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Oral Clofarabine for Acute Myeloid Leukemia
This study is currently recruiting participants.
Verified by Washington University School of Medicine, November 2008
Sponsored by: Washington University School of Medicine
Information provided by: Washington University School of Medicine
ClinicalTrials.gov Identifier: NCT00727766
  Purpose

This is a phase I study designed to test the safety of oral clofarabine when given as consolidation therapy to older patients with AML in remission.


Condition Intervention Phase
Leukemia, Myeloid, Acute
Drug: Clofarabine
Phase I

MedlinePlus related topics: Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Clofarabine
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Single Group Assignment, Safety Study
Official Title: Phase I Study of Oral Clofarabine Consolidation in Adults Aged 60 and Older With Acute Myeloid Leukemia

Further study details as provided by Washington University School of Medicine:

Primary Outcome Measures:
  • Maximum tolerated dose and dose limiting toxicity [ Time Frame: 1 month ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Adverse events by grade and attribution [ Time Frame: Continuous throughout study ] [ Designated as safety issue: Yes ]
  • Disease-free survival [ Time Frame: Length of study ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: Length of study ] [ Designated as safety issue: No ]

Estimated Enrollment: 30
Study Start Date: November 2008
Estimated Study Completion Date: October 2013
Estimated Primary Completion Date: October 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental Drug: Clofarabine
Clofarabine 1-5 mg po on days 1 to 14-21 of a 28 day cycle for up to 5 cycle.

Detailed Description:

The prognosis of acute myeloid leukemia (AML) in patients 60 and older is dismal with traditional therapy. Several factors contribute to the poor prognosis of older individuals, including the increased incidence of the multidrug resistance efflux pump, comorbidities and unfavorable cytogenetics. The recently reported AML-13 and ALFA trials suggest that less intense consolidation in this population is at least equivalent to more intense, induction style efforts.

Clofarabine is a next generation nucleoside analogue that was designed to optimize the favorable attributes of fludarabine and cladribine, while minimizing toxicity. The intravenous formulation has shown considerable activity in older patients with AML who have been considered either unfit for or unlikely to benefit from conventional therapy. Additionally, clofarabine has an oral formulation that patients may find more acceptable for consolidation therapy rather than multiple courses of intravenous medications, administered over several days.

This study is designed as a traditional 3x3 phase I trial with the intention of defining the maximum tolerated dose of oral clofarabine consolidation for older patients with AML in remission.

  Eligibility

Ages Eligible for Study:   60 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of Acute Myeloid Leukemia according to WHO criteria
  • Age ≥ 60 years at enrollment
  • Patients must be in complete remission by bone marrow examination, within 30 days of enrollment, following treatment with a cytotoxic induction chemotherapy regimen (such as 7+3)
  • Patients may have received "low-intensity" therapy (i.e. decitabine, lenalidomide, etc) prior to traditional induction chemotherapy.
  • Patients may have received 1 cycle of cytarabine-based consolidation therapy.
  • Patients must have an ECOG performance status of 0-2 at the beginning of consolidation therapy.
  • Have adequate renal and hepatic functions as indicated by the following laboratory values:
  • Serum creatinine ≤ 1.0 mg/dL; if serum creatinine >1.0 mg/dL, then the estimated glomerular filtration rate (GFR) must be >60 mL/min/1.73 m2 as calculated by the Modification of Diet in Renal Disease equation where Predicted GFR (ml/min/1.73 m2) = 186 x (Serum Creatinine)-1.154 x (age in years)-0.023 x (0.742 if patient is female) x (1.212 if patient is black)
  • Serum total bilirubin ≤ 1.5 mg/dL × upper limit of normal (ULN) except for unconjugated hyperbilirubinemia secondary Gilbert's syndrome
  • Aspartate transaminase (AST)/alanine transaminase (ALT) ≤ 2.5 × ULN
  • Alkaline phosphatase ≤ 2.5 × ULN
  • Capable of understanding the investigational nature, potential risks and benefits of the study, and able to provide signed valid written informed consent or when appropriate, have an appointed legally authorized representative who is capable of understanding the investigational nature, potential risks and benefits of the study, and able to provide signed valid written informed consent for the benefit of the patient.
  • Male and female patients who are of child bearing potential must use an effective contraceptive method during the study and for a minimum of 6 months after study treatment.
  • Patients MAY have received prior therapy with purine analogs (such as fludarabine and cladribine).

Exclusion Criteria:

  • Current concomitant chemotherapy, radiation therapy, or immunotherapy other than as specified in the protocol.
  • The diagnosis of AML-M3 (acute promyelocytic leukemia) characterized by translocations involving the retinoic acid receptor-alpha (RAR-alpha) gene.
  • Use of investigational agents within 2 weeks or any anticancer therapy within 2 weeks before study entry. The patient must have recovered from all acute toxicities from any previous therapy.
  • Have any other severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo treatment.
  • Patients with a systemic fungal, bacterial, viral, or other infection not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment).
  • Have currently active gastrointestinal disease, or prior surgery that may affect the ability of the patient to absorb oral clofarabine.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00727766

Contacts
Contact: Camille Abboud, M.D. 314-747-8304 cabboud@dom.wustl.edu

Locations
United States, Missouri
Washington University Recruiting
St. Louis, Missouri, United States, 63110
Contact: Camille Abboud, M.D.     314-454-8304     cabboud@dom.wustl.edu    
Sub-Investigator: Mike Martin, M.D.            
Sub-Investigator: John F DiPersio, M.D., Ph.D.            
Sub-Investigator: Geoffrey Uy, M.D.            
Sub-Investigator: Ravi Vij, M.D.            
Sub-Investigator: Matthew Walter, M.D.            
Sub-Investigator: Timothy Graubert, M.D.            
Sub-Investigator: Michael Tomasson, M.D.            
Sub-Investigator: Amanda Cashen, M.D.            
Sub-Investigator: Peter Westervelt, M.D., Ph.D.            
Sub-Investigator: Keith Stockerl-Goldstein, M.D.            
Sub-Investigator: Kristan Augustin, PharmD            
Sponsors and Collaborators
Washington University School of Medicine
Investigators
Principal Investigator: Camille N. Abboud, M.D. Washington Univerisity
  More Information

Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine  This link exits the ClinicalTrials.gov site

Responsible Party: Washington University School of Medicine ( Camille Abboud, M.D. )
Study ID Numbers: 08-0853
Study First Received: July 30, 2008
Last Updated: November 25, 2008
ClinicalTrials.gov Identifier: NCT00727766  
Health Authority: United States: Food and Drug Administration

Keywords provided by Washington University School of Medicine:
Clofarabine
Clolar
AML
Consolidation

Study placed in the following topic categories:
Clofarabine
Leukemia
Acute myelogenous leukemia
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Acute myelocytic leukemia

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 14, 2009