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IA14 Induction in Young Acute Myeloid Leukemia

Primary Purpose

Acute Myeloid Leukemia

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Idarubicin and cytarabine induction
Sponsored by
Peking Union Medical College Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring Acute Myeloid Leukemia, ultra-high dose idarubicin, induction

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Newly diagnosed, morphologically documented primary AML or AML secondary to myelodysplastic syndrome or a myeloproliferative neoplasm based on the World Health Organization (WHO) 2008 classification (at Screening)
  • Must be competent and able to comprehend, sign, and date an Ethics Committee or Institutional Review Board approved Informed Consent Form (ICF) before performance of any study-specific procedures or tests;
  • ≥18 yearsand ≤60 years (at Screening);
  • Eastern Cooperative Oncology Group performance status 0-2 (at Screening);
  • Adequate renal function defined as: Creatinine clearance rate >50 mL/min, as calculated with the modified Cockcroft Gault equation;
  • Adequate hepatic function defined as: Total serum bilirubin ≤1.5 × ULN; and serum alkaline phosphatase, aspartate transaminase and alanine transaminase ≤2.5 × ULN;
  • Serum electrolytes within normal limits: potassium, calcium (total or corrected for serum albumin in case of hypoalbuminemia). If outside of normal limits, subject will be eligible when electrolytes are corrected;

Exclusion Criteria:

  • Diagnosis of acute promyelocytic leukemia (APL), French-American-British classification M3 or WHO classification of APL with translocation, t(15;17)(q22;q12); subjects who undergo diagnostic workup for APL and treatment with all-trans retinoic acid (ATRA), but who are found not to have APL, are eligible (treatment with ATRA must be discontinued before starting induction chemotherapy).
  • Prior treatment for AML, except for the following allowances:

    1. Leukapheresis;
    2. Treatment for hyperleukocytosis with hydroxyurea;
    3. Growth factor/cytokine support;
  • Uncontrolled or significant cardiovascular disease, including any of the following:

    1. Bradycardia of less than 50 beats per minute, unless the subject has a pacemaker;
    2. Diagnosis of or suspicion of long QT syndrome (including family history of long QT syndrome);
    3. Systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg;
    4. History of clinically relevant ventricular arrhythmias (eg, ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes);
    5. History of second (Mobitz II) or third degree heart block (subjects with pacemakers are eligible if they have no history of fainting or clinically relevant arrhythmias while using the pacemaker);
    6. History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to Screening;
    7. History of New York Heart Association Class 3 or 4 heart failure;
    8. Complete left bundle branch block;
    9. Known history of left ventricular ejection fraction (LVEF) ≤45% or less than the institutional lower limit of normal;
  • Active acute or chronic systemic fungal, bacterial, or viral infection not well controlled by antifungal, antibacterial or antiviral therapy;
  • Concurrent of other malignancies, except adequately treated non-melanoma skin cancer, curatively treated in-situ disease, or other solid tumors curatively treated with no evidence of disease
  • Females who are pregnant or breastfeeding;

Sites / Locations

  • Xinxin CaoRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

IA14

Arm Description

Idarubicin 14mg/m2 for 3 days cytarabine 100mg/m2 every 12 hour for 7 days

Outcomes

Primary Outcome Measures

Complete remission (CR) rate
the rate of patient who get CR after induction therapy

Secondary Outcome Measures

Event-free survival (EFS)
EFS is defined as the duration from initiation of IA induction treatment to the date of a first event
Overall survival (OS)
OS was defined as the duration from initiation of IA induction treatment to the date of death or last follow-up
rate of Minimal Residual Disease (MRD) negativity
Percentage of subjects achieving CR with no evidence of Minimal Residual Disease (MRD) following induction therapy.

Full Information

First Posted
August 22, 2019
Last Updated
June 7, 2021
Sponsor
Peking Union Medical College Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04069208
Brief Title
IA14 Induction in Young Acute Myeloid Leukemia
Official Title
Dose-intense Idarubicin Induction in Young Patients With Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Unknown status
Study Start Date
September 3, 2019 (Actual)
Primary Completion Date
October 31, 2021 (Anticipated)
Study Completion Date
December 31, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking Union Medical College Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Acute myeloid leukemia (AML) is a clinically and biologically heterogeneous disease characterized by the clonal expansion of undifferentiated myeloid precursors. Although induction chemotherapy with cytarabine and daunorubicin/Idarubicin, typically called "7+3", has not changed for several decades, the best dosage of anthracycline is still unknown. Several prospective trials have demonstrated that intense dosage of anthracycline improved complete remission (CR) and overall survival (OS). Idarubicin 12mg/m2 (IA12) has been shown to be equal to dose intense daunorubicin (90 mg/m2 ) for achieving CR. Dose-intense daunorubicin 90 mg/m2 (DA90) has been shown to improve CR compared to standard dose daunorubucin 45mg/m2 in newly diagnosed AML patients. In our previous study, CR rate of induction with daunorubicin 60 mg/m2/d (3 days) and cytarabine 200 mg/m2/d days 1-7 was about 67%. Benefit of intensification seems limited to the patients without adverse cytogenetics. Wheher ultra high dose idarubicin 14mg/m2 (IA14) could further improve CR rate, give patients with adverse cytogenetics a chance to do allo-stem cell transplantation? This phase 2, prospective, single-center study is designed to evaluate the efficacy and safety of induction with idarubicin 14mg/m2/d (3 days) and cytarabine 200 mg/m2/d days 1-7 in young newly diagnosed AML patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
Acute Myeloid Leukemia, ultra-high dose idarubicin, induction

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Idarubicin 14mg/m2 for 3 days cytarabine 100mg/m2 every 12 hour for 7 days
Masking
None (Open Label)
Allocation
N/A
Enrollment
42 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
IA14
Arm Type
Experimental
Arm Description
Idarubicin 14mg/m2 for 3 days cytarabine 100mg/m2 every 12 hour for 7 days
Intervention Type
Drug
Intervention Name(s)
Idarubicin and cytarabine induction
Intervention Description
Idarubicin 14mg/m2 for 3 days cytarabine 100mg/m2 every 12 hour for 7 days
Primary Outcome Measure Information:
Title
Complete remission (CR) rate
Description
the rate of patient who get CR after induction therapy
Time Frame
On Day 21 (window Day 21 to Day 30), a bone marrow aspirate specimen will be collected for pathology.
Secondary Outcome Measure Information:
Title
Event-free survival (EFS)
Description
EFS is defined as the duration from initiation of IA induction treatment to the date of a first event
Time Frame
Assessed up to 24 months. Event is defined as any of the following: 1)Refractory disease (or treatment failure) which is determined at the end of the Induction Phase; 2)Relapse after CR or CRi; 3)Death from any cause at any time during the study.
Title
Overall survival (OS)
Description
OS was defined as the duration from initiation of IA induction treatment to the date of death or last follow-up
Time Frame
OS was defined as the duration from initiation of IA induction treatment to the date of death or last follow-up assessed up to 24 months.
Title
rate of Minimal Residual Disease (MRD) negativity
Description
Percentage of subjects achieving CR with no evidence of Minimal Residual Disease (MRD) following induction therapy.
Time Frame
MRD will be tested after on Day 21 (window Day 21 to Day 30)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Newly diagnosed, morphologically documented primary AML or AML secondary to myelodysplastic syndrome or a myeloproliferative neoplasm based on the World Health Organization (WHO) 2008 classification (at Screening) Must be competent and able to comprehend, sign, and date an Ethics Committee or Institutional Review Board approved Informed Consent Form (ICF) before performance of any study-specific procedures or tests; ≥18 yearsand ≤60 years (at Screening); Eastern Cooperative Oncology Group performance status 0-2 (at Screening); Adequate renal function defined as: Creatinine clearance rate >50 mL/min, as calculated with the modified Cockcroft Gault equation; Adequate hepatic function defined as: Total serum bilirubin ≤1.5 × ULN; and serum alkaline phosphatase, aspartate transaminase and alanine transaminase ≤2.5 × ULN; Serum electrolytes within normal limits: potassium, calcium (total or corrected for serum albumin in case of hypoalbuminemia). If outside of normal limits, subject will be eligible when electrolytes are corrected; Exclusion Criteria: Diagnosis of acute promyelocytic leukemia (APL), French-American-British classification M3 or WHO classification of APL with translocation, t(15;17)(q22;q12); subjects who undergo diagnostic workup for APL and treatment with all-trans retinoic acid (ATRA), but who are found not to have APL, are eligible (treatment with ATRA must be discontinued before starting induction chemotherapy). Prior treatment for AML, except for the following allowances: Leukapheresis; Treatment for hyperleukocytosis with hydroxyurea; Growth factor/cytokine support; Uncontrolled or significant cardiovascular disease, including any of the following: Bradycardia of less than 50 beats per minute, unless the subject has a pacemaker; Diagnosis of or suspicion of long QT syndrome (including family history of long QT syndrome); Systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg; History of clinically relevant ventricular arrhythmias (eg, ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes); History of second (Mobitz II) or third degree heart block (subjects with pacemakers are eligible if they have no history of fainting or clinically relevant arrhythmias while using the pacemaker); History of uncontrolled angina pectoris or myocardial infarction within 6 months prior to Screening; History of New York Heart Association Class 3 or 4 heart failure; Complete left bundle branch block; Known history of left ventricular ejection fraction (LVEF) ≤45% or less than the institutional lower limit of normal; Active acute or chronic systemic fungal, bacterial, or viral infection not well controlled by antifungal, antibacterial or antiviral therapy; Concurrent of other malignancies, except adequately treated non-melanoma skin cancer, curatively treated in-situ disease, or other solid tumors curatively treated with no evidence of disease Females who are pregnant or breastfeeding;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xinxin Cao
Phone
69155027
Email
caoxinxin@pumch.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jian Li, M.D.
Organizational Affiliation
Peking Union Medical College Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Xinxin Cao
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100038
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xinxin Cao
Email
caoxinxin@pumch.cn

12. IPD Sharing Statement

Learn more about this trial

IA14 Induction in Young Acute Myeloid Leukemia

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