BMS-354825 in Treating Patients With Chronic Phase Chronic Myelogenous Leukemia That Is Resistant to Imatinib Mesylate
Study Details
Study Description
Brief Summary
RATIONALE: BMS-354825 may stop the growth of cancer cells by stopping the enzymes necessary for cancer cell growth.
PURPOSE: This phase I trial is studying the side effects and best dose of BMS-354825 in treating patients with chronic phase chronic myelogenous leukemia that is resistant to imatinib mesylate.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1 |
Detailed Description
OBJECTIVES:
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Determine the maximum tolerated dose, maximum administered dose, dose-limiting toxicity, and a recommended phase II dose of BMS-354825 in patients with chronic phase chronic myelogenous leukemia who have hematologic resistance to imatinib mesylate.
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Determine the safety and tolerability of this drug in these patients.
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Determine the plasma pharmacokinetics of this drug in these patients.
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Determine, preliminarily, the efficacy of this drug, in terms of hematologic, cytogenetic, and molecular responses in these patients.
OUTLINE: This is an open-label, dose-escalation, multicenter study.
Patients receive oral BMS-354825 once daily on days 1-5. Courses repeat every 7 days for at least 3 months in the absence of disease progression or unacceptable toxicity. Patients may receive further treatment in the absence of disease progression.
Cohorts of 3-6 patients receive escalating doses of BMS-354825 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.
Once the MTD is determined, 20 additional patients receive treatment as in phase I at the MTD of BMS-354825.
Patients are followed for at least 30 days.
PROJECTED ACCRUAL: Approximately 50 patients (30 for phase I and 20 for phase II) will be accrued for this study within 12-18 months.
Study Design
Outcome Measures
Primary Outcome Measures
Eligibility Criteria
Criteria
INCLUSION CRITERIA:
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Diagnosis of Philadelphia chromosome positive, chronic phase chronic myelogenous leukemia (CML) meeting all of the following criteria*:
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Less than 15% blasts in peripheral blood and bone marrow
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Less than 20% basophils in peripheral blood
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Less than 30% blasts and promyelocytes in peripheral blood and bone marrow
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Platelet count at least 100,000/mm^3 NOTE: *Patients who previously met the criteria for accelerated phase or blast phase CML, responded to treatment, and currently meet the criteria for chronic phase CML are eligible
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Primary or acquired hematologic resistance to imatinib mesylate OR intolerance to imatinib mesylate defined as follows:
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Primary hematologic resistance is defined as failure to reach complete hematologic response (CHR) with a dose of 400 mg/day continued for at least 3 months
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Patients with hematological progression (i.e., WBC at least 10,000/mm^3 and rising consistently on at least 2 consecutive measurements obtained at least 14 days apart) while receiving imatinib mesylate of 400 mg/day are eligible if they have received less than 3 months of therapy
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Acquired hematologic resistance is defined as achieving a CHR, but subsequently developing a rising WBC to at least 10,000/mm^3
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WBC must be at least 10,000/mm3 and rising on at least 2 measurements obtained at least 14 days apart with at least 1 of these measurements greater than 15,000/mm3
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Intolerance is defined as having discontinued imatinib mesylate due to nonhematologic toxicity of any grade
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CD4^+ T-cell count at least 350/mm^3
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18 and over
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ECOG 0-1
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Life expectancy, At least 6 months.
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Hepatic
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Bilirubin no greater than 1.5 mg/dL
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ALT and AST no greater than 2.0 times upper limit of normal (ULN)
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Renal
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Creatinine no greater than 1.5 times ULN
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Potassium normal*
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Magnesium normal*
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Serum calcium or ionized calcium at least lower limit of normal NOTE: *Patients with low levels may be repleted to be eligible
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Negative pregnancy test
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Fertile patients must use effective contraception for 1 month before, during, and 1 month after study participation
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More than 14 days since prior interferon
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More than 14 days since prior cytarabine
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More than 3 days since prior hydroxyurea
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More than 28 days since other prior investigational or antineoplastic agents
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More than 7 days since prior imatinib mesylate
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At least 5 days or 5 half-lives since prior medications that inhibit platelet function, including the following:
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Aspirin
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Dipyridamole
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Epoprostenol
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Eptifibatide
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Clopidogrel
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Cilostazol
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Abciximab
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Ticlopidine
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At least 5 days or 5 half-lives since prior anticoagulants such as warfarin or heparin/low molecular weight heparin (e.g., danaparoid, dalteparin, tinzaparin, enoxaparin)
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At least 5 days or 5 half-lives since prior drugs accepted to have a risk of causing torsades de pointes, including the following:
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Class IA antiarrhythmic agents (e.g., quinidine, procainamide, or disopyramide)
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Class III antiarrhythmic agents (e.g., amiodarone, sotalol, ibutilide, or dofetilide)
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Macrolide antibiotics (e.g., erythromycin or clarithromycin)
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Antipsychotics (e.g., chlorpromazine, haloperidol, thioridazine, or pimozide)
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Tricyclic antidepressants
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Cisapride
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Bepridil
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Inapsine
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Methadone
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Arsenic
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Concurrent anagrelide for thrombocytosis due to CML allowed
Exclusion Criteria:
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extramedullary involvement (other than liver or spleen)
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significant bleeding disorder unrelated to CML
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acquired bleeding disorder within the past year (e.g., acquired antifactor VIII antibodies)
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congenital bleeding disorders (e.g., von Willebrand disease)
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uncontrolled or significant cardiovascular disease
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uncontrolled angina within the past 6 months
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congestive heart failure within the past 6 months
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myocardial infarction within the past 12 months
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history of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, or torsades de pointes)
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history of second or third degree heart block (may be eligible if patient has a pacemaker)
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diagnosed or suspected congenital long QT syndrome
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prolonged QTc interval on pre-entry EKG (i.e., greater than 450 msec)
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heart rate less than 50/minute on pre-entry EKG
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uncontrolled hypertension
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vasculitis
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pregnant or nursing
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gastrointestinal tract bleeding within the past 6 months
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connective tissue disorders
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other serious uncontrolled medical disorder or active infection that would impair the ability to receive study therapy
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dementia or altered mental status that would preclude giving informed consent
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evidence of organ dysfunction or any clinically significant deviation from normal in physical examination, vital signs, EKG, or clinical laboratory determinations unrelated to CML
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prisoners or patients who are compulsorily detained (e.g., involuntary incarceration for treatment of either a psychiatric or physical [e.g., infectious disease] illness)
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concurrent drugs accepted to have a risk of causing torsades de pointes
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other concurrent treatment for CML
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concurrent dolasetron or droperidol
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concurrent anticoagulants
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concurrent medications that inhibit platelet function
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Jonsson Comprehensive Cancer Center at UCLA | Los Angeles | California | United States | 90095-1781 |
Sponsors and Collaborators
- Jonsson Comprehensive Cancer Center
- Bristol-Myers Squibb
Investigators
- Principal Investigator: Charles Sawyers, MD, Jonsson Comprehensive Cancer Center
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CDR0000310142
- UCLA-0303035
- BMS-CA180002