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Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Newly Diagnosed Acute Myeloid 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: NCT00407966
  Purpose

RATIONALE: Drugs used in chemotherapy, such as flavopiridol, cytarabine, and mitoxantrone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells.

PURPOSE: This phase II trial is studying the side effects and how well giving flavopiridol together with cytarabine and mitoxantrone works in treating patients with newly diagnosed acute myeloid leukemia.


Condition Intervention Phase
Leukemia
Drug: alvocidib
Drug: cytarabine
Drug: mitoxantrone hydrochloride
Phase II

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Cytarabine Cytarabine hydrochloride Mitoxantrone hydrochloride Mitoxantrone Alvocidib Flavopiridol
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase II Study of Flavopiridol (NSC 649890, IND 46, 211) in Timed Sequential Combination With Cytosine Arabinoside (Ara-C) and Mitoxantrone for Adults With Newly Diagnosed, Previously Untreated, Poor- Risk Acute Myelogenous Leukemia

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

Primary Outcome Measures:
  • Complete response [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Toxicity [ Designated as safety issue: Yes ]

Estimated Enrollment: 25
Study Start Date: October 2006
Estimated Primary Completion Date: October 2007 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the efficacy of flavopiridol, cytarabine, and mitoxantrone hydrochloride, in terms of complete response, in patients with newly diagnosed, poor-risk acute myeloid leukemia.
  • Determine the toxicity of this regimen in these patients.

OUTLINE: Patients receive flavopiridol IV over 1 hour on days 1-3, cytarabine IV continuously over 72 hours on days 6-8, and mitoxantrone hydrochloride IV over 1-2 hours on day 9. Beginning 35-63 days after completion of course 1, patients achieving complete or partial remission may receive a second course of treatment as above.

Patients age 50 and over with "core binding factor" acute myeloid leukemia (AML) (e.g., t[8;21], inv[16], or t[16;16]) achieving a complete remission after course 1 of treatment may receive 3-4 courses of consolidation therapy comprising high-dose cytarabine at the discretion of the investigator.

After completion of study treatment, patients are followed periodically.

PROJECTED ACCRUAL: A total of 25 patients will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed acute myeloid leukemia (AML), including the following subtypes:

    • M0
    • M1
    • M2
    • M4
    • M5
    • M6
    • M7
  • Newly diagnosed de novo or secondary AML with ≥ 1 of the following poor-risk features:

    • Antecedent hematologic disorder (e.g., myelodysplasia-related AML or prior myeloproliferative disorder)
    • Treatment-related AML
    • AML with trilineage dysplasia
    • AML with adverse cytogenetics, including any of the following:

      • -5/-5q
      • -7/-7q
      • Abnormal 3q, 9q, 11q, 20q, 21q, or 17p
      • t(6;9)
      • t(9;22)
      • Trisomy 8
      • Trisomy 13
      • Complex karyotypes (i.e., ≥ 3 unrelated abnormalities)
  • No acute promyelocytic leukemia (M3 AML)
  • No hyperleukocytosis (≥ 50,000 blasts/µL)

    • Leukophoresis or hydroxyurea is allowed immediately prior to study drug administration for cytoreduction and provided it is stopped 24 hours before first dose of flavopiridol
  • No active CNS leukemia

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Creatinine ≤ 2.0 mg/dL
  • AST and ALT ≤ 5 times upper limit of normal
  • Bilirubin ≤ 2.0 mg/dL
  • LVEF ≥ 45 %
  • No active, uncontrolled infection (actively treated and antibiotic-controlled infection allowed)
  • No other life-threatening illness
  • No mental deficiencies or psychiatric disorder that would preclude study participation
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • Prior chemotherapy or bone marrow/stem cell transplant for a non-AML malignancy allowed
  • No prior treatment except hydroxyurea alone or noncytotoxic therapies for myelodysplastic syndromes or myeloproliferative disorders (e.g., thalidomide, lenidomide, interferon, cytokines, low-dose azacitidine, low-dose cyclophosphamide, or arsenic trioxide)
  • No prior flavopiridol
  • No other concurrent chemotherapy, radiotherapy, or immunotherapy
  • No other concurrent anticancer agents or therapies
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00407966

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: Judith E. Karp, 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: CDR0000518322, JHOC-J0669
Study First Received: December 4, 2006
Last Updated: September 9, 2008
ClinicalTrials.gov Identifier: NCT00407966  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
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)
secondary acute myeloid leukemia
untreated adult acute myeloid leukemia
adult acute basophilic leukemia
adult acute eosinophilic leukemia
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)
adult erythroleukemia (M6a)
adult pure erythroid leukemia (M6b)

Study placed in the following topic categories:
Leukemia, Monocytic, Acute
Acute myelogenous leukemia
Acute myelomonocytic leukemia
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Di Guglielmo's syndrome
Leukemia, Myelomonocytic, Acute
Flavopiridol
Leukemia
Leukemia, Erythroblastic, Acute
Neoplasm Metastasis
Acute erythroblastic leukemia
Mitoxantrone
Acute myeloid leukemia, adult
Congenital Abnormalities
Acute monoblastic leukemia
Acute myelocytic leukemia
Cytarabine

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Neoplasms by Histologic Type
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Enzyme Inhibitors
Protein Kinase Inhibitors
Antiviral Agents
Immunosuppressive Agents
Pharmacologic Actions
Neoplasms
Sensory System Agents
Therapeutic Uses
Growth Inhibitors
Peripheral Nervous System Agents
Analgesics
Central Nervous System Agents

ClinicalTrials.gov processed this record on January 16, 2009