Anti-Thymocyte Globulin and Etanercept in Treating Patients With Myelodysplastic Syndromes
Study Details
Study Description
Brief Summary
RATIONALE: Biological therapies, such as anti-thymocyte globulin and etanercept, may stimulate the immune system in different ways and stop cancer cells from growing. Giving anti-thymocyte globulin together with etanercept may kill more cancer cells.
PURPOSE: This phase II trial is studying how well giving anti-thymocyte globulin together with etanercept works in treating patients with myelodysplastic syndromes.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Phase 2 |
Detailed Description
OBJECTIVES:
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Determine the response rate in patients with low- or intermediate-1-risk myelodysplastic syndromes treated with anti-thymocyte globulin and etanercept.
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Correlate ex vivo and in vitro phenotypic, cytogenetic, and functional disease characteristics with in vivo response in patients treated with this regimen.
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Determine parameters that are associated with a high probability of response or non-response in patients treated with this regimen.
OUTLINE: This is a multicenter study.
Patients receive anti-thymocyte globulin IV over 8 hours on days 1-4. Patients also receive etanercept subcutaneously on days 8, 11, 15, and 18. Treatment with etanercept repeats every 28 days for at least 2 courses. Patients exhibiting hematologic improvement after course 2 may receive up to 2 additional courses of etanercept in the absence of disease progression or unacceptable toxicity. Patients with unresponsive disease or disease progression after course 2 are removed from the study and offered other treatment.
After completion of study treatment, patients are followed periodically.
PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study within 3 years.
Study Design
Outcome Measures
Primary Outcome Measures
- Response rate []
- Correlate results of ex vivo/in vitro studies on phenotypic, cytogenetic, and functional disease characteristics with in vivo treatment responses []
- Identify parameters that are associated with a high probability of response []
Eligibility Criteria
Criteria
DISEASE CHARACTERISTICS:
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Diagnosis of myelodysplastic syndromes (MDS)
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Low- or intermediate-1-risk disease, as defined by International Prognostic
Scoring System (IPSS) criteria, meeting 1 of the following criteria:
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Single or multilineage cytopenia, as defined by all of the following:
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Absolute neutrophil count < 1,500/mm^3
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Hemoglobin < 10 g/dL
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Platelet count < 100,000/mm^3
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Transfusion requirement of ≥ 2 units of packed red blood cells within an 8-week period
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Not eligible for stem cell transplantation due to any of the following reasons:
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No suitable bone marrow donor available
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Not eligible for a transplantation protocol
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Not willing to undergo transplantation
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No intermediate-2- or high-risk MDS
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No chronic myelomonocytic leukemia
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Not specified
Life expectancy
- Not specified
Hematopoietic
- See Disease Characteristics
Hepatic
- Not specified
Renal
- Not specified
Pulmonary
- No pneumonia within the past 2 weeks
Other
-
Not pregnant or nursing
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Negative pregnancy test
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Fertile patients must use effective contraception
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No other severe disease that would preclude study compliance
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No other active severe infection (e.g., septicemia) within the past 2 weeks
PRIOR CONCURRENT THERAPY:
Biologic therapy
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More than 4 weeks since prior and no concurrent hematopoietic growth factors for MDS
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More than 4 weeks since prior immunomodulatory therapy for MDS
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No prior anti-thymocyte globulin
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No prior hematopoietic stem cell transplantation
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No other concurrent immunomodulatory therapy for MDS
Chemotherapy
- Not specified
Endocrine therapy
- Prednisone < 5 mg/day allowed
Radiotherapy
- Not specified
Surgery
- Not specified
Other
-
More than 4 weeks since prior and no concurrent cytotoxic therapy for MDS
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More than 4 weeks since prior experimental therapy for MDS
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No other concurrent experimental therapy for MDS
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | St. Joseph Cancer Center | Bellingham | Washington | United States | 98225-1898 |
2 | Olympic Medical Center | Port Angeles | Washington | United States | 98362 |
3 | Seattle Cancer Care Alliance | Seattle | Washington | United States | 98109-1023 |
4 | Fred Hutchinson Cancer Research Center | Seattle | Washington | United States | 98109-1024 |
Sponsors and Collaborators
- Fred Hutchinson Cancer Center
- National Cancer Institute (NCI)
Investigators
- Principal Investigator: Bart L. Scott, MD, Fred Hutchinson Cancer Center
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 1872.00
- FHCRC-1872.00
- CDR0000430702