Recurrent Adult Acute Myeloid Leukemia Clinical Trial
Official title:
Phase I Study of Decitabine (Dacogen) and Bortezomib (Velcade) in Acute Myeloid Leukemia
This phase I trial is studying the side effects and best dose of bortezomib when given together with decitabine in treating patients with acute myeloid leukemia. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as decitabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving bortezomib together with decitabine may kill more cancer cells.
PRIMARY OBJECTIVES:
I. To determine the maximum tolerated dose (MTD) of bortezomib (Velcade, PS-341) in
combination with decitabine in patients with acute myeloid leukemia (AML) II. To define the
specific toxicities and the dose limiting toxicity (DLT) of decitabine plus bortezomib
combination
SECONDARY OBJECTIVES:
I. To determine the overall response rate (ORR). II. To determine the rate of complete
remission (CR) of decitabine plus bortezomib in AML III. To correlate the biological
activity of decitabine as demethylating agent (changes in target gene methylation and gene
expression, DNMT1 protein expression, global methylation) with clinical endpoints and plasma
pharmacokinetics of decitabine.
IV. To characterize the biological activity of bortezomib as a potential demethylating agent
V. To correlate intracellular concentration of decitabine-triphosphate with global DNA
methylation and other biological endpoints as well as clinical response.
VI. To explore the biologic role of microRNAs in determining clinical response to the
decitabine plus bortezomib combination and achievement of the other pharmacodynamic
endpoints.
OUTLINE: This is a dose-escalation study of bortezomib.
Patients receive decitabine intravenously (IV) over 1 hour on days 1-5 or 1-10 and
bortezomib IV on days 5 and 8 or days 5, 8, 12, and 15. Courses repeat every 28 days in the
absence of disease progression or unacceptable toxicity. Once the maximum tolerated dose is
determined, an additional 6 patients are treated at the recommended phase II dose.
After completion of study treatment, patients are followed for at least 30 days.
;
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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