NCT01433965已完成1 期
Phase I Trial of Maintenance Lenalidomide in Patients With Acute Myeloid Leukemia or High Risk Myelodysplastic Syndrome Post Allogeneic Bone Marrow Transplantation
适应症
干预措施
相关药物
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 16
- 试验地点
- 1
- 主要终点
- Maximum-tolerated dose as assessed by NCI CTCAE, Version 4.0 and Graft versus Host Disease Staging
研究概览
简要总结
The purpose of this study is to determine whether lenalidomide can stop the growth of leukemia stem cells and can be used to prevent the return of leukemia cells after a transplant.
详细描述
The purpose of this study is determine whether lenalidomide can directly inhibit leukemic stem cells in vivo and can be used to prevent the relapse of leukemia stem cells after transplant. A concern with any post transplant intervention is the possibility of multiple drug interactions, potential for graft versus host disease exacerbation and/or induction of cytopenia. Therefore, the smallest doses of lenalidomide (5 mg) that has been used in this setting will be utilized as dose level 1. Starting six months post-transplant, patients will begin on a daily dose of lenalidomide. Dependent on the cohort, patients will receive 5 to 20 mg of lenalidomide post transplant. The maximum tolerated dose (MTD) will be determined by the incidence of grade III-IV toxicities of all organs and grade II-IV GVHD. Duration of treatment is six months.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Understand and voluntarily sign an informed consent form
- •Age greater than or equal to 18 and less than or equal to 65 years
- •Able to adhere to the study visit schedule and other protocol requirements.
- •High risk acute myelogenous leukemia or high risk myelodysplastic syndrome status post allogeneic bone marrow transplant
- •ECOG performance status of less than or equal to 2
- •Disease free of other malignancies beside the AML or MDS for ≥ 2 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast.
- •All study participants must be registered into the mandatory RevAssist® program, and be willing and able to comply with the requirements of RevAssist®.
- •Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days and again within 24 hours prior to prescribing lenalidomide for Cycle 1 (prescriptions must be filled within 7 days as required by RevAssist) and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy.
- •Between 6 months to 8 months post transplant
- •Laboratory tests:
- •Neutrophil count of ≥ 1.5 x 109/L
- •Platelet count ≥ 50 x 109/L
- •Calculated creatinine clearance ≥ 60ml/min by Cockcroft-Gault formula
- •Total bilirubin ≤1.5 x upper limit of normal
- •AST (SGOT) and ALT (SGPT) ≤ 3 x upper limit of normal
- •Patients are eligible to start on this protocol if they are between 6 months to 10 months post transplant.
排除标准
- •Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form
- •Pregnant or breast feeding females (Lactating females must agree not to breast feed while taking lenalidomide)
- •Any level of acute graft versus host disease
- •Active, uncontrolled infection are not eligible for this study
- •Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study
- •Use of any other experimental drug or therapy within 28 days of baseline.
- •Known hypersensitivity to thalidomide
- •Development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drug
- •Known sero-positive for active viral infection with HI, hepatitis B virus (HBV) or hepatitis C virus (HCV)
- •Mixed chimerism (at 6 months post transplant will not be started on the protocol
- •Active AML or MDS at the time of the study are not eligible for this protocol
- •Not able to swallow the lenalidomide capsule as a whole are excluded from this study
- •Impaired gastrointestinal absorption
研究组 & 干预措施
Phase I Dose Escalation
Experimental
Subjects are given a single dose of the drug while they are observed and tested for a period of time. If they do not exhibit any adverse side effects the dose is escalated, and a new group of subjects is then given a higher dose.
干预措施: Lenalidomide (Drug)
结局指标
主要结局
Maximum-tolerated dose as assessed by NCI CTCAE, Version 4.0 and Graft versus Host Disease Staging
时间窗: 4 week cycle; the expected time frame is 24 weeks (or 6 cycles)
All patients will be followed closely and evaluated for toxicity. For grade III-IV non hematological toxicity or grade IV hematological toxicity associated with lenalidomide will be held until the toxicity resolves and then will be started at a lower dose; Patients who develop grade II to IV GVHD on study will stop lenalidomide
次要结局
- Disease relapse(One year)
- Disease-free survival(One year)
- Incidence of Graft versus Host disease(One year)
研究者
Mehrdad Abedi, MD
Professor
University of California, Davis
研究点 (1)
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