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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)

Providence Cancer Center

🇺🇸

Anchorage, Alaska, United States

Arkansas Cancer Research Center at University of Arkansas for Medical Sciences

🇺🇸

Little Rock, Arkansas, United States

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

🇺🇸

Orange, California, United States

Stanford Cancer Center

🇺🇸

Stanford, California, United States

M.D. Anderson Cancer Center at Orlando

🇺🇸

Orlando, Florida, United States

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

🇺🇸

Tampa, Florida, United States

Piedmont Hospital

🇺🇸

Atlanta, Georgia, United States

Northside Hospital Cancer Center

🇺🇸

Atlanta, Georgia, United States

Saint Joseph's Hospital of Atlanta

🇺🇸

Atlanta, Georgia, United States

CCOP - Atlanta Regional

🇺🇸

Atlanta, Georgia, United States

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Providence Cancer Center
🇺🇸Anchorage, Alaska, United States

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