Combination Chemotherapy and Dasatinib in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia
Acute Myeloid Leukemia, Acute Myeloid Leukemia Arising From Previous Myelodysplastic Syndrome, Adult Acute Myeloid Leukemia With Inv(16)(p13.1q22); CBFB-MYH11

About this trial
This is an interventional treatment trial for Acute Myeloid Leukemia
Eligibility Criteria
Inclusion Criteria:
- Documentation of disease as assessed by the Alliance reference laboratory at the Ohio State University per Cancer and Leukemia Group B (CALGB) 20202, molecular diagnosis of core-binding factor (CBF) acute myeloid leukemia (AML) by reverse transcriptase polymerase chain reaction (RT-PCR) positive for RUNX1-RUNX1T1 fusion transcript resulting from t(8;21)(q22;q22) (or a variant form) or CBFB-MYH11 fusion transcript resulting from inv(16)(p13.1q22) or t(16;16)(p13.1;q22) (any % bone marrow or blood blasts render the diagnosis of CBF AML based on the World Health Organization [WHO] classification)
No prior chemotherapy for leukemia or myelodysplasia with the following exceptions:
- Emergency leukapheresis
- Emergency treatment for hyperleukocytosis with hydroxyurea,
- Cranial radiotherapy (RT) for central nervous system (CNS) leukostasis (one dose only),
- Growth factor/cytokine support/non-cytotoxic molecular-targeted agents
- AML patients with a history of antecedent myelodysplasia (MDS) remain eligible for treatment on this trial
- Patients who have developed therapy related myeloid neoplasm (t-MN) after prior radiation therapy or chemotherapy for another cancer or disorder are eligible
- Left ventricular ejection fraction >= lower limit of institutional normal by multigated acquisition (MUGA) or echocardiogram (ECHO) scan
- Patients must not have had myocardial infarction within 6 months of registration
- Patients must not have had ventricular tachyarrhythmia within 6 months of registration
- Patients must have no major conduction abnormality (unless a cardiac pacemaker is present)
- Bilirubin must not be < 2.5 times upper limit of normal
- Patients must be non-pregnant and non-nursing; pregnant or nursing patients may not be enrolled; women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test within a sensitivity of at least 25 mIU/mL within 72 hours prior to registration; women of child-bearing potential must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control - one highly effective method (e.g., intrauterine device [IUD], hormonal, tubal ligation, or partner's vasectomy), and one additional effective method (e.g., latex condom, diaphragm, or cervical cap) - AT THE SAME TIME, before she begins dasatinib therapy, during treatment and at least 12 weeks after treatment is complete; "Women of childbearing potential" is defined as a sexually active mature woman who has not undergone a hysterectomy or who has had menses at any time in the preceding 24 consecutive months
- Patients with congenital long QT syndrome or non-congenital corrected QT (QTc) prolongation (defined as a QTc interval consistently equal to or greater than 480 msecs) that cannot be corrected by infusion of electrolytes and/or discontinuation of other medications prior to start of treatment are excluded
Sites / Locations
- Beebe Medical Center
- Christiana Care Health System-Christiana Hospital
- AdventHealth Orlando
- Saint Joseph Medical Center
- Illinois CancerCare-Bloomington
- Graham Hospital Association
- Illinois CancerCare-Canton
- Memorial Hospital
- University of Illinois
- University of Chicago Comprehensive Cancer Center
- Heartland Cancer Research NCORP
- Eureka Hospital
- Illinois CancerCare-Eureka
- Illinois CancerCare-Galesburg
- Mason District Hospital
- Illinois CancerCare-Macomb
- Mcdonough District Hospital
- Bromenn Regional Medical Center
- Carle Cancer Institute Normal
- Illinois CancerCare-Community Cancer Center
- Illinois CancerCare-Ottawa Clinic
- Ottawa Regional Hospital and Healthcare Center
- Illinois CancerCare-Pekin
- OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
- Proctor Hospital
- Illinois CancerCare-Peoria
- Methodist Medical Center of Illinois
- OSF Saint Francis Medical Center
- Illinois CancerCare-Peru
- Illinois Valley Hospital
- Perry Memorial Hospital
- Illinois CancerCare-Spring Valley
- Fort Wayne Medical Oncology and Hematology Inc-Parkview
- University of Iowa/Holden Comprehensive Cancer Center
- Harold Alfond Center for Cancer Care
- Eastern Maine Medical Center
- University of Maryland/Greenebaum Cancer Center
- Christiana Care - Union Hospital
- Massachusetts General Hospital Cancer Center
- Brigham and Women's Hospital
- Dana-Farber Cancer Institute
- Bronson Battle Creek
- Spectrum Health Big Rapids Hospital
- Cancer Research Consortium of West Michigan NCORP
- Mercy Health Saint Mary's
- Spectrum Health at Butterworth Campus
- Mercy Health Mercy Campus
- Spectrum Health Reed City Hospital
- Munson Medical Center
- University of Missouri - Ellis Fischel
- Washington University School of Medicine
- Dartmouth Hitchcock Medical Center
- Cooper Hospital University Medical Center
- Roswell Park Cancer Institute
- Northwell Health NCORP
- Northwell Health/Center for Advanced Medicine
- North Shore University Hospital
- Long Island Jewish Medical Center
- NYP/Weill Cornell Medical Center
- State University of New York Upstate Medical University
- Wayne Memorial Hospital
- Wake Forest University Health Sciences
- Ohio State University Comprehensive Cancer Center
- Central Vermont Medical Center/National Life Cancer Treatment
- University of Vermont and State Agricultural College
Arms of the Study
Arm 1
Experimental
Treatment (daunorubicin hydrochloride, cytarabine, dasatinib)
INDUCTION THERAPY (course 1): Patients receive daunorubicin hydrochloride IV on days 1-3, cytarabine IV continuously over 168 hours on days 1-7, and dasatinib PO QD on days 8-21. Patients with responsive disease on day 21 undergo consolidation therapy, and patients with non-responsive disease on day 21 (bone marrow cellularity >= 20% and leukemia blasts >= 5%) receive a second course of induction therapy. INDUCTION THERAPY (course 2): Patients receive daunorubicin hydrochloride IV on days 1-3, cytarabine IV continuously over 120 hours on days 1-5, and dasatinib PO QD on days 6-19. Patients achieving complete response receive consolidation therapy. CONSOLIDATION THERAPY: Patients receive high-dose cytarabine IV over 3 hours on days 1, 3, and 5, and dasatinib PO QD on days 6-26 or 7-27. Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Patients in complete remission receive continuation therapy.