Description:
The purpose of this Phase I study is to determine the safety and tolerability including the
maximum dose (MTD) and dose-limiting toxicities (DLTs) of alvocidib when administered over a
range of doses on Days 1-3 followed by cytarabine/daunorubicin (7+3) on Days 5-11 in adults
with newly diagnosed and previously untreated AML
Title
- Brief Title: Ph I Study of Alvocidib and Cytarabine/Daunorubicin (7+3) in Patients With Newly Diagnosed Acute Myeloid Leukemia (AML).
- Official Title: A Phase 1, Open-label, Dose-escalation, Safety and Biomarker Prediction of Alvocidib and Cytarabine/Daunorubicin (7+3) in Patients With Newly Diagnosed Acute Myeloid Leukemia (AML)
Clinical Trial IDs
- ORG STUDY ID:
TPI-ALV-101
- NCT ID:
NCT03298984
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Alvocidib | | Alvocidib and Cytarabine/Daunorubicin |
Cytarabine | | Alvocidib and Cytarabine/Daunorubicin |
Daunorubicin | | Alvocidib and Cytarabine/Daunorubicin |
Purpose
The purpose of this Phase I study is to determine the safety and tolerability including the
maximum dose (MTD) and dose-limiting toxicities (DLTs) of alvocidib when administered over a
range of doses on Days 1-3 followed by cytarabine/daunorubicin (7+3) on Days 5-11 in adults
with newly diagnosed and previously untreated AML
Detailed Description
Primary Objective:
• To determine the safety and tolerability including the maximum tolerated dose (MTD) and
dose-limiting toxicities (DLTs) of alvocidib when administered over a range of doses on Days
1-3 followed by cytarabine/daunorubicin (7+3) on Days 5-11 in adults with newly diagnosed and
previously untreated AML
Secondary Objectives:
- To observe patients for any evidence of antileukemic activity of alvocidib plus 7+3
using the 2017 ELN response criteria
- To establish the Recommended Phase 2 Dose (RP2D) for future studies with alvocidib in
combination with 7+3
Exploratory Objective:
• To assess levels of minimal residual disease (MRD) using standardized techniques (ie,
multiparametric flow cytometry [MPFC] and next generation sequencing [NGS] and evaluate other
potential biomarkers including, but not limited to, MCL-1 dependency.
Trial Arms
Name | Type | Description | Interventions |
---|
Alvocidib and Cytarabine/Daunorubicin | Experimental | The starting dose of alvocidib will be 20 mg/m2 as a 30-minute intravenous (IV) bolus followed by 30 mg/m2 over 4 hours as an IV infusion administered daily on Days 1-3 of Induction. Patients will have a one day drug holiday (Day 4) before initiation of the 7+3 regimen. Beginning on Day 5, cytarabine will be administered as a 100 mg/m2/day continuous IV infusion for seven consecutive days (Days 5-11) plus daunorubicin administered at a dosage of 60 mg/m2 IV on Days 5-7. | - Alvocidib
- Cytarabine
- Daunorubicin
|
Eligibility Criteria
Inclusion Criteria:
- To be eligible for participation in the study, patients must meet all of the following
inclusion criteria:
1. Be between the ages of ≥18 and ≤65 years
2. Have an established, pathologically confirmed diagnoses of AML by World Health
Organization (WHO) criteria with ≥20% bone marrow blasts based on histology or
flow cytometry
3. Be newly diagnosed and previously untreated
4. Have an Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤2
5. Have a serum creatinine level ≤1.8 mg/dL
6. Have an alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level
≤5 times upper limit of normal (ULN)
7. Have a total bilirubin level ≤2.0 mg/dL (unless secondary to Gilbert syndrome,
hemolysis, or leukemia)
8. Have a left ventricular ejection fraction (LVEF) >45% by echocardiogram (ECHO) or
multigated acquisition (MUGA) scan
9. Be nonfertile or agree to use an adequate method of contraception. Sexually
active patients and their partners must use an effective method of contraception
associated with a low failure rate prior to study entry, for the duration of
study participation, and for at least 6 months after the last dose of study drug.
10. Be able to comply with the requirements of the entire study.
11. Provide written informed consent prior to any study related procedure. (In the
event that the patient is re-screened for study participation or a protocol
amendment alters the care of an ongoing patient, a new informed consent form must
be signed.)
Exclusion Criteria:
- Patients meeting any one of these exclusion criteria will be prohibited from
participating in this study.
1. Received any previous treatment for AML
2. Diagnosed with APL-M3 or CBF-AML
3. Require concomitant chemotherapy, radiation therapy, or immunotherapy.
Hydroxyurea is allowed up to the evening before starting (but not within 12
hours) of starting Induction therapy.
4. Received >200 mg/m2 equivalents of daunorubicin
5. Have a peripheral blast count of >30,000/mm3 (may use hydroxyurea as in #3 above)
6. Have active central nervous system (CNS) leukemia
7. Have evidence of uncontrolled disseminated intravascular coagulation
8. Have an active, uncontrolled infection
9. Have other life-threatening illness
10. Have other active malignancies or diagnosed with other malignancies within the
last 6 months, except nonmelanoma skin cancer or cervical intraepithelial
neoplasia
11. Have mental deficits and/or psychiatric history that may compromise the ability
to give written informed consent or to comply with the study protocol.
12. Are pregnant and/or nursing
Maximum Eligible Age: | 65 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Maximum Tolerated Dose (MTD) of Alvocidib |
Time Frame: | During the first cycle |
Safety Issue: | |
Description: | Determine the safety and tolerability including the maximum tolerated dose (MTD) of alvocidib when administered over a range of doses on Days 1-3 followed by Ara-c/daunorubicin (7+3) on Days 5-11 in adults with newly diagnosed and previously untreated AML |
Secondary Outcome Measures
Measure: | Antileukemic Activity of Alvocidib Plus 7+3 - Response to Treatment Based on 2017 ELN Response Criteria |
Time Frame: | Best response during duration of study |
Safety Issue: | |
Description: | CR: Measurable residual disease is positive or unknown; BM blasts (bls) <5%; no circulating bls and bls w/ Auer rods; no extramedullary disease; ANC >1.0 x 109/L; platelets >100 x 109/L. CRMRD-: CR w/ negativity genetic marker. CRi: CR except residual neutropenia or thrombocytopenia. MLFS: BM bls <5%; no bls with Auer rods; no extramedullary disease; no hematologic recovery required. PR: all hematologic CR criteria; decrease (dec) BM bls % to 5-25%; dec pretreatment BM bls % by >50%. SD: no CRMRD-/CR/CRi/PR/MLFS; PD criteria not met. PD: increase (inc) BM bls % and/or inc absolute bls in blood: 50% inc BM bls over baseline (>15% point inc required in cases w/ <30% bls at baseline or persistent BM bls % of >70% over at least 3 months; without at least 100% improvement in ANC to absolute level [>0.5 x 109/L and/or platelet count to >50 x 109/L non-transfused); or >50% inc in peripheral bls to >25 x 109/L (in the absence of differentiation syndrome); or new extramedullary disease. |
Measure: | Recommended Phase 2 Dose (RP2D) of Alvocidib in Combination With 7+3 |
Time Frame: | During Cycle 1 beginning at 1st dose of study drug through Day 50 + or - 3 days |
Safety Issue: | |
Description: | The dose at which < 1 of 6 patients experience a DLT during Cycle 1 with the next higher dose having at least 2 of 3 to 6 patients experiencing a DLT during Cycle 1 |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | Sumitomo Dainippon Pharma Oncology, Inc |
Last Updated
May 24, 2021