Chronic Myelomonocytic Leukemia Clinical Trial
Official title:
A Randomized Phase II Trial of Azacitidine With or Without the Histone Deacetylase Inhibitor Entinostat for the Treatment of Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia (Dysplastic Type), and Acute Myeloid Leukemia With Multilineage Dysplasia
This randomized phase II trial studies azacitidine with or without entinostat to see how well they work compared to azacitidine alone in treating patients with myelodysplastic syndromes, chronic myelomonocytic leukemia, or acute myeloid leukemia. Drugs used in chemotherapy, such as azacitidine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Entinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving azacitidine together with entinostat may work better in treating patients with myelodysplastic syndromes, chronic myelomonocytic leukemia, or acute myeloid leukemia.
Status | Active, not recruiting |
Enrollment | 197 |
Est. completion date | April 2016 |
Est. primary completion date | July 2013 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - The following diagnoses will be eligible for this study: - Myelodysplastic syndromes: the diagnosis of MDS must be confirmed by a bone marrow aspirate and/or biopsy within two weeks prior to registration; NOTE: blast count must be < 20%; patients with any International Prognostic Score (IPSS) are eligible; patients with low or intermediate (INT)-1 IPSS must have a platelet count < 50,000/mm^3 and/or absolute neutrophil count (ANC) < 500/mm^3 within seven days prior to registration - Chronic myelomonocytic leukemia (dysplastic subtype): the diagnosis of CMMoL must be confirmed by a bone marrow aspirate and/or biopsy within two weeks prior to registration; patients with CMMoL must have a WBC < 12,000/mm^3, documented within 4 weeks prior to study entry (two sets of counts that are 2 weeks apart will be taken) - Acute myeloid leukemia with multilineage dysplasia: the diagnosis of AML-TLD must be confirmed by a bone marrow aspirate and/or biopsy within two weeks prior to registration; NOTE: there must be evidence of >= 20% blasts on the review of the bone marrow aspirate and/or biopsy; AML-TLD will be interpreted to include patients formerly diagnosed by French-American-British (FAB) criteria as refractory anemia with excess blasts in transformation (RAEB-t), as well as patients with no history of antecedent hematologic disorder who have AML which meets criteria for AML-TLD by World Health Organization (WHO) criteria; patients with AML-TLD must have a white blood cell (WBC) =< 30,000/mm^3 documented within 4 weeks prior to study entry (two sets of counts that are 2 weeks apart will be taken); patients whose WBC has doubled within this period of time and is greater than 20,000/mm^3 at the time of screening will not be eligible - Women must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study within two weeks prior to registration to rule out pregnancy - Women of childbearing potential and sexually active males must be strongly advised to use an accepted and effective method of contraception - Patient must have Eastern Cooperative Oncology Group (ECOG) performance status between 0-2 - Patient must have no prior treatment with azacitidine, decitabine or entinostat - Patients must not have active infections at the time of registration - Serum creatinine < 2.0 mg/dL; test must be done within seven days prior to registration - Total serum bilirubin within institutional limits unless due to intra- or extramedullary hemolysis or Gilbert's syndrome; test must be done within seven days prior to registration - Aspartate transaminase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine transaminase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional upper limit of normal (ULN); tests must be done within seven days prior to registration - Patients must not have received any AML induction chemotherapy or stem cell transplantation; any other treatment for their disease, including hematopoietic growth factors may not be given, within three weeks prior to registration, and should have recovered from all toxicities of prior therapy (to grade 0 or 1) - Patients must have no clinical evidence of central nervous system (CNS) or pulmonary leukostasis, disseminated intravascular coagulation, or CNS leukemia - Patients must have no serious or uncontrolled medical conditions - Patients who have therapy-induced MDS, CMMoL (dysplastic) and AML-TLD are eligible and will be treated as separate cohorts from the patients with de novo MDS, CMMoL (dysplastic) and AML-TLD - Patients should have a life expectancy of at least six months - Patients must not have advanced malignant hepatic tumors - Patients must not have a known hypersensitivity to azacitidine or mannitol - Southwest Oncology Group (SWOG) ONLY: all SWOG patients must be registered on SWOG-9007 ("Cytogenetic Studies in Leukemia Patients"); collection of the pretreatment bone marrow specimen (or of peripheral blood if the marrow is not aspirable) must be completed within 28 days before registration; the pretreatment specimen must be submitted to a SWOG-approved cytogenetics laboratory as described in protocol SWOG-9007; note that submission of bone marrow cytogenetic studies are required to calculate the IPSS score (stratification issue); in addition, cytogenetic response will be measured at follow-up requiring a second cytogenetic study at the end of protocol treatment; NOTE: In addition to SWOG-9007, SWOG patients must be offered participation in S9910, the leukemia centralized reference laboratories and tissue repositories ancillary study; If consent is given, collection of pretreatment blood and/or marrow specimens must be completed within 14 days prior to registration. If the patient consents to participate in S9910, pretreatment specimens of marrow and/or peripheral blood must be submitted to the Southwest Oncology Group Myeloid Repository at the University of New Mexico for cellular and molecular studies; S9910 also requests submission of remission and relapse specimens |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Akron General Medical Center | Akron | Ohio |
United States | Presbyterian Kaseman Hospital | Albuquerque | New Mexico |
United States | McFarland Clinic PC-William R Bliss Cancer Center | Ames | Iowa |
United States | Hospital District Sixth of Harper County | Anthony | Kansas |
United States | Emory University/Winship Cancer Institute | Atlanta | Georgia |
United States | Rush - Copley Medical Center | Aurora | Illinois |
United States | The Medical Center of Aurora | Aurora | Colorado |
United States | Johns Hopkins University/Sidney Kimmel Cancer Center | Baltimore | Maryland |
United States | University of Maryland/Greenebaum Cancer Center | Baltimore | Maryland |
United States | Eastern Maine Medical Center | Bangor | Maine |
United States | Sanford Clinic North-Bemidgi | Bemidji | Minnesota |
United States | MacNeal Hospital and Cancer Center | Berwyn | Illinois |
United States | Billings Clinic Cancer Center | Billings | Montana |
United States | Frontier Cancer Center and Blood Institute-Billings | Billings | Montana |
United States | Montana Cancer Consortium NCORP | Billings | Montana |
United States | Northern Rockies Radiation Oncology Center | Billings | Montana |
United States | Saint Vincent Healthcare | Billings | Montana |
United States | Illinois CancerCare-Bloomington | Bloomington | Illinois |
United States | Saint Joseph Medical Center | Bloomington | Illinois |
United States | Boston Medical Center | Boston | Massachusetts |
United States | Boulder Community Hospital | Boulder | Colorado |
United States | Bozeman Deaconess Cancer Center | Bozeman | Montana |
United States | Bozeman Deaconess Hospital | Bozeman | Montana |
United States | Ocean Medical Center | Brick | New Jersey |
United States | Albert Einstein College of Medicine | Bronx | New York |
United States | Montefiore Medical Center - Moses Campus | Bronx | New York |
United States | Bryn Mawr Hospital | Bryn Mawr | Pennsylvania |
United States | Roswell Park Cancer Institute | Buffalo | New York |
United States | Providence Saint Joseph Medical Center/Disney Family Cancer Center | Burbank | California |
United States | Saint James Community Hospital and Cancer Treatment Center | Butte | Montana |
United States | Cooper Hospital University Medical Center | Camden | New Jersey |
United States | Graham Hospital Association | Canton | Illinois |
United States | Illinois CancerCare-Canton | Canton | Illinois |
United States | Southeast Missouri Hospital | Cape Girardeau | Missouri |
United States | Illinois CancerCare-Carthage | Carthage | Illinois |
United States | Memorial Hospital | Carthage | Illinois |
United States | Rocky Mountain Oncology | Casper | Wyoming |
United States | Cancer Center of Kansas - Chanute | Chanute | Kansas |
United States | Carolinas Medical Center/Levine Cancer Institute | Charlotte | North Carolina |
United States | Hematology and Oncology Associates | Chicago | Illinois |
United States | Jesse Brown Veterans Affairs Medical Center | Chicago | Illinois |
United States | John H Stroger Jr Hospital of Cook County | Chicago | Illinois |
United States | Mercy Hospital and Medical Center | Chicago | Illinois |
United States | Northwestern University | Chicago | Illinois |
United States | Saint Joseph Hospital | Chicago | Illinois |
United States | University of Chicago Comprehensive Cancer Center | Chicago | Illinois |
United States | University of Illinois | Chicago | Illinois |
United States | Weiss Memorial Hospital | Chicago | Illinois |
United States | Case Western Reserve University | Cleveland | Ohio |
United States | Medical Oncology and Hematology Associates-West Des Moines | Clive | Iowa |
United States | Penrose-Saint Francis Healthcare | Colorado Springs | Colorado |
United States | University of Missouri - Ellis Fischel | Columbia | Missouri |
United States | Veterans Administration | Columbia | Missouri |
United States | Clements University Hospital | Dallas | Texas |
United States | UT Southwestern/Simmons Cancer Center-Dallas | Dallas | Texas |
United States | Zale Lipshy University Hospital | Dallas | Texas |
United States | Danville Regional Medical Center | Danville | Virginia |
United States | Geisinger Medical Center | Danville | Pennsylvania |
United States | Decatur Memorial Hospital | Decatur | Illinois |
United States | Heartland Cancer Research NCORP | Decatur | Illinois |
United States | Colorado Cancer Research Program NCORP | Denver | Colorado |
United States | Porter Adventist Hospital | Denver | Colorado |
United States | Presbyterian - Saint Lukes Medical Center - Health One | Denver | Colorado |
United States | Rose Medical Center | Denver | Colorado |
United States | SCL Health Saint Joseph Hospital | Denver | Colorado |
United States | Iowa Lutheran Hospital | Des Moines | Iowa |
United States | Iowa Methodist Medical Center | Des Moines | Iowa |
United States | Iowa-Wide Oncology Research Coalition NCORP | Des Moines | Iowa |
United States | Medical Oncology and Hematology Associates-Des Moines | Des Moines | Iowa |
United States | Medical Oncology and Hematology Associates-Laurel | Des Moines | Iowa |
United States | Mercy Capitol | Des Moines | Iowa |
United States | Mercy Medical Center - Des Moines | Des Moines | Iowa |
United States | Henry Ford Hospital | Detroit | Michigan |
United States | Cancer Center of Kansas - Dodge City | Dodge City | Kansas |
United States | Cancer Center of Kansas - El Dorado | El Dorado | Kansas |
United States | Union Hospital of Cecil County | Elkton MD | Maryland |
United States | Swedish Medical Center | Englewood | Colorado |
United States | Eureka Hospital | Eureka | Illinois |
United States | Illinois CancerCare-Eureka | Eureka | Illinois |
United States | NorthShore University HealthSystem-Evanston Hospital | Evanston | Illinois |
United States | Sanford Clinic North-Fargo | Fargo | North Dakota |
United States | Sanford Medical Center-Fargo | Fargo | North Dakota |
United States | Lake Region Healthcare Corporation-Cancer Care | Fergus Falls | Minnesota |
United States | Front Range Cancer Specialists | Fort Collins | Colorado |
United States | Poudre Valley Hospital | Fort Collins | Colorado |
United States | Cancer Center of Kansas - Fort Scott | Fort Scott | Kansas |
United States | Fort Wayne Medical Oncology and Hematology Inc-Parkview | Fort Wayne | Indiana |
United States | Galesburg Cottage Hospital | Galesburg | Illinois |
United States | Illinois CancerCare-Galesburg | Galesburg | Illinois |
United States | Adirondack Cancer Center | Glens Falls | New York |
United States | Saint Mary's Hospital and Regional Medical Center | Grand Junction | Colorado |
United States | Benefis Healthcare- Sletten Cancer Institute | Great Falls | Montana |
United States | Berdeaux, Donald MD (UIA Investigator) | Great Falls | Montana |
United States | Big Sky Oncology | Great Falls | Montana |
United States | Great Falls Clinic | Great Falls | Montana |
United States | North Colorado Medical Center | Greeley | Colorado |
United States | East Carolina University | Greenville | North Carolina |
United States | Illinois CancerCare-Havana | Havana | Illinois |
United States | Mason District Hospital | Havana | Illinois |
United States | Northern Montana Hospital | Havre | Montana |
United States | Geisinger Medical Center-Cancer Center Hazleton | Hazleton | Pennsylvania |
United States | Saint Peter's Community Hospital | Helena | Montana |
United States | Hopedale Medical Complex - Hospital | Hopedale | Illinois |
United States | Cancer Center of Kansas-Independence | Independence | Kansas |
United States | Centerpoint Medical Center LLC | Independence | Missouri |
United States | University of Iowa/Holden Comprehensive Cancer Center | Iowa City | Iowa |
United States | Jackson-Madison County General Hospital | Jackson | Tennessee |
United States | Joliet Oncology-Hematology Associates Limited | Joliet | Illinois |
United States | Midwest Center for Hematology Oncology | Joliet | Illinois |
United States | Glacier Oncology PLLC | Kalispell | Montana |
United States | Kalispell Medical Oncology | Kalispell | Montana |
United States | Kalispell Regional Medical Center | Kalispell | Montana |
United States | Heartland Hematology and Oncology Associates Incorporated | Kansas City | Missouri |
United States | North Kansas City Hospital | Kansas City | Missouri |
United States | Providence Medical Center | Kansas City | Kansas |
United States | Radiation Oncology Practice Corporation - North | Kansas City | Missouri |
United States | Radiation Oncology Practice Corporation South | Kansas City | Missouri |
United States | Research Medical Center | Kansas City | Missouri |
United States | Saint Joseph Health Center | Kansas City | Missouri |
United States | Saint Luke's Cancer Institute | Kansas City | Missouri |
United States | Saint Luke's Hospital of Kansas City | Kansas City | Missouri |
United States | Truman Medical Center | Kansas City | Missouri |
United States | Illinois CancerCare-Kewanee Clinic | Kewanee | Illinois |
United States | Cancer Center of Kansas-Kingman | Kingman | Kansas |
United States | Kinston Medical Specialists PA | Kinston | North Carolina |
United States | University of Tennessee - Knoxville | Knoxville | Tennessee |
United States | Saint Anthony Hospital | Lakewood | Colorado |
United States | Lawrence Memorial Hospital | Lawrence | Kansas |
United States | Saint Luke's East - Lee's Summit | Lee's Summit | Missouri |
United States | Beebe Medical Center | Lewes | Delaware |
United States | Cancer Center of Kansas-Liberal | Liberal | Kansas |
United States | Liberty Hospital | Liberty | Missouri |
United States | Liberty Radiation Oncology Center | Liberty | Missouri |
United States | NorthShore Hematology Oncology-Libertyville | Libertyville | Illinois |
United States | Sky Ridge Medical Center | Lone Tree | Colorado |
United States | Longmont United Hospital | Longmont | Colorado |
United States | Los Angeles Oncology Institute | Los Angeles | California |
United States | McKee Medical Center | Loveland | Colorado |
United States | Illinois CancerCare-Macomb | Macomb | Illinois |
United States | Mcdonough District Hospital | Macomb | Illinois |
United States | University of Wisconsin Hospital and Clinics | Madison | Wisconsin |
United States | North Shore University Hospital | Manhasset | New York |
United States | North Shore-LIJ Health System NCORP | Manhasset | New York |
United States | Loyola University Medical Center | Maywood | Illinois |
United States | Franciscan Saint Anthony Health-Michigan City | Michigan City | Indiana |
United States | Orange Regional Medical Center | Middletown | New York |
United States | Medical Consultants Limited | Milwaukee | Wisconsin |
United States | University of Minnesota/Masonic Cancer Center | Minneapolis | Minnesota |
United States | Community Medical Hospital | Missoula | Montana |
United States | Guardian Oncology and Center for Wellness | Missoula | Montana |
United States | Montana Cancer Specialists | Missoula | Montana |
United States | Saint Patrick Hospital - Community Hospital | Missoula | Montana |
United States | Holy Family Medical Center | Monmouth | Illinois |
United States | Illinois CancerCare-Monmouth | Monmouth | Illinois |
United States | Cottonwood Hospital Medical Center | Murray | Utah |
United States | DuPage Medical Group-Ogden | Naperville | Illinois |
United States | Long Island Jewish Medical Center | New Hyde Park | New York |
United States | Laura and Isaac Perlmutter Cancer Center at NYU Langone | New York | New York |
United States | Mount Sinai Medical Center | New York | New York |
United States | Christiana Care Health System-Christiana Hospital | Newark | Delaware |
United States | Cancer Center of Kansas - Newton | Newton | Kansas |
United States | Illinois Cancer Specialists-Niles | Niles | Illinois |
United States | Bromenn Regional Medical Center | Normal | Illinois |
United States | Community Cancer Center Foundation | Normal | Illinois |
United States | Illinois CancerCare-Community Cancer Center | Normal | Illinois |
United States | Illinois CancerCare-Ottawa Clinic | Ottawa | Illinois |
United States | Ottawa Regional Hospital and Healthcare Center | Ottawa | Illinois |
United States | Menorah Medical Center | Overland Park | Kansas |
United States | Radiation Oncology Practice Corporation Southwest | Overland Park | Kansas |
United States | Saint Luke's South Hospital | Overland Park | Kansas |
United States | Stanford Cancer Institute | Palo Alto | California |
United States | Paoli Memorial Hospital | Paoli | Pennsylvania |
United States | Cancer Center of Kansas - Parsons | Parsons | Kansas |
United States | Illinois CancerCare-Pekin | Pekin | Illinois |
United States | OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center | Pekin | Illinois |
United States | Pekin Hospital | Pekin | Illinois |
United States | Illinois CancerCare-Peoria | Peoria | Illinois |
United States | Methodist Medical Center of Illinois | Peoria | Illinois |
United States | OSF Saint Francis Medical Center | Peoria | Illinois |
United States | Proctor Hospital | Peoria | Illinois |
United States | Illinois CancerCare-Peru | Peru | Illinois |
United States | Illinois Valley Hospital | Peru | Illinois |
United States | Fox Chase Cancer Center | Philadelphia | Pennsylvania |
United States | University of Pittsburgh Cancer Institute (UPCI) | Pittsburgh | Pennsylvania |
United States | Kansas City NCI Community Oncology Research Program | Prairie Village | Kansas |
United States | Cancer Center of Kansas - Pratt | Pratt | Kansas |
United States | Illinois CancerCare-Princeton | Princeton | Illinois |
United States | Perry Memorial Hospital | Princeton | Illinois |
United States | Saint Mary Corwin Medical Center | Pueblo | Colorado |
United States | Mayo Clinic | Rochester | Minnesota |
United States | Swedish American Hospital | Rockford | Illinois |
United States | SwedishAmerican Regional Cancer Center/ACT | Rockford | Illinois |
United States | Sutter Roseville Medical Center | Roseville | California |
United States | Sutter General Hospital | Sacramento | California |
United States | Heartland Regional Medical Center | Saint Joseph | Missouri |
United States | Saint Joseph Oncology Inc | Saint Joseph | Missouri |
United States | Saint Louis University Hospital | Saint Louis | Missouri |
United States | Cancer Center of Kansas - Salina | Salina | Kansas |
United States | Salina Regional Health Center | Salina | Kansas |
United States | Mayo Clinic in Arizona | Scottsdale | Arizona |
United States | Mercy Hospital | Scranton | Pennsylvania |
United States | Scranton Hematology Oncology | Scranton | Pennsylvania |
United States | Shawnee Mission Medical Center-KCCC | Shawnee Mission | Kansas |
United States | Welch Cancer Center | Sheridan | Wyoming |
United States | Mercy Medical Center-Sioux City | Sioux City | Iowa |
United States | Saint Luke's Regional Medical Center | Sioux City | Iowa |
United States | Siouxland Regional Cancer Center | Sioux City | Iowa |
United States | Medical X-Ray Center | Sioux Falls | South Dakota |
United States | Sanford Cancer Center-Oncology Clinic | Sioux Falls | South Dakota |
United States | Sanford USD Medical Center - Sioux Falls | Sioux Falls | South Dakota |
United States | Edward H Kaplan MD and Associates | Skokie | Illinois |
United States | Hematology Oncology Associates of Illinois - Skokie | Skokie | Illinois |
United States | Illinois CancerCare-Spring Valley | Spring Valley | Illinois |
United States | Saint Margaret's Hospital | Spring Valley | Illinois |
United States | Memorial Medical Center | Springfield | Illinois |
United States | Geisinger Medical Group | State College | Pennsylvania |
United States | Scott and White Memorial Hospital | Temple | Texas |
United States | North Suburban Medical Center | Thornton | Colorado |
United States | Saint Francis Hospital and Medical Center - Topeka | Topeka | Kansas |
United States | Carle Clinic-Urbana Main | Urbana | Illinois |
United States | Sibley Memorial Hospital | Washington | District of Columbia |
United States | Cancer Center of Kansas - Wellington | Wellington | Kansas |
United States | SCL Health Lutheran Medical Center | Wheat Ridge | Colorado |
United States | Associates In Womens Health | Wichita | Kansas |
United States | Cancer Center of Kansas - Main Office | Wichita | Kansas |
United States | Cancer Center of Kansas-Wichita Medical Arts Tower | Wichita | Kansas |
United States | Via Christi Regional Medical Center | Wichita | Kansas |
United States | Wichita NCI Community Oncology Research Program | Wichita | Kansas |
United States | Geisinger Wyoming Valley/Henry Cancer Center | Wilkes-Barre | Pennsylvania |
United States | Cancer Center of Kansas - Winfield | Winfield | Kansas |
United States | Wake Forest University Health Sciences | Winston-Salem | North Carolina |
United States | Lankenau Medical Center | Wynnewood | Pennsylvania |
United States | Main Line Health NCORP | Wynnewood | Pennsylvania |
United States | WellSpan Health-York Hospital | York | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
National Cancer Institute (NCI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Proportion of Patients With Clinical Response | Clinical response is defined as a complete response (CR), partial response (PR) or trilineage response (TR) graded according to the following criteria: World Health Organization classification of the acute leukemias and myelodysplastic syndrome (by Bennett) Myelodysplastic syndromes standardized response criteria: further definition (by Cheson et al.) Report of an international working group to standardize response criteria for myelodysplastic syndromes (by Cheson et al.) |
Assessed every 3 months if patient is < 2 years from study entry, every 6 months if patient is 2 - 5 years from study entry. | No |
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