Evaluation of CPX-351 Monotherapy in Acute Myeloid Leukemia Secondary to Myeloproliferative Neoplasm (CPX-351 TA-SMP)
Acute Myeloid Leukemia, Myeloproliferative Syndrome
About this trial
This is an interventional treatment trial for Acute Myeloid Leukemia
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of newly secondary AML according to WHO 2016 classification following an antecedent of Myeloproliferative Neoplasm including Essential Thrombocythemia (ET), Polycythemia Vera (PV), primary or secondary Myelofibrosis
- Performance status 2 Eastern Cooperative Oncology Group (ECOG) grading.
- Eligible for standard intensive chemotherapy
- Absence of concomitant severe cardiovascular disease which would make intensive chemotherapy impossible, i.e. arrhythmias requiring chronic treatment, congestive heart failure or symptomatic ischemic heart disease, reduced left ventricular function assessed by multigated acquisition (MUGA) scan or echocardiogram. Cardiac ejection fraction ≥ 50% by echocardiography ou MUGA
Patient must have adequate organ function as indicated by the following laboratory values:
Renal
- Serum creatinine: < 2 mg/dl OR calculated creatinine clearance*: ≥ 30 mL/min by MDRD formula for patients with creatinine levels > 1.5 X institutional Upper Limit Normal (ULN)
Hepatic
- Serum total bilirubin: ≤ 2.5 X ULN OR direct bilirubin ≤ ULN for patients with total bilirubin levels ≥ 2 mg/dL unless Gilbert's Syndrome
- Aspartate-Amino-Transferase (ASAT) and Alanine-Transaminase (ALAT): ≤ 2.5 times ULN
- Alkaline Phosphatase: ≤ 5 X ULN, if > 2.5 X ULN, then liver fraction should be ≤ 2.5 X ULN *Creatinine clearance should be calculated per institutional standard
- Life expectancy should be of 12 weeks at least according to investigator evaluation
- Female patients of childbearing potential must have a negative serum pregnancy test (β-hCG) within 72 hours prior to receiving the first dose of CPX-351. Female patients who are not post-menopausal, free from menses for > 2 years or surgically sterilized, will have to use adequate barrier methods of contraception to prevent pregnancy or agree to abstain from becoming pregnant throughout the study, starting with Visit 1.
- Male patients agree to use an adequate method of contraception for the duration of the study. Men should be advised not to father a child while receiving CPX-351 and for 3 months post study.
- Patients have the ability to understand and willingness to sign an informed consent form indicating the investigational nature of the study.
Exclusion Criteria:
- MPN/MDS mixed types
- Prior therapy for AML transformation except for Hydroxyurea
- Prior treatment with growth factors such as erythropoietin alfa (EPO) or granulocyte colony-stimulating factor (G-CSF), low-dose oral chemotherapy or Hypomethylating agents chemotherapy given in the chronic phase of MPN in the 30 days before inclusion, except for hydroxyurea.
- Uncontrolled undercurrent illness or circumstances that could limit compliance with the study, including but not limited to the following: symptomatic congestive heart failure, unstable angina pectoris, uncontrolled cardiac arrhythmia, pancreatitis, or psychiatric or social conditions that may interfere with patient compliance.
- Active and uncontrolled infection
- Current participation or participation in a study with an investigational compound or device within 30 days of initial dosing with study drug
- Patients with acute promyelocytic leukemia.
- Known human immunodeficiency virus (HIV) infection or HIV-related malignancy
- Clinically active hepatitis B or hepatitis C infection.
- Known allergy or hypersensitivity to any component of CPX-351.
- Currently active second malignancy, other than non-melanoma skin cancer and in situ carcinoma of the cervix. Patients are not considered to have a "currently active" malignancy if they have completed therapy for a prior malignancy, are disease free from prior malignancies for >3 years or are considered by their physician to be at less than 30% risk of relapse
- Clinical evidence of Central Nervous System Leukemia.
- Pregnancy or breastfeeding during the projected duration of the study.
Sites / Locations
- AMIENS - CHU Amiens PicardieRecruiting
- ANGERS - CHU - Maladies du sangRecruiting
- AVIGNON - Centre HospitalierRecruiting
- BAYONNE - CH de la Côte Basque - HématologieRecruiting
- AVICENNE - Centre de Recherche Clinique
- BREST - Hôpital Morvan
- CAEN - CHU Caen - IHBN
- CLAMART - Hôpital d'Instruction des Armées de PercyRecruiting
- Clermont-Ferrand - Chu EstaingRecruiting
- CRETEIL - CHU Henri Mondor
- Grenoble - CHUGA - Hématologie CliniqueRecruiting
- LILLE CHU - Hôpital Claude HuriezRecruiting
- LIMOGES - CHU Dupuytren 1
- LYON-Centre Léon BérardRecruiting
- MARSEILLE - Institut Paoli-CalmettesRecruiting
- MONTPELLIER - Hôpital Saint-Eloi - Hématologie CliniqueRecruiting
- NANTES - Hôpital Hôtel Dieu - Hématologie CliniqueRecruiting
- NICE - Centre Antoine LacassagneRecruiting
- NICE - CHU - Hopital Archet 1Recruiting
- NIMES - CHU CaremeauRecruiting
- ORLEANS - CHR - HématologieRecruiting
- Paris St Antoine
- Paris Saint Louis
- BORDEAUX - Hôpital Haut-LevêqueRecruiting
- LYON HCL - CH Lyon SudRecruiting
- POITIERS - Hôpital La Milétrie - Hématologie Clinique
- REIMS - Hôpital Robert Debré - Hématologie CliniqueRecruiting
- RENNES - Hôpital Pontchaillou - Hématologie
- Strasbourg - IcansRecruiting
- Toulouse - IUCT Oncopole - Service d'HématologieRecruiting
- TOURS - Hôpital BretonneauRecruiting
- NANCY - CHU de Brabois
- VERSAILLES - Hôpital André Mignot
- Institut Gustave Roussy
Arms of the Study
Arm 1
Experimental
CPX351
Induction : patients will receive induction treatment with CPX-351 100 U/m2 on days 1, 3, and 5. Patients who fail to achieve CR/CRi after the induction cycle will be offered a second induction course of CPX-351 100 U/m2 on days 1 and 3, at the investigators' discretion. If CR/CRi is not achieved following the second induction cycle, patients will go off study Consolidation : patients in CR/CRi after induction cycle will receive up to 2 course of CONSOLIDATION therapy with CPX-351 65 U/m2 on days 1 and 3. CPX351 doses could be reduced to 65 U/m2 on day 1 in case of unacceptable toxicity following the previous course.