Daunorubicin, Cytarabine, and Midostaurin in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia
Leukemia
About this trial
This is an interventional treatment trial for Leukemia focused on measuring adult acute basophilic leukemia, adult acute eosinophilic leukemia, adult acute lymphoblastic leukemia, adult acute megakaryoblastic leukemia (M7), adult acute minimally differentiated myeloid leukemia (M0), adult acute monoblastic leukemia (M5a), adult acute monocytic leukemia (M5b), adult acute myeloblastic leukemia with maturation (M2), adult acute myeloblastic leukemia without maturation (M1), adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), adult acute myelomonocytic leukemia (M4), adult erythroleukemia (M6a), adult pure erythroid leukemia (M6b), untreated adult acute myeloid leukemia
Eligibility Criteria
Documentation of Disease:
- Unequivocal diagnosis of AML ( > 20% blasts in the bone marrow based on the WHO classification), excluding M3 (acute promyelocytic leukemia). Patients with neurologic symptoms suggestive of CNS leukemia are recommended to have a lumbar puncture. Patients whose CSF is positive for AML blasts are not eligible.
- Documented FLT3 mutation (ITD or point mutation), determined by analysis in a protocol- designated FLT3 screening laboratory.
Age Requirement:
- Age ≥ 18 and < 60 years
Prior Therapy:
No prior chemotherapy for leukemia or myelodysplasia with the following exceptions:
- emergency leukapheresis
- emergency treatment for hyperleukocytosis with hydroxyurea for ≤ 5 days
- cranial RT for CNS leukostasis (one dose only)
- growth factor/cytokine support
- AML patients with a history of antecedent myelodysplasia (MDS) remain eligible for treatment on this trial, but must not have had prior cytotoxic therapy (e.g., azacitidine or decitabine)
- Patients who have developed therapy related AML after prior RT or chemotherapy for another cancer or disorder are not eligible.
- Cardiac Function: Patients with symptomatic congestive heart failure are not eligible.
- Initial Laboratory Value: Total bilirubin < 2.5 x ULN (Upper Limit of Normal)
Pregnancy and Nursing Status:
- Non-pregnant and non-nursing due to the unknown teratogenic potential of midostaurin in humans, pregnant or nursing patients may not be enrolled.
- Women of childbearing potential must have a negative serum or urine pregnancy test within a sensitivity of at least 50 mIU/mL within 16 days prior to registration.
Women of child-bearing potential must either commit to continued abstinence from heterosexual intercourse or commit to TWO acceptable methods of birth control:
- one highly effective method (eg, IUD, hormonal (non-oral contraceptive), tubal ligation, or partner's vasectomy) and
- one additional effective method (e.g., latex condom, diaphragm or cervical cap)
- The two acceptable methods of birth control must be used AT THE SAME TIME, before beginning midostaurin/placebo therapy and continuing for 12 weeks after completion of all therapy.
- Note that oral contraceptives are not considered a high effective method because of the possibility of a drug interaction with midostaurin.
- Women of childbearing potential is defined as a sexually active mature woman who has not undergone a hysterectomy or who has not 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 contact with women of childbearing potential while taking midostaurin/placebo and for 12 weeks after therapy is stopped, even if they have undergone a successful vasectomy.
Sites / Locations
- UAB Comprehensive Cancer Center
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
- University of California Davis Cancer Center
- Aurora Presbyterian Hospital
- Boulder Community Hospital
- Penrose Cancer Center at Penrose Hospital
- St. Anthony Central Hospital
- Porter Adventist Hospital
- Presbyterian - St. Luke's Medical Center
- St. Joseph Hospital
- Rose Medical Center
- CCOP - Colorado Cancer Research Program
- Swedish Medical Center
- North Colorado Medical Center
- Sky Ridge Medical Center
- Hope Cancer Care Center at Longmont United Hospital
- McKee Medical Center
- North Suburban Medical Center
- Exempla Lutheran Medical Center
- Helen and Harry Gray Cancer Center at Hartford Hospital
- Tunnell Cancer Center at Beebe Medical Center
- CCOP - Christiana Care Health Services
- University of Florida Shands Cancer Center
- Memorial Cancer Institute at Memorial Regional Hospital
- Baptist Cancer Institute - Jacksonville
- Florida Hospital Cancer Institute at Florida Hospital Orlando
- H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
- MBCCOP - Medical College of Georgia Cancer Center
- Charles B. Eberhart Cancer Center at DeKalb Medical Center
- Medical Center of Central Georgia
- Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler
- Cancer Research Center of Hawaii
- Queen's Cancer Institute at Queen's Medical Center
- Illinois CancerCare - Bloomington
- Robert H. Lurie Comprehensive Cancer Center at Northwestern University
- University of Illinois Cancer Center
- University of Chicago Cancer Research Center
- Decatur Memorial Hospital Cancer Care Institute
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- BroMenn Regional Medical Center
- Oncology Hematology Associates of Central Illinois, PC - Peoria
- Methodist Medical Center of Illinois
- Fort Wayne Medical Oncology and Hematology
- McFarland Clinic, PC
- Holden Comprehensive Cancer Center at University of Iowa
- Siouxland Hematology-Oncology Associates, LLP
- Mercy Medical Center - Sioux City
- St. Luke's Regional Medical Center
- Lucille P. Markey Cancer Center at University of Kentucky
- Tulane Cancer Center Office of Clinical Research
- Feist-Weiller Cancer Center at Louisiana State University Health Sciences
- Greenebaum Cancer Center at University of Maryland Medical Center
- Massachusetts General Hospital
- Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute
- Boston University Cancer Research Center
- Beth Israel Deaconess Medical Center
- Baystate Regional Cancer Program at D'Amour Center for Cancer Care
- Battle Creek Health System Cancer Care Center
- Mecosta County Medical Center
- Butterworth Hospital at Spectrum Health
- CCOP - Grand Rapids
- Lacks Cancer Center at Saint Mary's Health Care
- Borgess Medical Center
- West Michigan Cancer Center
- Bronson Methodist Hospital
- Providence Cancer Institute at Providence Hospital - Southfield Campus
- Munson Medical Center
- Metro Health Hospital
- Fairview Ridges Hospital
- Mercy and Unity Cancer Center at Mercy Hospital
- Fairview Southdale Hospital
- Mercy and Unity Cancer Center at Unity Hospital
- HealthEast Cancer Care at St. John's Hospital
- Minnesota Oncology Hematology, PA - Maplewood
- Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
- Hennepin County Medical Center - Minneapolis
- Masonic Cancer Center at University of Minnesota
- Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center
- Mayo Clinic Cancer Center
- CCOP - Metro-Minnesota
- Park Nicollet Cancer Center
- Regions Hospital Cancer Care Center
- United Hospital
- Ridgeview Medical Center
- Minnesota Oncology Hematology, PA - Woodbury
- University of Mississippi Cancer Clinic
- Ellis Fischel Cancer Center at University of Missouri - Columbia
- Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
- UNMC Eppley Cancer Center at the University of Nebraska Medical Center
- University Medical Center of Southern Nevada
- CCOP - Nevada Cancer Research Foundation
- Sunrise Hospital and Medical Center
- Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
- University of New Mexico Cancer Center
- Roswell Park Cancer Institute
- Monter Cancer Center of the North Shore-LIJ Health System
- CCOP - North Shore University Hospital
- Don Monti Comprehensive Cancer Center at North Shore University Hospital
- Tucker Center for Cancer Care at Orange Regional Medical Center
- Winthrop University Hospital
- Long Island Jewish Medical Center
- New York Weill Cornell Cancer Center at Cornell University
- Mount Sinai Medical Center
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- SUNY Upstate Medical University Hospital
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
- Blumenthal Cancer Center at Carolinas Medical Center
- Duke Comprehensive Cancer Center
- Leo W. Jenkins Cancer Center at ECU Medical School
- Kinston Medical Specialists
- Wake Forest University Comprehensive Cancer Center
- Summa Center for Cancer Care at Akron City Hospital
- Barberton Citizens Hospital
- Charles M. Barrett Cancer Center at University Hospital
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center
- St. Rita's Medical Center
- Cleo Craig Cancer Research Clinic
- Oklahoma University Cancer Institute
- Geisinger Cancer Institute at Geisinger Health
- Geisinger Hazleton Cancer Center
- Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center
- Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital
- UPMC Cancer Centers
- Geisinger Medical Group - Scenery Park
- Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
- Hollings Cancer Center at Medical University of South Carolina
- Cancer Centers of the Carolinas - Easley
- Cancer Centers of the Carolinas - Faris Road
- Cancer Centers of the Carolinas - Grove Commons
- Greenville Hospital Cancer Center
- CCOP - Greenville
- Self Regional Cancer Center at Self Regional Medical Center
- Cancer Centers of the Carolinas - Greer Medical Oncology
- Cancer Centers of the Carolinas - Seneca
- Cancer Centers of the Carolinas - Spartanburg
- Avera Cancer Institute
- Sanford Cancer Center at Sanford USD Medical Center
- University of Tennessee Cancer Institute - Memphis
- Tennessee Oncology, PLLC at Sarah Cannon Cancer Center
- Vanderbilt-Ingram Cancer Center
- Baylor University Medical Center - Houston
- Ben Taub General Hospital
- Veterans Affairs Medical Center - Houston
- Mountainview Medical
- Fletcher Allen Health Care - University Health Center Campus
- Virginia Commonwealth University Massey Cancer Center
- West Virginia University Health Sciences Center - Charleston
- Mary Babb Randolph Cancer Center at West Virginia University Hospitals
- Marshfield Clinic - Chippewa Center
- Center for Cancer Treatment & Prevention at Sacred Heart Hospital
- Marshfield Clinic Cancer Care at Regional Cancer Center
- Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
- Green Bay Oncology, Limited at St. Mary's Hospital
- St. Mary's Hospital Medical Center - Green Bay
- St. Vincent Hospital Regional Cancer Center
- University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
- Holy Family Memorial Medical Center Cancer Care Center
- Bay Area Cancer Care Center at Bay Area Medical Center
- Marshfield Clinic - Marshfield Center
- Saint Joseph's Hospital
- Marshfield Clinic - Lakeland Center
- D.N. Greenwald Center
- Regional Cancer Center at Oconomowoc Memorial Hospital
- Ministry Medical Group at Saint Mary's Hospital
- Marshfield Clinic - Indianhead Center
- Marshfield Clinic at Saint Michael's Hospital
- Waukesha Memorial Hospital Regional Cancer Center
- Marshfield Clinic - Weston Center
- Ministry Saint Clare's Hospital
- Marshfield Clinic - Wisconsin Rapids Center
- Tom Baker Cancer Centre - Calgary
- CancerCare Manitoba
- Nova Scotia Cancer Centre
- Princess Margaret Hospital
- Maisonneuve-Rosemont Hospital
- McGill Cancer Centre at McGill University
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Induction and consolidation chemotherapy plus midostaurin
Induction and consolidation chemotherapy plus placebo
Patients will receive a standard combination of chemotherapy drugs during remission induction therapy that includes cytarabine, daunorubicin, and the experimental drug midostaurin. Depending on the outcome of remission induction treatment, there may be a decision to discontinue the study treatment or a second remission induction cycle may be given. If remission induction therapy is successfully completed, patients will receive four courses of high-dose cytarabine consolidation chemotherapy plus dexamethasone together with the experimental drug midostaurin. All patients will undergo a bone marrow aspiration (and perhaps a biopsy) after the final course of remission consolidation chemotherapy. If the patient continues to respond to the treatment, the patient will receive continuation therapy with midostaurin for twelve (12) months.
Patients will receive a standard combination of chemotherapy drugs during remission induction therapy that includes cytarabine, daunorubicin, and placebo. Depending on the outcome of remission induction treatment, there may be a decision to discontinue the study treatment or a second remission induction cycle may be given. If remission induction therapy is successfully completed, patients will receive four courses of high-dose cytarabine consolidation chemotherapy plus dexamethasone together with placebo. All patients will undergo a bone marrow aspiration (and perhaps a biopsy) after the final course of remission consolidation chemotherapy. If the patient continues to respond to the treatment, the patient will receive continuation therapy with placebo for twelve (12) months.