Recurrent Adult Acute Myeloid Leukemia Clinical Trial
Official title:
Phase I Study of Lenalidomide and Conventional Chemotherapy in Acute Myeloid Leukemia
This phase I trial studies the side effects and best dose of lenalidomide when given together with cytarabine and idarubicin in treating patients with acute myeloid leukemia. Biological therapies, such as lenalidomide, may stimulate the immune system in different ways and stop cancer cells from growing. Drugs used in chemotherapy, such as cytarabine and idarubicin, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving lenalidomide together with cytarabine and idarubicin may kill more cancer cells.
PRIMARY OBJECTIVES:
I. To determine the maximum tolerated dose (MTD) of lenalidomide in combination with
conventional chemotherapy in two separate cohorts of patients with 1) relapsed or refractory
acute myeloid leukemia (AML) and 2) age >= 60 with untreated AML and recommend starting
doses for phase II studies of this combination of agents.
SECONDARY OBJECTIVES:
I. To define the qualitative and quantitative toxicities of these combinations of agents in
regard to organ specificity, time course, predictability, and reversibility.
II. To document the therapeutic response of these combinations of agents in patients with
poor risk AML.
III. To conduct pharmacodynamic studies to investigate the potential mechanism of
lenalidomide activity in this trial.
OUTLINE: This is a dose-escalation study of lenalidomide.
INDUCTION:
COHORT I: Patients receive lenalidomide orally (PO) once daily (QD) on days 1-21, cytarabine
intravenously (IV) continuously over 96 hours on days 5-8, and idarubicin IV over 1 hour on
days 5-7.
COHORT II: Patients receive lenalidomide PO QD on days 1-21, cytarabine IV continuously over
24 hours on days 5-11, and idarubicin as above.
Patients with residual disease on day 18 undergo a second course of induction therapy.
CONSOLIDATION:
COHORT I: Patients receive lenalidomide PO QD on days 1-14, idarubicin IV over 1 hour on
days 5-6, cytarabine IV continuously on days 5-7. Treatment continues for 1 course in the
absence of disease progression or unacceptable toxicity.
COHORT II: Patients 2 receive 4 courses of consolidation therapy comprising lenalidomide PO
QD on days 1-14 and cytarabine IV every 12 hours on days 5, 7, and 9. Treatment repeats
every 28 days for up to 4 courses in the absence of disease progression or unacceptable
toxicity.
After completion of study treatment, patients are followed up for 30 days.
;
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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