NCT01696084已完成3 期
Phase III, Multicenter, Randomized, Trial of CPX-351 (Cytarabine:Daunorubicin) Liposome Injection Versus Cytarabine and Daunorubicin in Patients 60-75 Years of Age With Untreated High Risk (Secondary) AML
适应症
干预措施
相关药物
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 309
- 试验地点
- 43
- 主要终点
- Overall Survival
研究概览
简要总结
To confirm the efficacy of CPX-351 compared to 7+3 as first line therapy in elderly patients (60-75 yrs) with high risk (secondary) Acute Myeloid Leukemia. The primary efficacy endpoint will be overall survival.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 60 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Ability to understand and voluntarily give informed consent
- •Age 60-75 years at the time of diagnosis of AML
- •Pathological diagnosis of AML according to WHO criteria (with at least 20% blasts in the peripheral blood or bone marrow)
- •Confirmation of:
- •Therapy related AML: t-AML must have a documented history of prior cytotoxic therapy or ionizing radiotherapy for an unrelated disease
- •AML with a history of myelodysplasia: MDSAML must have bone marrow documentation of prior MDS
- •AML with a history of CMMoL: CMMoLAML must have bone marrow documentation of prior CMMoL
- •De novo AML with karyotypic abnormalities characteristic of MDS: de novoAML must have cytogenetics with abnormalities per WHO.
- •Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- •Able to adhere to the study visit schedule and other protocol requirements
- •Laboratory values fulfilling the following:
- •Serum creatinine < 2.0 mg/dL
- •Serum total bilirubin < 2.0 mg/dL, patients with Gilbert's Syndrome should contact the medical monitor
- •Serum alanine aminotransferase or aspartate aminotransferase < 3 times the ULN Note: If elevated liver enzymes, above the ULN, are related to disease; contact medical monitor to discuss.
- •Cardiac ejection fraction ≥ 50% by echocardiography or MUGA
- •Patients with second malignancies in remission may be eligible if there is clinical evidence of disease stability for a period of greater than 6 months off cytotoxic chemotherapy, documented by imaging, tumor marker studies, etc., at screening. Patients maintained on long-term non-chemotherapy treatment, e.g., hormonal therapy, are eligible.
排除标准
- •Except for CMMoL, patients with history of myeloproliferative neoplasms (MPN) (defined as a history of essential thrombocytosis or polycythemia vera, or idiopathic myelofibrosis prior to the diagnosis of AML) or combined MDS/MPN are not eligible.
- •Acute promyelocytic leukemia [t(15;17)] or favorable cytogenetics, including t(8;21) or inv16 if known at the time of randomization.
- •Clinical evidence of active CNS leukemia
- •Patients with active (uncontrolled, metastatic) second malignancies are excluded.
- •Prior treatment intended for induction therapy of AML; only hydroxyurea is permitted for control of blood counts. For example, a patient with MDS that changes HMA dose and schedule after the diagnosis of AML is excluded. AML-type therapy, such as cytarabine alone (>1g/m2/day) or cytarabine plus an anthracycline as well as prior HSCT are also excluded.
- •Administration of any therapy for MDS (conventional or investigational) must be completed by 2 weeks prior to of the first dose of study drug; in the event of rapidly proliferative disease use of hydroxyurea is permitted until 24 hours before the start of study treatment. Toxicities associated with prior MDS therapy must have recovered to grade 1 or less prior to start of treatment.
- •Any major surgery or radiation therapy within four weeks.
- •Patients with prior cumulative anthracycline exposure of greater than 368 mg/m2 daunorubicin (or equivalent).
- •Any serious medical condition, laboratory abnormality or psychiatric illness that would prevent obtaining informed consent
- •Patients with myocardial impairment of any cause (e.g. cardiomyopathy, ischemic heart disease, significant valvular dysfunction, hypertensive heart disease, and congestive heart failure) resulting in heart failure by New York Heart Association Criteria (Class III or IV staging)
- •Active or uncontrolled infection. Patients with an infection receiving treatment (antibiotic, antifungal or antiviral treatment) may be entered into the study but must be afebrile and hemodynamically stable for ≥72 hrs.
- •Current evidence of invasive fungal infection (blood or tissue culture); patients with recent fungal infection must have a subsequent negative cultures to be eligible; known HIV (new testing not required) or evidence of active hepatitis B or C infection (with rising transaminase values)
- •Hypersensitivity to cytarabine, daunorubicin or liposomal products
- •History of Wilson's disease or other copper-metabolism disorder
研究组 & 干预措施
Arm A (CPX-351)
Experimental
Subjects are eligible to receive up to 2 inductions and up to 2 consolidations with CPX-351. The number of inductions and consolidations a subject received depended on response.
干预措施: CPX-351 (Drug)
Arm B (7+3)
Active Comparator
Subjects are eligible to receive up to 2 inductions and up to 2 consolidations with cytarabine and daunorubicin given as a 7 + 3, or 5 days of continuous infusion of cytarabine and 2 days of daunorubicin (5+2, second induction, consolidation courses) therapy. The number of inductions and consolidations a subject received depended on response.
干预措施: 7+3 (cytarabine and daunorubicin) (Drug)
结局指标
主要结局
Overall Survival
时间窗: From the date of randomization to death from any cause
Overall survival was measured from the date of randomization to death from any cause, subjects not known to have died by the last follow-up were censored on the date they were last known to be alive.
次要结局
- Proportion of Subjects With a Response(Post Induction)
- Event-free Survival(From the date of randomization to the date that persistent disease was documented or the date of relapse after CR or death, whichever came first)
- Remission Duration(From the date of achievement of a remission until the date of relapse or death from any cause)
- Rate of Achieving Morphologic Leukemia-free State(Day 14)
- Proportion of Subjects Receiving a Stem Cell Transplant(Post Induction)
研究者
研究点 (43)
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