Omacetaxine and Decitabine in Acute Myelogenous Leukemia (AML) and Myelodysplastic Syndrome (MDS)

Sponsor
M.D. Anderson Cancer Center (Other)
Overall Status
Terminated
CT.gov ID
NCT02141477
Collaborator
Teva Pharmaceuticals USA (Industry)
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Study Details

Study Description

Brief Summary

This clinical research study is made up of 2 phases. The goal of Phase 1 of the study is to test the safety of the combination of omacetaxine and decitabine and to find the best dose to give to future patients. The goal of Phase 2 of the study is to learn if this dose can help to control AML and/or MDS. The safety will then continue to be studied.

Condition or Disease Intervention/Treatment Phase
Phase 1

Detailed Description

Study Groups:

If you are found to be eligible to take part in this study, you will be assigned to a study group based on when you join this study. Up to 2 groups of up to 6 participants (combined) will be enrolled in the Phase 1 portion of the study, and up to 60 participants will be enrolled in Phase 2.

If you are enrolled in Phase 1, the dose of decitabine you receive will depend on when you joined this study. If the first group of participants to receive decitabine has intolerable side effects, a second group will receive a lower dose.

If you are enrolled in Phase 2, you will receive decitabine at the highest dose that was tolerated in Phase 1.

All participants will receive the same dose level of omacetaxine.

Study Drug Administration:

Each cycle is 28 days.

Omacetaxine will be given as an injection under your skin 2 times each day, 12 hours apart (+/- 3 hours) on Days 1-3 of every cycle.

Decitabine will be given by vein over about 1 hour on Days 1-5 of every cycle.

Study Visits:

Every week (+/- 2 days), blood (about 2-3 teaspoons) will be collected for routine tests. If the disease appears to get better, this blood will only be drawn every 2-4 weeks while you are still receiving the study drugs, and every 4 to 8 weeks after that as long as you are on study. If you live far from the clinic, this blood and urine can be collected at a clinic close to your home, and the results will be reported to the study doctor.

At the beginning of every cycle, you will have a physical exam.

At Week 3 (+/- 7 days) and then every 4 weeks after that (+/- 7 days), you may (based on the results of your blood tests) have a bone marrow aspirate/biopsy collected to check the status of the disease and for cytogenetic testing.

Length of Study:

You may continue taking the study drugs for up to 3 years or as long as the doctor thinks it is in your best interest. You will no longer be able to take the study drugs if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.

Your participation on the study will be over after the follow-up visits.

Follow Up:

You will have follow-up visits every 3-6 months for up to 5 years after you stop receiving the study drugs. At these visits, you will have a physical exam. If you cannot come to the clinic, you may just be called by the study staff and asked about your health. These calls should last about 5-10 minutes.

This is an investigational study. Omacetaxine is FDA approved and commercially available for the treatment of chronic myelogenous leukemia (CML). Its use in this study is investigational. Decitabine is FDA approved and commercially available for the treatment of MDS.

The study doctor can explain how the study drugs are designed to work.

Up to 66 participants will be enrolled in this study. All will take part at MD Anderson.

Study Design

Study Type:
Interventional
Actual Enrollment :
2 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase II Study of Omacetaxine (OM) and Decitabine (DAC) in Older Patients With Acute Myelogenous Leukemia (AML) and High-Risk Myelodysplastic Syndrome (MDS)
Actual Study Start Date :
May 6, 2015
Actual Primary Completion Date :
Jun 22, 2017
Actual Study Completion Date :
Jun 22, 2017

Arms and Interventions

Arm Intervention/Treatment
Experimental: Omacetaxine + Decitabine

Phase I and Phase II Omacetaxine Dose: 1.25 mg/m2 subcutaneously every 12 hours on Days 1 - 3 of a 28 day cycle. Phase I Starting Decitabine Dose: 20 mg/m2 by vein on Days 1 - 5 of a 28 day cycle. Phase II Starting Decitabine Dose: Maximum tolerated dose from Phase I.

Drug: Omacetaxine
Phase I and Phase II Omacetaxine Dose: 1.25 mg/m2 subcutaneously every 12 hours on Days 1 - 3 of a 28 day cycle.
Other Names:
  • Synribo
  • Homoharringtonine
  • Drug: Decitabine
    Phase I Starting Decitabine Dose: 20 mg/m2 by vein on Days 1 - 5 of a 28 day cycle. Phase II Starting Decitabine Dose: Maximum tolerated dose from Phase I.
    Other Names:
  • Dacogen
  • Outcome Measures

    Primary Outcome Measures

    1. Safe Dose Combination of Omacetaxine (OM) and Decitabine (DAC) [28 days]

      Safe dose defined as highest dose level with </= 1 out of 6 patients experience a dose limiting toxicity (DLT) during first treatment cycle. DLT defined as clinically significant Grade 3 or 4 adverse event or abnormal laboratory value according to Common Toxicity Criteria for Adverse Effects (CTCAE) criteria assessed by treating physician as related to study drug (and unrelated to disease progression, intercurrent illness, or concomitant medications) occurring during the first 28 days on study.

    Secondary Outcome Measures

    1. Complete Response Rate (CRR) [8 weeks]

      Complete response rate (CRR) is defined as CR or CR with incomplete platelet recovery (CRp).

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    70 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Previously untreated AML (>/= 20% blasts) or AML M6. Patients with high-risk (intermediate-2 or high by IPSS or >/= 10% blasts) MDS will also be eligible. Prior therapy with hydroxyurea, biological or targeted therapy (e.g. flt3 inhibitors, other kinase inhibitors, azacitidine), or hematopoietic growth factors is allowed. No prior chemotherapy is allowed except for a single or a two day dose of cytarabine (up to 3 g/m2) for emergency use is also allowed as prior therapy.

    2. Age >/= 70 years.

    3. Eastern Cooperative Oncology Group (ECOG) performance status </= 2.

    4. Adequate hepatic (serum total bilirubin </= 1.5 x ULN, serum glutamate pyruvate transaminase (SGPT) and/or SGOT </= 2.5 x ULN) and renal function (creatinine </= 2.0 mg/dL).

    5. Patients must be willing and able to review, understand, and provide written consent before starting therapy.

    6. Men of childbearing potential who agree to use contraception prior to study entry and for the duration of participation.

    Exclusion Criteria:
    1. New York Heart Association (NYHA) class III or IV heart disease, active ischemia or any other uncontrolled cardiac condition such as angina pectoris, clinically significant cardiac arrhythmia and requiring therapy, uncontrolled hypertension (blood pressure >/= 160 systolic and >/= 110 diastolic not responsive to antihypertensive medication), uncontrolled diabetes mellitus, or congestive heart failure.

    2. Myocardial infarction in the previous 12 weeks (from the start of treatment).

    3. Active and uncontrolled disease/infection as judged by the treating physician.

    4. Acute promyelocytic leukemia (APL).

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of Texas MD Anderson Cancer Center Houston Texas United States 77030

    Sponsors and Collaborators

    • M.D. Anderson Cancer Center
    • Teva Pharmaceuticals USA

    Investigators

    • Principal Investigator: Elias Jabbour, MD, M.D. Anderson Cancer Center

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    M.D. Anderson Cancer Center
    ClinicalTrials.gov Identifier:
    NCT02141477
    Other Study ID Numbers:
    • 2013-0812
    • NCI-2014-02157
    First Posted:
    May 19, 2014
    Last Update Posted:
    Feb 13, 2018
    Last Verified:
    Feb 1, 2018
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by M.D. Anderson Cancer Center
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Feb 13, 2018