (defined by 2016 World Health Organization [WHO] criteria) patients who are not suitable for or not willing to receive intensive chemotherapy as evaluated by the treating physician. Primary refractory disease is defined as:
- Failure to achieve a CR, CRi, or mLFS (defined as <5% Bone Marrow (BM) blasts) after receiving 1 or 2 cycles of remission induction chemotherapy.
- Failure to achieve a CR, CRi, or MLFS (defined as <5% BM blasts) after receiving 4 cycles of non-intensive chemotherapy or whose disease progressed at any time point during the treatment.
- Participants with MDS (according to 2016 WHO criteria) who did not respond to treatment with azacitidine, decitabine, or combination of HMA with another drug or lost their response to initial therapy with HMA.
- Eastern Cooperative Oncology Group (ECOG) performance status <=2
- Adequate hepatic (serum total bilirubin < 1.5 x ULN, Serum glutamic pyruvic transaminase (SGPT) and/or serum glutamate oxaloacetate transaminase (SGOT) <2.5 x ULN) and renal function (creatinine < 1.5mg/dL).
- Participants must be willing and able to review, understand, and provide written consent before starting therapy.
Exclusion Criteria:
- Active signs or symptoms of central nervous system (CNS) involvement by malignancy (lumbar puncture [LP] not required).
- Prior 7+3 remission induction chemotherapy for MDS or AML
- More than 2 lines of prior non-intensive therapy.
- New York Heart Association (NYHA) class III or IV heart disease, active ischemia or any other uncontrolled cardiac condition such as angina pectoris, clinically significant cardiac arrhythmia on rhythm control strategy or on pacemaker, uncontrolled hypertension (blood pressure > 160 systolic and > 110 diastolic not responsive to antihypertensive medication)
- Acute myocardial infarction in the previous 12 weeks (from the start of treatment).
- Any serious medical condition, laboratory abnormality, or psychiatric illness that, in the view of the treating physician, would place the participant at an unacceptable risk if he or she were to participate in the study or would prevent that person from giving informed consent.
- Any active malignancy (unrelated, non-hematological malignancy) diagnosed within the past 6 months of starting the study drug (other than curatively treated carcinoma-in-situ of the cervix or non-melanoma skin cancer).
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to CPX-351.
- Subjects with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, uncontrolled cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- Known history of HIV or active hepatitis B or C.
- No major surgery within 2 weeks prior to study enrollment.
- Pregnant or breast feeding
- Male and female participants who are fertile who do not agree to use an effective barrier methods of birth control (i.e. abstinence) to avoid pregnancy while receiving study treatment and for 30 days after last dose of study treatment. Non-childbearing is defined as > 1 year postmenopausal or surgically sterilized.
- Acute promyelocytic leukemia (APL)
Sites / Locations
- Cleveland Clinic, Case Comprehensive Cancer Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Primary refractory/relapsed AML
MDS after HMA failure
Arm Description
Lower dose CPX-351 in participants with primary refractory/relapsed AML. Participants will receive an induction and maintenance phase of CPX-351
Lower dose CPX-351 in participants with MDS after HMA failure. Participants will receive an induction and maintenance phase of CPX-351
Outcomes
Primary Outcome Measures
Overall response rate (ORR) per 2003 International Working Group (IWG) criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Overall response rate (ORR) per 2003 IWG criteria
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Secondary Outcome Measures
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time to response (TTR)
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Duration of response (DOR)
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Event-free survival (EFS)
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Overall Survival (OS)
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Full Information
NCT ID
NCT04668885
First Posted
December 9, 2020
Last Updated
November 8, 2022
Sponsor
Case Comprehensive Cancer Center
1. Study Identification
Unique Protocol Identification Number
NCT04668885
Brief Title
CPX-351 as a Novel Approach for the Treatment of Older Patients With AML and MDS
Official Title
Lower Doses of CPX-351 as a Novel Approach for the Treatment of Older Patients With Relapsed or Refractory Acute Myeloid Leukemia and Myelodysplastic Syndromes
Study Type
Interventional
2. Study Status
Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 14, 2021 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Case Comprehensive Cancer Center
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
The purpose of this study is to evaluate how effective lower doses of CPX-351 are in older participants with relapsed/refractory acute myeloid leukemia (AML) who are not eligible to receive intensive chemotherapy and in participants with myelodysplastic syndromes (MDS) after Hypomethylating Agents (HMA) failure.
Detailed Description
Currently, elderly patients with AML and high risk MDS, who are ineligible to receive induction chemotherapy and fail HMA +/- combination, have very poor outcomes and there is no FDA-approved therapy outside of some targeted therapies which can only be applied to a small patient population. CPX-351 is an investigational (experimental) drug that works by combining two anti-cancer drugs cytarabine and daunorubicin. CPX-351 is experimental because it is only FDA approved for the treatment of adults with two types of AML: newly diagnosed therapy-related AML or AML with myelodysplasia-related changes.
This is an open label clinical trial of lower doses of CPX-351 in relapsed/primary refractory older AML and MDS patients ineligible to receive intensive chemotherapy. The first arm is for particpants with primary refractory/relapsed AML and the second arm is for higher risk MDS participants after HMA failure.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Refractory Acute Myeloid Leukemia, Relapsed Acute Myelomonocytic Leukemia, Myelodysplastic Syndromes
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
13 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Primary refractory/relapsed AML
Arm Type
Experimental
Arm Description
Lower dose CPX-351 in participants with primary refractory/relapsed AML. Participants will receive an induction and maintenance phase of CPX-351
Arm Title
MDS after HMA failure
Arm Type
Experimental
Arm Description
Lower dose CPX-351 in participants with MDS after HMA failure. Participants will receive an induction and maintenance phase of CPX-351
Intervention Type
Drug
Intervention Name(s)
CPX-351
Intervention Description
Induction phase: CPX-351 15 mg/m^2 on days 1 and 3 of each 28-day cycle for up to a total of 6 cycles in the absence of unacceptable toxicity
Maintenance phase: CPX-351 7.5 mg/m^2 on days 1 and 3 for two cycles alternating with 15 mg/m^2 for one cycle. Participants may receive up to 12 cycles of maintenance phase in the absence of unacceptable toxicity.
Primary Outcome Measure Information:
Title
Overall response rate (ORR) per 2003 International Working Group (IWG) criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 6 months
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 1 year
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 1.5 years
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 2 years
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 2.5 years
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 3 years
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 3.5 years
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 4 years
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 4.5 years
Title
Overall response rate (ORR) per 2003 IWG criteria
Description
ORR = complete response (CR) + CR with incomplete blood count recovery (CRi) + partial remission (PR) as defined by 2003 IWG criteria for AML patients, and ORR = CR + PR + hematologic improvement (HI) and as defined per 2006 IWG criteria for MDS patients
Time Frame
At 5 years
Secondary Outcome Measure Information:
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 6 months
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 1 year
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 1.5 years
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 2 years
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 2.5 years
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 3 years
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 3.5 years
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 4 years
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 4.5 years
Title
Time to response (TTR)
Description
TTR is measured from start of treatment to the date of achieving a response. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 5 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 6 months
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 1 year
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 1.5 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 2 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 2.5 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 3 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 3.5 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 4 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 4.5 years
Title
Duration of response (DOR)
Description
DOR measured from the time of achieving a response to time of disease progression. Wilcoxon rank test will be used for comparison of continuous variables.
Time Frame
At 5 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 6 months
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 1 year
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 1.5 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 2 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 2.5 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 3 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 3.5 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 4 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 4.5 years
Title
Event-free survival (EFS)
Description
EFS measured from date of first dose to the date of treatment failure, relapse, or death from any cause. Wilcoxon rank test will be used for comparison of continuous variables
Time Frame
At 5 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 6 months
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 1 year
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 1.5 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 2 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 2.5 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 3 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 3.5 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 4 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 4.5 years
Title
Overall Survival (OS)
Description
OS measured from start of treatment to death or last follow up. OS function will be estimated using the Kaplan-Meier method
Time Frame
At 5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Primary refractory or relapsed AML (defined by 2016 World Health Organization [WHO] criteria) patients who are not suitable for or not willing to receive intensive chemotherapy as evaluated by the treating physician. Primary refractory disease is defined as:
Failure to achieve a CR, CRi, or mLFS (defined as <5% Bone Marrow (BM) blasts) after receiving 1 or 2 cycles of remission induction chemotherapy.
Failure to achieve a CR, CRi, or MLFS (defined as <5% BM blasts) after receiving 4 cycles of non-intensive chemotherapy or whose disease progressed at any time point during the treatment.
Participants with MDS (according to 2016 WHO criteria) who did not respond to treatment with azacitidine, decitabine, or combination of HMA with another drug or lost their response to initial therapy with HMA.
Eastern Cooperative Oncology Group (ECOG) performance status <=2
Adequate hepatic (serum total bilirubin < 1.5 x ULN, Serum glutamic pyruvic transaminase (SGPT) and/or serum glutamate oxaloacetate transaminase (SGOT) <2.5 x ULN) and renal function (creatinine < 1.5mg/dL).
Participants must be willing and able to review, understand, and provide written consent before starting therapy.
Exclusion Criteria:
Active signs or symptoms of central nervous system (CNS) involvement by malignancy (lumbar puncture [LP] not required).
Prior 7+3 remission induction chemotherapy for MDS or AML
More than 2 lines of prior non-intensive therapy.
New York Heart Association (NYHA) class III or IV heart disease, active ischemia or any other uncontrolled cardiac condition such as angina pectoris, clinically significant cardiac arrhythmia on rhythm control strategy or on pacemaker, uncontrolled hypertension (blood pressure > 160 systolic and > 110 diastolic not responsive to antihypertensive medication)
Acute myocardial infarction in the previous 12 weeks (from the start of treatment).
Any serious medical condition, laboratory abnormality, or psychiatric illness that, in the view of the treating physician, would place the participant at an unacceptable risk if he or she were to participate in the study or would prevent that person from giving informed consent.
Any active malignancy (unrelated, non-hematological malignancy) diagnosed within the past 6 months of starting the study drug (other than curatively treated carcinoma-in-situ of the cervix or non-melanoma skin cancer).
History of allergic reactions attributed to compounds of similar chemical or biologic composition to CPX-351.
Subjects with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, uncontrolled cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Known history of HIV or active hepatitis B or C.
No major surgery within 2 weeks prior to study enrollment.
Pregnant or breast feeding
Male and female participants who are fertile who do not agree to use an effective barrier methods of birth control (i.e. abstinence) to avoid pregnancy while receiving study treatment and for 30 days after last dose of study treatment. Non-childbearing is defined as > 1 year postmenopausal or surgically sterilized.
Acute promyelocytic leukemia (APL)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sudipto Mukherjee, MD, PhD
Organizational Affiliation
Cleveland Clinic, Case Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cleveland Clinic, Case Comprehensive Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106-5065
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
There are no plans to share individual patient data in order to protect the confidentiality of the participants who enroll on this study
Learn more about this trial
CPX-351 as a Novel Approach for the Treatment of Older Patients With AML and MDS
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