MedPath

S0530 Cytarabine and Clofarabine in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia

Phase 2
Completed
Conditions
Leukemia
Interventions
Registration Number
NCT00337168
Lead Sponsor
SWOG Cancer Research Network
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as cytarabine and clofarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving cytarabine together with clofarabine works in treating patients with relapsed or refractory acute lymphoblastic leukemia.

Detailed Description

Primary objective:

* Determine whether the complete remission rate in adult patients with relapsed or refractory acute lymphoblastic leukemia (ALL) is sufficiently high after treatment with cytarabine and clofarabine to warrant further investigation.

Secondary objectives:

* Estimate the frequency and severity of toxicities associated with this dosing schedule of cytarabine and clofarabine.

* Investigate, preliminarily, the prognostic effects of cytogenetic features on response to treatment in these patients.

Other objectives (if funding allows):

* Investigate, preliminarily, the prognostic effects of laboratory correlates (expression of nucleoside transporters, expression of other pertinent genes by tissue microarray) and FISH features on response to treatment in these patients

OUTLINE: This is an open-label, multicenter study.

* Induction therapy (1 or 2 courses): Patients receive induction therapy comprising clofarabine IV over 1 hour followed 4 hours later by cytarabine IV over 2 hours on days 1-5 (course 1). Patients who achieve a response (5-25% blasts in the bone marrow with a ≥ 50% reduction in blasts from initial bone marrow aspirate) receive 1 more course of induction therapy beginning no later than day 45. Patients who achieve complete remission (\< 5% blasts in the bone marrow) after 1 or 2 courses of induction therapy may proceed to consolidation therapy.

* Consolidation therapy (1 course): Beginning within 60 days after the first day of the last induction therapy, patients may receive consolidation therapy comprising clofarabine IV over 1 hour followed 4 hours later by cytarabine IV over 2 hours on days 1-4.

After completion of study treatment, patients are followed periodically for up to 5 years.

PROJECTED ACCRUAL: A total of 35 patients will be accrued for this study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
36
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Induc, ReInduc, Consol, clofarabine, cytarabineclofarabineInduction: 40mg/m2/d; IV over 1 hr; days 1-5 Re-induction (if necessary): 40mg/m2/d; IV over 1 hr; days 1-5 Consolidation: 40mg/m2/d; IV over 1 hr; days 1-4
Induc, ReInduc, Consol, clofarabine, cytarabinecytarabineInduction: 40mg/m2/d; IV over 1 hr; days 1-5 Re-induction (if necessary): 40mg/m2/d; IV over 1 hr; days 1-5 Consolidation: 40mg/m2/d; IV over 1 hr; days 1-4
Primary Outcome Measures
NameTimeMethod
Number of Patients With Complete RemissionBetween day 28 and day 35 inclusive

Complete remission is defined as: less than 5% bone marrow blasts, neutrophils greater or equal to 1,000 per microliter, platelets greater than 100,000 per microliter, no blasts in the peripheral blood, and no extramedullary disease

Secondary Outcome Measures
NameTimeMethod
Expression of Nucleoside TransportersOn average, two weeks before treatment started

Expression was examined in paraffin-embedded tissue by immunohistochemistry. Intensities were scored on a 0-2+ scale. High expression was a score of 2+.

Number of Patients With Very Poor Risk CytogeneticsOn average, 2 weeks before treatment started
ToxicityPatients were assess for adverse events after each induction cycle (up to two cycles) and after the one consolidation cycle

Number of patients with Grade 3-5 adverse events that are related to study drug by given type of adverse event

Trial Locations

Locations (91)

Arkansas Cancer Research Center at University of Arkansas for Medical Sciences

🇺🇸

Little Rock, Arkansas, United States

CCOP - Montana Cancer Consortium

🇺🇸

Billings, Montana, United States

Charles B. Eberhart Cancer Center at DeKalb Medical Center

🇺🇸

Decatur, Georgia, United States

Glacier Oncology, PLLC

🇺🇸

Kalispell, Montana, United States

Community Medical Center

🇺🇸

Missoula, Montana, United States

Frontier Cancer Center

🇺🇸

Great Falls, Montana, United States

Great Falls Clinic - Main Facility

🇺🇸

Great Falls, Montana, United States

Kalispell Medical Oncology at KRMC

🇺🇸

Kalispell, Montana, United States

Montana Cancer Specialists at Montana Cancer Center

🇺🇸

Missoula, Montana, United States

Cleveland Clinic Taussig Cancer Center

🇺🇸

Cleveland, Ohio, United States

Middletown Regional Hospital

🇺🇸

Franklin, Ohio, United States

Charles F. Kettering Memorial Hospital

🇺🇸

Kettering, Ohio, United States

Baylor University Medical Center - Houston

🇺🇸

Houston, Texas, United States

Veterans Affairs Medical Center - Houston

🇺🇸

Houston, Texas, United States

Harborview Medical Center

🇺🇸

Seattle, Washington, United States

Group Health Central Hospital

🇺🇸

Seattle, Washington, United States

Swedish Cancer Institute at Swedish Medical Center - First Hill Campus

🇺🇸

Seattle, Washington, United States

Polyclinic First Hill

🇺🇸

Seattle, Washington, United States

University Cancer Center at University of Washington Medical Center

🇺🇸

Seattle, Washington, United States

Wenatchee Valley Medical Center

🇺🇸

Wenatchee, Washington, United States

Providence Cancer Center

🇺🇸

Anchorage, Alaska, United States

Stanford Cancer Center

🇺🇸

Stanford, California, United States

Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center

🇺🇸

Orange, California, United States

Saint Joseph's Hospital of Atlanta

🇺🇸

Atlanta, Georgia, United States

M.D. Anderson Cancer Center at Orlando

🇺🇸

Orlando, Florida, United States

Piedmont Hospital

🇺🇸

Atlanta, Georgia, United States

Northside Hospital Cancer Center

🇺🇸

Atlanta, Georgia, United States

WellStar Cobb Hospital

🇺🇸

Austell, Georgia, United States

CCOP - Atlanta Regional

🇺🇸

Atlanta, Georgia, United States

Gwinnett Medical Center

🇺🇸

Lawrenceville, Georgia, United States

Kennestone Cancer Center at Wellstar Kennestone Hospital

🇺🇸

Marietta, Georgia, United States

Cardinal Bernardin Cancer Center at Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

St. Francis Hospital and Health Centers - Beech Grove Campus

🇺🇸

Beech Grove, Indiana, United States

Southern Regional Medical Center

🇺🇸

Riverdale, Georgia, United States

Reid Hospital & Health Care Services

🇺🇸

Richmond, Indiana, United States

Southwest Medical Center

🇺🇸

Liberal, Kansas, United States

Cancer Center of Kansas, PA - Parsons

🇺🇸

Parsons, Kansas, United States

Tammy Walker Cancer Center at Salina Regional Health Center

🇺🇸

Salina, Kansas, United States

Billings Clinic - Downtown

🇺🇸

Billings, Montana, United States

Cancer Center of Kansas, PA - Kingman

🇺🇸

Kingman, Kansas, United States

Cancer Center of Kansas, PA - Pratt

🇺🇸

Pratt, Kansas, United States

Cancer Center of Kansas, PA - Newton

🇺🇸

Newton, Kansas, United States

Cancer Center of Kansas, PA - Salina

🇺🇸

Salina, Kansas, United States

Cancer Center of Kansas, PA - Wellington

🇺🇸

Wellington, Kansas, United States

Cancer Center of Kansas, PA - Chanute

🇺🇸

Chanute, Kansas, United States

Cancer Center of Kansas, PA - Dodge City

🇺🇸

Dodge City, Kansas, United States

Cancer Center of Kansas, PA - El Dorado

🇺🇸

El Dorado, Kansas, United States

Huntsman Cancer Institute at University of Utah

🇺🇸

Salt Lake City, Utah, United States

Associates in Womens Health, PA - North Review

🇺🇸

Wichita, Kansas, United States

CCOP - Wichita

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas, PA - Medical Arts Tower

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas, PA - Wichita

🇺🇸

Wichita, Kansas, United States

Wesley Medical Center

🇺🇸

Wichita, Kansas, United States

Good Samaritan Hospital

🇺🇸

Dayton, Ohio, United States

Ruth G. McMillan Cancer Center at Greene Memorial Hospital

🇺🇸

Xenia, Ohio, United States

Cancer Center of Kansas, PA - Winfield

🇺🇸

Winfield, Kansas, United States

Blanchard Valley Medical Associates

🇺🇸

Findlay, Ohio, United States

Clinton Memorial Hospital

🇺🇸

Wilmington, Ohio, United States

Via Christi Cancer Center at Via Christi Regional Medical Center

🇺🇸

Wichita, Kansas, United States

Tulane Cancer Center Office of Clinical Research

🇺🇸

Alexandria, Louisiana, United States

Grandview Hospital

🇺🇸

Dayton, Ohio, United States

Samaritan North Cancer Care Center

🇺🇸

Dayton, Ohio, United States

Hematology-Oncology Centers of the Northern Rockies - Billings

🇺🇸

Billings, Montana, United States

Olympic Hematology and Oncology

🇺🇸

Bremerton, Washington, United States

Northern Rockies Radiation Oncology Center

🇺🇸

Billings, Montana, United States

Bozeman Deaconess Cancer Center

🇺🇸

Bozeman, Montana, United States

St. James Healthcare Cancer Care

🇺🇸

Butte, Montana, United States

Kalispell Regional Medical Center

🇺🇸

Kalispell, Montana, United States

Guardian Oncology and Center for Wellness

🇺🇸

Missoula, Montana, United States

Montana Cancer Center at St. Patrick Hospital and Health Sciences Center

🇺🇸

Missoula, Montana, United States

Ben Taub General Hospital

🇺🇸

Houston, Texas, United States

St. Vincent Healthcare Cancer Care Services

🇺🇸

Billings, Montana, United States

James P. Wilmot Cancer Center at University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Veterans Affairs Medical Center - Dayton

🇺🇸

Dayton, Ohio, United States

CCOP - Dayton

🇺🇸

Dayton, Ohio, United States

Hollings Cancer Center at Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

St. Peter's Hospital

🇺🇸

Helena, Montana, United States

Cleveland Clinic - Wooster

🇺🇸

Wooster, Ohio, United States

Methodist Hospital

🇺🇸

Houston, Texas, United States

Minor and James Medical, PLLC

🇺🇸

Seattle, Washington, United States

CCOP - Scott and White Hospital

🇺🇸

Temple, Texas, United States

St. Joseph Cancer Center

🇺🇸

Bellingham, Washington, United States

Welch Cancer Center at Sheridan Memorial Hospital

🇺🇸

Sheridan, Wyoming, United States

Cancer Care Northwest - Spokane South

🇺🇸

Spokane, Washington, United States

H. Lee Moffitt Cancer Center and Research Institute at University of South Florida

🇺🇸

Tampa, Florida, United States

University of Michigan Comprehensive Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Community Oncology Group at Cleveland Clinic Cancer Center

🇺🇸

Independence, Ohio, United States

UVMC Cancer Care Center at Upper Valley Medical Center

🇺🇸

Troy, Ohio, United States

St. Luke's Texas Cancer Institute at St. Luke's Episcopal Hospital

🇺🇸

Houston, Texas, United States

Fred Hutchinson Cancer Research Center

🇺🇸

Seattle, Washington, United States

David L. Rike Cancer Center at Miami Valley Hospital

🇺🇸

Dayton, Ohio, United States

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