Phase I Dose Escalation Study of ON 01910.Na With Increasing Duration of an Initial 3-Day Continuous Infusion in Patients With Refractory Leukemia or MDS
Patients must have histologically documented or cytologically confirmed diagnosis of acute
myelocytic leukemia refractory to standard induction treatment, or relapsed after standard
therapy; acute lymphocytic leukemia refractory to induction treatment, or relapsed after
effective therapy; chronic myelocytic leukemia refractory to imatinib therapy or second line
tyrosine kinase inhibition, or relapsed after tyrosine kinase inhibition, in chronic,
accelerated, or blastic phase; chronic lymphocytic leukemia refractory to standard therapy,
or relapsed in second relapse; a myelodysplastic syndrome (including chronic myelomonocytic
leukemia) refractory to azacitidine; and an int-2 or high myelodysplastic syndrome relapsed
after a hypomethylating agent. Patients may not be eligible for, or must have declined,
bone marrow transplantation or other chemotherapeutic regimens known to produce consistent
remissions. Because hematopoietic criteria in leukemia and lymphoma are confounded by the
nature of the diseases themselves, there are no hematologic exclusions from treatment. If
leukopenia is clinically determined to be attributable to prior treatment, ON 01910.Na
treatment may start when the leukocyte count increases on two successive determinations
performed at least three days apart. Thrombocytopenia is not a criterion, and patients will
be supported with platelet transfusions as clinically necessary. In the absence of
leukopenia, a failed prior treatment may be succeeded immediately by entry into study of ON
01910.Na if the leukocyte count is stable or rising, on two successive determinations
performed at least three days apart, in the absence of other drug toxicity.
The patient population will involve approximately 12 to 28 patients ≥ 18 years of age in the
dose escalation portion of the protocol. All patients must have relapsed or refractory
leukemia or poor risk MDS (i.e., int-2 or high risk MDS who have failed standard therapy).
They must not be candidates for known regimens or protocol treatments of higher efficacy or
priority. Patients with relapsed/refractory leukemia or poor risk MDS must have an ECOG
Performance Status of 0, 1, or 2. Patients must have an expected survival, in the opinion of
the Investigator, to allow a sufficient observation period for evaluating ON 01910.Na, and
meet the eligibility criteria for patients with leukemia or poor risk MDS. After the
maximally tolerated dose and the Recommended Phase II Dose (RPTD) and duration are
determined, up to 12 additional patients with histologically documented or cytologically
confirmed leukemia or poor risk MDS will be added to confirm the appropriateness of the
RPTD. Inclusion criteria for the dose confirmation phase will be similar to those of the
dose escalation phase of the study, but the ECOG Performance Status must be 0 or 1.
Safety data, including laboratory parameters and adverse events, will be collected for all
patients in order to determine the qualitative and quantitative toxicity, and reversibility
of toxicity, of ON 01910.Na. Leukemic cells and MDS cells in peripheral blood will be
measured on a daily basis during infusion, and at least two times weekly during the
following week. If leukemic cells disappear from the blood or blood counts improve as
defined by IWG criteria in MDS patients, a bone marrow aspiration will be performed to
determine response status in the bone marrow.
All patients may continue therapy for at least six cycles unless rapid disease progression
is documented. Patients with an objective clinical response or stable disease can continue
up to six more cycles. Further continuation will be determined by the clinical judgment of
the Investigator.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Safety data, including laboratory parameters and adverse events, will be collected for all patients in order to determine the qualitative and quantitative toxicity, and reversibility of toxicity, of ON 01910.Na.
2 - 4 months
Yes
Lewis R. Silverman, MD
Principal Investigator
Mount Sinai School of Medicine
United States: Food and Drug Administration
Onconova 04-05
NCT00854646
October 2008
December 2013
Name | Location |
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Mount Sinai Medical Center | New York, New York 10029 |