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A Phase III Randomized, Double-Blind Study of Induction (Daunorubicin/Cytarabine) and Consolidation (High-Dose Cytarabine) Chemotherapy + Midostaurin (PKC412) (IND #101261) or Placebo in Newly Diagnosed Patients < 60 Years of Age With FLT3 Mutated Acute Myeloid Leukemia (AML)

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Ce qui est testé

cytarabine

+ daunorubicin

+ midostaurin

MédicamentAutre
Qui peut participer

Anomalies Congénitales+20

+ Maladies de la moelle osseuse

+ Leucémie érythroblastique aiguë

De 18 à 59 ans
Voir tous les critères d'éligibilité
Comment se déroule l'étude

Étude thérapeutique

Phase 3
Interventionnel
Date de début : avril 2008
Voir le détail du protocole

Résumé

Sponsor principalAlliance for Clinical Trials in Oncology
Dernière mise à jour : 28 janvier 2026
Issu d'une base de données validée par les autorités. Revendiquer en tant que partenaire

Date de début de l'étude : 1 avril 2008

Date à laquelle le premier participant a commencé l'étude.

In this study, patients will receive either the experimental agent (midostaurin) or placebo combined with chemotherapy treatment. Patients are stratified according to FLT3 mutation status (internal tandem duplication \[ITD\] allelic ratio < 0.7 vs ITD allelic ratio ≥ 0.7 vs tandem kinase domain \[TKD\]). There are three parts to the study treatment: remission induction therapy, remission consolidation therapy and continuation therapy. Remission Induction Therapy: * Cytarabine 200 mg/m2/day by continuous intravenous infusion on days 1-7 * Daunorubicin 60 mg/m2/day by intravenous push or short infusion on days 1-3 * Midostaurin 50 mg (two 25 mg capsules) or placebo for midostaurin (2 capsules) twice a day by mouth on days 8-21 * A bone marrow aspiration will be performed in all patients on Day 21 to determine the need for a second induction cycle. Remission Consolidation (Four Remission Consolidation Cycles): * High dose cytarabine 3000 mg/m2 will be given by intravenous infusion over 3 hours every 12 hours on days 1, 3 and 5. Serial neurologic evaluation will be performed before and following the infusion of high-dose cytarabine. * Dexamethasone 0.1% or other corticosteroid ophthalmic solution 2 drops to each eye once daily to begin 6-12 hours prior to the initiation of the cytarabine infusion and to continue for at least 24 hours after the last cytarabine dose. * Midostaurin 50 mg (two 25 mg capsules) or placebo for midostaurin (2 capsules) twice a day by mouth on days 8-21 Midostaurin/Placebo Continuation Therapy: * Midostaurin 50 mg (two 25 mg capsules) or placebo for midostaurin (2 capsules) by mouth twice a day for 28 days. Each cycle will be 28 days in length. Continuation therapy with midostaurin/placebo will continue until relapse or for 12 cycles maximum. The primary and secondary objectives of this study are: Primary objective: * To determine if the addition of midostaurin to daunorubicin/cytarabine induction, high-dose cytarabine consolidation, and continuation therapy improves overall survival (OS) in both the mutant FLT3-ITD and FLT3-TKD AML patients Secondary objectives: * To compare the overall survival (OS) in the two groups using an analysis in which patients who receive a stem cell transplant are censored at the time of transplant * To compare the complete response (CR) rate between the two treatment groups * To compare the event-free survival (EFS) between the two treatment groups * To compare the disease free survival (DFS) of the two treatment groups * To compare the disease free survival rate one year after completion of the continuation phase of the two groups * To assess the toxicity of the experimental combination * To describe the interaction between treatment outcome and pretreatment characteristics such as age, performance status, white blood cell (WBC) count, morphology, cytogenetics, and molecular and pharmacodynamic features * To assess the population pharmacokinetics (popPK) of midostaurin and its two major metabolites (CGP52421 and CGP62221). The potential association(s) between PK exposure and FLT3 status, OS, EFS and clinical response will be explored There is a pharmacokinetic sub-study (CALGB 60706) within CALGB 10603. This embedded companion study must be offered to all patients enrolled on CALGB 10603, although patients may opt not to participate in CALGB 60706. After study entry, patients are followed periodically for up to 10 years.

Titre officielA Phase III Randomized, Double-Blind Study of Induction (Daunorubicin/Cytarabine) and Consolidation (High-Dose Cytarabine) Chemotherapy + Midostaurin (PKC412) (IND #101261) or Placebo in Newly Diagnosed Patients < 60 Years of Age With FLT3 Mutated Acute Myeloid Leukemia (AML)
NCT00651261
Sponsor principalAlliance for Clinical Trials in Oncology
Dernière mise à jour : 28 janvier 2026
Issu d'une base de données validée par les autorités. Revendiquer en tant que partenaire

Protocole

Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.
Détails du design

717 participants à inclure

Nombre total de participants que l'essai clinique vise à recruter.

Traitement

Cette étude teste un ou plusieurs traitements pour évaluer leur efficacité contre une maladie ou un problème de santé spécifique. L'objectif est de voir si un nouveau médicament ou une thérapie fonctionne mieux, ou provoque moins d'effets secondaires que les options existantes.



Éligibilité

Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.
Conditions
Critères

Tout sexe

Le sexe biologique des participants éligibles à s'inscrire.

De 18 à 59 ans

Tranche d'âge des participants éligibles à participer.

Volontaires sains non autorisés

Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.

Conditions

Pathologie

Anomalies CongénitalesMaladies de la moelle osseuseLeucémie érythroblastique aiguëMaladies HématologiquesMaladies hématologiques et lymphatiquesMaladies du Système ImmunitaireTroubles immunoprolifératifsLeucémieLeucémie Aiguë MonocytaireLeucémie myéloïdeLeucémie lymphoïdeLeucémie mégacaryoblastique aiguëMaladies lymphatiquesTroubles LymphoprolifératifsTroubles MyéloprolifératifsMaladies et anomalies congénitales, héréditaires et néonatalesNéoplasmes par type histologiqueNéoplasmesLeucémie aiguë basophileLeucémie myéloïde aiguëLeucémie myélomonocytaire aiguëLeucémie éosinophilique aiguëLeucémie-Lymphome Lymphoblastique de Cellules Précursors

Critères

1. Documentation of Disease: * Unequivocal diagnosis of AML ( \> 20% blasts in the bone marrow based on the WHO classification), excluding M3 (acute promyelocytic leukemia). Patients with neurologic symptoms suggestive of CNS leukemia are recommended to have a lumbar puncture. Patients whose CSF is positive for AML blasts are not eligible. * Documented FLT3 mutation (ITD or point mutation), determined by analysis in a protocol- designated FLT3 screening laboratory. 2. Age Requirement: * Age ≥ 18 and \< 60 years 3. Prior Therapy: * No prior chemotherapy for leukemia or myelodysplasia with the following exceptions: * emergency leukapheresis * emergency treatment for hyperleukocytosis with hydroxyurea for ≤ 5 days * cranial RT for CNS leukostasis (one dose only) * growth factor/cytokine support * AML patients with a history of antecedent myelodysplasia (MDS) remain eligible for treatment on this trial, but must not have had prior cytotoxic therapy (e.g., azacitidine or decitabine) * Patients who have developed therapy related AML after prior RT or chemotherapy for another cancer or disorder are not eligible. 4. Cardiac Function: Patients with symptomatic congestive heart failure are not eligible. 5. Initial Laboratory Value: Total bilirubin \< 2.5 x ULN (Upper Limit of Normal) 6. Pregnancy and Nursing Status: * Non-pregnant and non-nursing due to the unknown teratogenic potential of midostaurin in humans, pregnant or nursing patients may not be enrolled. * Women of childbearing potential must have a negative serum or urine pregnancy test within a sensitivity of at least 50 mIU/mL within 16 days prior to registration. * Women of child-bearing potential must either commit to continued abstinence from heterosexual intercourse or commit to TWO acceptable methods of birth control: * one highly effective method (eg, IUD, hormonal (non-oral contraceptive), tubal ligation, or partner's vasectomy) and * one additional effective method (e.g., latex condom, diaphragm or cervical cap) * The two acceptable methods of birth control must be used AT THE SAME TIME, before beginning midostaurin/placebo therapy and continuing for 12 weeks after completion of all therapy. * Note that oral contraceptives are not considered a high effective method because of the possibility of a drug interaction with midostaurin. * Women of childbearing potential is defined as a sexually active mature woman who has not undergone a hysterectomy or who has not had menses at any time in the preceding 24 consecutive months. * Men must agree not to father a child and must use a latex condom during any sexual contact with women of childbearing potential while taking midostaurin/placebo and for 12 weeks after therapy is stopped, even if they have undergone a successful vasectomy.

Plan de l'étude

Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.
Groupes de traitement
Objectifs de l'étude

2 groupes d'intervention sont désignés dans cette étude

Cette étude ne comporte pas de groupe placebo. 

Groupes de traitement

Groupe I

Expérimental
Patients will receive a standard combination of chemotherapy drugs during remission induction therapy that includes cytarabine, daunorubicin, and the experimental drug midostaurin. Depending on the outcome of remission induction treatment, there may be a decision to discontinue the study treatment or a second remission induction cycle may be given. If remission induction therapy is successfully completed, patients will receive four courses of high-dose cytarabine consolidation chemotherapy plus dexamethasone together with the experimental drug midostaurin. All patients will undergo a bone marrow aspiration (and perhaps a biopsy) after the final course of remission consolidation chemotherapy. If the patient continues to respond to the treatment, the patient will receive continuation therapy with midostaurin for twelve (12) months.

Groupe II

Comparateur actif
Patients will receive a standard combination of chemotherapy drugs during remission induction therapy that includes cytarabine, daunorubicin, and placebo. Depending on the outcome of remission induction treatment, there may be a decision to discontinue the study treatment or a second remission induction cycle may be given. If remission induction therapy is successfully completed, patients will receive four courses of high-dose cytarabine consolidation chemotherapy plus dexamethasone together with placebo. All patients will undergo a bone marrow aspiration (and perhaps a biopsy) after the final course of remission consolidation chemotherapy. If the patient continues to respond to the treatment, the patient will receive continuation therapy with placebo for twelve (12) months.

Objectifs de l'étude

Objectifs principaux

Objectifs secondaires

Centres d'étude

Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.

Cette étude comporte 176 sites

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UAB Comprehensive Cancer Center

Birmingham, United StatesOuvrir UAB Comprehensive Cancer Center dans Google Maps
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Arkansas Cancer Research Center at University of Arkansas for Medical Sciences

Little Rock, United States
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University of California Davis Cancer Center

Sacramento, United States
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Aurora Presbyterian Hospital

Aurora, United States
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