Description:
This phase II trial studies the how well fractionated gemtuzumab ozogamicin works in treating
measurable residual disease in patients with acute myeloid leukemia, high-risk
myelodysplastic syndrome or high-risk myeloproliferative neoplasm. Gemtuzumab ozogamicin is a
monoclonal antibody, called gemtuzumab, linked to a chemotherapy drug, called ozogamicin.
Gemtuzumab is a form of targeted therapy because it attaches to specific molecules
(receptors) on the surface of cancer cells, known as CD33 receptors, and delivers a
chemotherapy known as calicheamicin to kill them.
Title
- Brief Title: Fractionated Gemtuzumab Ozogamicin in Treating Measurable Residual Disease in Patients With Acute Myeloid Leukemia, High-Risk Myelodysplastic Syndrome or High-Risk Myeloproliferative Neoplasm
- Official Title: A Phase 2 Trial of Fractionated Gemtuzumab Ozogamicin to Eradicate Measurable Residual Disease in Acute Myeloid Leukemia Patients (GO for MRD)
Clinical Trial IDs
- ORG STUDY ID:
RG1018001
- SECONDARY ID:
NCI-2018-01613
- SECONDARY ID:
9966
- SECONDARY ID:
P30CA015704
- NCT ID:
NCT03737955
Conditions
- Acute Myeloid Leukemia
- Myelodysplastic Syndrome
- Myeloproliferative Neoplasm
Interventions
Drug | Synonyms | Arms |
---|
Gemtuzumab Ozogamicin | CDP-771, Calicheamicin-Conjugated Humanized Anti-CD33 Monoclonal Antibody, Mylotarg | Treatment (gemtuzumab ozogamicin) |
Purpose
This phase II trial studies the how well fractionated gemtuzumab ozogamicin works in treating
measurable residual disease in patients with acute myeloid leukemia, high-risk
myelodysplastic syndrome or high-risk myeloproliferative neoplasm. Gemtuzumab ozogamicin is a
monoclonal antibody, called gemtuzumab, linked to a chemotherapy drug, called ozogamicin.
Gemtuzumab is a form of targeted therapy because it attaches to specific molecules
(receptors) on the surface of cancer cells, known as CD33 receptors, and delivers a
chemotherapy known as calicheamicin to kill them.
Detailed Description
OUTLINE:
Patients receive gemtuzumab ozogamicin intravenously (IV) on days 1, 4, 7. Treatment
continues for 35 days in the absence of disease progression or unacceptable toxicity.
Responders and non-responders, without significant adverse events during the first course,
may receive a second course of gemtuzumab ozogamicin within 60 days after course 1.
After completion of study treatment, patients are followed up for 6 months.
Trial Arms
Name | Type | Description | Interventions |
---|
Treatment (gemtuzumab ozogamicin) | Experimental | Patients receive gemtuzumab ozogamicin IV on days 1, 4, 7. Treatment continues for 35 days in the absence of disease progression or unacceptable toxicity. Responders and non-responders, without significant adverse events during the first course, may receive a second course of gemtuzumab ozogamicin within 60 days after course 1. | |
Eligibility Criteria
Inclusion Criteria:
- Prior diagnosis of either high-risk myelodysplastic syndrome (myelodysplastic syndrome
[MDS]; defined as >= 10% blasts in bone marrow or blood), high-risk myeloproliferative
neoplasms (myeloproliferative neoplasms [MPN]; defined as >= 10% blasts in bone marrow
or blood), or AML based on 2016 World Health Organization criteria. Acute
promyelocytic leukemia (APL) and biphenotypic AML are not eligible
- Patients must have MRD-level disease only and otherwise meet criteria for complete
response (CR) or complete remission with incomplete hematologic recovery (CRi) per the
2017 European Leukemia Net response criteria (< 5% blasts in the marrow without a
requirement for peripheral blood count recovery). MRD must be measurable by
multiparameter flow cytometry (MPFC) and/or polymerase chain reaction (PCR)-based
molecular markers and/or karyotypic markers (e.g., classical cytogenetics or
fluorescence in situ hybridization). MRD status will be centrally confirmed by the
UW/FHCRC clinical laboratory in order to standardize response assessment following
administration of study therapy.
- Patients must have received at least 1 cycle of standard induction chemotherapy prior
to enrollment on the study. However, adult patients (>= 18 years of age) are eligible
for participation at any time point in treatment (after induction, during or after
consolidation, pre-transplant, or post-transplant). Pediatric patients (2-18 years of
age) must have MRD positivity during/after consolidation or post-transplant.
- Age >= 2 years of age
- Eastern Cooperative Oncology Group (ECOG) performance status =< 3 (for adults) or
Lansky performance status >= 40 (for children).
- Patient's AML blasts must have CD33 expression.
- For adults (>= 18 years of age): Serum creatinine =< 2.0 mg/dL.
- For adults (>= 18 years of age): Total bilirubin =< 2 x institutional upper limit of
normal for age (unless known history of Gilbert's disease).
- For adults (>= 18 years of age): Aspartate aminotransferase (AST) and alanine
aminotransferase (ALT) < 2.5 x institutional upper limit of normal for age (unless
thought to be related to resolving infectious complications).
- For children (< 18 years of age): Glomerular filtration rate (GFR) in ml/min (age 2:
63-175; age 3-12: 89-165; females 13 and older: 75-115; males 13 and older: 85-125).
- For children (< 18 years of age): Total bilirubin =< 2 x institutional upper limit of
normal for age (unless known history of Gilbert's disease).
- For children (< 18 years of age): AST and ALT < 2.5 x institutional upper limit of
normal for age (unless thought to be related to resolving infectious complications).
- Ability of patient or representative to provide written informed consent.
- Females of childbearing potential must have a negative pregnancy test prior to
receiving GO.
Exclusion Criteria:
- Subjects who have had chemotherapy or radiation therapy within 14 days prior to
entering the study.
- Subjects may not be receiving other investigational agents.
- Uncontrolled or concurrent illness including, but not limited to, uncontrolled
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 2 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Clinical response rate |
Time Frame: | Up to 70 days |
Safety Issue: | |
Description: | Measured by clearance of measurable residual disease (MRD) with bone marrow evaluation after one or two cycles of therapy and compare responses (rate of eradication of MRD) based on CD33 single nucleotide polymorphism rs12459419 genotype. |
Secondary Outcome Measures
Measure: | Rate of sinusoidal obstructive syndrome (SOS) |
Time Frame: | Up to 6 months |
Safety Issue: | |
Description: | Measured by grade III/IV non-hematologic toxicities using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4. |
Measure: | Rate of allogeneic hematopoietic cell transplantation (HCT) |
Time Frame: | Up to 6 Months |
Safety Issue: | |
Description: | Measured by those receiving HCT |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | University of Washington |
Trial Keywords
- Myeloid and Monocytic Leukemia
- Other Hematopoietic
Last Updated
August 5, 2021