A Study of Crenolanib With Fludarabine and Cytarabine in Pediatric Patients With Relapsed/Refractory FLT3-Mutated Acute Myeloid Leukemia
Primary Purpose
Relapsed/Refractory FLT3-mutated AML
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Crenolanib
Fludarabine
Cytarabine
Sponsored by
About this trial
This is an interventional treatment trial for Relapsed/Refractory FLT3-mutated AML
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 1 years and ≤ 21 years
- Confirmed diagnosis of AML according to World Health Organization (WHO) 2016 classification
- Definitive evidence of a FLT3-ITD and/or FLT3-TKD (D835/I836) mutation at the time of enrollment
- Patients must have histologically or molecularly confirmed relapsed or refractory AML
- Karnofsky or Lansky performance score ≥ 50. Use Karnofsky for patients > 16 years old and Lansky for patients ≤ 16 years of age.
Adequate renal function, defined as:
- Creatinine clearance or radioisotope GFR ≥ 70 mL/min/1.73 m2 or
- Normal serum creatinine based on age/gender
Adequate liver function, defined as:
- Serum total bilirubin ≤ 1.5x ULN for age,
- Serum aspartate aminotransferase (AST) ≤ 3.0x ULN for age, and
- Serum alanine aminotransferase (ALT) ≤ 3.0x ULN for age.
Exclusion Criteria:
Patients with any of the following current or previous diagnoses:
- Acute promyelocytic leukemia (APL)
- Down syndrome
- DNA fragility or bone marrow failure syndromes (such as Fanconi anemia, Bloom syndrome, Kostmann syndrome, or Shwachman syndrome)
- AML secondary to prior MDS/MPN, including chronic myelomonocytic leukemia and juvenile myelomonocytic leukemia
- Blastic plasmacytoid dendritic cell neoplasm
- Acute leukemia of ambiguous lineage
- B-lymphoblastic leukemia/lymphoma
- T-lymphoblastic leukemia/lymphoma, including early T-cell precursor lymphoblastic leukemia (ETP-ALL)
- Patients who are refractory to first line (induction and re-induction) and a second line (1st salvage) treatment for AML.
- Patients who have received more than 1 prior allogeneic HSCT
- Patients will be excluded if they have a systemic fungal, bacterial, viral or other infection of which they exhibit ongoing signs/symptoms related to the infection without improvement despite appropriate antibiotics or other treatment.
- Patients will be excluded if there is a plan to administer non-protocol chemotherapy, radiation therapy, or immunotherapy during the study period.
- Known severe liver disease (e.g. cirrhosis, non-alcoholic steatohepatitis, sclerosing cholangitis or hyperbilirubinemia)
- Known, active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV)
- Currently receiving prophylactic treatment of hepatitis B with anti-viral therapy
- Known infection with human immunodeficiency virus (HIV)
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Crenolanib
Arm Description
Outcomes
Primary Outcome Measures
Number of patients experiencing ≥ Grade 3 adverse events as assessed by CTCAE v4.0
Number of patients experiencing Grade 4 adverse events related to crenolanib as assessed by CTCAE v4.0
Rate of early mortality
Number of patients who died within 60 days of start of therapy
Secondary Outcome Measures
Event-free survival (EFS)
EFS is defined as the time from the date of start of treatment to the date of failure to achieve a remission, relapse, or death from any cause.
Relapse-free survival (RFS)
RFS is defined as the time from the date of remission to date of relapse or death.
Overall survival (OS)
OS is defined as the time from the date of start of treatment until death.
Full Information
NCT ID
NCT03324243
First Posted
October 18, 2017
Last Updated
January 8, 2019
Sponsor
Arog Pharmaceuticals, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT03324243
Brief Title
A Study of Crenolanib With Fludarabine and Cytarabine in Pediatric Patients With Relapsed/Refractory FLT3-Mutated Acute Myeloid Leukemia
Official Title
A Phase II Study of Crenolanib With Fludarabine and Cytarabine in Pediatric Patients With Relapsed/Refractory FLT3-Mutated Acute Myeloid Leukemia
Study Type
Interventional
2. Study Status
Record Verification Date
January 2019
Overall Recruitment Status
Withdrawn
Why Stopped
Withdrawn: Study halted prior to enrollment of first participant
Study Start Date
January 2018 (Anticipated)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
December 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Arog Pharmaceuticals, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a phase II, multicenter, single-arm study to assess the safety and feasibility of combining crenolanib with fludarabine and cytarabine chemotherapy in pediatric patients with relapsed/refractory FLT3-mutated AML. Patients will receive up to two courses of salvage chemotherapy with fludarabine, cytarabine, and crenolanib. Response will be assessed between day 29-43 of each course.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed/Refractory FLT3-mutated AML
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Crenolanib
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Crenolanib
Other Intervention Name(s)
Crenolanib besylate
Intervention Description
66.7 mg/m2 three times a day (TID)
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Intervention Description
30 mg/m2/day, intravenous infusions over 30 mins.
Intervention Type
Drug
Intervention Name(s)
Cytarabine
Intervention Description
2000 mg/m2/day, intravenous infusions over 1-3 hours.
Primary Outcome Measure Information:
Title
Number of patients experiencing ≥ Grade 3 adverse events as assessed by CTCAE v4.0
Time Frame
From study entry to 30 days post-treatment
Title
Number of patients experiencing Grade 4 adverse events related to crenolanib as assessed by CTCAE v4.0
Time Frame
60 days
Title
Rate of early mortality
Description
Number of patients who died within 60 days of start of therapy
Time Frame
60 days
Secondary Outcome Measure Information:
Title
Event-free survival (EFS)
Description
EFS is defined as the time from the date of start of treatment to the date of failure to achieve a remission, relapse, or death from any cause.
Time Frame
4 years
Title
Relapse-free survival (RFS)
Description
RFS is defined as the time from the date of remission to date of relapse or death.
Time Frame
4 years
Title
Overall survival (OS)
Description
OS is defined as the time from the date of start of treatment until death.
Time Frame
4 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 1 years and ≤ 21 years
Confirmed diagnosis of AML according to World Health Organization (WHO) 2016 classification
Definitive evidence of a FLT3-ITD and/or FLT3-TKD (D835/I836) mutation at the time of enrollment
Patients must have histologically or molecularly confirmed relapsed or refractory AML
Karnofsky or Lansky performance score ≥ 50. Use Karnofsky for patients > 16 years old and Lansky for patients ≤ 16 years of age.
Adequate renal function, defined as:
Creatinine clearance or radioisotope GFR ≥ 70 mL/min/1.73 m2 or
Normal serum creatinine based on age/gender
Adequate liver function, defined as:
Serum total bilirubin ≤ 1.5x ULN for age,
Serum aspartate aminotransferase (AST) ≤ 3.0x ULN for age, and
Serum alanine aminotransferase (ALT) ≤ 3.0x ULN for age.
Exclusion Criteria:
Patients with any of the following current or previous diagnoses:
Acute promyelocytic leukemia (APL)
Down syndrome
DNA fragility or bone marrow failure syndromes (such as Fanconi anemia, Bloom syndrome, Kostmann syndrome, or Shwachman syndrome)
AML secondary to prior MDS/MPN, including chronic myelomonocytic leukemia and juvenile myelomonocytic leukemia
Blastic plasmacytoid dendritic cell neoplasm
Acute leukemia of ambiguous lineage
B-lymphoblastic leukemia/lymphoma
T-lymphoblastic leukemia/lymphoma, including early T-cell precursor lymphoblastic leukemia (ETP-ALL)
Patients who are refractory to first line (induction and re-induction) and a second line (1st salvage) treatment for AML.
Patients who have received more than 1 prior allogeneic HSCT
Patients will be excluded if they have a systemic fungal, bacterial, viral or other infection of which they exhibit ongoing signs/symptoms related to the infection without improvement despite appropriate antibiotics or other treatment.
Patients will be excluded if there is a plan to administer non-protocol chemotherapy, radiation therapy, or immunotherapy during the study period.
Known severe liver disease (e.g. cirrhosis, non-alcoholic steatohepatitis, sclerosing cholangitis or hyperbilirubinemia)
Known, active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV)
Currently receiving prophylactic treatment of hepatitis B with anti-viral therapy
Known infection with human immunodeficiency virus (HIV)
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Study of Crenolanib With Fludarabine and Cytarabine in Pediatric Patients With Relapsed/Refractory FLT3-Mutated Acute Myeloid Leukemia
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