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Phase I Trial of Vorinostat (MK-0683, SAHA) in Combination With Decitabine in Patients With AML or MDS (MK-0683-055 EXT1)

Primary Purpose

Leukemia, Myelocytic, Acute Myelodysplastic Syndromes, Myelodysplastic Syndromes

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
vorinostat
decitabine
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Myelocytic, Acute Myelodysplastic Syndromes focused on measuring Leukemia, Myelocytic, Acute Myelodysplastic Syndromes

Eligibility Criteria

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

Inclusion Criteria:

  • Patient is at least 18 years old with refractory/relapsed AML

    • If untreated AML, patient is older than 60 years old and not a candidate for standard chemotherapy
  • Patient is at least 4 weeks from prior treatment and has recovered from all prior treatment side effects
  • Patient has no known liver or kidney problems
  • Patient knows of no reason they can not receive transfusions of blood clotting cells (platelets)
  • Patient is able to swallow capsules
  • Patients both male and female are willing to practice birth control during the study

Exclusion Criteria:

  • Patient has received prior treatment with valproic acid, decitabine or azacitidine
  • Being is less than 18 years of age or if patient has untreated AML is below 60 years of age
  • Patient is a women who is pregnant or breastfeeding. Patient has an active infection that requires antibiotics
  • Patient has uncontrolled illness including but not limited to the following: heart problems (congestive heart failure, unstable angina pectoris, cardiac arrhythmia), inflammation of the pancreas; a mental or social condition that may interfere with patient following study procedures
  • Patient has known human immunodeficiency virus (HIV) infection or HIV-related malignancy. Patient has a known history of hepatitis B or C infection
  • Patient currently has another active cancer other than certain types of skin cancer
  • Patient is heterosexual and able to have a child and is unwilling to practice birth control during the study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Cohort 1: Vorinostat (sequential)

    Cohort 2: Vorinostat (concurrent)

    Arm Description

    Vorinostat 400 mg capsules once daily given 7, 10 or 14 days in 28 day cycles. Up to 24 months of treatment. Decitabine IV 20 mg/m^2 daily for 5 days in each 28 day cycle. Up to 24 months of treatment.

    Vorinostat 400 mg capsules once daily given 7 days, 14 days with 8 day break after first 7 days or 14 days without break, out of 28 day cycles. Decitabine IV 20 mg/m^2 daily for 5 days in each 28 day cycle. Up to 24 months of treatment.

    Outcomes

    Primary Outcome Measures

    Number of Participants Experiencing Dose Limiting Toxicity (DLT) Events
    Participants who received at least one dose of vorinostat in combination with decitabine intravenous (IV) at a dose of 20 mg/m^2 daily for 5 days along with oral vorinostat 400 mg once daily for 7 to 14 days in a 28-day cycle concurrently or sequentially, were evaluated to determine the maximum tolerable dose (MTD) determined by the number of participants experiencing dose limiting toxicity (DLT) events defined as any Grade 3 or 4 non-hematological toxicity (reported adverse event) and/or myelosuppression lasting >42 days.

    Secondary Outcome Measures

    Full Information

    First Posted
    May 24, 2007
    Last Updated
    September 4, 2015
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00479232
    Brief Title
    Phase I Trial of Vorinostat (MK-0683, SAHA) in Combination With Decitabine in Patients With AML or MDS (MK-0683-055 EXT1)
    Official Title
    A Phase I Clinical Trial of Vorinostat in Combination With Decitabine in Patients With Acute Myelogenous Leukemia or Myelodysplastic Syndrome
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2015
    Overall Recruitment Status
    Completed
    Study Start Date
    June 2007 (undefined)
    Primary Completion Date
    April 2010 (Actual)
    Study Completion Date
    March 2012 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    5. Study Description

    Brief Summary
    This study is to evaluate the safety and tolerability of vorinostat in combination with decitabine as well as the in vivo molecular and biological effects of vorinostat in patients with refractory or relapsed Acute Myelogenous Leukemia (AML) and intermediate or high risk as defined by International Prognostic Scoring System (IPSS) Myelodysplastic Syndrome (MDS). Participants with Acute Myelogenous Leukemia or Myelodysplastic Syndrome are eligible.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Leukemia, Myelocytic, Acute Myelodysplastic Syndromes, Myelodysplastic Syndromes
    Keywords
    Leukemia, Myelocytic, Acute Myelodysplastic Syndromes

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    71 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Cohort 1: Vorinostat (sequential)
    Arm Type
    Experimental
    Arm Description
    Vorinostat 400 mg capsules once daily given 7, 10 or 14 days in 28 day cycles. Up to 24 months of treatment. Decitabine IV 20 mg/m^2 daily for 5 days in each 28 day cycle. Up to 24 months of treatment.
    Arm Title
    Cohort 2: Vorinostat (concurrent)
    Arm Type
    Experimental
    Arm Description
    Vorinostat 400 mg capsules once daily given 7 days, 14 days with 8 day break after first 7 days or 14 days without break, out of 28 day cycles. Decitabine IV 20 mg/m^2 daily for 5 days in each 28 day cycle. Up to 24 months of treatment.
    Intervention Type
    Drug
    Intervention Name(s)
    vorinostat
    Other Intervention Name(s)
    MK-0683, SAHA
    Intervention Type
    Drug
    Intervention Name(s)
    decitabine
    Other Intervention Name(s)
    Dacogen
    Primary Outcome Measure Information:
    Title
    Number of Participants Experiencing Dose Limiting Toxicity (DLT) Events
    Description
    Participants who received at least one dose of vorinostat in combination with decitabine intravenous (IV) at a dose of 20 mg/m^2 daily for 5 days along with oral vorinostat 400 mg once daily for 7 to 14 days in a 28-day cycle concurrently or sequentially, were evaluated to determine the maximum tolerable dose (MTD) determined by the number of participants experiencing dose limiting toxicity (DLT) events defined as any Grade 3 or 4 non-hematological toxicity (reported adverse event) and/or myelosuppression lasting >42 days.
    Time Frame
    Day 1 to 28 of Cycle 1
    Other Pre-specified Outcome Measures:
    Title
    Objective Response Rate in Participants Treated With Vorinostat + Decitabine With Refractory or Relapse Acute Myelogenous Leukemia (AML)
    Description
    Objective Response Rate was measured in participants with refractory or relapse AML (acute myelogenous leukemia) in combination with Decitabine who were treated with vorinostat and decitabine on either a concurrent or sequential regimen. The Objective response was defined as any confirmed complete remission or any confirmed partial remission for AML participants and complete remission, confirmed partial remission or confirmed hematologic improvement for Myelodysplastic Syndrome (MDS) participants.
    Time Frame
    Approximately 6 months
    Title
    Objective Response Rate in Participants Treated With Vorinostat + Decitabine With Intermediate-high Risk Myelodysplastic Syndrome (MDS) or Untreated Acute Myelogenous Leukemia (AML)
    Description
    Objective Response Rate was measured in participants with intermediate-high risk MDS or untreated AML who were treated with vorinostat and decitabine either on a concurrent or sequential regimen. The Objective response was defined as any confirmed complete remission or any confirmed partial remission for AML participants and complete remission, confirmed partial remission or confirmed hematologic improvement for MDS participants.
    Time Frame
    Approximately 6 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patient is at least 18 years old with refractory/relapsed AML If untreated AML, patient is older than 60 years old and not a candidate for standard chemotherapy Patient is at least 4 weeks from prior treatment and has recovered from all prior treatment side effects Patient has no known liver or kidney problems Patient knows of no reason they can not receive transfusions of blood clotting cells (platelets) Patient is able to swallow capsules Patients both male and female are willing to practice birth control during the study Exclusion Criteria: Patient has received prior treatment with valproic acid, decitabine or azacitidine Being is less than 18 years of age or if patient has untreated AML is below 60 years of age Patient is a women who is pregnant or breastfeeding. Patient has an active infection that requires antibiotics Patient has uncontrolled illness including but not limited to the following: heart problems (congestive heart failure, unstable angina pectoris, cardiac arrhythmia), inflammation of the pancreas; a mental or social condition that may interfere with patient following study procedures Patient has known human immunodeficiency virus (HIV) infection or HIV-related malignancy. Patient has a known history of hepatitis B or C infection Patient currently has another active cancer other than certain types of skin cancer Patient is heterosexual and able to have a child and is unwilling to practice birth control during the study
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Monitor
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    25040094
    Citation
    Kirschbaum M, Gojo I, Goldberg SL, Bredeson C, Kujawski LA, Yang A, Marks P, Frankel P, Sun X, Tosolini A, Eid JE, Lubiniecki GM, Issa JP. A phase 1 clinical trial of vorinostat in combination with decitabine in patients with acute myeloid leukaemia or myelodysplastic syndrome. Br J Haematol. 2014 Oct;167(2):185-93. doi: 10.1111/bjh.13016. Epub 2014 Jul 8.
    Results Reference
    result

    Learn more about this trial

    Phase I Trial of Vorinostat (MK-0683, SAHA) in Combination With Decitabine in Patients With AML or MDS (MK-0683-055 EXT1)

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