Clofarabine and Daunorubicin in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia

Roswell Park Comprehensive Cancer Center

Status and phase

Terminated

Phase 2

Conditions

Leukemia

Treatments

Genetic: protein expression analysis

Drug: daunorubicin hydrochloride

Other: pharmacological study

Other: immunologic technique

Drug: clofarabine

Genetic: cytogenetic analysis

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT00814164

CDR0000630678

RPCI-I-132208 (Other Identifier)

Details and patient eligibility

About

RATIONALE: Drugs used in chemotherapy, such as clofarabine and daunorubicin, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving clofarabine together with daunorubicin may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving clofarabine together with daunorubicin works in treating older patients with newly diagnosed acute myeloid leukemia.

Full description

OBJECTIVES:

Primary

Study complete response (CR) and CR without platelet recovery (CRp) following treatment with clofarabine and daunorubicin hydrochloride in older patients with newly diagnosed acute myeloid leukemia.

Secondary

Study disease-free and overall survival of these patients following treatment with this regimen.
Compare disease-free and overall survival of patients whose cells do or do not demonstrate apoptosis following treatment with this regimen.

OUTLINE:

Induction therapy: Patients receive clofarabine IV over 1 hour on days 1-5 and daunorubicin hydrochloride IV over 5 minutes on days 1, 3, and 5. Patients are assessed after induction course 1. Patients with ≥ 5% blasts in bone marrow may receive another course of induction therapy beginning between 28-84 days after initiation of course 1. Patients who achieve complete remission (CR) or CR without platelet recovery (CRp) (after 1 or 2 courses of induction therapy) proceed to consolidation therapy.
Consolidation therapy: Beginning between 28 -84 days after initiation of last course of induction therapy, patients receive clofarabine IV over 1 hour on days 1-3 and daunorubicin hydrochloride IV over 5 minutes on days 1 and 3. Patients may receive a second course of consolidation therapy beginning between 28-84 days of consolidation course 1.

Blood and bone marrow samples are collected periodically to assess response and for pharmacokinetic, cytogenetic, immunophenotyping, and molecular analyses.

After completion of study treatment, patients are followed for at least 2 years.

Enrollment

21 patients

Sex

All

Ages

60 to 120 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

DISEASE CHARACTERISTICS:

Newly diagnosed acute myeloid leukemia
- At least 10% blasts in the peripheral blood
De novo or secondary disease
No acute promyelocytic leukemia with t[15;17] or any other variant
No clinical evidence of CNS disease

PATIENT CHARACTERISTICS:

ECOG performance status 0-2
Serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
AST and ALT ≤ 2.5 times ULN
Alkaline phosphatase ≤ 2.5 times ULN
LVEF ≥ 45%
Estimated glomerular filtration rate ≥ 50 mL/min
Not pregnant or nursing
Fertile patients must use effective barrier contraception during and for at least 6 months following study treatment
No known HIV positivity
Able to comply with study procedures and follow-up examinations
No psychiatric disorders that would interfere with consent, study participation, or follow-up
No uncontrolled systemic fungal, bacterial, viral, or other infection (i.e., exhibiting ongoing signs/symptoms related to the infection and without improvement despite appropriate antibiotics or other treatment)
No history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo induction therapy with both agents
No other malignancy, unless disease-free for at least 3 years following curative intent therapy
- Nonmelanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia, regardless of the disease-free duration, are allowed if definitive treatment for the condition has been completed
- Patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on prostate-specific antigen values are also eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed
No other severe concurrent disease

PRIOR CONCURRENT THERAPY:

No other concurrent systemic antileukemic therapy (standard or investigational)
No concurrent cytotoxic therapy or investigational therapy
No concurrent alternative medications (e.g., herbal or botanical for anticancer purposes)
No prior chemotherapy
- Prior hydroxyurea allowed