Aezea® (Cenersen) and Chemotherapy for AML Subjects ≥ 55 Years of Age With No Response to Frontline Induction Course
Primary Purpose
Acute Myelogenous Leukemia
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
cenersen
placebo
idarubicin, cytarabine
Sponsored by
About this trial
This is an interventional treatment trial for Acute Myelogenous Leukemia focused on measuring Oligonucleotides, Antisense, Tumor Suppressor Protein p53, idarubicin, cytarabine
Eligibility Criteria
Inclusion Criteria:
- In response to their first course of frontline treatment, patients who did not achieve a response (CR, CRi, or PR) and have ≥ 15% bone marrow blasts in a BM specimen between day 14 - 42 from the initiation of a single frontline course. If within that timeframe the BM is hypoplastic, the BM assessment can be repeated within a subsequent two-week period and the patient entered into the study if there is ≥ 15% blasts in the bone marrow.
- ≥ 55 years old
- Have an understanding of the importance of not taking paracetamol (acetaminophen) or high dose antioxidants from 1 day before through 1 day after treatment during any given course
- Have a life expectancy of more than 4 weeks following initiation of treatment
- Secondary AML is allowed as are antecedent hematologic disorders
- Zubrod performance status ≤ 2
- Have recovered from acute toxicities of prior chemotherapy (≤ Grade 2)
- Have signed an informed consent
- Total bilirubin ≤ 1.5 x upper normal limit (UNL) and Alanine Amino Transferase [ALT (Serum Glutamic-pyruvic Transaminase (SGPT))] ≤ 2.5 x UNL
- Creatinine ≤ 1.5 x UNL
- Serum magnesium should be within the normal range (Mg replacement being acceptable)
- Left Ventricular Ejection Fraction (LVEF) of >50% as determined by multiple-gated acquisition scan (MUGA) or Echocardiogram (ECHO)
- Ability to receive all courses of therapy, as outlined in the treatment schedules at the investigative site
- Willingness to comply with scheduled follow-up as required by the protocol
- Use of adequate contraceptive techniques if premenopausal and sexually active; examples include implantable, injectable or oral contraceptives, intrauterine devices (IUD), sterilization, or sexual abstinence
- If premenopausal, have negative pregnancy tests at screening
Exclusion Criteria:
- Presence of any pneumonia regardless of severity or other life-threatening illness including, but not limited to, ongoing infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, high blood pressure, history of labile hypertension, history of poor compliance with an antihypertensive regimen, myocardial infarction less than or equal to 6 months prior to registration, diabetes, or extensive and symptomatic interstitial fibrosis of lung, chronic liver disease or psychiatric illness/social situations that limits compliance with study requirements
- Acute promyelocytic leukemia (APL [FAB classification M3])
- Requirement for transplant before Course 2 is complete
- Concurrent use of other experimental agents (i.e., drugs not approved for clinical indications) or having received other investigational agents within the 30 days prior to the start of Course 1
- Pregnancy (includes a positive pregnancy test at the screening visit) or lactation
- Known HIV infection
- Active hepatitis B or C or other active liver disease
- Presence of dyspnea at rest or with minimal exertion after correction for anemia
- Known or suspected hypersensitivity or allergy to idarubicin or ara-C
- Occurrence of major surgery within two weeks of the start of Course 1
- Chemotherapy within two weeks prior to initiation of therapy under this protocol, or hydroxyurea within 7 days
- Patients who, with appropriate explanation, are not prepared to exclude the use of paracetamol (acetaminophen) or paracetamol-containing medications from 1 day before through 1 day after treatment during any course
- Patients who are not prepared to commit to the exclusion of high dose antioxidants from 1 day before through 1 day after treatment during any given course
- Medical or psychiatric conditions that compromise the ability to give informed consent, to comply with the protocol or to complete the study
- Inability, in the opinion of the principal investigator or clinical staff, to comply with protocol requirements for the duration of the study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
cenersen, idarubicin, cytarabine
placebo, idarubicin, cytarabine
Arm Description
cenersen, idarubicin, cytarabine
placebo, idarubicin, cytarabine
Outcomes
Primary Outcome Measures
Complete Remission Rate
Secondary Outcome Measures
Overall Survival
Safety Profile
Complete Remission + Complete Remission with Incomplete Blood Count Recovery Rate
Morphologic Leukemia-Free State Rate
Partial Remission Rate
Remission Duration
Early deaths measured as deaths at 30, 60 and 90 days of the start of treatment
Time to Neutrophil and Platelet Recovery
Death in Complete Remission
Zubrod Score
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00967512
Brief Title
Aezea® (Cenersen) and Chemotherapy for AML Subjects ≥ 55 Years of Age With No Response to Frontline Induction Course
Official Title
Aezea (Cenersen) in Combination With Chemotherapy for Treatment of Acute Myelogenous Leukemia Subjects ≥55 Years of Age With No Response to Single Frontline Induction Course in a Randomized Double-Blind Placebo-Controlled Multi-Center Study
Study Type
Interventional
2. Study Status
Record Verification Date
September 2014
Overall Recruitment Status
Withdrawn
Why Stopped
Study Was Terminated due to lack of Funding.
Study Start Date
January 2012 (undefined)
Primary Completion Date
January 2012 (Anticipated)
Study Completion Date
January 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eleos, Inc.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to assess whether treatment with cenersen in combination with 4 cycles of high and low-dose chemotherapy (idarubicin and cytarabine) improves the complete response rate in acute myelogenous leukemia (AML) patients ≥ 55 years of age who did not show a response (CR, CRi, or PR) to a single aggressive frontline induction course.
Detailed Description
Cenersen is a phosphorothioate antisense oligonucleotide of sequence 5'-CCCTG5-CTCCC10-CCCTG15-GCTCC20-3'. For AML, cenersen is specific for blocking p53 expression in the stem cells. When AML stem cells are dividing, cenersen sensitizes them to even low-level DNA damage of the type caused by idarubicin, etoposide and possibly ara-C.
Because AML stem cells are not all dividing at any given time, this protocol is designed to treat patients with a total of four cycles of cenersen plus chemotherapy within a two to three month period. For a limited period of time, proliferating non-stem cells can be expected to maintain or even expand the tumor while the stem cells are being depleted. If the proliferating non-stem cells are not resupplied by the stem cells, they will all become end stage blasts after a few divisions and undergo elimination.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myelogenous Leukemia
Keywords
Oligonucleotides, Antisense, Tumor Suppressor Protein p53, idarubicin, cytarabine
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
cenersen, idarubicin, cytarabine
Arm Type
Experimental
Arm Description
cenersen, idarubicin, cytarabine
Arm Title
placebo, idarubicin, cytarabine
Arm Type
Placebo Comparator
Arm Description
placebo, idarubicin, cytarabine
Intervention Type
Drug
Intervention Name(s)
cenersen
Other Intervention Name(s)
Aezea®, cenersen sodium, EL625
Intervention Description
solution for injection, intravenous infusion, 0.1 mg/kg/h x 24h x 4 days, and 0.4 mg/kg/h x 3h x 4 days
Intervention Type
Drug
Intervention Name(s)
placebo
Other Intervention Name(s)
saline
Intervention Description
solution for injection, intravenous infusion, 0.1 mg/kg/h x 24h x 4 days, and 0.4 mg/kg/h x 3h x 4 days
Intervention Type
Drug
Intervention Name(s)
idarubicin, cytarabine
Other Intervention Name(s)
idamycin, Ara-C
Intervention Description
idarubicin, cytarabine
Primary Outcome Measure Information:
Title
Complete Remission Rate
Time Frame
within day 28-42 of Course 1, and within day 28-42 of Course 2
Secondary Outcome Measure Information:
Title
Overall Survival
Time Frame
2 years
Title
Safety Profile
Time Frame
up to 2 years
Title
Complete Remission + Complete Remission with Incomplete Blood Count Recovery Rate
Time Frame
within day 28-42 of Course 1, and within day 28-42 of Course 2
Title
Morphologic Leukemia-Free State Rate
Time Frame
within day 28-42 of Course 1, and within day 28-42 of Course 2
Title
Partial Remission Rate
Time Frame
within day 28-42 of Course 1, and within day 28-42 of Course 2
Title
Remission Duration
Time Frame
2 years
Title
Early deaths measured as deaths at 30, 60 and 90 days of the start of treatment
Time Frame
30, 90, and 90 days from start of treatment
Title
Time to Neutrophil and Platelet Recovery
Time Frame
within day 28-42 of Course 1, and within day 28-42 of Course 2
Title
Death in Complete Remission
Time Frame
2 years
Title
Zubrod Score
Time Frame
during Frontline Assessment (screening); Course 1: on days 6, 15, 18, and within day 28-42; Course 2: on days 1, 7, 15, 18, and within day 28-42; Course 3: on days 1 and 6; and Course 4: on days 1 and 6
10. Eligibility
Sex
All
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
In response to their first course of frontline treatment, patients who did not achieve a response (CR, CRi, or PR) and have ≥ 15% bone marrow blasts in a BM specimen between day 14 - 42 from the initiation of a single frontline course. If within that timeframe the BM is hypoplastic, the BM assessment can be repeated within a subsequent two-week period and the patient entered into the study if there is ≥ 15% blasts in the bone marrow.
≥ 55 years old
Have an understanding of the importance of not taking paracetamol (acetaminophen) or high dose antioxidants from 1 day before through 1 day after treatment during any given course
Have a life expectancy of more than 4 weeks following initiation of treatment
Secondary AML is allowed as are antecedent hematologic disorders
Zubrod performance status ≤ 2
Have recovered from acute toxicities of prior chemotherapy (≤ Grade 2)
Have signed an informed consent
Total bilirubin ≤ 1.5 x upper normal limit (UNL) and Alanine Amino Transferase [ALT (Serum Glutamic-pyruvic Transaminase (SGPT))] ≤ 2.5 x UNL
Creatinine ≤ 1.5 x UNL
Serum magnesium should be within the normal range (Mg replacement being acceptable)
Left Ventricular Ejection Fraction (LVEF) of >50% as determined by multiple-gated acquisition scan (MUGA) or Echocardiogram (ECHO)
Ability to receive all courses of therapy, as outlined in the treatment schedules at the investigative site
Willingness to comply with scheduled follow-up as required by the protocol
Use of adequate contraceptive techniques if premenopausal and sexually active; examples include implantable, injectable or oral contraceptives, intrauterine devices (IUD), sterilization, or sexual abstinence
If premenopausal, have negative pregnancy tests at screening
Exclusion Criteria:
Presence of any pneumonia regardless of severity or other life-threatening illness including, but not limited to, ongoing infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, high blood pressure, history of labile hypertension, history of poor compliance with an antihypertensive regimen, myocardial infarction less than or equal to 6 months prior to registration, diabetes, or extensive and symptomatic interstitial fibrosis of lung, chronic liver disease or psychiatric illness/social situations that limits compliance with study requirements
Acute promyelocytic leukemia (APL [FAB classification M3])
Requirement for transplant before Course 2 is complete
Concurrent use of other experimental agents (i.e., drugs not approved for clinical indications) or having received other investigational agents within the 30 days prior to the start of Course 1
Pregnancy (includes a positive pregnancy test at the screening visit) or lactation
Known HIV infection
Active hepatitis B or C or other active liver disease
Presence of dyspnea at rest or with minimal exertion after correction for anemia
Known or suspected hypersensitivity or allergy to idarubicin or ara-C
Occurrence of major surgery within two weeks of the start of Course 1
Chemotherapy within two weeks prior to initiation of therapy under this protocol, or hydroxyurea within 7 days
Patients who, with appropriate explanation, are not prepared to exclude the use of paracetamol (acetaminophen) or paracetamol-containing medications from 1 day before through 1 day after treatment during any course
Patients who are not prepared to commit to the exclusion of high dose antioxidants from 1 day before through 1 day after treatment during any given course
Medical or psychiatric conditions that compromise the ability to give informed consent, to comply with the protocol or to complete the study
Inability, in the opinion of the principal investigator or clinical staff, to comply with protocol requirements for the duration of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Larry J Smith, PhD
Organizational Affiliation
Eleos, Inc.
Official's Role
Study Chair
12. IPD Sharing Statement
Learn more about this trial
Aezea® (Cenersen) and Chemotherapy for AML Subjects ≥ 55 Years of Age With No Response to Frontline Induction Course
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