Chronic Myelomonocytic Leukemia Clinical Trial
Official title:
A Phase I Study of PXD101 in Combination With Azacitidine (5-Aza) for Advanced Hematologic Malignancies
This phase I trial is studying the side effects and best dose of belinostat when given together with azacitidine in treating patients with advanced hematologic cancers or other diseases. Belinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the cancer. Drugs used in chemotherapy, such as azacitidine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving belinostat together with azacitidine may kill more cancer cells.
Status | Completed |
Enrollment | 56 |
Est. completion date | March 2013 |
Est. primary completion date | March 2013 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Histologically confirmed diagnosis of 1 of the following: - Relapsed or refractory acute myeloid leukemia (AML) - Relapsed or refractory acute promyelocytic leukemia (must have failed both tretinoin and arsenic trioxide) - Relapsed or refractory acute lymphoblastic leukemia - Secondary AML, including AML arising from antecedent hematologic diseases, such as myelodysplastic syndromes (MDS) or myeloproliferative disorders, OR therapy-related AML - Chronic myelogenous leukemia in accelerated or blast phase - Advanced phases of Philadelphia chromosome-negative (Ph-) chronic myeloproliferative disorders, as defined by = 1 of the following: - Presence of anemia (hemoglobin < 10 g/dL and/or red blood cell transfusion dependent) - Presence of palpable splenomegaly - MDS, including chronic myelomonocytic leukemia - Must have intermediate or high-risk International Prognostic Scoring System (IPSS) scores (= 0.5) - Low-risk IPSS scores allowed provided = 1 of the following criteria are met: - Hemoglobin < 10 g/dL and/or red blood cell transfusion dependent - Platelet count < 50,000/mm³ - Absolute neutrophil count < 1,000/mm³ - Refractory disease OR no standard therapy exists - Evidence of AML associated with dysplasia on bone marrow histology for elderly patients (i.e., > 60 years old) who are previously untreated and not candidates for or unwilling to undergoing induction therapy - No known active CNS involvement with disease - CALGB performance status (PS) 0-2 OR Karnofsky PS 60-100% - Bilirubin = 2.0 mg/dL (unless due to Gilbert's syndrome) - ALT = 3 times upper limit of normal (unless due to disease) - Creatinine = 2 mg/dL - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception - No history of allergic reactions attributed to compounds of similar chemical or biologic composition to PXD101 or Azacitidine - No history of allergic reactions to mannitol - No history of dose-limiting toxicity during prior treatment with Azacitidine - No concurrent uncontrolled illness including, but not limited to, the following: - Ongoing or active infection - Symptomatic congestive heart failure - Unstable angina pectoris - Cardiac arrhythmia - Psychiatric illness or social situation that would preclude compliance with study requirements - No marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval > 500 msec) - No long QT syndrome - No uncontrolled cardiovascular disease, including the following: - Severe uncontrolled hypertension - Uncontrolled congestive heart failure related to primary cardiac disease - Uncontrolled cardiac arrhythmia - Uncontrolled ischemic or severe valvular heart disease - Myocardial infarction within the past 6 months - See Disease Characteristics - Recovered from prior therapy - At least 2 weeks since prior chemotherapy (6 weeks for mitomycin C or nitrosoureas) - At least 2 weeks since prior radiotherapy - At least 4 weeks since prior investigational agents - At least 24 hours since prior hydroxyurea - At least 2 weeks since prior valproic acid - No concurrent combination antiretroviral therapy for HIV-positive patients - No other concurrent investigational agents - No concurrent medication that may cause torsade de pointes - No other concurrent anticancer therapy, including chemotherapy, radiotherapy, or biological agents |
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Canada | University Health Network-Princess Margaret Hospital | Toronto | Ontario |
New Zealand | Princess Margaret Hospital | Cashmere | Canterbury |
United States | University of Chicago Comprehensive Cancer Center | Chicago | Illinois |
United States | University of Wisconsin Hospital and Clinics | Madison | Wisconsin |
Lead Sponsor | Collaborator |
---|---|
National Cancer Institute (NCI) |
United States, Canada, New Zealand,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Maximum tolerated dose of belinostat in combination with azacitidine | Graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 or 4.0. | Course 1 (28 days) | Yes |
Secondary | Changes in pharmacodynamic variables (target gene expression, apoptosis) | Compared between the two groups using two-sample t tests. | Course 1 (baseline to day 5) | No |
Secondary | Association of methylation status, categorized as positive or negative, with changes in target gene expression | Distinguished by sequence-specific polymerase chain reaction (PCR) primers. Compared using a two-sample t or Wilcoxon nonparametric test. | Baseline, days 4 or 5, and days 25-28 | No |
Secondary | Clinical activity (complete remission, partial remission, stable disease, hematologic improvement) | Recorded and tabulated for both the MTD and randomized cohorts. | After 4, 8, and 16 weeks | No |
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