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CalPeg for Newly Diagnosed Acute Lymphoblastic Leukemia (ALL)

Primary Purpose

Acute Lymphoblastic Leukemia

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hyper CVAD Protocol (Standard of Care Multi-Agent Chemotherapy)
Calaspargase Pegol
Rituximab
Sponsored by
H. Lee Moffitt Cancer Center and Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Lymphoblastic Leukemia focused on measuring A.L.L.

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Pathologically confirmed Philadelphia negative B- or T-cell acute lymphoblastic leukemia, with >10% peripheral blood or bone marrow lymphoblasts at diagnosis.
  • Treatment and full recovery from arm 1A of the Hyper-CVAD regimen.
  • Be willing and able to provide written informed consent/assent for the trial.
  • Able to adhere to the study visit schedule and other protocol requirements.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
  • Cardiac ejection fraction ≥ 50% by echocardiography or MUGA, as measured prior to arm 1A of Hyper-CVAD.
  • Serum bilirubin and creatinine < 1.5x upper limit of normal (ULN). AST and ALT must be <3x ULN.
  • Females of childbearing potential (FCBP) must have a negative serum pregnancy test at screening. A FCBP is considered when a sexually mature female: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 12 consecutive months.
  • A FCBP must agree to use of two methods of highly effective non-hormonal contraception, be surgically sterile, or abstain from heterosexual activity for the course of the study through 3 monthsafter the last dose of study treatment.
  • Male subjects must agree to use an adequate method of contraception starting with the first dose of study therapy through 30 days after the last dose of study therapy. Men must agree to not donate sperm during and after the study for 3 months

Exclusion Criteria:

  • Induction therapy with any regimen other than Hyper-CVAD 1A.
  • Diagnosis of L3 type Burkitt's lymphoma
  • Clinical evidence of active central nervous system (CNS) leukemia.
  • Any major surgery or radiation therapy within four weeks.
  • Diagnosis of Down Syndrome.
  • Any active infection requiring systemic therapy, including HIV, Hepatitis B, and/or Hepatitis C.
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator (including but not limited to unstable angina, pre-existing liver disease, recurrent pancreatitis, uncontrolled diabetes, hypertriglyceridemia, pulmonary hypertension, or severeheart failure (New York Heart Association Class III-IV).
  • Recurrent thrombosis, or non-central venous catheter associated thrombosis within 3 months prior to enrollment.
  • Severe comorbid conditions for which life expectancy would be <6 months.
  • Patients with active (uncontrolled, metastatic) second malignancies are excluded.
  • Is pregnant, breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 3 months after the last dose of trial treatment.

Sites / Locations

  • Moffitt Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Hyper-CVAD + Calaspargase pegol Treatment

Arm Description

Participants will receive calaspargase pegol administered over 1 hour with each cycle of Hyper-CVAD, mini-CVD, and late intensification, beginning with Cycle 1B. Responding patients will have dose reduction of HyperCVAD for Cycles 2B-4B. Participants with CD20+ ALL will also be given Rituximab once per cycle.

Outcomes

Primary Outcome Measures

Mortality Rate of Hyper-CVAD after first infusion of calaspargase pegol
Mortality rate is hypothesized to be less than 10% when combining calaspargase pegol with Hyper-CVAD.

Secondary Outcome Measures

Minimal Residual Disease Remission Rate
Minimal Residual Disease (MRD) will be studied as a dichotomous endpoint using a cutoff of 1x10^4 cells/transcripts as the lower limit for residual leukemia and presented as the percentage of patients reaching this landmark as their best response. MRD assessment will be obtained with each bone marrow biopsy assessment, every 3 months in the first year following their last cycle of therapy and every 6 months in the subsequent 2 years following their last cycle.
Progression Free Survival
Progression Free Survival defined as the time from start of treatment to the time of progression or death.
Overall Survival
Overall Survival (OS) will be measured from the initial date of treatment to the recorded date of death.

Full Information

First Posted
October 12, 2022
Last Updated
August 16, 2023
Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
Servier
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1. Study Identification

Unique Protocol Identification Number
NCT05581030
Brief Title
CalPeg for Newly Diagnosed Acute Lymphoblastic Leukemia (ALL)
Official Title
A Single-Arm, Open-Label Phase 1b Study of Hyper-CVAD + Calaspargase Pegol in Young Adults With Newly Diagnosed Acute Lymphoblastic Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 1, 2023 (Actual)
Primary Completion Date
September 2027 (Anticipated)
Study Completion Date
September 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
Servier

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 the study is to evaluate the safety and tolerability of the study drug, calaspargase pegol, when given with multi-agent chemotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Lymphoblastic Leukemia
Keywords
A.L.L.

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Hyper-CVAD + Calaspargase pegol Treatment
Arm Type
Experimental
Arm Description
Participants will receive calaspargase pegol administered over 1 hour with each cycle of Hyper-CVAD, mini-CVD, and late intensification, beginning with Cycle 1B. Responding patients will have dose reduction of HyperCVAD for Cycles 2B-4B. Participants with CD20+ ALL will also be given Rituximab once per cycle.
Intervention Type
Drug
Intervention Name(s)
Hyper CVAD Protocol (Standard of Care Multi-Agent Chemotherapy)
Intervention Description
Hyper-CVAD consists of two combinations of drugs (courses A and B) given in an alternating fashion. The term "hyper" refers to the hyperfractionated nature of the chemotherapy, which is given in small doses, more frequently, to minimize side effects. CVAD is the acronym of the drugs in course a: cyclophosphamide, vincristine, doxorubicin and dexamethasone. Course A: Cyclophosphamide days 1, 2 and 3. Vincristine days 4 and 11, Doxorubicin day 4, dexamethasone days 1-4 and 11-14, Cytarabine day 7. Mesna is also given orally with cyclophosphamide, to reduce the incidence of haemorrhagic cystitis, a common side effect of cyclophosphamide. Methotrexate, an antimetabolite, may be given when necessary to get chemotherapy past the blood brain barrier. Course B: Methotrexate Day 1 and Cytarabine Days 2 and 3. Dosage is individualized to the patient.
Intervention Type
Drug
Intervention Name(s)
Calaspargase Pegol
Other Intervention Name(s)
Asparlas, CalPeg
Intervention Description
Calaspargase pegol 2000 IU/m^2 (capped at 3750 IU) will be administered beginning in cycle 1B of Hyper-CVAD, and will continue at this dose for the duration of the trial.
Intervention Type
Drug
Intervention Name(s)
Rituximab
Other Intervention Name(s)
Rituxan
Intervention Description
Rituximab 375mg/m^2 will be administered once per cycle for patients with CD20+ ALL.
Primary Outcome Measure Information:
Title
Mortality Rate of Hyper-CVAD after first infusion of calaspargase pegol
Description
Mortality rate is hypothesized to be less than 10% when combining calaspargase pegol with Hyper-CVAD.
Time Frame
Up to 12 months
Secondary Outcome Measure Information:
Title
Minimal Residual Disease Remission Rate
Description
Minimal Residual Disease (MRD) will be studied as a dichotomous endpoint using a cutoff of 1x10^4 cells/transcripts as the lower limit for residual leukemia and presented as the percentage of patients reaching this landmark as their best response. MRD assessment will be obtained with each bone marrow biopsy assessment, every 3 months in the first year following their last cycle of therapy and every 6 months in the subsequent 2 years following their last cycle.
Time Frame
Up to 3 years
Title
Progression Free Survival
Description
Progression Free Survival defined as the time from start of treatment to the time of progression or death.
Time Frame
Up to 42 months
Title
Overall Survival
Description
Overall Survival (OS) will be measured from the initial date of treatment to the recorded date of death.
Time Frame
Up to 42 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pathologically confirmed Philadelphia negative B- or T-cell acute lymphoblastic leukemia, with >10% peripheral blood or bone marrow lymphoblasts at diagnosis. Treatment and full recovery from arm 1A of the Hyper-CVAD regimen. Be willing and able to provide written informed consent/assent for the trial. Able to adhere to the study visit schedule and other protocol requirements. Eastern Cooperative Oncology Group (ECOG) performance status 0-1. Cardiac ejection fraction ≥ 50% by echocardiography or MUGA, as measured prior to arm 1A of Hyper-CVAD. Serum bilirubin and creatinine < 1.5x upper limit of normal (ULN). AST and ALT must be <3x ULN. Females of childbearing potential (FCBP) must have a negative serum pregnancy test at screening. A FCBP is considered when a sexually mature female: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 12 consecutive months. A FCBP must agree to use of two methods of highly effective non-hormonal contraception, be surgically sterile, or abstain from heterosexual activity for the course of the study through 3 monthsafter the last dose of study treatment. Male subjects must agree to use an adequate method of contraception starting with the first dose of study therapy through 30 days after the last dose of study therapy. Men must agree to not donate sperm during and after the study for 3 months Exclusion Criteria: Induction therapy with any regimen other than Hyper-CVAD 1A. Diagnosis of L3 type Burkitt's lymphoma Clinical evidence of active central nervous system (CNS) leukemia. Any major surgery or radiation therapy within four weeks. Diagnosis of Down Syndrome. Any active infection requiring systemic therapy, including HIV, Hepatitis B, and/or Hepatitis C. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator (including but not limited to unstable angina, pre-existing liver disease, recurrent pancreatitis, uncontrolled diabetes, hypertriglyceridemia, pulmonary hypertension, or severeheart failure (New York Heart Association Class III-IV). Recurrent thrombosis, or non-central venous catheter associated thrombosis within 3 months prior to enrollment. Severe comorbid conditions for which life expectancy would be <6 months. Patients with active (uncontrolled, metastatic) second malignancies are excluded. Is pregnant, breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 3 months after the last dose of trial treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bijal Shah, MD
Organizational Affiliation
Moffitt Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Waleed Kelada
Phone
813-745-4673
Email
Waleed.Kelada@moffitt.org
First Name & Middle Initial & Last Name & Degree
Bijal Shah, MD
First Name & Middle Initial & Last Name & Degree
Julio Chavez, MD, MS
First Name & Middle Initial & Last Name & Degree
Sameh Gaballa, MD
First Name & Middle Initial & Last Name & Degree
Leidy Isenalumhe, MD, MS
First Name & Middle Initial & Last Name & Degree
Hayder Saeed, MD
First Name & Middle Initial & Last Name & Degree
Lubomir Sokol, MD, PhD

12. IPD Sharing Statement

Links:
URL
https://www.moffitt.org/clinical-trials-and-studies/clinical-trial-21213/
Description
Moffitt Cancer Center Clinical Trials website

Learn more about this trial

CalPeg for Newly Diagnosed Acute Lymphoblastic Leukemia (ALL)

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