A Phase I Study of G3139 (NSC 683428) in Combination With Salvage Chemotherapy for Treatment of Refractory and Relapsed Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL)
filgrastim
+ oblimersen sodium
+ cytarabine
Hematologic Diseases+10
+ Hemic and Lymphatic Diseases
+ Immune System Diseases
Treatment Study
Summary
Study start date: October 1, 1999
Actual date on which the first participant was enrolled.OBJECTIVES: I. Determine the maximum tolerated dose of fludarabine and cytarabine when combined with augmerosen (G3139) in patients with refractory or relapsed acute myeloid leukemia or acute lymphoblastic leukemia and recommend a starting dose for phase II studies. II. Determine the qualitative and quantitative toxic effects of this regimen in these patients with regard to organ specificity, time course, predictability, and reversibility. III. Document the therapeutic response in patients treated with this regimen. IV. Measure bcl-2 and related antiapoptotic and proapoptotic proteins in circulating and/or marrow leukemia cells before, during, and after treatment with G3139. V. Measure WT1 expression in leukemic blasts as a surrogate marker for minimal residual disease and correlate it with bcl-2 and related antiapoptotic and proapoptotic gene expression. VI. Determine the time required for bcl-2 levels to recover after treatment with this regimen. VII. Determine if TP53 mutations are present in leukemic blasts and how these mutations may affect expression of BAX, level of treatment induced apoptosis, and clinical endpoints. VIII. Assess apoptosis in leukemic cells before, during, and after treatment with this regimen. IX. Determine the pharmacokinetics of fludarabine and cytarabine in patients treated with this regimen. X. Perform pharmacodynamic studies of fludarabine and cytarabine on the leukemic cells of patients prior to treatment. OUTLINE: This is a dose-escalation study of fludarabine and cytarabine. Patients receive augmerosen IV continuously on days 1-10 and filgrastim (G-CSF) subcutaneously beginning on day 5 and continuing until blood counts recover. Patients receive fludarabine IV over 30 minutes followed 3.5 hours later by cytarabine IV over 4 hours on days 6-10. Patients who achieve complete response (CR) receive a second course beginning 4 weeks after completion of the first course. Patients who achieve CR and have a matched sibling or unrelated bone marrow donor may undergo allogeneic bone marrow transplantation. Cohorts of 3-6 patients receive escalating doses of fludarabine and cytarabine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.24 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 16 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: Histologically proven refractory or relapsed acute myeloid leukemia or acute lymphoblastic leukemia Marrow cellularity must be at least 20% Must have diagnostic lumbar puncture and treatment with prophylactic intrathecal methotrexate within 1 week prior to entering study No active CNS involvement CNS involvement allowed if no residual leukemic cells are detected in CSF following intrathecal chemotherapy PATIENT CHARACTERISTICS: Age: 16 and over Performance status: ECOG 0-2 Life expectancy: At least 4 weeks Bilirubin no greater than 2 times upper limit of normal(ULN) ALT and AST no greater than 2 times ULN Alkaline phosphatase no greater than 2 times ULN* Unless attributable to malignancy Creatinine no greater than 1.5 mg/dL unless attributable to malignancy No symptomatic congestive heart failure No unstable angina pectoris No or cardiac arrhythmia Resting cardiac ejection fraction no less than 45% unless attributable to malignancy Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception before and during study No history of allergy to study medications No uncontrolled concurrent illness No active infection No serious medical or psychiatric illness that would preclude informed consent or limit survival to less than 4 weeks PRIOR CONCURRENT THERAPY: At least 2 weeks since prior chemotherapy except hydroxyurea No concurrent corticosteroids except for grade 4 toxicity unresponsive to all other agents At least 4 weeks since prior radiotherapy No other concurrent investigational or standard agents or therapies for leukemia
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.One single intervention group is designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalStudy Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location
Arthur G. James Cancer Hospital - Ohio State University
Columbus, United StatesOpen Arthur G. James Cancer Hospital - Ohio State University in Google Maps