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Voriconazole or Placebo in the Prophylaxis of Lung Infiltrates in Patients Undergoing Induction Chemotherapy for Acute Myelogenous Leukemia

Primary Purpose

Leukemia, Myelocytic, Acute

Status
Terminated
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
voriconazole
Sponsored by
University of Cologne
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional prevention trial for Leukemia, Myelocytic, Acute

Eligibility Criteria

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

Inclusion Criteria: Newly diagnosed or relapsed, de novo or secondary AML First induction chemotherapy cycle Expected neutropenic phase of a minimum duration of 10 days Age >= 18 years Legally signed consent form Exclusion Criteria: Known proven, probable or possible invasive fungal infection at randomization or in patient history Computed tomography (CT) with any signs of a fungal infection according to the European Organisation for the Research and Treatment of Cancer (EORTC)/Mycosis Study Group (MSG) criteria, i.e. with any infiltrate (Ascioglu, et al 2002) Any current fever unless explained by non-infectious causes Antibacterial prophylaxis other than TMP/SMX Liver function test [LFT] (AST/ALT/bilirubin) more than 3x the upper normal limit Subjects who are receiving and cannot discontinue one of the following drugs at least 24 hours prior to randomization: Drugs with a known possibility of QTc prolongation (e.g. terfenadine, astemizole, cisapride, pimozide, quinidine); Drugs whose plasma levels may be increased by voriconazole therapy (e.g. sulfonylureas, ergot alkaloids, sirolimus, vinca alkaloids). Subjects who have received the following drugs within 14 days prior to randomization: potent inducers of hepatic enzymes that will reduce voriconazole levels (e.g. rifampicin, carbamazepine and barbiturates) Concomitant therapy with absorbable antifungals Patient has a diagnosis of acute hepatitis or cirrhosis due to any cause Known hypersensitivity or other contraindication to voriconazole Patient is unwilling or unable to comply with the protocol. Diseases or disabilities preventing the patient from participating in the trial Females of childbearing potential without negative serum pregnancy test at baseline or within 72 hours prior to start of study drug

Sites / Locations

  • Johann Wolfgang Goethe-Universität Frankfurt am Main
  • Universitätsklinikum Mannheim, Universität Heidelberg
  • Klinikum der Universität Köln

Outcomes

Primary Outcome Measures

To determine the incidence of lung infiltrates until day 21 among patients undergoing the first induction chemotherapy for acute myelogenous leukemia who are randomized to prophylactic voriconazole or placebo

Secondary Outcome Measures

To determine and compare between study arms the: incidence of fever and other signs of infection
incidence and type of documented bacteremia
rate of patients with systemic open-label antifungal therapy
time to initiation of systemic open-label antifungal therapy
duration of absolute neutrophil count < 500/µl
rate and type of proven, probable and possible breakthrough invasive fungal infections
rate of patients with fever of unknown origin
incidence and severity of adverse events
trough voriconazole plasma level after day 8 of study treatment
direct costs of systemic antibiotics, antifungals and antivirals and diagnostic imaging
overall costs in terms of the diagnosis related groups applied to the study patients

Full Information

First Posted
September 7, 2005
Last Updated
November 13, 2006
Sponsor
University of Cologne
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1. Study Identification

Unique Protocol Identification Number
NCT00152594
Brief Title
Voriconazole or Placebo in the Prophylaxis of Lung Infiltrates in Patients Undergoing Induction Chemotherapy for Acute Myelogenous Leukemia
Official Title
Phase III Study of Safety, Tolerance, Efficacy, Pharmacokinetics, and Costs of Therapy With Voriconazole or Placebo in the Prophylaxis of Lung Infiltrates in Patients Undergoing Induction Chemotherapy for Acute Myelogenous Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
November 2006
Overall Recruitment Status
Terminated
Study Start Date
October 2004 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
January 2006 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
University of Cologne

4. Oversight

5. Study Description

Brief Summary
The purpose of the study is to determine whether voriconazole is as effective as antifungal prophylaxis in patients undergoing chemotherapy for acute myelogenous leukemia (AML). Hypothesis: Voriconazole is superior to placebo in the prophylaxis of lung infiltrates until day 21 after the start of induction chemotherapy.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
150 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
voriconazole
Primary Outcome Measure Information:
Title
To determine the incidence of lung infiltrates until day 21 among patients undergoing the first induction chemotherapy for acute myelogenous leukemia who are randomized to prophylactic voriconazole or placebo
Secondary Outcome Measure Information:
Title
To determine and compare between study arms the: incidence of fever and other signs of infection
Title
incidence and type of documented bacteremia
Title
rate of patients with systemic open-label antifungal therapy
Title
time to initiation of systemic open-label antifungal therapy
Title
duration of absolute neutrophil count < 500/µl
Title
rate and type of proven, probable and possible breakthrough invasive fungal infections
Title
rate of patients with fever of unknown origin
Title
incidence and severity of adverse events
Title
trough voriconazole plasma level after day 8 of study treatment
Title
direct costs of systemic antibiotics, antifungals and antivirals and diagnostic imaging
Title
overall costs in terms of the diagnosis related groups applied to the study patients

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Newly diagnosed or relapsed, de novo or secondary AML First induction chemotherapy cycle Expected neutropenic phase of a minimum duration of 10 days Age >= 18 years Legally signed consent form Exclusion Criteria: Known proven, probable or possible invasive fungal infection at randomization or in patient history Computed tomography (CT) with any signs of a fungal infection according to the European Organisation for the Research and Treatment of Cancer (EORTC)/Mycosis Study Group (MSG) criteria, i.e. with any infiltrate (Ascioglu, et al 2002) Any current fever unless explained by non-infectious causes Antibacterial prophylaxis other than TMP/SMX Liver function test [LFT] (AST/ALT/bilirubin) more than 3x the upper normal limit Subjects who are receiving and cannot discontinue one of the following drugs at least 24 hours prior to randomization: Drugs with a known possibility of QTc prolongation (e.g. terfenadine, astemizole, cisapride, pimozide, quinidine); Drugs whose plasma levels may be increased by voriconazole therapy (e.g. sulfonylureas, ergot alkaloids, sirolimus, vinca alkaloids). Subjects who have received the following drugs within 14 days prior to randomization: potent inducers of hepatic enzymes that will reduce voriconazole levels (e.g. rifampicin, carbamazepine and barbiturates) Concomitant therapy with absorbable antifungals Patient has a diagnosis of acute hepatitis or cirrhosis due to any cause Known hypersensitivity or other contraindication to voriconazole Patient is unwilling or unable to comply with the protocol. Diseases or disabilities preventing the patient from participating in the trial Females of childbearing potential without negative serum pregnancy test at baseline or within 72 hours prior to start of study drug
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Oliver A. Cornely, MD
Organizational Affiliation
Klinikum der Universität Köln
Official's Role
Principal Investigator
Facility Information:
Facility Name
Johann Wolfgang Goethe-Universität Frankfurt am Main
City
Frankfurt am Main
ZIP/Postal Code
60590
Country
Germany
Facility Name
Universitätsklinikum Mannheim, Universität Heidelberg
City
Heidelberg
ZIP/Postal Code
68305
Country
Germany
Facility Name
Klinikum der Universität Köln
City
Köln
ZIP/Postal Code
50931
Country
Germany

12. IPD Sharing Statement

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Voriconazole or Placebo in the Prophylaxis of Lung Infiltrates in Patients Undergoing Induction Chemotherapy for Acute Myelogenous Leukemia

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