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Phase I Study of Lenalidomide in Patients With Acute Leukemia

Primary Purpose

Acute Leukemia

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Lenalidomide
Sponsored by
Mehrdad Abedi, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Leukemia focused on measuring Acute Leukemia, Bone Marrow Transplant, High Dose Lenalidomide

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Understand and voluntarily sign an informed consent form.
  • Between 18 and 80 years of age at the time of signing the informed consent form.
  • Able to adhere to the study visit schedule and other protocol requirements.
  • Non-M3 Acute Myeloid Leukemia with the presence of residual disease in the bone marrow on day 14-28 post induction (or re-induction) chemotherapy. Day 14-28 residual disease is defined in this study as the presence of more than 10 % blasts in the marrow, presence of between 5-10% blasts cells that are not in cluster in hypocellular marrow is ambiguous and bone marrow biopsy should be repeated in 5-7 days.
  • Patient should have an already identified sibling, matched unrelated donor or cord blood donor at the time of enrollment to this clinical trial.
  • Eastern Cooperative Oncology Group (ECOG) performance status of equal or less than 3 at study entry (this patient population is typically admitted and is in the hospital)
  • Laboratory test results within defined ranges
  • Disease free of other malignancies beside the acute myeloid leukemia (AML) for greater than or equal to 2 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast.
  • All study participants must be registered into the mandatory RevAssist® program, and be willing and able to comply with the requirements of RevAssist®.
  • Females of childbearing potential (FCBP)must have a negative serum or urine pregnancy test with a sensitivity of at least 50 milli-International unit (mIU)/mL within 10 - 14 days and again within 24 hours prior to prescribing lenalidomide prescriptions must be filled within 7 days as required by RevAssist) and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or breast feeding females (Lactating females must agree not to breast feed while taking lenalidomide).
  • Patients younger than 50 years old, after first induction of chemotherapy, who are able to safely tolerate re-induction therapy with high dose chemotherapy are not eligible for this study.
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Use of any other experimental drug or therapy within 14 days of baseline.
  • Known hypersensitivity to thalidomide or lenalidomide (if applicable).
  • The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
  • Known sero-positive for active viral infection with human immunodeficiency virus, hepatitis B virus or hepatitis C virus. Patients who are sero-positive because of hepatitis B virus vaccine are eligible.
  • Patients who are not able to swallow the lenalidomide capsule as a whole are excluded from this study.
  • Patients with impaired gastrointestinal absorption
  • Symptomatic congestive heart failure
  • Unstable angina pectoris or cardiac arrhythmia
  • History of adrenal insufficiency

Sites / Locations

  • University of California Comprehensive Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dose Escalation/High Dose Lenalidomide

Arm Description

Subjects are given a single dose of the drug while they are observed and tested for a period of time. If they do not exhibit any adverse side effects the dose is escalated, and a new group of subjects is then given a higher dose.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (measured by NCI Common Toxicity Criteria for Adverse Effects (CTCAE) version 4.0)
All patients who receive the study drug will be followed closely and evaluated for toxicity. Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental ADL. Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL. Grade 4 Life-threatening consequences; urgent intervention indicated. Grade 5 Death related to AE

Secondary Outcome Measures

Rates of complete response (CR) and complete response without platelet recovery (CRi)
Patients will be assessed for the efficacy (CR or CRi) if they have received at least 7 continuous days of study drug.
Pharmacokinetics of high-dose lenalidomide cell activity.
Plasma concentrations of lenalidomide will be studied
Define the effects of lenalidomide on T and Natural Killer (NK) cell activity.
Blood samples will be drawn and will be tested for NK cell and T cell activity.

Full Information

First Posted
June 6, 2012
Last Updated
May 26, 2020
Sponsor
Mehrdad Abedi, MD
Collaborators
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT01615042
Brief Title
Phase I Study of Lenalidomide in Patients With Acute Leukemia
Official Title
Phase I Trial of High Dose Lenalidomide in Patients With Refractory/Relapsed Acute Leukemia as a Bridge to Bone Marrow Transplant
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Terminated
Why Stopped
Lack of enrollment
Study Start Date
August 2012 (Actual)
Primary Completion Date
May 2017 (Actual)
Study Completion Date
May 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Mehrdad Abedi, MD
Collaborators
Celgene

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
Lenalidomide is a drug that alters the immune system and it may also be directly toxic to tumor. Therefore, in theory, it may reduce or prevent the growth of cancer cells or directly kill them. We will be studying how lenalidomide can be used to decrease bone marrow blast cells in preparation for a bone transplant.
Detailed Description
We hypothesize that lenalidomide in high doses can be used to decrease bone marrow blast count in patients with relapsed or refractory acute myeloid leukemia in preparation for an allogeneic stem cell transplant with acceptable toxicities that are no worse than current cytotoxic chemotherapeutic agents. The known dose-limiting toxicity at 75 mg was excessive fatigue in a previous phase I trial which in this study may be irrelevant as all study participants will have an in-patient status.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Leukemia
Keywords
Acute Leukemia, Bone Marrow Transplant, High Dose Lenalidomide

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation/High Dose Lenalidomide
Arm Type
Experimental
Arm Description
Subjects are given a single dose of the drug while they are observed and tested for a period of time. If they do not exhibit any adverse side effects the dose is escalated, and a new group of subjects is then given a higher dose.
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Other Intervention Name(s)
Revlimid
Intervention Description
Oral capsule, daily, 50mg-100mg, one cycle (21 days)
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (measured by NCI Common Toxicity Criteria for Adverse Effects (CTCAE) version 4.0)
Description
All patients who receive the study drug will be followed closely and evaluated for toxicity. Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental ADL. Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL. Grade 4 Life-threatening consequences; urgent intervention indicated. Grade 5 Death related to AE
Time Frame
One Cycle (21 days)
Secondary Outcome Measure Information:
Title
Rates of complete response (CR) and complete response without platelet recovery (CRi)
Description
Patients will be assessed for the efficacy (CR or CRi) if they have received at least 7 continuous days of study drug.
Time Frame
One Cycle (21 days)
Title
Pharmacokinetics of high-dose lenalidomide cell activity.
Description
Plasma concentrations of lenalidomide will be studied
Time Frame
At 0.25, 0.5, 1, 2, 3, 4, 6, 8, and 24 hours after dose on day 1, as well as before morning dosing on days 8, 15, and 21 during the clinical therapy
Title
Define the effects of lenalidomide on T and Natural Killer (NK) cell activity.
Description
Blood samples will be drawn and will be tested for NK cell and T cell activity.
Time Frame
Baseline and at two weeks after therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Understand and voluntarily sign an informed consent form. Between 18 and 80 years of age at the time of signing the informed consent form. Able to adhere to the study visit schedule and other protocol requirements. Non-M3 Acute Myeloid Leukemia with the presence of residual disease in the bone marrow on day 14-28 post induction (or re-induction) chemotherapy. Day 14-28 residual disease is defined in this study as the presence of more than 10 % blasts in the marrow, presence of between 5-10% blasts cells that are not in cluster in hypocellular marrow is ambiguous and bone marrow biopsy should be repeated in 5-7 days. Patient should have an already identified sibling, matched unrelated donor or cord blood donor at the time of enrollment to this clinical trial. Eastern Cooperative Oncology Group (ECOG) performance status of equal or less than 3 at study entry (this patient population is typically admitted and is in the hospital) Laboratory test results within defined ranges Disease free of other malignancies beside the acute myeloid leukemia (AML) for greater than or equal to 2 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast. All study participants must be registered into the mandatory RevAssist® program, and be willing and able to comply with the requirements of RevAssist®. Females of childbearing potential (FCBP)must have a negative serum or urine pregnancy test with a sensitivity of at least 50 milli-International unit (mIU)/mL within 10 - 14 days and again within 24 hours prior to prescribing lenalidomide prescriptions must be filled within 7 days as required by RevAssist) and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. Exclusion Criteria: Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form. Pregnant or breast feeding females (Lactating females must agree not to breast feed while taking lenalidomide). Patients younger than 50 years old, after first induction of chemotherapy, who are able to safely tolerate re-induction therapy with high dose chemotherapy are not eligible for this study. Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study. Use of any other experimental drug or therapy within 14 days of baseline. Known hypersensitivity to thalidomide or lenalidomide (if applicable). The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs. Known sero-positive for active viral infection with human immunodeficiency virus, hepatitis B virus or hepatitis C virus. Patients who are sero-positive because of hepatitis B virus vaccine are eligible. Patients who are not able to swallow the lenalidomide capsule as a whole are excluded from this study. Patients with impaired gastrointestinal absorption Symptomatic congestive heart failure Unstable angina pectoris or cardiac arrhythmia History of adrenal insufficiency
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mehrdad Abedi, MD
Organizational Affiliation
University of California, Davis
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California Comprehensive Cancer Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.ucdmc.ucdavis.edu/cancer/
Description
University of California Davis Comprehensive Cancer Center Website

Learn more about this trial

Phase I Study of Lenalidomide in Patients With Acute Leukemia

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