Study With Temsirolimus Added to Standard Chemotherapy for Patients Over 60 Years With Acute Myeloblastic Leukemia (TOR-AML)
Primary Purpose
Acute Myeloblastic Leukemia
Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
sodium chloride solution 0.9%
temsirolimus
Sponsored by
About this trial
This is an interventional treatment trial for Acute Myeloblastic Leukemia
Eligibility Criteria
Inclusion Criteria:
- Newly diagnosed AML (except APL) according to the FAB classification, including AML evolving from MDS or other hematological diseases and AML after previous cytotoxic therapy or radiation (secondary AML)
- Bone marrow aspirate or biopsy contains ≥ 20% blasts of all nucleated cells or differential blood count must contain ≥ 20% blasts. In AML FAB M6 ≥ 30% of non-erythroid cells in the bone marrow must be leukemic blasts. In AML defined by cytogenetic aberrations the proportion of blasts may be < 20%.
- Age ≥ 61 years
- Informed consent, personally signed and dated to participate in the study
- Willingness of male patients whose sexual partners are women of child-bearing potential (WOCBP), to use an effective form of contraception (pearl index < 1%) during the study and at least 6 months thereafter.
Exclusion Criteria:
- Patients who are not eligible for standard chemotherapy
- Previous treatment for AML, except leukapheresis for patients with hyperleukocytosis (leukocytes > 100,000/µl and / or leukostatic syndrome) or hydroxyurea
- Known central nervous system manifestation of AML
- Cardiac Disease: Heart failure NYHA III° or IV°; active coronary artery disease (MI more than 6 months prior to study entry is permitted); serious cardiac ventricular arrhythmias, defined as: ventricular extrasystoles grade LOWN IV, sustained or non-sustained ventricular tachycardias, and history of ventricular fibrillation / ventricular flutter, unless patient is protected by an internal cardioverter / defibrillator or ventricular arrhythmia was attributable to a myocardial ischemia > 6 months before study entry.
- Chronically impaired renal function (creatinine clearance < 30 ml / min)
- Chronic pulmonary disease with relevant hypoxia
- Inadequate liver function (ALT and AST ≥ 2.5 x ULN) if not caused by leukemic infiltration
- Total bilirubin ≥ 1.2 mg/dL if not caused by leukemic infiltration
- Uncontrolled active infection
- Concurrent malignancies other than AML with an estimated life expectancy of less than two years and requiring therapy
- Known HIV and/or hepatitis C infection
- Evidence or history of CNS disease, including primary or metastatic brain tumors, seizure disorders
- History of organ allograft
- Concomitant treatment with kinase inhibitors, angiogenesis inhibitors, calcineurin inhibitors and Mylotarg
- Serious, non-healing wound, ulcer or bone fracture
- Allergy to study medication or excipients in study medication
- Investigational drug therapy outside of this trial during or within 4 weeks of study entry
- Any severe concomitant condition which makes it undesirable for the patient to participate in the study or which could jeopardise compliance with the protocol
Sites / Locations
- Charité University Hospital Berlin, Campus Benjamin Franklin
- University Hospital Dresden
- University Hospital Erlangen
- University Hospital Frankfurt
- University Hospital Münster
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Experimental
Arm Label
sodium chloride solution 0.9%
temsirolimus
Arm Description
Outcomes
Primary Outcome Measures
median Event Free Survival (EFS)
Event Free Survival defined as time interval from day 1 of study treatment until treatment failure, relapse from complete remission (CR) or incomplete remission (CRi), or death from any cause, whichever occurs first.
event free survival probability
Event Free Survival defined as time interval from day 1 of study treatment until treatment failure, relapse from complete remission (CR) or incomplete remission (CRi), or death from any cause, whichever occurs first.
Secondary Outcome Measures
median Event Free Survival (EFS) of AML patients with different cytogenetic and molecular risk groups
rate of early response after the first induction cycle in the temsirolimus and the control group
rate of early response of AML patients with different cytogenetic and molecular risk groups
Complete Remission (CR) rate in the temsirolimus and the control group
CR rate of AML patients with different cytogenetic and molecular risk groups
Relapse Free Survival (RFS) of AML patients in the temsirolimus and the control group
Relapse Free Survival (RFS) of AML patients with different cytogenetic and molecular risk groups
Overall Survival (OS) of all AML patients in the temsirolimus and the control group
Overall Survival (OS) of AML patients with different cytogenetic and molecular risk groups
rate of molecular remissions in the temsirolimus and the control group
Number of adverse events in the temsirolimus and the control group
rate of molecular relapse after molecular remission of all AML patients in the temsirolimus and the control group after induction therapy and in the course of the first remission
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01611116
Brief Title
Study With Temsirolimus Added to Standard Chemotherapy for Patients Over 60 Years With Acute Myeloblastic Leukemia
Acronym
TOR-AML
Official Title
A Double-blind, Placebo-controlled, Randomized, Multicenter Phase II Trial to Assess the Efficacy of Temsirolimus Added to Standard Primary Therapy in Elderly Patients With Newly Diagnosed AML
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
May 2012 (undefined)
Primary Completion Date
April 26, 2017 (Actual)
Study Completion Date
April 26, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Goethe University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Standard chemotherapy is capable of eliminating most leukemic blasts in acute myeloblastic leukemia (AML), while leukemia-initiating cells are not sufficiently eradicated. As a consequence, refractory disease and relapse frequently occur in AML, especially in elderly patients. The investigators propose that the addition of temsirolimus may improve standard AML chemotherapy. Furthermore, temsirolimus may specifically target the leukemia-initiating cells in AML, thereby reducing the risk of leukemia relapse.
The study's main part is preceded by a open label run-in part, in which optimal temsirolimus dose and schedule for the main part o the study will be determined.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloblastic Leukemia
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
33 (Actual)
8. Arms, Groups, and Interventions
Arm Title
sodium chloride solution 0.9%
Arm Type
Placebo Comparator
Arm Title
temsirolimus
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
sodium chloride solution 0.9%
Intervention Description
intravenous application added to standard chemotherapy on up to 8 predefined days during the course of study treatment
Intervention Type
Drug
Intervention Name(s)
temsirolimus
Other Intervention Name(s)
Torisel
Intervention Description
intravenous application added to standard chemotherapy on up to 16 predefined days during the course of study treatment
Primary Outcome Measure Information:
Title
median Event Free Survival (EFS)
Description
Event Free Survival defined as time interval from day 1 of study treatment until treatment failure, relapse from complete remission (CR) or incomplete remission (CRi), or death from any cause, whichever occurs first.
Time Frame
participants will be followed for one year after start of study treatment
Title
event free survival probability
Description
Event Free Survival defined as time interval from day 1 of study treatment until treatment failure, relapse from complete remission (CR) or incomplete remission (CRi), or death from any cause, whichever occurs first.
Time Frame
participants will be followed for one year after start of study treatment
Secondary Outcome Measure Information:
Title
median Event Free Survival (EFS) of AML patients with different cytogenetic and molecular risk groups
Time Frame
participants will be followed for one year after start of study treatment
Title
rate of early response after the first induction cycle in the temsirolimus and the control group
Time Frame
participants will be followed for one year after start of study treatment
Title
rate of early response of AML patients with different cytogenetic and molecular risk groups
Time Frame
participants will be followed for one year after start of study treatment
Title
Complete Remission (CR) rate in the temsirolimus and the control group
Time Frame
participants will be followed for one year after start of study treatment
Title
CR rate of AML patients with different cytogenetic and molecular risk groups
Time Frame
participants will be followed for one year after start of study treatment
Title
Relapse Free Survival (RFS) of AML patients in the temsirolimus and the control group
Time Frame
participants will be followed for one year after start of study treatment
Title
Relapse Free Survival (RFS) of AML patients with different cytogenetic and molecular risk groups
Time Frame
participants will be followed for one year after start of study treatment
Title
Overall Survival (OS) of all AML patients in the temsirolimus and the control group
Time Frame
participants will be followed for one year after start of study treatment
Title
Overall Survival (OS) of AML patients with different cytogenetic and molecular risk groups
Time Frame
participants will be followed for one year after start of study treatment
Title
rate of molecular remissions in the temsirolimus and the control group
Time Frame
participants will be followed for one year after start of study treatment
Title
Number of adverse events in the temsirolimus and the control group
Time Frame
participants will be followed for one year after start of study treatment
Title
rate of molecular relapse after molecular remission of all AML patients in the temsirolimus and the control group after induction therapy and in the course of the first remission
Time Frame
participants will be followed for one year after start of study treatment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
61 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Newly diagnosed AML (except APL) according to the FAB classification, including AML evolving from MDS or other hematological diseases and AML after previous cytotoxic therapy or radiation (secondary AML)
Bone marrow aspirate or biopsy contains ≥ 20% blasts of all nucleated cells or differential blood count must contain ≥ 20% blasts. In AML FAB M6 ≥ 30% of non-erythroid cells in the bone marrow must be leukemic blasts. In AML defined by cytogenetic aberrations the proportion of blasts may be < 20%.
Age ≥ 61 years
Informed consent, personally signed and dated to participate in the study
Willingness of male patients whose sexual partners are women of child-bearing potential (WOCBP), to use an effective form of contraception (pearl index < 1%) during the study and at least 6 months thereafter.
Exclusion Criteria:
Patients who are not eligible for standard chemotherapy
Previous treatment for AML, except leukapheresis for patients with hyperleukocytosis (leukocytes > 100,000/µl and / or leukostatic syndrome) or hydroxyurea
Known central nervous system manifestation of AML
Cardiac Disease: Heart failure NYHA III° or IV°; active coronary artery disease (MI more than 6 months prior to study entry is permitted); serious cardiac ventricular arrhythmias, defined as: ventricular extrasystoles grade LOWN IV, sustained or non-sustained ventricular tachycardias, and history of ventricular fibrillation / ventricular flutter, unless patient is protected by an internal cardioverter / defibrillator or ventricular arrhythmia was attributable to a myocardial ischemia > 6 months before study entry.
Chronically impaired renal function (creatinine clearance < 30 ml / min)
Chronic pulmonary disease with relevant hypoxia
Inadequate liver function (ALT and AST ≥ 2.5 x ULN) if not caused by leukemic infiltration
Total bilirubin ≥ 1.2 mg/dL if not caused by leukemic infiltration
Uncontrolled active infection
Concurrent malignancies other than AML with an estimated life expectancy of less than two years and requiring therapy
Known HIV and/or hepatitis C infection
Evidence or history of CNS disease, including primary or metastatic brain tumors, seizure disorders
History of organ allograft
Concomitant treatment with kinase inhibitors, angiogenesis inhibitors, calcineurin inhibitors and Mylotarg
Serious, non-healing wound, ulcer or bone fracture
Allergy to study medication or excipients in study medication
Investigational drug therapy outside of this trial during or within 4 weeks of study entry
Any severe concomitant condition which makes it undesirable for the patient to participate in the study or which could jeopardise compliance with the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christian Brandts, MD
Organizational Affiliation
Goethe University
Official's Role
Study Director
Facility Information:
Facility Name
Charité University Hospital Berlin, Campus Benjamin Franklin
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
University Hospital Dresden
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
University Hospital Erlangen
City
Erlangen
ZIP/Postal Code
91054
Country
Germany
Facility Name
University Hospital Frankfurt
City
Frankfurt am Main
ZIP/Postal Code
60590
Country
Germany
Facility Name
University Hospital Münster
City
Münster
ZIP/Postal Code
48149
Country
Germany
12. IPD Sharing Statement
Citations:
Citation
Posting of Results in EUDRACT Database: https://www.clinicaltrialsregister.eu/ctr-search/trial/2011-002365-37/results
Results Reference
result
Links:
URL
http://www.uct-frankfurt.de
Description
University Cancer Center Frankfurt
URL
http://www.kompetenznetz-leukaemie.de
Description
German Competency Network for Leukemia
Learn more about this trial
Study With Temsirolimus Added to Standard Chemotherapy for Patients Over 60 Years With Acute Myeloblastic Leukemia
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