Fludarabine, Cytarabine, and Pegcrisantaspase for the Treament of Relapsed or Refractory Leukemia

NCT04526795 | Terminated Phase 1 FDA Drug

• 2 other identifiers: 2020-0434NCI-2020-05459
• Study Type: interventional
• Target: 19
• Locations: 1 country
• Sites: 1

Brief Summary

This phase Ib trial investigates the side effects and best dose of pegcrisantaspase when given together with fludarabine and cytarabine for the treatment of patients with leukemia that has come back (relapsed) or has not responded to treatment (refractory). Pegcrisantaspase may block the growth of cancer cells. Chemotherapy drugs, such as fludarabine and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving pegcrisantaspase in combination with fludarabine and cytarabine may work better in treating patients with leukemia compared to the combination of fludarabine and cytarabine.

Conditions

Blast Phase Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Recurrent Acute Biphenotypic Leukemia; Recurrent Acute Lymphoblastic Leukemia; Recurrent Acute Myeloid Leukemia; Recurrent Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Recurrent T-Cell Prolymphocytic Leukemia; Refractory Acute Biphenotypic Leukemia; Refractory Acute Lymphoblastic Leukemia; Refractory Acute Myeloid Leukemia; Refractory Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Refractory T-Cell Prolymphocytic Leukemia

Outcome Measures

Primary Outcomes (1)

• Maximum tolerated dose (MTD)

  Measured by dose limiting toxicities (DLTs). DLTs will be graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE, version 5) by organ system. DLT will be defined as drug-related adverse events during cycle one (during the lead-in phase).

  End of cycle 1 (5 weeks)

Secondary Outcomes (5)

• Overall response rate (ORR) of pegcrisantaspase

  Up to 20 weeks

• ORR of fludarabine, cytarabine (araC), and pegcrisantaspase

  Up to 20 weeks

• Overall survival (OS)

  From date of treatment start until date of death due to any cause, assessed up to 20 weeks

• Disease-free survival (DFS)

  From date of remission until the date of first objective documentation ofdisease-relapse or death, assessed up to 20 weeks

• Duration of response

  Up to 20 weeks

Study Arms (1)

Treatment (pegcrisantaspase, fludarabine, cytarabine)

EXPERIMENTAL

INDUCTION: Patients receive pegcrisantaspase IV over 60 minutes on days 1 and 15, and fludarabine IV over 15-30 minutes and cytarabine IV over 2 hours on days 8-11 in the absence of disease progression or unacceptable toxicity. CONSOLIDATION: Patients receive pegcrisantaspase IV over 60 minutes on days 1 and 15, and fludarabine IV over 15-30 minutes and cytarabine IV over 2 hours on days 8-10. Treatment repeats every 5 weeks for up 3 cycles in the absence of disease progression or unacceptable toxicity.

Drug: Cytarabine; Drug: Fludarabine; Drug: Pegcrisantaspase

Interventions

Cytarabine DRUG

Given IV

Also known as: .beta.-Cytosine arabinoside, 1-.beta.-D-Arabinofuranosyl-4-amino-2(1H)pyrimidinone, 1-.beta.-D-Arabinofuranosylcytosine, 1-Beta-D-arabinofuranosyl-4-amino-2(1H)pyrimidinone, 1-Beta-D-arabinofuranosylcytosine, 1.beta.-D-Arabinofuranosylcytosine, 2(1H)-Pyrimidinone, 4-Amino-1-beta-D-arabinofuranosyl-, 2(1H)-Pyrimidinone, 4-amino-1.beta.-D-arabinofuranosyl-, Alexan, Ara-C, ARA-cell, Arabine, Arabinofuranosylcytosine, Arabinosylcytosine, Aracytidine, Aracytin, Aracytine, Beta-Cytosine Arabinoside, CHX-3311, Cytarabinum, Cytarbel, Cytosar, Cytosine Arabinoside, Cytosine-.beta.-arabinoside, Cytosine-beta-arabinoside, Erpalfa, Starasid, Tarabine PFS, U 19920, U-19920, Udicil, WR-28453

Treatment (pegcrisantaspase, fludarabine, cytarabine)

Fludarabine DRUG

Given IV

Also known as: Fluradosa

Treatment (pegcrisantaspase, fludarabine, cytarabine)

Pegcrisantaspase DRUG

Given IV

Treatment (pegcrisantaspase, fludarabine, cytarabine)

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with a diagnosis of relapsed or refractory leukemia including, but not limited to acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), T-cell prolymphocytic leukemia, biphenotypic acute leukemia, or blast-phase of chronic myeloid Leukemia (CML) will be allowed during the safety lead-in phase
• For cohort A of the expansion phase: Patients with a diagnosis untreated adverse-risk AML (as defined by ELN \[European Leukemia Net Classification\] 2017) will be enrolled
• For cohort B of the expansion phase: Patients with a diagnosis of relapsed or refractory AML will be enrolled
• Bilirubin =\< 2 mg/dL
• Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) =\< 2.5 x upper limit of normal (ULN)
• Creatinine =\< 1.5 x ULN
• Cardiac ejection fraction of \> or = 45% within the past 3 months
• Amylase and lipase =\< 1.5 x ULN
• Eastern Cooperative Oncology Group (ECOG) performance status of =\< 2
• A negative urine pregnancy test is required within one week (7 days) for all women of childbearing potential prior to being registered on this trial
• Patient must have the ability to understand the requirements of the study and signed informed consent. A signed informed consent by the patient or his legally authorized representative is required prior to their enrollment on the protocol

You may not qualify if:

• Pregnant women are excluded from this study because the agents used in this study have the potential for teratogenic or abortifacient effects. Because there is a potential risk for adverse events in nursing infants secondary to treatment of the mother with the chemotherapy agents, breastfeeding should also be avoided
• Uncontrolled intercurrent illness including, but not limited to active uncontrolled infection, symptomatic congestive heart failure (New York Heart Association \[NYHA\] class III or IV), unstable angina pectoris, clinically significant cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Patient with documented hypersensitivity to any of the components of the chemotherapy program
• Prior treatment with pegylated asparaginase
• Patients with a diagnoses of acute promyelocytic leukemia (AML-M3) will be excluded from this trial
• Men and women of childbearing potential who do not practice contraception. Women of childbearing potential and men must agree to use contraception prior to study entry and for the duration of study participation. Effective methods of birth control include:
• Birth control pills, shots, implants or patches
• Intrauterine devices (IUDs)
• Condom or occlusive cap (diaphragm or cervical/vault caps) used with spermicide
• Abstinence
• Females of non-childbearing potential are those who are postmenopausal greater than 1 year or who have had a bilateral tubal ligation, oophorectomy, and/or hysterectomy
• Patients with history of clinically significant venous thromboembolism

Sponsors & Collaborators

• M.D. Anderson Cancer Center: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

M D Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Links

• MD Anderson Cancer Center

MeSH Terms

Conditions

Blast Crisis; Leukemia, Biphenotypic, Acute; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Leukemia, Myeloid, Acute; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Prolymphocytic, T-Cell

Interventions

Cytarabine; fludarabine

Condition Hierarchy (Ancestors)

Leukemia, Myeloid; Leukemia; Neoplasms by Histologic Type; Neoplasms; Cell Transformation, Neoplastic; Carcinogenesis; Neoplastic Processes; Myeloproliferative Disorders; Bone Marrow Diseases; Hematologic Diseases; Hemic and Lymphatic Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Leukemia, Lymphoid; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Immune System Diseases; Leukemia, Prolymphocytic; Leukemia, T-Cell

Intervention Hierarchy (Ancestors)

Cytidine; Pyrimidine Nucleosides; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Arabinonucleosides; Nucleosides; Nucleic Acids, Nucleotides, and Nucleosides

Study Officials

• Tapan M Kadia

  M.D. Anderson Cancer Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 13, 2020
• First Posted: August 26, 2020
• Study Start: April 9, 2021
• Primary Completion: November 15, 2024
• Study Completion: November 15, 2024
• Last Updated: December 12, 2024

Record last verified: 2024-12

Locations

US (1)