Lenalidomide in Acute Leukemias and Chronic Lymphocytic Leukemia.

Acute Myeloid Leukemia Clinical Trial

Official title:

Phase I Study of Lenalidomide in Acute Leukemias and Chronic Lymphocytic Leukemia.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00466895
• Other study ID #: OSU-06003
• Secondary ID: NCI-2011-03218
• Status: Completed
• Phase: Phase 1
• First received: April 26, 2007
• Last updated: November 9, 2017
• Start date: April 2007
• Est. completion date: July 2016

Study information

• Verified date: November 2017
• Source: Ohio State University Comprehensive Cancer Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Phase I Study of Lenalidomide in Acute Leukemias and Chronic Lymphocytic Leukemia.

Description:

Rationale:

Lenalidomide has properties of thalidomide and appears to have some activity against cancer in laboratory tests. Researchers are still learning how lenalidomide works against cancer in patients. Some ways that this drug seems to produce anti-cancer effects include through stimulating the immune system and blocking blood vessels contributing to cancer growth. The current study will explore different dose levels in patients to gather more information about lenalidomide.

Purpose:

This study will assess the maximum tolerated dose of lenalidomide in patients with relapsed or refractory acute leukemias and chronic lymphocytic leukemias. Toxicity or side effects within patients will also be evaluated. Other purposes of this study include analyzing preliminary clinical activity, pharmacokinetics, and pharmacodynamics. Pharmacokinetics refers to the activity of drugs in the body over a period of time, including how drugs are absorbed, distributed, localized in tissues, and excreted. Pharmacodynamics refers to the bodily processes that lead the drug to effect cancer and other cellular components in the body.

Treatment:

Study participants will be given lenalidomide through intravenous infusions once every 28 days. A 28-day period constitutes a cycle. Since this study will assess the maximum tolerated dose of lenalidomide, some study participants will receive different amounts of this drug compared to others depending upon when each individual enrolls in the study. Each group of 3 to 6 study participants will receive a higher dose of lenalidomide until the maximum tolerated dose is established. Several tests will be performed throughout the study, including bone marrow biopsies. Imaging exams will be conducted as well. Treatments will be discontinued due to disease growth or intolerable adverse effects. Lenalidomide administration will be repeated for 12 or more cycles in patients that experience clinical benefit.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 37
• Est. completion date: July 2016
• Est. primary completion date: December 2014
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Blood blast count must be < 40,000/uL prior to initiation of therapy. Hydroxyurea (up to 6g/day) may be administered prior to initiation of therapy and during the first week to maintain blood blast count < 40,000/uL

• ECOG(Eastern Cooperative Oncology Group)performance status 0-2.

• Patients with CNS(central nervous system)involvement will be considered eligible for this study if no residual leukemic cells are detected in the CSF (cerebrospinal fluid)following intrathecal chemotherapy or radiation.

Exclusion Criteria:

• Patients with acute promyelocytic leukemia are excluded unless patient has failed salvage therapy with arsenic.

• Patients with HIV are excluded due to increased risk of infectious complications, marrow suppression, and potential interactions with antiviral therapy.

• CLL patients who have had chemotherapy (with the exception of hydroxyurea) or radiotherapy within 4 weeks prior to entering the study are excluded. CLL patients receiving corticosteroids (within 2 weeks) for treatment of disease (other than autoimmune manifestations of CLL) are not eligible.

• Patients who have received mitomycin C or nitrosourea require a six weeks recovery period before they can be enrolled on the current study.

• Patients with the following abnormal clinical values are excluded (unless abnormalities in these parameters are directly attributable to malignancy): Serum creatinine >2.0 mg/dl Total bilirubin > 2 x upper limit of normal (unless due to Gilbert's syndrome) ALT and AST > 5 x upper limit of normal

Related Conditions & MeSH terms

• Acute Lymphoblastic Leukemia
• Acute Myeloid Leukemia
• Chronic Lymphocytic Leukemia
• Leukemia
• Leukemia, Lymphocytic, Chronic, B-Cell
• Leukemia, Lymphoid
• Leukemia, Myeloid, Acute
• Precursor Cell Lymphoblastic Leukemia-Lymphoma

Intervention

Drug:
• lenalidomide
Dose level -1: 2.5 mg daily for days 1-7, 2.5 mg daily for days 8-21. Dose level 1: 2.5 mg daily for days 1-7, 5 mg daily for days 8-21. Dose level 2: 2.5 mg daily for days 1-7, 7.5 mg daily for days 8-21. Dose level 3: 2.5 mg daily for days 1-7, 10 mg daily for days 8-21. Dose level 4: 2.5 mg daily for days 1-7, 15 mg daily for days 8-21

Locations

Country	Name	City	State
United States	Ohio State University Medical Center	Columbus	Ohio

Sponsors (2)

Lead Sponsor	Collaborator
Leslie Andritsos	Celgene Corporation

Country where clinical trial is conducted

United States, 

References & Publications (1)

Maddocks K, Ruppert AS, Browning R, Jones J, Flynn J, Kefauver C, Gao Y, Jiang Y, Rozewski DM, Poi M, Phelps MA, Harper E, Johnson AJ, Byrd JC, Andritsos LA. A dose escalation feasibility study of lenalidomide for treatment of symptomatic, relapsed chroni — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maximum tolerable dose		Every 2 weeks during cycle 1; Monthly during subsequent cycles
Primary	Toxicities of lenalidomide		Every 2 weeks during cycle 1; Monthly for subsequent cycles
Secondary	preliminary clinical activity		Twice weekly during cycle 1; Weekly during cycles 2-6; Monthly thereafter
Secondary	plasma and cellular pharmacokinetics		Days 1, 8, 15 and 21 of first cycle.
Secondary	pharmacodynamics		Days 1, 8 and 26.

External Links

•   Jamesline