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Sunitinib in Treating Patients With Myelodysplastic Syndromes or Chronic Myelomonocytic Leukemia
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
First Received: March 20, 2007   Last Updated: May 2, 2009   History of Changes
Sponsors and Collaborators: Princess Margaret Hospital, Canada
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00451048
  Purpose

RATIONALE: Sunitinib may stop the growth of abnormal cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase II trial is studying how well sunitinib works in treating patients with myelodysplastic syndromes or chronic myelomonocytic leukemia.


Condition Intervention Phase
Leukemia
Myelodysplastic Syndromes
Drug: sunitinib malate
Phase II

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Sunitinib malate Sunitinib Malic acid
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Study of Sunitinib Malate (Sutent; SU11248) in Patients With Intermediate-2 or High-Risk Myelodysplastic Syndrome or Chronic Myelomonocytic Leukemia

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

Primary Outcome Measures:
  • Overall response rate (complete response, partial response, or hematologic improvement) defined by the International Working Group Criteria [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Duration of response [ Designated as safety issue: No ]
  • Overall survival and progression-free survival at 6 months and 1 year [ Designated as safety issue: No ]
  • Time to progression at 6 months and 1 year [ Designated as safety issue: No ]
  • Toxicity and safety [ Designated as safety issue: Yes ]

Estimated Enrollment: 32
Study Start Date: February 2007
Estimated Primary Completion Date: December 2007 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the overall response rate (complete response, partial response, or hematological improvement) in patients with intermediate-2 or high-risk myelodysplastic syndromes or chronic myelomonocytic leukemia treated with sunitinib malate.
  • Determine the duration of response in patients treated with this drug.
  • Determine the overall survival of patients treated with this drug.
  • Determine the progression-free survival of patients treated with this drug.
  • Determine the time to disease progression in patients treated with this drug.
  • Determine the toxicity of this drug in these patients.

OUTLINE: This is a multicenter study.

Patients receive oral sunitinib malate once daily on days 1-28. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 3-4 weeks and then monthly thereafter.

PROJECTED ACCRUAL: A total of 32 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 1 of the following diseases:

    • Myelodysplastic syndromes (MDS) meeting 1 of the following criteria:

      • Intermediate-2 disease
      • High-risk disease (International Prognostic Scoring System [IPSS] score ≥ 1.5)
    • Chronic myelomonocytic leukemia (CMML)

      • WBC > 12,000/mm^3
      • Intermediate-2 disease with WBC ≤ 12,000/mm³
      • High-risk disease (IPSS score ≥ 1.5) with WBC ≤ 12,000/mm³
  • Patients with insufficient or inadequate metaphases for cytogenetic analysis are eligible provided bone marrow blasts are > 10% and/or 2-3 cytopenias are present
  • No known brain metastases

PATIENT CHARACTERISTICS:

  • Life expectancy > 12 weeks
  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • Calcium ≤ 3.0 mmol/L
  • Bilirubin normal
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • No history of significant electrocardiogram abnormalities including, but not limited to, the following:

    • Ventricular arrhythmias

      • Ventricular tachycardia
      • Ventricular fibrillation ≥ 3 beats in a row
    • QTc prolongation (i.e., QTc interval ≥ 500 msec)
  • No history of allergic reaction to compounds of similar chemical or biological composition to sunitinib malate
  • No NYHA class III-IV congestive heart failure

    • Patients with a history of NYHA class II congestive heart failure who are asymptomatic on treatment are eligible
  • No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
  • No serious cardiovascular disease within the past 12 months, including the following:

    • Cerebrovascular accident or transient ischemic attack
    • Myocardial infarction
    • Cardiac arrhythmia
    • Stable or unstable angina
    • Symptomatic congestive heart failure
    • Coronary or peripheral artery bypass graft or stenting
  • No pulmonary embolism within the past 12 months
  • No uncontrolled hypertension, defined as systolic blood pressure (BP) ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg
  • No condition that impairs the ability to swallow and retain sunitinib malate tablets, including the following:

    • Gastrointestinal tract disease resulting in an inability to take oral medication
    • Requirement for IV alimentation
    • Prior surgical procedures affecting absorption
    • Active peptic ulcer disease
  • No serious or nonhealing wound, ulcer, or bone fracture
  • No uncontrolled pre-existing thyroid abnormality
  • No concurrent uncontrolled illness, including ongoing or active infection
  • No psychiatric illness or social situation that would preclude study participation
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

  • At least 4 weeks since prior major surgery
  • Prior central thoracic radiotherapy that included the heart in the radiotherapy port allowed provided New York Heart Association (NYHA) congestive heart failure ≤ class II
  • Prior anthracycline exposure allowed provided NYHA congestive heart failure ≤ class II
  • No other prior therapy for MDS or CMML except for epoetin alfa, darbepoetin alfa, filgrastim (G-CSF), or sargramostim (GM-CSF)

    • At least 2 weeks since prior epoetin alfa
    • At least 4 weeks since prior darbepoetin alfa
  • No other prior antiangiogenic agents including, but not limited to, the following:

    • Bevacizumab
    • Sorafenib tosylate
    • Pazopanib hydrochloride
    • AZD2171
    • Vatalanib
    • VEGF Trap
  • More than 7 days since prior and no concurrent potent CYP3A4 inhibitors, including the following:

    • Azole antifungals (e.g., ketoconazole or itraconazole)
    • HIV protease inhibitors (e.g., indinavir sulfate, saquinavir mesylate, ritonavir, atazanavir, or nelfinavir mesylate)
    • Verapamil
    • Clarithromycin
    • Erythromycin
    • Diltiazem hydrochloride
    • Delavirdine
  • More than 12 days since prior and no concurrent potent CYP3A4 inducers, including the following:

    • Rifampin
    • Rifabutin
    • Carbamazepine
    • Phenobarbital
    • Phenytoin
    • Hypericum perforatum (St. John's wort)
    • Efavirenz
    • Tipranavir
  • No concurrent birth control patch, oral birth control pills, depot, or injectable birth control methods
  • No concurrent therapeutic coumarin-derivative anticoagulants (e.g., warfarin)

    • Low dose (≤ 2 mg) warfarin for prophylaxis of thrombosis allowed
    • Low molecular weight heparin allowed provided INR ≤ 1.5
  • No concurrent agents with proarrhythmic potential, including the following:

    • Terfenadine
    • Quinidine
    • Procainamide
    • Disopyramide
    • Sotalol
    • Probucol
    • Bepridil
    • Haloperidol
    • Risperidone
    • Indapamide
    • Flecainide acetate
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational agents
  • No other concurrent anticancer agents or therapies
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00451048

Locations
United States, New York
Roswell Park Cancer Institute Recruiting
Buffalo, New York, United States, 14263-0001
Contact: Clinical Trials Office - Roswell Park Cancer Institute     877-275-7724        
Canada, Ontario
Edmond Odette Cancer Centre at Sunnybrook Recruiting
Toronto, Ontario, Canada, M4N 3M5
Contact: Rena Buckstein, MD     416-480-5847     rena.buckstein@sunnybrook.ca    
London Regional Cancer Program at London Health Sciences Centre Recruiting
London, Ontario, Canada, N6A 465
Contact: Kang Howson-Jan, MD     519-685-5194     Kang.howsonjan@lhsc.on.ca    
McMaster Children's Hospital at Hamilton Health Sciences Recruiting
Hamilton, Ontario, Canada, L8N 3Z5
Contact: Brian Leber, MD, FRCPC     905-521-2100 ext. 76384     leberb@mcmaster.ca    
Princess Margaret Hospital Recruiting
Toronto, Ontario, Canada, M5G 2M9
Contact: Karen W. L. Yee, MD     416-946-4495     karen.yee@uhn.on.ca    
Canada, Quebec
Jewish General Hospital - Montreal Recruiting
Montreal, Quebec, Canada, H3T 1E2
Contact: Sarit Assouline, MD     514-340-8222 ext 8207     sarit.assouline@mcgill.ca    
Montreal General Hospital Recruiting
Montreal, Quebec, Canada, H3G 1A4
Contact: John Storring     514-934-1937 ext. 42428        
Sponsors and Collaborators
Princess Margaret Hospital, Canada
Investigators
Study Chair: Karen W. L. Yee, MD Princess Margaret Hospital, Canada
  More Information

Additional Information:
No publications provided

Responsible Party: Princess Margaret Hospital ( Amit M. Oza )
Study ID Numbers: CDR0000535656, PMH-PHL-063
Study First Received: March 20, 2007
Last Updated: May 2, 2009
ClinicalTrials.gov Identifier: NCT00451048     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
de novo myelodysplastic syndromes
secondary myelodysplastic syndromes
chronic myelomonocytic leukemia

Study placed in the following topic categories:
Chronic Myelomonocytic Leukemia
Precancerous Conditions
Hematologic Diseases
Leukemia, Myelomonocytic, Chronic
Myelodysplastic Syndromes
Myeloproliferative Disorders
Leukemia, Myeloid
Angiogenesis Inhibitors
Leukemia, Myelomonocytic, Acute
Leukemia
Preleukemia
Sunitinib
Neoplasm Metastasis
Myelodysplastic-Myeloproliferative Diseases
Bone Marrow Diseases
Myelodysplastic Myeloproliferative Disease

Additional relevant MeSH terms:
Disease
Neoplasms by Histologic Type
Precancerous Conditions
Antineoplastic Agents
Hematologic Diseases
Growth Substances
Leukemia, Myelomonocytic, Chronic
Physiological Effects of Drugs
Myelodysplastic Syndromes
Leukemia, Myeloid
Angiogenesis Inhibitors
Pharmacologic Actions
Leukemia, Myelomonocytic, Acute
Leukemia
Preleukemia
Neoplasms
Pathologic Processes
Sunitinib
Therapeutic Uses
Syndrome
Growth Inhibitors
Angiogenesis Modulating Agents
Myelodysplastic-Myeloproliferative Diseases
Bone Marrow Diseases

ClinicalTrials.gov processed this record on May 07, 2009