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Study of XIAP Antisense Given With Chemotherapy for Refractory/Relapsed AML

Primary Purpose

Leukemia, Myelomonocytic, Acute

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
XIAP antisense
Sponsored by
Aegera Therapeutics
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Myelomonocytic, Acute focused on measuring AML, leukemia, relapse, refractory, antisense, oligonucleotide

Eligibility Criteria

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

Inclusion Criteria Subjects with relapsed or refractory AML, except those with APL (acute promyelocytic leukemia), that are about to receive their initial treatment for first relapse after an initial CR that lasted less than 6 months or for primary refractory AML that have an expected complete response rate ≤20%. The initial diagnosis of AML has to be based on the presence of > 10% blasts in marrow or blood, and the diagnosis of relapsed/refractory AML based on the presence of either > 10% blasts in marrow or blood or 5-10% blasts in either site together with cytopenia (Hb < 10 g/dL, or platelets < 100,000 /uL, or neutrophil count < 1000 /uL). Peripheral AML blast count < 50,000 /uL that is not projected to rise above 50,000 /uL within 5 days of beginning treatment. Subjects must have an Eastern Cooperative Oncology Group (ECOG) performance status of ≤2. Subjects must be >18 years old. Male, or female subjects who are post-menopausal (amenorrhagic for at least 12 months), or surgically or biologically sterile. Females of childbearing potential with a negative serum pregnancy test 72-96 hours prior to the 1st infusion in the study and using adequate forms of contraception for the duration of the study, including 30 days after the last treatment. Adequate methods of contraception should be used by both male and female subjects. Subjects must have adequate organ and immune function as indicated by the following laboratory values: Parameter Laboratory Values Serum creatinine; <2.0mg/dL Total Bilirubin <2.0mg/dL AST (SGOT) and ALT (SGPT) <3 X ULN * *ULN: Institution's upper limit of normal. The subject must understand and be able and willing and likely to fully comply with study procedures, including scheduled follow-up, and restrictions. The subject, or the subject's legal guardian, must have given written personally signed and dated informed consent to participate in the study, in accordance with the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines, before completing any study related procedures. Exclusion Criteria Clinical evidence of active CNS leukemic involvement. Patients with left-ventricular ejection fractions <50%. Active and uncontrolled infection. Patients with an infection that are under active treatment with antibiotics and whose infections are controlled may be entered to the study. Current evidence of invasive fungal infection (blood or tissue culture). Current evidence of an active second malignancy except for non-melanoma skin cancer. Uncontrolled medical problems, unrelated to the malignancy, or of sufficient severity that in the opinion of the investigator, impair a subject's ability to give informed consent or unacceptably reduce the safety of the proposed treatment. Neurological or psychiatric disorders that would interfere with consent or study follow-up. Known or suspected intolerance or hypersensitivity to the study materials [or closely related compounds] or any of their stated ingredients. History of alcohol or other substance abuse within the last year. Use of another investigational agent or participation in a clinical trial within the last 14 days prior to enrolment. Subjects who have used a previous AS agent for at least 90 days will be excluded. Female subjects who are pregnant or lactating, or females with a positive pregnancy test at screening must be excluded. Subjects that have previously been enrolled into this study and subsequently withdrawn must also be excluded.

Sites / Locations

  • Norris Cancer Center - University of Southern California
  • UCLA Medical Center
  • Northwestern Memorial Hospital
  • Johns Hopkins - Sidney Kimmel Comprehensive Cancer Center
  • M.D. Anderson Cancer Center
  • Princess Margaret Hospital
  • Hopital Maisonneuve-Rosemont

Outcomes

Primary Outcome Measures

Dose at which AEG35156 when combined with fixed doses of ara-C and idarubicin, produces acceptable CR and toxicity rates as defined and observed at 30 days post-last dose

Secondary Outcome Measures

Effects of AEG35156 on XIAP mRNA and protein expression and plasma pharmacokinetic profile of AEG35156.

Full Information

First Posted
August 10, 2006
Last Updated
November 30, 2009
Sponsor
Aegera Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT00363974
Brief Title
Study of XIAP Antisense Given With Chemotherapy for Refractory/Relapsed AML
Official Title
An Open-Label Phase I/II Study of XIAP Antisense AEG35156 Administered to Patients With Refractory/Relapsed AML in Combination With Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
November 2009
Overall Recruitment Status
Completed
Study Start Date
October 2005 (undefined)
Primary Completion Date
March 2009 (Actual)
Study Completion Date
March 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Aegera Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine if the drug, called AEG35156, can be safely given to AML patients and whether it effectively reduces levels of a protein (XIAP) to increase the sensitivity of cancer cells to chemotherapy (ara-C and idarubicin) in patients with refractory or relapsed AML.
Detailed Description
This is a phase I/II, single-arm, open-label, study to establish the recommended dose and activity of AEG35156 administered as a daily x3 two-hour infusion prior to reinduction chemotherapy with idarubicin and ara-C followed by weekly two-hour AEG35156 infusions. Subjects eligible for study entry must have confirmed diagnosis of AML in first relapse after an initial CR that lasted less than 6 months or primary refractory AML. Fixed dose of idarubicin and ara-C will be given, plus one of eight doses of AEG35156: 12, 24, 48, 75, 110, 165, 250 and 350mg/m2. A maximum of 54 patients will be treated in cohorts of size 3, starting at 12mg/m2, and not skipping any untried dose level when escalating. Following dose escalation, approximately 20 patients will be treated at the best acceptable dose as determined by the method of Thall and Cook (2004).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Myelomonocytic, Acute
Keywords
AML, leukemia, relapse, refractory, antisense, oligonucleotide

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
54 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
XIAP antisense
Intervention Description
2 days loading dose followed by weekly 2hr infusion
Primary Outcome Measure Information:
Title
Dose at which AEG35156 when combined with fixed doses of ara-C and idarubicin, produces acceptable CR and toxicity rates as defined and observed at 30 days post-last dose
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Effects of AEG35156 on XIAP mRNA and protein expression and plasma pharmacokinetic profile of AEG35156.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Subjects with relapsed or refractory AML, except those with APL (acute promyelocytic leukemia), that are about to receive their initial treatment for first relapse after an initial CR that lasted less than 6 months or for primary refractory AML that have an expected complete response rate ≤20%. The initial diagnosis of AML has to be based on the presence of > 10% blasts in marrow or blood, and the diagnosis of relapsed/refractory AML based on the presence of either > 10% blasts in marrow or blood or 5-10% blasts in either site together with cytopenia (Hb < 10 g/dL, or platelets < 100,000 /uL, or neutrophil count < 1000 /uL). Peripheral AML blast count < 50,000 /uL that is not projected to rise above 50,000 /uL within 5 days of beginning treatment. Subjects must have an Eastern Cooperative Oncology Group (ECOG) performance status of ≤2. Subjects must be >18 years old. Male, or female subjects who are post-menopausal (amenorrhagic for at least 12 months), or surgically or biologically sterile. Females of childbearing potential with a negative serum pregnancy test 72-96 hours prior to the 1st infusion in the study and using adequate forms of contraception for the duration of the study, including 30 days after the last treatment. Adequate methods of contraception should be used by both male and female subjects. Subjects must have adequate organ and immune function as indicated by the following laboratory values: Parameter Laboratory Values Serum creatinine; <2.0mg/dL Total Bilirubin <2.0mg/dL AST (SGOT) and ALT (SGPT) <3 X ULN * *ULN: Institution's upper limit of normal. The subject must understand and be able and willing and likely to fully comply with study procedures, including scheduled follow-up, and restrictions. The subject, or the subject's legal guardian, must have given written personally signed and dated informed consent to participate in the study, in accordance with the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines, before completing any study related procedures. Exclusion Criteria Clinical evidence of active CNS leukemic involvement. Patients with left-ventricular ejection fractions <50%. Active and uncontrolled infection. Patients with an infection that are under active treatment with antibiotics and whose infections are controlled may be entered to the study. Current evidence of invasive fungal infection (blood or tissue culture). Current evidence of an active second malignancy except for non-melanoma skin cancer. Uncontrolled medical problems, unrelated to the malignancy, or of sufficient severity that in the opinion of the investigator, impair a subject's ability to give informed consent or unacceptably reduce the safety of the proposed treatment. Neurological or psychiatric disorders that would interfere with consent or study follow-up. Known or suspected intolerance or hypersensitivity to the study materials [or closely related compounds] or any of their stated ingredients. History of alcohol or other substance abuse within the last year. Use of another investigational agent or participation in a clinical trial within the last 14 days prior to enrolment. Subjects who have used a previous AS agent for at least 90 days will be excluded. Female subjects who are pregnant or lactating, or females with a positive pregnancy test at screening must be excluded. Subjects that have previously been enrolled into this study and subsequently withdrawn must also be excluded.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jacques Jolivet, MD
Organizational Affiliation
Aegera Therapeutics Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Norris Cancer Center - University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
UCLA Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Northwestern Memorial Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Johns Hopkins - Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Facility Name
M.D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-4009
Country
United States
Facility Name
Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Facility Name
Hopital Maisonneuve-Rosemont
City
Montreal
State/Province
Quebec
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
15339291
Citation
Thall PF, Cook JD. Dose-finding based on efficacy-toxicity trade-offs. Biometrics. 2004 Sep;60(3):684-93. doi: 10.1111/j.0006-341X.2004.00218.x.
Results Reference
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Study of XIAP Antisense Given With Chemotherapy for Refractory/Relapsed AML

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