Leukemia Clinical Trial
Official title:
Gemtuzumab Ozogamicin (CMA-676) Followed or Not by Intensive Chemotherapy as Initial Treatment for Elderly Patients With Acute Myeloid Leukemia: An EORTC-LG Pilot Phase II Study
RATIONALE: Monoclonal antibodies such as gemtuzumab ozogamicin can locate cancer cells and
either kill them or deliver cancer-killing substances to them without harming normal cells.
Drugs used in chemotherapy uses different ways to stop cancer cells from dividing so they
stop growing or die. Combining gemtuzumab ozogamicin with chemotherapy may kill more cancer
cells.
PURPOSE: Phase II trial to study the effectiveness of gemtuzumab ozogamicin with or without
chemotherapy in treating older patients who have acute myeloid leukemia.
OBJECTIVES: I. Determine the feasibility, toxicity, and antileukemic activity of gemtuzumab
ozogamicin (CMA-676) with or without mitoxantrone, etoposide, cytarabine, and idarubicin in
elderly patients with acute myeloid leukemia.
OUTLINE: This is a multicenter study. Patients are stratified according to risk (standard
risk, defined as age 61-75 and WHO performance status 0-1 vs poor risk, defined as over 75
years and WHO performance status 0-2 OR under 76 years and WHO performance status 2).
Frontline therapy: Patients receive gemtuzumab ozogamicin IV over 2 hours on days 1 and 15.
Stratum I (Standard risk patients): Patients with disease progression at any time during
frontline therapy may begin induction therapy immediately. Induction therapy begins 7-10
days after response assessment regardless of response and in the absence of unacceptable
toxicity. Stratum II (Poor risk patients): Patients experiencing complete remission with or
without platelet recovery will begin consolidation therapy within 4-8 weeks of response
assessment in the absence of unacceptable toxicity. Stratum I Induction therapy: Patients
receive mitoxantrone IV over 30 minutes on days 1, 3 and 5; etoposide IV over 1 hour on days
1-3; and cytarabine IV continuously on days 1-7. Patients experiencing partial response are
given a second induction therapy course. Patients experiencing complete remission with or
without platelet recovery after 1 or 2 induction courses begin consolidation therapy within
4-8 weeks of response assessment in the absence of unacceptable toxicity. Consolidation
therapy: Patients receive idarubicin IV on days 1, 3 and 5; etoposide IV over 1 hour on days
1-3; and cytarabine IV continuously on days 1-5. Stratum II Consolidation therapy: Patients
receive gemtuzumab ozogamicin IV over 2 hours on day 1 and then 1-3 months later. Patients
are followed monthly for 1 year, every 3 months for 2 years, and then every 6 months
thereafter.
PROJECTED ACCRUAL: A total of 45-82 (28-49 for stratum I, and 17-33 for stratum II) patients
will be accrued for this study.
;
Primary Purpose: Treatment
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