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Sorafenib in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, or Chronic Myelogenous Leukemia
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Sidney Kimmel Comprehensive Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00131989
  Purpose

RATIONALE: Sorafenib 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.

PURPOSE: This phase I trial is studying the side effects and best dose of sorafenib in treating patients with relapsed or refractory acute myeloid leukemia, acute lymphoblastic leukemia, or chronic myelogenous leukemia.


Condition Intervention Phase
Leukemia
Drug: sorafenib tosylate
Phase I

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Sorafenib Sorafenib tosylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase I Dose Escalation Trial of the Raf Kinase Inhibitor BAY 43-9006 (NSC #724772) as Single Agent for Adults With Relapsed and Refractory Acute Leukemias and Chronic Myeloid Leukemia in Blast Crisis

Further study details as provided by National Cancer Institute (NCI):

Estimated Enrollment: 48
Study Start Date: June 2005
Detailed Description:

OBJECTIVES:

Primary

  • Determine the dose-limiting toxic effects and maximum tolerated dose of sorafenib in patients with relapsed or refractory acute myeloid leukemia, acute lymphoblastic leukemia, or chronic myelogenous leukemia in blast crisis.

Secondary

  • Determine, preliminarily, tumor response in patients treated with this drug.
  • Determine the pharmacokinetic profile of this drug in these patients.
  • Determine, preliminarily, the adverse events profile and changes in laboratory parameters in patients treated with this drug.

OUTLINE: This is an open-label, dose-escalation study.

Patients receive oral sorafenib twice daily on days 1-14 or 1-21. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients achieving a complete remission (CR) may be considered for retreatment with sorafenib for up to an additional 6 courses upon disease recurrence provided the duration of CR is longer than 1 month.

Cohorts of 3-6 patients receive escalating doses of sorafenib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. A total of 12 patients are treated at the MTD.

After completion of study treatment, patients are followed monthly for up to 1 year.

PROJECTED ACCRUAL: Approximately 48 patients will be accrued for this study within 16-24 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed hematologic malignancy of 1 of the following types:

    • Acute myeloid leukemia, except acute promyelocytic leukemia
    • Acute lymphoblastic leukemia
    • Chronic myelogenous leukemia in blast crisis
  • Refractory or relapsed disease after most recent therapy AND considered ineligible for potential curative therapy, including allogeneic stem cell transplantation
  • Multilineage bone marrow failure due to leukemia allowed
  • Total peripheral blood blast count < 30,000/mm^3

    • No rapidly increasing peripheral blood blast counts (i.e., increase in absolute blast count > 50% within 1 week) OR uncontrolled peripheral blood blast counts (i.e., absolute blast count > 30,000/mm^3) despite hydroxyurea treatment
  • No active and/or untreated CNS leukemia

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2 OR
  • Karnofsky 60-100%

Life expectancy

  • More than 2 months

Hematopoietic

  • See Disease Characteristics
  • No bleeding diathesis

Hepatic

  • Bilirubin ≤ 2 mg/dL
  • AST and ALT ≤ 5 times upper limit of normal (ULN)

Renal

  • Creatinine normal OR
  • Creatinine clearance ≥ 60 mL/min

Cardiovascular

  • No uncontrolled hypertension (i.e., persistent grade 3 hypertension despite treatment)
  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No cardiac arrhythmia

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No ongoing or active infection
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to the study drug
  • No psychiatric illness or social situation that would preclude study compliance
  • No other uncontrolled illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 3 weeks since prior biologic therapy, including myeloid growth factors

Chemotherapy

  • See Disease Characteristics
  • At least 3 weeks since prior cytotoxic chemotherapy, except hydroxyurea
  • Prior hydroxyurea used to control blast counts allowed provided it is discontinued within 48 hours of the initiation of the study drug

Endocrine therapy

  • Not specified

Radiotherapy

  • At least 2 weeks since prior radiotherapy

Surgery

  • Not specified

Other

  • Recovered from all prior therapy
  • No other concurrent investigational agents
  • No other concurrent anticancer therapy
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent therapeutic anticoagulation

    • Concurrent prophylactic anticoagulation (i.e., low-dose warfarin) for venous or arterial access devices allowed provided requirements for PT, INR, or PTT are met
  • No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs, including any of the following:

    • Phenytoin
    • Carbamazepine
    • Phenobarbital
  • No concurrent rifampin
  • No concurrent Hypericum perforatum (St. John's wort)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00131989

Locations
United States, Maryland
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, Maryland, United States, 21231-2410
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center
Investigators
Study Chair: B. Douglas Smith, MD Sidney Kimmel Comprehensive Cancer Center
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000438710, JHOC-J-0509, NCI-6745
Study First Received: August 16, 2005
Last Updated: May 23, 2008
ClinicalTrials.gov Identifier: NCT00131989  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
recurrent adult acute lymphoblastic leukemia
adult acute myeloid leukemia with 11q23 (MLL) abnormalities
adult acute myeloid leukemia with inv(16)(p13;q22)
adult acute myeloid leukemia with t(16;16)(p13;q22)
adult acute myeloid leukemia with t(8;21)(q22;q22)
recurrent adult acute myeloid leukemia
adult acute basophilic leukemia
adult acute eosinophilic leukemia
adult erythroleukemia (M6a)
adult pure erythroid leukemia (M6b)
adult acute megakaryoblastic leukemia (M7)
adult acute minimally differentiated myeloid leukemia (M0)
adult acute monoblastic leukemia (M5a)
adult acute monocytic leukemia (M5b)
adult acute myeloblastic leukemia with maturation (M2)
adult acute myeloblastic leukemia without maturation (M1)
adult acute myelomonocytic leukemia (M4)
relapsing chronic myelogenous leukemia
blastic phase chronic myelogenous leukemia

Study placed in the following topic categories:
Leukemia, Monocytic, Acute
Blast Crisis
Leukemia, Lymphoid
Chronic myelogenous leukemia
Acute myelomonocytic leukemia
Di Guglielmo's syndrome
Leukemia, Myeloid, Acute
Acute lymphoblastic leukemia, adult
Leukemia
Acute erythroblastic leukemia
Acute myeloid leukemia, adult
Congenital Abnormalities
Lymphoma
Acute myelocytic leukemia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Immunoproliferative Disorders
Hematologic Diseases
Myeloproliferative Disorders
Acute myelogenous leukemia
Leukemia, Myeloid
Recurrence
Leukemia, Myelomonocytic, Acute
Lymphatic Diseases
Leukemia, Erythroblastic, Acute
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Lymphoproliferative Disorders
Bone Marrow Diseases
Sorafenib
Acute monoblastic leukemia

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009