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A PHASE I COOPERATIVE AGREEMENT PEDIATRIC TRIAL OF MITOXANTRONE, ETOPOSIDE AND PSC-833 (PSC-ME) THERAPY IN PATIENTS WITH RELAPSED AND REFRACTORY ACUTE LEUKEMIA


Phase 1
N/A
21 Years
Not Enrolling
Both
Leukemia

Thank you

Trial Information

A PHASE I COOPERATIVE AGREEMENT PEDIATRIC TRIAL OF MITOXANTRONE, ETOPOSIDE AND PSC-833 (PSC-ME) THERAPY IN PATIENTS WITH RELAPSED AND REFRACTORY ACUTE LEUKEMIA


OBJECTIVES:

I. Determine the maximum tolerated dose of PSC-833 in combination with mitoxantrone and
etoposide in children with refractory or relapsed acute leukemia.

II. Determine the effects of PSC-833 on mitoxantrone and etoposide pharmacokinetics.

III. Quantify MDR1 gene expression and MDR1 P-glycoprotein expression and function in
patient-derived leukemia cells.

OUTLINE: This is a dose escalation study of PSC-833.

Patients undergo induction therapy consisting of etoposide IV and mitoxantrone IV on days
1-5. Patients then receive PSC-833 IV over 124 hours beginning on day 2. A second course is
administered no sooner than 21 days from the start of the first course if the marrow is
hypocellular after the first course. Patients with persistent disease after 2 induction
courses are removed from the study. Patients receive a total of 3 courses of
etoposide/mitoxantrone. Patients who achieve complete remission after 1 induction course
receive 2 courses of etoposide/mitoxantrone with PSC-833 as consolidation, beginning within
4 weeks of attainment of complete remission. Patients who achieve complete remission after 2
induction courses receive 1 course of etoposide/mitoxantrone with PSC-833 as consolidation.
Cohorts of 3-6 patients receive escalating doses of PSC-833 until the maximum tolerated dose
is determined. Patients are followed every 6 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Acute myeloid leukemia (AML) in one of the following categories:

- First relapse if initial CR less than 6 months

- Refractory to first or second induction with daunomycin, cytarabine, and thioguanine
(DAT) or other anthracycline-containing regimens

- Relapse following bone marrow transplantation provided good trilineage engraftment
followed transplant and greater than 6 months since transplant

- Presentation with secondary AML or AML evolving from myelodysplastic syndrome --Acute
lymphocytic leukemia in one of the following categories:

- In second or subsequent relapse or failed second or later induction attempts
regardless of prior remissions

- Relapsed following bone marrow transplantation provided good trilineage engraftment
followed transplant and greater than 6 months since transplant

- No isolated CNS or extramedullary relapse

PATIENT CHARACTERISTICS:

- Age: Under 22 at diagnosis

- Performance status: Karnofsky 50-100% (ECOG 0-2)

- Lansky 40-100% (in patients under 12 years of age)

- Life expectancy: At least 8 weeks

- Bilirubin less than 1.5 mg/dL

- ALT less than twice normal

- Creatinine normal for age (within 2 standard deviations) OR glomular filtration rate
at least 70 mL/min

- Albumin at least 3 g/dL

- Ejection fraction greater than 50% at rest or with 5% increase with exercise OR
shortening fraction greater than 27% by echocardiogram

- No history of clinical heart failure

- No uncontrolled infection

- No anticonvulsant therapy

- No history of allergic reactions or anaphylaxis to etoposide not remediable by
premedication

- Not pregnant or nursing

- Fertile patients must use effective contraception

- Third percentile weight for height

PRIOR CONCURRENT THERAPY:

- At least 4 weeks since chemotherapy and recovered

- Prior cumulative anthracycline dose no greater than 360 mg per square meter

- Hydroxyurea therapy allowed just prior to study for rapidly rising blast count

Type of Study:

Interventional

Study Design:

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Principal Investigator

Gary V.H. Dahl, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Lucile Packard Children's Hospital at Stanford University Medical Center

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2012-01835

NCT ID:

NCT00002912

Start Date:

January 1997

Completion Date:

Related Keywords:

  • Leukemia
  • recurrent childhood acute lymphoblastic leukemia
  • recurrent childhood acute myeloid leukemia
  • secondary acute myeloid leukemia
  • Leukemia

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
Memorial Sloan-Kettering Cancer Center New York, New York  10021
University of Texas - MD Anderson Cancer Center Houston, Texas  77030-4009
University of Michigan Comprehensive Cancer Center Ann Arbor, Michigan  48109-0752
Children's Hospital of Philadelphia Philadelphia, Pennsylvania  19104
Mayo Clinic Cancer Center Rochester, Minnesota  55905
Jonsson Comprehensive Cancer Center, UCLA Los Angeles, California  90095-1781
Stanford University Medical Center Stanford, California  94305-5408
Emory University Hospital - Atlanta Atlanta, Georgia  30322
Indiana University Cancer Center Indianapolis, Indiana  46202-5265
Johns Hopkins Oncology Center Baltimore, Maryland  21287
University of Minnesota Cancer Center Minneapolis, Minnesota  55455
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Washington University School of Medicine Saint Louis, Missouri  63110
Duke Comprehensive Cancer Center Durham, North Carolina  27710
Medical University of South Carolina Charleston, South Carolina  29425-0721
Simmons Cancer Center - Dallas Dallas, Texas  75235-9154
Robert H. Lurie Comprehensive Cancer Center, Northwestern University Chicago, Illinois  60611
Children's Hospital of Michigan Detroit, Michigan  48201
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
Midwest Children's Cancer Center Milwaukee, Wisconsin  53226
University of California San Diego Cancer Center La Jolla, California  92093-0658
UCSF Cancer Center and Cancer Research Institute San Francisco, California  94115-0128
State University of New York - Upstate Medical University Syracuse, New York  13210
Vanderbilt Cancer Center Nashville, Tennessee  37232-6838
NYU School of Medicine's Kaplan Comprehensive Cancer Center New York, New York  10016
Boston Floating Hospital Infants and Children Boston, Massachusetts  02111
University of Florida Health Science Center Gainesville, Florida  32610-0296
University of Wisconsin Comprehensive Cancer Center Madison, Wisconsin  53792
Dana-Farber Cancer Institute Boston, Massachusetts  02115
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
University of Kansas Medical Center Kansas City, Kansas  66160-7353
Cancer Institute of New Jersey New Brunswick, New Jersey  08901
Hackensack University Medical Center Hackensack, New Jersey  07601
Children's Hospital Los Angeles Los Angeles, California  90027-0700
Children's Hospital of Orange County Orange, California  92668
Children's National Medical Center Washington, District of Columbia  20010-2970
Children's Mercy Hospital Kansas City, Missouri  64108
Children's Hospital Medical Center - Cincinnati Cincinnati, Ohio  45229-3039
Children's Hospital of Columbus Columbus, Ohio  43205-2696
Children's Hospital of Pittsburgh Pittsburgh, Pennsylvania  15213
Children's Hospital and Regional Medical Center - Seattle Seattle, Washington  98105
Cardinal Glennon Children's Hospital Saint Louis, Missouri  63104
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Cook Children's Medical Center - Fort Worth Fort Worth, Texas  76104
Texas Children's Cancer Center Houston, Texas  77030-2399
Columbia Presbyterian Hospital New York, New York  10032
Children's Memorial Hospital, Chicago Chicago, Illinois  60614
Primary Children's Medical Center Salt Lake City, Utah  84113-1100
City of Hope National Medical Center Los Angeles, California  91010