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BMS-354825 in Treating Patients With Blastic Phase Chronic Myelogenous Leukemia That Did Not Respond to Previous Imatinib Mesylate
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Jonsson Comprehensive Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00108719
  Purpose

RATIONALE: BMS-354825 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase II trial is studying how well BMS-354825 works in treating patients with blastic phase chronic myelogenous leukemia that did not respond to previous imatinib mesylate.


Condition Intervention Phase
Leukemia
Drug: dasatinib
Phase II

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Imatinib Imatinib mesylate Dasatinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Study of BMS-354825 in Subjects With Myeloid Blast Phase Chronic Myeloid Leukemia Resistant to or Intolerant of Imatinib Mesylate

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

Study Start Date: January 2005
Detailed Description:

OBJECTIVES:

Primary

  • Determine the complete and overall hematologic response rate in patients with blastic phase chronic myelogenous leukemia (CML) with primary or acquired resistance to imatinib mesylate treated with BMS-354825.

Secondary

  • Determine the durability of complete and overall hematologic response in patients treated with this drug.
  • Determine time to complete and overall response in patients treated with this drug.
  • Determine the cytogenetic and molecular response in patients treated with this drug.
  • Determine the hematologic, cytogenetic, and molecular response in patients with imatinib mesylate-intolerant CML treated with this drug.
  • Determine the response rate in patients with no evidence of leukemia and in patients who return to chronic phase CML after treatment with this drug.
  • Determine the role of BCR-ABL mRNA expression and point mutations in the BCR-ABL gene as predictors or surrogates of response in patients treated with this drug.
  • Determine the health-related quality of life, as measured by the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, in patients treated with this drug.
  • Determine the safety and tolerability of this drug in these patients.
  • Determine the pharmacokinetics of this drug in these patients.

OUTLINE: This is an open-label, multicenter study.

Patients receive oral BMS-354825 twice daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, on day 15 of course 1, on days 1 and 15 of courses 2 and 3, once a month in all subsequent courses, and at the completion of study treatment.

After completion of study treatment, patients are followed for at least 30 days.

PROJECTED ACCRUAL: A minimum of 60 patients will be accrued for this study within 6 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Diagnosis of blastic phase chronic myelogenous leukemia (CML), defined by ≥ 1 of the following criteria:

    • At least 30% myeloid blasts in peripheral blood or bone marrow
    • Extramedullary infiltrates of leukemic cells (other than in the spleen or liver) with peripheral blood myeloid blast morphology
  • Philadelphia chromosome-positive OR BCR-ABL-positive disease
  • Previously treated with imatinib mesylate AND meets 1 of the following criteria:

    • Primary* or acquired** hematologic resistance to imatinib mesylate, defined as 1 of the following:

      • Initial diagnosis of chronic phase CML that progressed to blastic phase CML during treatment with imatinib mesylate at a dose ≥ 400 mg/day
      • Initial diagnosis of accelerated phase CML that progressed to blastic phase CML during treatment with imatinib mesylate at a dose ≥ 600 mg/day ( 400-599 mg/day in patients intolerant to a dose ≥ 600 mg/day)
      • Initial diagnosis of blastic phase CML, meeting the criteria for blast crisis after ≥ 4 weeks (2 weeks for rapid disease progression) of treatment with imatinib mesylate at a dose ≥ 600 mg/day (400-599 mg/day in patients intolerant to a dose ≥ 600 mg/day) NOTE: *Disease did not respond to treatment with imatinib mesylate

NOTE: **Disease responded to treatment with imatinib mesylate but subsequently progressed to accelerated phase CML

  • Intolerant to imatinib mesylate, defined as toxicity possibly related to treatment with imatinib mesylate at a dose ≤ 400 mg/day that led to discontinuation of therapy OR patient can only tolerate imatinib mesylate at doses < 400 mg/day

    • Patients who tolerate a dose of imatinib mesylate at 400 mg/day but are intolerant to higher doses are not considered intolerant to imatinib mesylate NOTE: Imatinib mesylate need not be the most recent treatment for CML prior to study entry

      • Not eligible for OR refused to undergo transplantation

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • Not specified

Hematopoietic

  • See Disease Characteristics
  • No history of significant bleeding disorder unrelated to CML, including any of the following:

    • Congenital bleeding disorder (e.g., von Willebrand's disease)
    • Acquired bleeding disorder within the past year (e.g., acquired anti-factor VIII antibodies)

Hepatic

  • Bilirubin ≤ 2.0 times upper limit of normal (ULN)
  • ALT and AST ≤ 2.5 times ULN

Renal

  • Creatinine ≤ 1.5 times ULN
  • Total calcium normal* OR
  • Ionized calcium normal* NOTE: *Supplementation allowed

Cardiovascular

  • No myocardial infarction within the past 6 months
  • No uncontrolled angina within the past 3 months
  • No congestive heart failure within the past 3 months
  • No diagnosis or suspicion of congenital long QT syndrome
  • No history of clinically significant ventricular arrhythmia (e.g., ventricular tachycardia, ventricular fibrillation, or torsades de pointes)
  • No prolonged QTc interval (i.e., > 450 msec) on electrocardiogram determined by Bazett's correction or Fridericia correction
  • No history of second or third degree heart block unless patient has a pacemaker
  • No heart rate consistently < 50 beats/minute on electrocardiogram
  • No uncontrolled hypertension
  • No other uncontrolled or significant cardiovascular disease

Gastrointestinal

  • No clinically significant gastrointestinal tract bleeding within the past 6 months
  • No digestive dysfunction that would preclude study participation

Other

  • Not pregnant or nursing

    • No nursing during and for ≥ 3 months after completion of study treatment
  • Negative pregnancy test
  • Fertile patients must use effective contraception for 1 month before, during, and for ≥ 3 months after completion of study treatment
  • Potassium normal*
  • Magnesium normal*
  • No serious uncontrolled medical disorder or active infection that would preclude study participation
  • No dementia or altered mental status that would preclude giving informed consent
  • No evidence of organ dysfunction that would preclude study participation
  • No prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of a psychiatric or physical (e.g., infectious disease) illness
  • No other incurable malignancy NOTE: *Supplementation allowed

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 14 days since prior interferon

Chemotherapy

  • More than 14 days since prior cytarabine
  • Prior or concurrent hydroxyurea allowed for treatment of elevated WBC (i.e., WBC > 50,000/mm^3)

Endocrine therapy

  • Not specified

Radiotherapy

  • Not specified

Surgery

  • Not specified

Other

  • No prior BMS-354825
  • More than 7 days since prior imatinib mesylate
  • At least 7 days since prior and no concurrent low-dose aspirin (i.e., ≤ 325 mg/day)
  • At least 14 days since prior and no concurrent high-dose aspirin (i.e., > 325 mg/day)
  • More than 14 days since prior targeted small molecule anticancer agents
  • More than 28 days since prior investigational or antineoplastic agents
  • At least 5 days or 5 half-lives (whichever is greater) since prior and no concurrent drugs that carry a risk of causing torsades de pointes, including any of the following:

    • Quinidine
    • Procainamide
    • Disopyramide
    • Amiodarone
    • Sotalol
    • Ibutilide
    • Dofetilide
    • Erythromycin
    • Clarithromycin
    • Chlorpromazine
    • Haloperidol
    • Mesoridazine
    • Thioridazine
    • Pimozide
    • Cisapride
    • Bepridil
    • Droperidol
    • Methadone
    • Arsenic
    • Chloroquine
    • Domperidone
    • Halofantrine
    • Levomethadyl
    • Pentamidine
    • Sparfloxacin
    • Lidoflazine
  • At least 5 days or 5 half-lives (whichever is greater) since prior and no concurrent medication that directly inhibits platelet function (except anagrelide for thrombocytosis due to CML), including any of the following:

    • Dipyridamole
    • Epoprostenol
    • Eptifibatide
    • Clopidogrel
    • Cilostazol
    • Abciximab
    • Ticlopidine
  • At least 5 days or 5 half-lives (whichever is greater) since prior and no concurrent anticoagulant (e.g., warfarin, heparin, or low molecular weight heparin [e.g., danaparoid, dalteparin, tinzaparin, or enoxaparin])

    • Concurrent prophylactic low-dose warfarin for prevention of catheter thrombosis and heparin-flush for IV lines allowed
  • No other concurrent therapy for CML
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00108719

Locations
United States, California
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, United States, 90095-1781
Sponsors and Collaborators
Jonsson Comprehensive Cancer Center
Investigators
Study Chair: Neil P. Shah, MD Jonsson Comprehensive Cancer Center
  More Information

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

Publications of Results:
Cortes JE, Kim DW, Rosti G, et al.: Dasatinib (D) in patients (pts) with chronic myelogenous leukemia (CML) in myeloid blast crisis (MBC) who are imatinib-resistant (IM-R) or IM-intolerant (IM-I): results of the CA180006 'START-B' study. [Abstract] J Clin Oncol 24 (Suppl 18): A-6529, 344s, 2006.
Talpaz M, Rousselot P, Kim DW, et al.: A phase II study of dasatinib in patients with chronic myeloid leukemia (CML) in myeloid blast crisis who are resistant or intolerant to imatinib: first results of the CA180006 'START-B' study. [Abstract] Blood 106 (11): A-40, 2005.

Other Publications:
Publications indexed to this study:
Study ID Numbers: CDR0000422431, UCLA-0411069-01, BMS-CA180006, EUDRACT-2004-002516-28
Study First Received: April 18, 2005
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00108719  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
blastic phase chronic myelogenous leukemia
Philadelphia chromosome positive chronic myelogenous leukemia
relapsing chronic myelogenous leukemia

Study placed in the following topic categories:
Imatinib
Philadelphia Chromosome
Blast Crisis
Leukemia
Chronic myelogenous leukemia
Hematologic Diseases
Dasatinib
Myeloproliferative Disorders
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myeloid
Bone Marrow Diseases

Additional relevant MeSH terms:
Neoplastic Processes
Neoplasms
Pathologic Processes
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Cell Transformation, Neoplastic

ClinicalTrials.gov processed this record on January 15, 2009