Clinical Trials /

Controlled Study of Post-transplant Azacitidine for Prevention of Acute Myelogenous Leukemia and Myelodysplastic Syndrome Relapse (VZ-AML-PI-0129)

NCT00887068

Description:

The goal of this clinical research study is to learn if Vidaza (azacitidine) will help to control the disease in patients with AML, CMML, or MDS after an allogeneic (donor) stem cell transplant. The safety of this drug will also be studied.

Related Conditions:
  • Acute Biphenotypic Leukemia
  • Acute Myeloid Leukemia
  • Chronic Myelomonocytic Leukemia
  • Myelodysplastic Syndromes
Recruiting Status:

Completed

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: Controlled Study of Post-transplant Azacitidine for Prevention of Acute Myelogenous Leukemia and Myelodysplastic Syndrome Relapse (VZ-AML-PI-0129)
  • Official Title: Randomized Controlled Study of Post-transplant Azacitidine for Prevention of Acute Myelogenous Leukemia and Myelodysplastic Syndrome Relapse (VZ-AML-PI-0129)

Clinical Trial IDs

  • ORG STUDY ID: 2008-0503
  • SECONDARY ID: NCI-2012-01259
  • NCT ID: NCT00887068

Conditions

  • Leukemia
  • AML
  • MDS

Interventions

DrugSynonymsArms
Azacitidine5-Azacitidine, 5-aza, Vidaza, 5-AZC, AZA-CR, Ladakamycin, NSC-102816Azacitidine

Purpose

The goal of this clinical research study is to learn if Vidaza (azacitidine) will help to control the disease in patients with AML, CMML, or MDS after an allogeneic (donor) stem cell transplant. The safety of this drug will also be studied.

Detailed Description

      The Study Drug:

      Azacitidine is designed to block certain genes in cancer cells whose job is to stop the
      function of the tumor-fighting genes. By blocking the "bad" genes, the tumor-fighting genes
      may be able to work better.

      Study Groups:

      If you are found to be eligible to take part in this study, you will be randomly assigned (as
      in a flip of a coin) to 1 of 2 groups.

        -  If you are in Group 1, you will receive azacitidine.

        -  If you are in Group 2, you will not receive azacitidine.

      Study Drug Administration:

      If you are in Group 1, you will receive azacitidine through a needle under your skin on Days
      1-5 of each cycle.

      Each cycle is 28 days long.

      Your dose of azacitidine may be lowered or stopped if certain side effects develop.

      Study Visits:

      About 2 or 3 days before each cycle and, if your doctor thinks it is needed, on Day 3 of each
      cycle and 1 time during Weeks 2 and 3 of each cycle, blood (about 4 teaspoons each time) will
      be drawn for routine tests.

      At 3, 6, and 12 months after the stem cell transplant:

        -  You will have a complete medical history and physical exam.

        -  Blood (about 4 teaspoons each time) will be drawn for routine tests.

        -  You will have a bone marrow aspiration to check the status of the disease.

      You may come back for study visits more often if the doctor thinks it is needed.

      While on study, you will need to stay in Houston for about 3 months after the transplant
      (this is standard after stem cell transplants).

      Length of Study:

      You will be on study treatment for up to 1 year (up to 12 cycles of azacitidine). You will be
      taken off study early if you experience intolerable side effects or the disease gets worse.

      End-of-Treatment Visit:

      After you complete the planned treatment with azacitidine, you will have an end-of-treatment
      visit:

        -  You will have a complete medical history and physical exam.

        -  Blood (about 4 teaspoons) will be drawn for routine tests.

        -  You will have a bone marrow aspiration to check the status of the disease.

      This is an investigational study. Azacitidine is FDA approved and is commercially available
      for the treatment of myelodysplastic syndrome.

      Up to 246 patients will take part in this study. All will be enrolled at MD Anderson.
    

Trial Arms

NameTypeDescriptionInterventions
AzacitidineExperimentalAzacitidine 32 mg/m^2 given through a needle under the skin for five consecutive days of each 28 day cycle and the maximum treatment will be 12 cycles.
  • Azacitidine
No AzacitidineNo InterventionStandard treatment post allogeneic transplant is supportive care only.

    Eligibility Criteria

            Inclusion Criteria:
    
              1. Patients with a diagnosis of AML (World Health Organization classification: >=20%
                 blasts in the bone marrow and / or peripheral blood) or MDS (International Prognostic
                 Scoring System intermediate-1 or higher) that at the time of allogeneic
                 transplantation were in: - Induction Failure, relapsed disease or second or greater
                 remission; patients in first complete remission that required more than 1 cycle of
                 treatment to achieve the remission, or that have AML evolving from MDS, or that had
                 the following abnormalities: FLT3 mutation, deletion of chromosome 5 or 7, MLL gene
                 rearrangement, or more than or equal to 3 cytogenetics abnormalities. Patients with de
                 novo or therapy-related MDS, CMML, or AML are also eligible, regardless of
                 cytogenetics or molecular rearrangements.
    
              2. Biphenotypic Leukemia that at the time of allogeneic transplantation was in induction
                 failure, relapsed disease, first, second or greater remission.
    
              3. Patients must be in complete remission post transplant.
    
              4. Patient may be enrolled 40 to 100 days after transplant.
    
              5. Age 18 to 75 years old.
    
              6. Serum creatinine < 1.8 mg/dL or creatinine clearance greater or equal than 40 cc/min
                 as defined by the Cockcroft-Gault Equation*. a. Males(mL/min):(140-age)*IBW(kg) /
                 72*(serum creatinine(mg/dl)) b. Females(mL/min):0.85*(140-age)*IBW(kg) / 72*(serum
                 creatinine(mg/dl)).
    
              7. Serum direct bilirubin < 1.5 mg/dL (unless Gilbert's syndrome).
    
              8. SGPT </= 200 IU/ml unless related to patient's malignancy.
    
              9. Be able to understand and sign informed consent.
    
            Exclusion Criteria:
    
              1. Active uncontrolled infection.
    
              2. Presence of uncontrolled graft-versus-host disease.
    
              3. Patients that underwent allogeneic transplantation as a treatment of graft failure.
    
              4. Pregnancy or breast-feeding (women of childbearing potential, any female who has
                 experienced menarche and who has not undergone surgical sterilization or is not
                 post-menopausal with a positive serum pregnancy test.
    
              5. Known or suspected hypersensitivity to azacitidine or mannitol.
    
              6. Patients with advanced malignant hepatic tumors.
          
    Maximum Eligible Age:75 Years
    Minimum Eligible Age:18 Years
    Eligible Gender:All
    Healthy Volunteers:No

    Primary Outcome Measures

    Measure:Relapse-free survival (RFS) Time
    Time Frame:3, 6, and 12 months
    Safety Issue:
    Description:Goal is to test hypothesis that AZA provides at least a 50% improvement in m = median RFS, from 6 to 9 months. Complete response defined as bone marrow with < 6% blasts. Molecular studies of minimal residual disease not be required to define response. Secondary graft failure defined as a sustained decline of ANC below 0.5 x 109/L for 3 consecutive days after initial documented engraftment with no evidence of disease progression.

    Details

    Phase:Phase 3
    Primary Purpose:Interventional
    Overall Status:Completed
    Lead Sponsor:M.D. Anderson Cancer Center

    Trial Keywords

    • Leukemia
    • Acute myelogenous leukemia
    • AML
    • Myelodysplastic syndrome
    • MDS
    • Remission
    • Allogeneic stem cell transplant
    • Allotx
    • Azacitidine
    • 5-Azacitidine
    • 5-aza
    • Vidaza
    • 5-AZC
    • AZA-CR
    • Ladakamycin
    • NSC-102816

    Last Updated