Description:
This is a research study of ribavirin which will be given in combination with vismodegib
and/or decitabine. The purpose of this study is to see if patients respond to treatment when
ribavirin is given with vismodegib alone or in combination with decitabine.
Title
- Brief Title: Ribavirin and Hedgehog Inhibitor With or Without Decitabine in AML
- Official Title: A Phase II, Multi-center, Open Label, Randomized Study of Ribavirin and Hedgehog Inhibitor With or Without Decitabine in Acute Myeloid Leukemia (AML)
Clinical Trial IDs
- ORG STUDY ID:
Ribavirin=005
- NCT ID:
NCT02073838
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Ribavirin | | Ribavirin, vismodegib |
Vismodegib | | Ribavirin, vismodegib, decitabine |
Decitabine | | Ribavirin, vismodegib |
Purpose
This is a research study of ribavirin which will be given in combination with vismodegib
and/or decitabine. The purpose of this study is to see if patients respond to treatment when
ribavirin is given with vismodegib alone or in combination with decitabine.
Trial Arms
Name | Type | Description | Interventions |
---|
Ribavirin, vismodegib, decitabine | Experimental | Decitabine 20mg/m2 IV QD days -7 to -3 for cycle 1. Ribavirin 1400mg BID and vismodegib 150mg QD starting on day 1. On subsequent cycles, decitabine will be administered on days 1 to 5. | - Ribavirin
- Vismodegib
- Decitabine
|
Ribavirin, vismodegib | Experimental | Ribavirin 1400mg BID, vismodegib 150mg QD | |
Eligibility Criteria
INCLUSION CRITERIA
1. Patients with AML M4 or M5 FAB subtype or high eIF4E are eligible.
2. All patients must have failed primary therapy (defined as two induction
chemotherapies), must have relapsed, or must not be suitable candidates for intensive
induction chemotherapy.
3. Patients who have a dry aspirate or extramedullary disease only are eligible for this
study if they have a pre-treatment marrow or tissue biopsy demonstrating AML M4 or M5
subtype or high eIF4E.
4. ECOG performance status 0, 1, 2.
5. Life expectancy>4 weeks.
6. Age is > 18 years.
7. Female patients of childbearing potential (FCBP) is defined as a sexually mature woman
who: 1) has not undergone a hysterectomy or bilateral oophorectomy, or 2) has not been
naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at
any time in the preceding 24 consecutive months). In addition, women under the age of
55 years must have a serum follicle stimulating hormone (FSH) level > 40IU/L to
confirm menopause.
FCBP must have a negative serum (beta-HCG) pregnancy test (minimum sensitivity 25 IU/L
of equivalent units of HCG) within 7 days of starting treatment and must not be
breastfeeding. Men and females of childbearing potential must agree to use two
effective means of contraception, with one method being highly effective and the other
method being either highly effective or less effective as listed below throughout the
study and for at least 24 months after completion of protocol.
An effective means of contraception includes the following:
i. Male condoms with spermicide ii. Hormonal methods of contraception including
combined oral contraception pills, vaginal ring, injectables, implants, and
intrauterine devices (IUDs).
iii. Nonhormonal IUDs iv. Tubal ligation v. Vasectomy vi. Complete Abstinence
A less effective means of contraception includes the following:
i. Diaphragm with spermicide ii. Vaginal sponge iii. Male condom without spermicide
iv. Progestin only pills by females of childbearing potential or male subject's FCBP
partners v. Female condom (a male and female condom must not be used together)
Male subjects must not donate semen while on study and during 24 months after
treatment discontinuation.
8. Adequate renal and hepatic function: serum creatinine < 1.5 x ULN; AST or ALT < 2.5 x
ULN (or < 5 x ULN if liver involvement with leukemia); serum bilirubin < 1.5 x ULN
9. Provide written consent after the investigational nature, study design, risks and
benefits of the study have been explained.
10. Accessible for treatment and follow up.
EXCLUSION CRITERIA
1. Patients with impaired ribavirin uptake. As tested in the central laboratory.
2. Uncontrolled central nervous system involvement by AML.
3. Active cardiovascular disease as defined by New York Heart Association (NYHA) class
III-IV categorization.
4. Patients with hemoglobinopathies which may affect their ability to tolerate ribavirin.
5. Intercurrent illness or medical condition precluding safe administration of the
planned protocol treatment or required follow-up.
6. Received any previous therapy for AML within 28 days prior to the study entry. Hydrea
is permitted for the treatment of leukocytosis but must be stopped prior to starting
study drugs.
7. Female patients who are pregnant or breastfeeding.
8. Concurrent treatment with other anti-cancer therapy except adjuvant antihormonal
agents for breast cancer or for limited stage prostate cancer.
9. Known infection with HIV.
10. History of other active malignancy. Subjects who have been disease-free for 2 year or
subjects with a history of completely resected non-melanoma skin cancer or
successfully treated in situ carcinoma are eligible.
11. FAB AML M1, 2, 6, 7 will be excluded if they do not have high eIF4E expression. AML M3
is always excluded.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Efficacy will be measured by overall response rate (ORR). |
Time Frame: | Measured up to 2 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Time to response |
Time Frame: | Measured up to 2 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Measure: | Duration of response |
Time Frame: | Measured up to 2 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Measure: | One year survival |
Time Frame: | Measured up to 2 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Measure: | Overall survival |
Time Frame: | Measured up to 3 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Measure: | Hematologic improvement defined by the number of individual, positively affected cell lines (erythroid, neutrophil and platelet cells) per patient. |
Time Frame: | Measured up to 2 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Measure: | Number of participants with Adverse Events as a Measure of Safety and Tolerability |
Time Frame: | Measured up to 2 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Measure: | Changes in eIF4E expression, localization, and signalling pathways (measured by immuno-histochemical analysis, PCR or western blot) and correlating with each patient's overall response. |
Time Frame: | Measured up to 2 years after the last subject has enrolled in the study. |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Unknown status |
Lead Sponsor: | Sarit Assouline |
Last Updated
March 7, 2017