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Tipifarnib in Treating Patients With Anemia or Neutropenia and Large Granular Lymphocyte Leukemia
This study has been suspended.
Sponsors and Collaborators: Case Comprehensive Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00360776
  Purpose

RATIONALE: Tipifarnib may stop the growth of leukemia by blocking blood flow to the cancer cells and by blocking some of the enzymes needed for cancer cell growth.

PURPOSE: This phase II trial is studying how well tipifarnib works in treating patients with anemia or neutropenia and large granular lymphocyte leukemia.


Condition Intervention Phase
Cancer-Related Problem/Condition
Leukemia
Drug: tipifarnib
Procedure: laboratory biomarker analysis
Procedure: mutation analysis
Phase II

MedlinePlus related topics: Anemia Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Tipifarnib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Study of R115777 in Large Granular Lymphocyte (LGL) Leukemia Bone Marrow Failure Diseases Consortium

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

Primary Outcome Measures:
  • Complete response rate, partial response rate, and overall response rate [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Toxicity of treatment [ Designated as safety issue: Yes ]
  • Mechanism of treatment response as measured by biomarkers in peripheral blood at baseline and at the end of 4 and 8 courses of treatment [ Designated as safety issue: No ]

Estimated Enrollment: 56
Study Start Date: June 2006
Estimated Primary Completion Date: September 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Estimate the complete response rate, partial response rate, and overall response rate in patients with natural killer (NK)- or T-cell-large granular lymphocyte (LGL) leukemia who present with neutropenia or anemia treated with tipifarnib.

Secondary

  • Determine the toxicity of tipifarnib in these patients.
  • Determine the mechanism of treatment responses in these patients through correlative laboratory studies.

OUTLINE: This is a multicenter study. Patients are stratified by disease type (natural killer-large granular lymphocyte [LGL] leukemia vs T-cell-LGL leukemia).

Patients receive oral tipifarnib twice daily on days 1-21. Treatment repeats every 28 days for 4 courses in the absence of disease progression or unacceptable toxicity. Patients are evaluated after completion of course 4. Patients achieving complete response receive 1 additional course of treatment. Patients achieving partial response receive 4 additional courses of treatment in the absence of disease progression or unacceptable toxicity.

Patients undergo blood collection periodically during study for response mechanism studies and other biomarker correlative studies, including mutations of K-ras and N-ras genes.

After completion of study treatment, patients are followed every 6 months for 5 years.

PROJECTED ACCRUAL: A total of 56 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:

  • Diagnosis of T-cell-large granular lymphocyte (LGL) leukemia or natural killer (NK)-LGL leukemia associated with ≥ 1 of the following clinical manifestations:

    • Severe neutropenia (i.e., < 500/mm³)
    • Neutropenia associated with recurrent infections, meeting 1 of the following criteria:

      • One severe infection requiring hospitalization
      • At least 2 infections requiring antibiotic therapy
    • Symptomatic anemia with any of the following:

      • Significant fatigue with ECOG performance status 0-1
      • Dyspnea on exertion, but can walk one flight of stairs without stopping (< grade 1 respiratory symptoms)
      • Cardiac symptoms including worsening of angina or new onset of chest pain
    • Transfusion-dependent anemia
  • T-cell-LGL leukemia must meet all of the following criteria:

    • CD3+ and CD57+ cells > 300/mm³ or CD8+ cells > 650/mm³ by phenotypic studies of peripheral blood
    • Evidence for clonal T-cell receptor gene rearrangement based on positive flow cytometric analysis, T-cell receptor (TCR)-γ chain polymerase chain reaction (PCR), TCR-Vβ PCR, or by Southern blot analysis
  • NK-LGL leukemia must have CD56+ or CD16+ NK cells > 750/mm³ by phenotypic studies of peripheral blood

PATIENT CHARACTERISTICS:

  • Life expectancy > 2 years
  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • Bilirubin ≤ 2.0 mg/dL
  • AST and ALT ≤ 2.5 times upper limit of normal
  • Creatinine ≤ 2.0 mg/dL
  • Not pregnant or nursing
  • Fertile patients must use effective contraception prior to and during study
  • Negative pregnancy test
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to tipifarnib
  • No allergies to imidazoles (e.g., clotrimazole, ketoconazole, miconazole, econazole, fenticonazole, isoconazole, sulconazole, tioconazole, or terconazole)
  • No uncontrolled concurrent illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situations that would limit study compliance
  • No other serious medical illness that would limit survival to < 2 years
  • No other malignancy within the past 5 years except inactive nonmelanoma skin cancer or carcinoma in situ of the cervix

PRIOR CONCURRENT THERAPY:

  • More than 1 month since prior methotrexate, cyclophosphamide, or cyclosporine
  • At least 4 weeks since prior supportive growth factor therapy
  • No concurrent antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational agents
  • No prior tipifarnib or other inhibitors of MAPK signaling intermediates
  • No other anticancer agents or therapies
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00360776

Locations
United States, Florida
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
Tampa, Florida, United States, 33612-9497
United States, Ohio
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, United States, 44195
United States, Pennsylvania
Penn State Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States, 17033-0850
Sponsors and Collaborators
Case Comprehensive Cancer Center
Investigators
Study Chair: Thomas P. Loughran, MD Milton S. Hershey Medical Center
  More Information

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

Study ID Numbers: CDR0000489291, CASE-4202, NCI-6823, CASE-RDN-5402
Study First Received: August 3, 2006
Last Updated: December 6, 2008
ClinicalTrials.gov Identifier: NCT00360776  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
T-cell large granular lymphocyte leukemia
anemia
neutropenia

Study placed in the following topic categories:
Neutropenia
Leukemia
Large granular lymphocyte leukemia
Anemia
Pancytopenia
Tipifarnib

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

ClinicalTrials.gov processed this record on January 15, 2009