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Fractionated Gemtuzumab Ozogamicin in Treating Measurable Residual Disease in Patients With Acute Myeloid Leukemia, High-Risk Myelodysplastic Syndrome or High-Risk Myeloproliferative Neoplasm

NCT03737955

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.

Related Conditions:
  • Acute Myeloid Leukemia
  • Myelodysplastic Syndromes
  • Myeloproliferative Neoplasm
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

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

DrugSynonymsArms
Gemtuzumab OzogamicinCDP-771, Calicheamicin-Conjugated Humanized Anti-CD33 Monoclonal Antibody, MylotargTreatment (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

NameTypeDescriptionInterventions
Treatment (gemtuzumab ozogamicin)ExperimentalPatients 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.
  • Gemtuzumab Ozogamicin

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