MedPath

A randomized study to assess the tolerability and efficacy of the addition of ibrutinib to 10-day decitabine treatment in patients with AML and high risk myelodysplasia (MDS), UNFIT for intensive chemotherapy, aged >= 66 years.

Phase 1
Conditions
Acute Meyloid Leukemia and High Risk Myelodysplastic syndromes
MedDRA version: 18.1Level: LLTClassification code 10000886Term: Acute myeloid leukemiaSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
MedDRA version: 18.1Level: PTClassification code 10028533Term: Myelodysplastic syndromeSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2015-002855-85-BE
Lead Sponsor
HOVON Foundation
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
170
Inclusion Criteria

• Patients with:
-a diagnosis of AML and related precursor neoplasms according to WHO 2008 classification (excluding acute promyelocytic leukemia) including secondary AML (after an antecedent hematological disease (e.g. MDS) and therapy-related AML, or
-acute leukemia's of ambiguous lineage according to WHO 2008 or
-a diagnosis of refractory anemia with excess of blasts (MDS) and IPSS-R > 4.5
• Patients 66 years and older.
• Patients NOT eligible for standard chemotherapy, defined as HCT-CI = 3. or
Patient NOT eligible for standard chemotherapy for other reasons (wish of patient).
• WBC = 30 x109/L (prior hydroxyurea allowed for a maximum of 5 days, stop 2 days before start decitabine treatment)
• Adequate renal and hepatic functions unless clearly disease related as indicated by the following laboratory values:
- Serum creatinine = 2.5 mg/dL (= 221.7 µmol/L), unless considered AML-related
- Serum bilirubin = 2.5 x upper limit of normal (ULN), unless considered AML-related or due to Gilbert’s syndrome
- Alanine transaminase (ALT) = 2.5 x ULN, unless considered AML-related
• WHO performance status 0, 1 or 2 (see Appendix D).
• Male patients must use an effective contraceptive method during the study and for a minimum of 6 months after study treatment.
• Written informed consent.
• Patient is capable of giving informed consent.

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) no
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 170

Exclusion Criteria

• Acute promyelocytic leukemia.
• Patients previously treated for AML (any antileukemic therapy including investigational agents), a short treatment period ( = 5 days) with Hydroxyurea is allowed
• Diagnosis of any previous or concomitant malignancy is an exclusion criterion: except when the patient completed successfully treatment (chemotherapy and/or surgery and/or radiotherapy) with curative intent for this malignancy at least 6 months prior to randomization.
• Blast crisis of chronic myeloid leukemia.
• Inability to discontinue anti-coagulants
• Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled diabetes, infection, hypertension, pulmonary disease etc.)
• Cardiac dysfunction as defined by:
- Myocardial infarction within the last 3 months of study entry, or
- Reduced left ventricular function with an ejection fraction < 40% as measured by MUGA scan or echocardiogram or
- Unstable angina or
- New York Heart Association (NYHA) grade IV congestive heart failure or
- Unstable cardiac arrhythmias
• Patient has had major surgery within the past 4 weeks or a major wound that has not fully healed.
• Vaccinated with live, attenuated vaccines within 4 weeks prior to randomization.
• History of stroke or intracranial hemorrhage within 6 months prior to randomization.
• Patient has a history of human immunodeficiency virus (HIV) or active infection with Hepatitis C or B.
• Patient has symptomatic central nervous system (CNS) leukemia (NO routinely lumbar puncture required to investigate CNS involvement)
• Patients with a history of non-compliance to medical regimens or who are considered unreliable with respect to compliance.
• Patients with any serious concomitant medical condition which could, in the opinion of the investigator, compromise participation in the study.
• Patients who have senile dementia, mental impairment or any other psychiatric disorder that prohibits the patient from understanding and giving informed consent.
• Current concomitant chemotherapy, radiation therapy, or immunotherapy; other than hydroxyurea
• Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
© Copyright 2025. All Rights Reserved by MedPath