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Phase III, Randomized, Multicenter Study to Assess the Efficacy and Safety of HuM195 (Recombinant Humanized Anti-CD33 Monoclonal Antibody) in Combination With Standardized Chemotherapy Compared to Standardized Chemotherapy Alone in the Treatment of Patients With Refractory or First-Relapsed Acute Myelogenous Leukemia (AML)


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Leukemia

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Trial Information

Phase III, Randomized, Multicenter Study to Assess the Efficacy and Safety of HuM195 (Recombinant Humanized Anti-CD33 Monoclonal Antibody) in Combination With Standardized Chemotherapy Compared to Standardized Chemotherapy Alone in the Treatment of Patients With Refractory or First-Relapsed Acute Myelogenous Leukemia (AML)


OBJECTIVES: I. Compare the efficacy, safety, pharmacokinetics, and immunogenicity of
mitoxantrone, etoposide, and cytarabine (MEC) with or without monoclonal antibody HuG1-M195
in patients with refractory or relapsed acute myelogenous leukemia.

OUTLINE: This is a randomized, multicenter study. Patients are stratified by age (under 50
vs 50 and over) and duration of previous complete remission (CR) (0-6 vs 7-12 months). All
patients receive induction chemotherapy comprised of cytarabine IV over 2 hours,
mitoxantrone IV over a maximum of 20 minutes, and etoposide IV over 1-2 hours on days 1-6.
On day 5 of induction, patients are randomized to one of two treatment arms: Arm I: Patients
receive day 6 of induction chemotherapy. Patients then receive monoclonal antibody HuG1-M195
(MOAB HuM195) IV over 4 hours on days 6-9 or 7-10. Treatment with MOAB HuM195 repeats every
2 weeks for 2 courses (courses 1 and 2) in the absence of disease progression or
unacceptable toxicity. During course 1, MOAB HuM195 begins 30 minutes to 24 hours
postchemotherapy. Patients who do not achieve CR by day 70 of induction and show evidence of
bone marrow progression (regimen failure (RF)) are taken off study. Patients without RF are
assigned to one of two consolidation groups based on response: Group A (CR): Patients
receive consolidation chemotherapy comprised of mitoxantrone IV over a maximum of 20 minutes
on days 1 and 2, and cytarabine IV over 2 hours and etoposide IV over 1-2 hours on days 1-4.
Patients with New York Heart Association class II heart disease preconsolidation receive no
mitoxantrone during consolidation. Patients receive MOAB HuM195 IV over 4 hours on days 4-7
or 5-8. Treatment with MOAB HuM195 repeats every 2 weeks for 2 additional courses (courses 3
and 4). During course 3, MOAB HuM195 begins 30 minutes to 24 hours postchemotherapy. Group B
(partial remission (PR), hematologic improvement (HI), or stable disease (SD)): Patients
receive MOAB HuM195 as in group A but no consolidation chemotherapy. Patients without RF
after treatment on group A or B receive maintenance MOAB HuM195 IV over 4 hours on days 1-4.
Treatment repeats every month for 8 additional courses (courses 5-12). Arm II: Patients
receive day 6 of induction chemotherapy. Patients receive no MOAB HuM195 during the entire
study. Patients without RF at day 70 of induction are assigned to one of two consolidation
groups based on response: Group C (CR): Patients receive consolidation chemotherapy as in
group A. Group D (PR, HI, or SD): Patients receive no further treatment. Patients may be
eligible to receive MOAB HuM195 on PDL Study 195-302. Patients are followed every 3 months
for 1 year, and then every 6 months thereafter.

PROJECTED ACCRUAL: A maximum of 200 patients (100 per arm) will be accrued for this study.

Inclusion Criteria


DISEASE CHARACTERISTICS: Histologically proven acute myelogenous leukemia (AML) that may
have been primary AML, secondary AML, or preceded by hematologic disorder All FAB subtypes
except M3 Must meet one of the following three criteria: First relapse within 1 year after
documentation of a previous complete remission (CR) achieved by chemotherapy Refractory to
prior chemotherapy comprised of a minimum of 1 induction course, including cytarabine at a
minimum of 500 mg/m2 (e.g., 100 mg/m2/day for 5 days) plus an anthracycline No high dose
cytarabine (no cumulative dose greater than 3 g/m2) First relapse from a previous CR with
subsequent autologous bone marrow transplantation (BMT), only if all of the following
criteria are met: First BMT At least 100 days but less than 1 year posttransplantation At
least 25% cellularity of the bone marrow Previous BMT included full hematopoietic
recovery, defined by all of the following: Hemoglobin at least 10 g/dL (without
transfusion) Platelet count at least 100,000/mm3 (without transfusion) Absolute neutrophil
count at least 1,500/mm3 No transplantation candidates Bone marrow blasts (leukemic cells)
greater than 10% No chronic myelogenous leukemia in blast crisis No active CNS leukemia

PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 50-100% Life
expectancy: Not specified Hematopoietic: See Disease Characteristics Hepatic: Bilirubin
less than 2.0 mg/dL (unless related to Gilbert's disease or due to leukemic infiltration)
SGOT or SGPT no greater than 4 times upper limit of normal (unless related to AML) Renal:
Creatinine less than 2.0 mg/dL (unless related to AML) Cardiovascular: Left ventricular
function normal No unstable cardiac arrhythmias, unstable angina pectoris, or myocardial
infarction within the past 6 months No New York Heart Association class III or IV heart
disease No electrocardiogram evidence of active ischemia Other: Not pregnant or nursing
Negative pregnancy test Fertile patients must use effective contraception during and for 1
month after study HIV negative No other active malignancy requiring therapy No active
serious infection that is uncontrolled by antimicrobial therapy Medically stable No
significant organ dysfunction

PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics At least 30 days
since prior experimental biologic therapy (e.g., interleukin-2) No concurrent biologic
therapy, including bone marrow transplantation Chemotherapy: See Disease Characteristics
For first relapse AML with recent or prior chemotherapy: Prior hydroxyurea given as a
short course (up to 48 hours) allowed, if needed, to reduce the peripheral leukocyte count
Hydroxyurea must be discontinued prior to study For refractory AML with recent or prior
chemotherapy: Greater than 2 weeks since prior chemotherapy except hydroxyurea given as
above No other concurrent chemotherapy Endocrine therapy: Not specified Radiotherapy: No
concurrent radiotherapy Surgery: Not specified Other: No other concurrent experimental
therapy Concurrent therapy for other preexisting diseases allowed

Type of Study:

Interventional

Study Design:

Primary Purpose: Treatment

Principal Investigator

Daniel Levitt, MD, PhD

Investigator Role:

Study Chair

Investigator Affiliation:

Facet Biotech

Authority:

United States: Federal Government

Study ID:

CDR0000068061

NCT ID:

NCT00006045

Start Date:

March 2000

Completion Date:

Related Keywords:

  • Leukemia
  • recurrent adult acute myeloid leukemia
  • adult acute erythroid leukemia (M6)
  • adult acute myeloblastic leukemia without maturation (M1)
  • adult acute myeloblastic leukemia with maturation (M2)
  • adult acute myelomonocytic leukemia (M4)
  • adult acute monoblastic leukemia (M5a)
  • adult acute megakaryoblastic leukemia (M7)
  • secondary acute myeloid leukemia
  • adult acute monocytic leukemia (M5b)
  • adult acute minimally differentiated myeloid leukemia (M0)
  • Leukemia
  • Leukemia, Myeloid, Acute
  • Leukemia, Myeloid

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
Memorial Sloan-Kettering Cancer Center New York, New York  10021
Albert Einstein Comprehensive Cancer Center Bronx, New York  10461
Jonsson Comprehensive Cancer Center, UCLA Los Angeles, California  90095-1781
USC/Norris Comprehensive Cancer Center Los Angeles, California  90033-0800
University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
Johns Hopkins Oncology Center Baltimore, Maryland  21287
Lineberger Comprehensive Cancer Center, UNC Chapel Hill, North Carolina  27599-7295
Duke Comprehensive Cancer Center Durham, North Carolina  27710
Ireland Cancer Center Cleveland, Ohio  44106-5065
Milton S. Hershey Medical Center Hershey, Pennsylvania  17033
University of Pennsylvania Cancer Center Philadelphia, Pennsylvania  19104
Beth Israel Deaconess Medical Center Boston, Massachusetts  02215
New England Medical Center Hospital Boston, Massachusetts  02111
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Loyola University Medical Center Maywood, Illinois  60153
Massachusetts General Hospital Cancer Center Boston, Massachusetts  02114
New York Presbyterian Hospital - Cornell Campus New York, New York  10021
Medical College of Wisconsin Milwaukee, Wisconsin  53226
Beckman Research Institute, City of Hope Los Angeles, California  91010
New York Medical College Valhalla, New York  10595
Akron General Medical Center Akron, Ohio  44302
Dana-Farber Cancer Institute Boston, Massachusetts  02115
North Shore University Hospital Manhasset, New York  11030
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
Sutter Cancer Center Sacramento, California  95816
Cancer Institute of New Jersey New Brunswick, New Jersey  08901
University of California Davis Cancer Center Sacramento, California  95817
St. Joseph Hospital - Orange Orange, California  92868
University of Illinois at Chicago Chicago, Illinois  60612
Sidney Kimmel Cancer Center San Diego, California  92121
Washington University Barnard Cancer Center Saint Louis, Missouri  63110
Louisiana State University School of Medicine New Orleans, Louisiana  70112-2822
Nevada Cancer Center Las Vegas, Nevada  89109
Emory Clinic Atlanta, Georgia  30365
Vanderbilt University Medical Center Nashville, Tennessee  37232-2516
University of Pittsburgh Medical Center Pittsburgh, Pennsylvania  15213
Washington Cancer Institute Washington, District of Columbia  20010
West Clinic, P.C. Memphis, Tennessee  38117
North Mississippi Hematology and Oncology Associates, Ltd. Tupelo, Mississippi  38801