Description:
The NCRI Adult ALL sub-group propose to collaborate with the Dutch/Belgian group HOVON to
carry out a prospective, non randomised multi-arm study (including a choice of regimen
intensity) to investigate the safety, tolerability and feasibility of a standardised therapy
protocol for patients ≥ 60 years old with de novo ALL. The overall aim is define a basic
standard of care upon which trials of novel therapies will be based in future. The design of
the study will enable collection of a comprehensive dataset regarding the clinical outcome,
Complete Response Rate (CR) and Minimal Residual Disease (MRD) response rates in a previously
completely uncharacterised population, thus providing the essential platform for designing
future randomised advanced phase studies in which new therapeutic approaches and novel
therapies can be prospectively investigated.
Title
- Brief Title: A Study for Older Adults With Acute Lymphoblastic Leukaemia
- Official Title: A Phase 2 Study for Older Adults With Acute Lymphoblastic Leukaemia
Clinical Trial IDs
- ORG STUDY ID:
UCL/11/0532
- NCT ID:
NCT01616238
Conditions
- Acute Lymphoblastic Leukaemia
Interventions
Drug | Synonyms | Arms |
---|
Chemotherapy | | Philadelphia -ve Patients- Intensive |
Purpose
The NCRI Adult ALL sub-group propose to collaborate with the Dutch/Belgian group HOVON to
carry out a prospective, non randomised multi-arm study (including a choice of regimen
intensity) to investigate the safety, tolerability and feasibility of a standardised therapy
protocol for patients ≥ 60 years old with de novo ALL. The overall aim is define a basic
standard of care upon which trials of novel therapies will be based in future. The design of
the study will enable collection of a comprehensive dataset regarding the clinical outcome,
Complete Response Rate (CR) and Minimal Residual Disease (MRD) response rates in a previously
completely uncharacterised population, thus providing the essential platform for designing
future randomised advanced phase studies in which new therapeutic approaches and novel
therapies can be prospectively investigated.
Detailed Description
The study will
1. establish baseline expectations for Event Free Survival (EFS), Overall Survival (OS),
MRD responses and quality of life measures for older patients of all ages and pre-morbid
states;
2. disclose how best to use knowledge of pre-morbid characteristics to apply the
appropriate intensity of therapy in order to balance the best disease related outcomes
against quality of life;
3. establish national standards of care for this patient group;
4. provide the essential platform for careful design of future randomised advanced phase
studies of new therapeutic approaches and agents.
Trial Arms
Name | Type | Description | Interventions |
---|
Philadelphia Positive Patients | Experimental | All patients with Philadelphia positive ALL will be treated in this group and will receive a standard imatinib-containing chemotherapy regimen | |
Philadelphia -ve Patients- Intensive | Experimental | Patients with Philadelphia negative ALL who are fit for intensive treatment will be allocated into this group. | |
Philadelphia -ve Patients- Intensive + | Experimental | Patients with Philadelphia negative disease and who are fit for intensive treatment will be entered into this group | |
Philadelphia -ve Patients- Non Intensive | Experimental | Patients with Philadelphia negative disease who are not fit for intensive chemotherapy will be entered into this group | |
Registration only | No Intervention | Patients with either Philadelphia positive or negative ALL who do not wish to enter the study will be allocated to this group for data collection purposes only. | |
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 60 with Acute Lymphoblastic Leukaemia (ALL) OR ≥ 55 with Acute Lymphoblastic
Leukaemia (ALL) unsuitable for the UKALL14 or HOVON 100 trial
- Newly diagnosed, previously untreated ALL (a steroid pre-phase of 5-7 days may be
given before trial registration))
- Willing and able to give consent
Exclusion Criteria:
- Known HIV infection
- Blast transformation of CML
- Mature B-cell leukaemia i.e. Burkitts disease t(8,14)(q24 ;q32) and variant c-myc
translocations e.g. t(2;8)(p12 ;q24), t(8;22)(q24;q11)
- Women who are pregnant or lactating
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 55 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Complete remission rate after 2 phases of induction |
Time Frame: | Approximately 2 months after start of treatment |
Safety Issue: | |
Description: | All patients will be assessed for their remission status at the end of Phase 2 induction. The CR rate at this timepoint will then be calculated. |
Secondary Outcome Measures
Measure: | Complete remission rate after 1 phase of induction |
Time Frame: | Approximately 1 month after start of treatment |
Safety Issue: | |
Description: | All patients will be assessed for their remission status at the end of Phase 1 induction. The CR rate at this timepoint will then be calculated. |
Measure: | Overall Survival at 1 year |
Time Frame: | 1 year after registration |
Safety Issue: | |
Description: | Overall survival for all patients will be measured 1 year after registration |
Measure: | Prognostic significance of molecularly determined minimal residual disease (MRD) at various time-points during therapy with respect to relapse occurrence. |
Time Frame: | At diagnosis, 4 weeks, 8 weeks, 12 weeks after starting treatment |
Safety Issue: | |
Description: | MRD levels will be measured at distinct timepoints during the trial. |
Measure: | Tolerability of treatment as determined by occurrence of key adverse effects |
Time Frame: | Approximately 4 weeks, 8 weeks, 12 weeks, 24 weeks after starting treatment |
Safety Issue: | |
Description: | Patients in arms A-D will be assessed for adverse events at distinct timepoints during the trial |
Measure: | Duration of in-patient hospitalisation |
Time Frame: | Approximately 4 weeks, 8 weeks, 12 weeks, 24 weeks, 28 after starting treatment and every 3 months during maintenance |
Safety Issue: | |
Description: | All patients will be assessed for the number of days they have spent as in-patients at distinct timepoints during the trial. |
Measure: | Relationship between performance status/co-morbidity and treatment option chosen |
Time Frame: | At registration |
Safety Issue: | |
Description: | |
Measure: | Quality of life aspects assessed at diagnosis/baseline at various time points |
Time Frame: | Registration, Approximately 4 weeks, 8 weeks, 12 weeks, 24 weeks, 28 after starting treatment, before starting maintenance and at the end of maintenance |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | University College, London |
Last Updated
February 15, 2019