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Dasatinib (Sprycel™) in Patients With Newly Diagnosed Core Binding Factor (CBF) Acute Myeloid Leukemia (AML)

Primary Purpose

Acute Myeloid Leukemia (AML)

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Dasatinib
daunorubicin
Cytarabine
Sponsored by
University of Ulm
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia (AML) focused on measuring CBF AML, Dasatinib, Core Binding Factor (CBF)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Core binding factor (CBF) AML with molecular diagnosis of RUNX1-RUNX1T1 fusion transcript resulting from t(8;21)(q22;q22) (or a variant form) or of CBFB-MYH11 fusion transcript resulting from inv(16)(p13.1q22)/t(16;16)(p13.1;q22) as assessed in one of the central AMLSG reference laboratories.
  • Age ≥ 18; there is no upper age limit.
  • No prior chemotherapy for leukemia except hydroxyurea for up to 5 days during the diag-nostic screening phase.
  • Non-pregnant and non-nursing. Due to the unknown teratogenic potential of dasatinib in humans, pregnant or nursing patients may not be enrolled. Women of childbearing poten-tial (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., 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, at least four weeks before she begins dasatinib therapy. "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.
  • Men must agree not to father a child and must use a latex condom during any sexual con-tact with women of childbearing potential while taking dasatinib and for 4 weeks after therapy is stopped, even if they have undergone a successful vasectomy.
  • Signed written informed consent

Exclusion Criteria:

  • Performance status WHO >2
  • Pulmonary edema and/or pleural/pericardial effusion within 14 days of Day 1. If edema/effusion resolves to CTC Grade ≤ 1, patients can be treated with dasatinib.
  • Patients with ejection fraction < 50% by echocardiography within 14 days of day 1
  • Organ insufficiency (creatinine >1.5x upper normal serum level; bilirubin, AST or AP >2.5x upper normal serum level; heart failure NYHA III/IV; severe obstructive or restrictive ventilation disorder)
  • Uncontrolled infection
  • Severe neurological or psychiatric disorder interfering with ability of giving an informed consent
  • Known positive for HIV
  • Bleeding disorder independent of leukemia
  • No consent for registration, storage and processing of the individual disease-characteristics and course

Sites / Locations

  • Universitätsklinikum Innsbruck
  • Krankenhaus der Barmherzigen Schwestern
  • Elisabethinen Krankenhaus
  • Landeskliniken Salzburg
  • Hanuschkrankenhaus Wien
  • Ubbo-Emmius Klinik Aurich
  • Charité Universitätsmedizin Berlin
  • Universitätsklinikum Bonn
  • Städtisches Klinikum Braunschweig
  • Klinikum Bremen-Mitte gGmbH
  • Klinikum Darmstadt
  • Universitätsklinikum Duesseldorf
  • Kliniken Essen-Sued
  • Klinikum Esslingen
  • Städtische Kliniken Frankfurt Höchst
  • Medizinische Universitätsklinik
  • Medizinisches Versorgungszentrum Osthessen GmbH
  • Klinik der Justus Liebig Universität
  • Wilhelm- Anton- Hospital gGmbH
  • Universitätsmedizin Göttingen
  • Universitätsklinikum Hamburg-Eppendorf
  • Asklepios Klinik Altona
  • Evangelisches Krankenhaus Hamm
  • Klinikum Hanau gGmbH
  • Klinikum Hannover Siloah
  • Medizinische Hochschule Hannover
  • SLK-Kliniken Heilbronn GmbH
  • Universitätsklinikum des Saarlandes
  • Staedtisches Klinikum Karlsruhe
  • Staedtisches Krankenhaus Kiel GmbH
  • Caritas Krankenhaus Lebach
  • Klinikum Lippe-Lemgo
  • Klinikum Luedenscheid
  • Univ-Klinikum der Otto- von Guericke- Universität
  • Universitätsklinikum der Johannes Gutenberguniversität Mainz
  • Johannes Wesling Klinikum
  • Klinikum rechts der Isar der TU Muenchen
  • Klinikum Oldenburg
  • Klinikum Passau
  • Elisabeth Krankenhaus
  • Krankenhaus der Barmherzigen Brueder
  • Caritas-Klinik St. Theresia
  • Klinikum Sindelfingen-Böblingen
  • Klinikum Stuttgart
  • Diakonie-Klinikum Stuttgart
  • Krankenhaus der Barmherzigen Brüder Trier
  • Medizinische Universitätsklinik Tuebingen
  • Universitätsklinik Ulm
  • Schwarzwald-Baar Klinikum
  • Helios Klinikum Wuppertal

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dasatinib

Arm Description

Induction cycle(s): Patients will receive in cycle 1 induction therapy with daunorubicin 60 mg/m2/day administered on days 1 through 3 and cytarabine 200 mg/m2/day administered by continuous IV infusion daily for 7 days (days 1 through 7). Patients will receive dasatinib 100 mg QD on days 8-21. Patients not achieving CR or CRi at the end of cycle 1 will be evaluable to receive a second induction cycle identical in schedule and dosage to the first induction cycle. Consolidation Cycles 1, 2, 3, 4: Patients achieving CR or CRi at the end of cycle 1 will receive consolidation therapy for 4 cy-cles. Consolidation therapy consists of high-dose cytarabine 3 g/m2 (>60 years: 1 g/m2) q12h, d 1, 3, 5, administered intravenously over three hours. Patients will receive dasatinib 100 mg QD on days 6-28. Maintenance therapy: Patients completing consolidation therapy will continue to receive single agent dasatinib 100 mg QD for one year (or until relapse).

Outcomes

Primary Outcome Measures

Feasibility as combined endpoint: Rate of ED/HD Rate of pleural/pericardial effusion grade 3/4 Rate of liver toxicity grade 3/4 that does not improve to <= grade 2 within 14 days after discontinuing responsible medication Rate of refractory disease

Secondary Outcome Measures

Cumulative incidence of relapse (CIR) and death (CID)
Overall survival (os)

Full Information

First Posted
February 23, 2009
Last Updated
February 29, 2016
Sponsor
University of Ulm
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1. Study Identification

Unique Protocol Identification Number
NCT00850382
Brief Title
Dasatinib (Sprycel™) in Patients With Newly Diagnosed Core Binding Factor (CBF) Acute Myeloid Leukemia (AML)
Official Title
Open-Label, Multicenter Phase Ib/IIa Study For the Evaluation of Dasatinib (Sprycel™) Following Induction and Consolida-tion Therapy as Well as in Maintenance Therapy in Patients With Newly Diagnosed Core Binding Factor (CBF) Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2016
Overall Recruitment Status
Completed
Study Start Date
June 2009 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Ulm

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase Ib/IIa open-labeled multi-center trial evaluating the feasibility of dasatinib given after standard induction therapy with daunorubicin (DNR) and cytarabine (ARA-C), after consolidation therapy with high-dose cytarabine (HDAC), and as single agent in a one-year maintenance therapy in patients with newly diagnosed CBF AML. 82 patients with newly diagnosed CBF AML will be enrolled at AMLSG study centers. All AML patients will be assessed for the CBF fusion genes via the central laboratory of the AMLSG within 48 hours of diagnosis of AML, and only patients with CBF AML will be enrolled into the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia (AML)
Keywords
CBF AML, Dasatinib, Core Binding Factor (CBF)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
89 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dasatinib
Arm Type
Experimental
Arm Description
Induction cycle(s): Patients will receive in cycle 1 induction therapy with daunorubicin 60 mg/m2/day administered on days 1 through 3 and cytarabine 200 mg/m2/day administered by continuous IV infusion daily for 7 days (days 1 through 7). Patients will receive dasatinib 100 mg QD on days 8-21. Patients not achieving CR or CRi at the end of cycle 1 will be evaluable to receive a second induction cycle identical in schedule and dosage to the first induction cycle. Consolidation Cycles 1, 2, 3, 4: Patients achieving CR or CRi at the end of cycle 1 will receive consolidation therapy for 4 cy-cles. Consolidation therapy consists of high-dose cytarabine 3 g/m2 (>60 years: 1 g/m2) q12h, d 1, 3, 5, administered intravenously over three hours. Patients will receive dasatinib 100 mg QD on days 6-28. Maintenance therapy: Patients completing consolidation therapy will continue to receive single agent dasatinib 100 mg QD for one year (or until relapse).
Intervention Type
Drug
Intervention Name(s)
Dasatinib
Intervention Description
Induction cycle(s): Dasatinib 100 mg QD on days 8-21. Consolidation Cycles 1, 2, 3, 4: Patients will receive dasatinib 100 mg QD on days 6-28. Maintenance therapy: Patients completing consolidation therapy will continue to receive single agent dasatinib 100 mg QD for one year (or until relapse).
Intervention Type
Drug
Intervention Name(s)
daunorubicin
Intervention Description
Induction cycle(s): Daunorubicin 60 mg/m2/day administered on days 1 through 3
Intervention Type
Drug
Intervention Name(s)
Cytarabine
Intervention Description
Induction cycle(s): Cytarabine 200 mg/m2/day administered by continuous IV infusion daily for 7 days (days 1 through 7). Consolidation cycles 1, 2, 3, 4: Consolidation therapy consists of high-dose cytarabine 3 g/m2 (>60 years: 1 g/m2) q12h, d 1, 3, 5, administered intravenously over three hours.
Primary Outcome Measure Information:
Title
Feasibility as combined endpoint: Rate of ED/HD Rate of pleural/pericardial effusion grade 3/4 Rate of liver toxicity grade 3/4 that does not improve to <= grade 2 within 14 days after discontinuing responsible medication Rate of refractory disease
Time Frame
after 4 weeks
Secondary Outcome Measure Information:
Title
Cumulative incidence of relapse (CIR) and death (CID)
Time Frame
After follow-up period of two years
Title
Overall survival (os)
Time Frame
After follow-up period of two years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Core binding factor (CBF) AML with molecular diagnosis of RUNX1-RUNX1T1 fusion transcript resulting from t(8;21)(q22;q22) (or a variant form) or of CBFB-MYH11 fusion transcript resulting from inv(16)(p13.1q22)/t(16;16)(p13.1;q22) as assessed in one of the central AMLSG reference laboratories. Age ≥ 18; there is no upper age limit. No prior chemotherapy for leukemia except hydroxyurea for up to 5 days during the diag-nostic screening phase. Non-pregnant and non-nursing. Due to the unknown teratogenic potential of dasatinib in humans, pregnant or nursing patients may not be enrolled. Women of childbearing poten-tial (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., 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, at least four weeks before she begins dasatinib therapy. "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. Men must agree not to father a child and must use a latex condom during any sexual con-tact with women of childbearing potential while taking dasatinib and for 4 weeks after therapy is stopped, even if they have undergone a successful vasectomy. Signed written informed consent Exclusion Criteria: Performance status WHO >2 Pulmonary edema and/or pleural/pericardial effusion within 14 days of Day 1. If edema/effusion resolves to CTC Grade ≤ 1, patients can be treated with dasatinib. Patients with ejection fraction < 50% by echocardiography within 14 days of day 1 Organ insufficiency (creatinine >1.5x upper normal serum level; bilirubin, AST or AP >2.5x upper normal serum level; heart failure NYHA III/IV; severe obstructive or restrictive ventilation disorder) Uncontrolled infection Severe neurological or psychiatric disorder interfering with ability of giving an informed consent Known positive for HIV Bleeding disorder independent of leukemia No consent for registration, storage and processing of the individual disease-characteristics and course
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hartmut Doehner, MD
Organizational Affiliation
University Hospital of Ulm
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsklinikum Innsbruck
City
Innsbruck
ZIP/Postal Code
6020
Country
Austria
Facility Name
Krankenhaus der Barmherzigen Schwestern
City
Linz
ZIP/Postal Code
4010
Country
Austria
Facility Name
Elisabethinen Krankenhaus
City
Linz
ZIP/Postal Code
4020
Country
Austria
Facility Name
Landeskliniken Salzburg
City
Salzburg
ZIP/Postal Code
5020
Country
Austria
Facility Name
Hanuschkrankenhaus Wien
City
Wien
ZIP/Postal Code
1140
Country
Austria
Facility Name
Ubbo-Emmius Klinik Aurich
City
Aurich
ZIP/Postal Code
26603
Country
Germany
Facility Name
Charité Universitätsmedizin Berlin
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Universitätsklinikum Bonn
City
Bonn
ZIP/Postal Code
53105
Country
Germany
Facility Name
Städtisches Klinikum Braunschweig
City
Braunschweig
ZIP/Postal Code
38114
Country
Germany
Facility Name
Klinikum Bremen-Mitte gGmbH
City
Bremen
ZIP/Postal Code
28177
Country
Germany
Facility Name
Klinikum Darmstadt
City
Darmstadt
ZIP/Postal Code
64283
Country
Germany
Facility Name
Universitätsklinikum Duesseldorf
City
Duesseldorf
ZIP/Postal Code
40225
Country
Germany
Facility Name
Kliniken Essen-Sued
City
Essen
ZIP/Postal Code
45239
Country
Germany
Facility Name
Klinikum Esslingen
City
Esslingen
ZIP/Postal Code
73730
Country
Germany
Facility Name
Städtische Kliniken Frankfurt Höchst
City
Frankfurt-Höchst
ZIP/Postal Code
65929
Country
Germany
Facility Name
Medizinische Universitätsklinik
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Medizinisches Versorgungszentrum Osthessen GmbH
City
Fulda
ZIP/Postal Code
36043
Country
Germany
Facility Name
Klinik der Justus Liebig Universität
City
Gießen
ZIP/Postal Code
35385
Country
Germany
Facility Name
Wilhelm- Anton- Hospital gGmbH
City
Goch
ZIP/Postal Code
47574
Country
Germany
Facility Name
Universitätsmedizin Göttingen
City
Göttingen
ZIP/Postal Code
37075
Country
Germany
Facility Name
Universitätsklinikum Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Asklepios Klinik Altona
City
Hamburg
ZIP/Postal Code
22763
Country
Germany
Facility Name
Evangelisches Krankenhaus Hamm
City
Hamm
ZIP/Postal Code
59063
Country
Germany
Facility Name
Klinikum Hanau gGmbH
City
Hanau
ZIP/Postal Code
63450
Country
Germany
Facility Name
Klinikum Hannover Siloah
City
Hannover
ZIP/Postal Code
30449
Country
Germany
Facility Name
Medizinische Hochschule Hannover
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
SLK-Kliniken Heilbronn GmbH
City
Heilbronn
ZIP/Postal Code
74078
Country
Germany
Facility Name
Universitätsklinikum des Saarlandes
City
Homburg Saar
ZIP/Postal Code
66424
Country
Germany
Facility Name
Staedtisches Klinikum Karlsruhe
City
Karlsruhe
ZIP/Postal Code
76133
Country
Germany
Facility Name
Staedtisches Krankenhaus Kiel GmbH
City
Kiel
ZIP/Postal Code
24116
Country
Germany
Facility Name
Caritas Krankenhaus Lebach
City
Lebach
ZIP/Postal Code
66822
Country
Germany
Facility Name
Klinikum Lippe-Lemgo
City
Lemgo
ZIP/Postal Code
32657
Country
Germany
Facility Name
Klinikum Luedenscheid
City
Luedenscheid
ZIP/Postal Code
58515
Country
Germany
Facility Name
Univ-Klinikum der Otto- von Guericke- Universität
City
Magdeburg
ZIP/Postal Code
39120
Country
Germany
Facility Name
Universitätsklinikum der Johannes Gutenberguniversität Mainz
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Facility Name
Johannes Wesling Klinikum
City
Minden
ZIP/Postal Code
32429
Country
Germany
Facility Name
Klinikum rechts der Isar der TU Muenchen
City
Muenchen
ZIP/Postal Code
81675
Country
Germany
Facility Name
Klinikum Oldenburg
City
Oldenburg
ZIP/Postal Code
26133
Country
Germany
Facility Name
Klinikum Passau
City
Passau
ZIP/Postal Code
94032
Country
Germany
Facility Name
Elisabeth Krankenhaus
City
Recklinghausen
ZIP/Postal Code
45661
Country
Germany
Facility Name
Krankenhaus der Barmherzigen Brueder
City
Regensburg
ZIP/Postal Code
93049
Country
Germany
Facility Name
Caritas-Klinik St. Theresia
City
Saarbrücken
ZIP/Postal Code
66113
Country
Germany
Facility Name
Klinikum Sindelfingen-Böblingen
City
Sindelfingen
ZIP/Postal Code
71065
Country
Germany
Facility Name
Klinikum Stuttgart
City
Stuttgart
ZIP/Postal Code
70174
Country
Germany
Facility Name
Diakonie-Klinikum Stuttgart
City
Stuttgart
ZIP/Postal Code
70176
Country
Germany
Facility Name
Krankenhaus der Barmherzigen Brüder Trier
City
Trier
ZIP/Postal Code
54292
Country
Germany
Facility Name
Medizinische Universitätsklinik Tuebingen
City
Tuebingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Universitätsklinik Ulm
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Schwarzwald-Baar Klinikum
City
Villingen-Schwenningen
ZIP/Postal Code
78050
Country
Germany
Facility Name
Helios Klinikum Wuppertal
City
Wuppertal
ZIP/Postal Code
42283
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
29720733
Citation
Paschka P, Schlenk RF, Weber D, Benner A, Bullinger L, Heuser M, Gaidzik VI, Thol F, Agrawal M, Teleanu V, Lubbert M, Fiedler W, Radsak M, Krauter J, Horst HA, Greil R, Mayer K, Kundgen A, Martens U, Heil G, Salih HR, Hertenstein B, Schwanen C, Wulf G, Lange E, Pfreundschuh M, Ringhoffer M, Girschikofsky M, Heinicke T, Kraemer D, Gohring G, Ganser A, Dohner K, Dohner H. Adding dasatinib to intensive treatment in core-binding factor acute myeloid leukemia-results of the AMLSG 11-08 trial. Leukemia. 2018 Jul;32(7):1621-1630. doi: 10.1038/s41375-018-0129-6. Epub 2018 Apr 17.
Results Reference
derived

Learn more about this trial

Dasatinib (Sprycel™) in Patients With Newly Diagnosed Core Binding Factor (CBF) Acute Myeloid Leukemia (AML)

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