ABT-751 With Chemotherapy for Relapsed Pediatric ALL

Sponsor
Therapeutic Advances in Childhood Leukemia Consortium (Other)
Overall Status
Terminated
CT.gov ID
NCT00439296
Collaborator
Abbott (Industry)
9
5
7
40.1
1.8
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Study Details

Study Description

Brief Summary

This is a phase I/II study of an investigational drug called ABT-751, produced by Abbott Laboratories, given in combination with chemotherapy drugs used to treat acute lymphoblastic leukemia (ALL) that has come back (recurred). The phase I portion of this study is being done to find the highest dose of ABT-751 that can be given safely in combination with other chemotherapy drugs. A safe dose is one that does not result in unacceptable side effects. After a safe dose for ABT-751 given with chemotherapy has been found, the study will add additional patients to find out if ABT-751 (given at the maximal safe dose) when given with additional chemotherapy is an effective therapy for the treatment of children with relapsed ALL. It is expected that approximately 15-35 children and young adults will take part in this study.

Detailed Description

All patients will receive the 2 courses of chemotherapy unless medical complications prevent the administration of some of the drugs. Treatment for the first 2 courses of therapy will last about 2 months.

Treatment on this study will consist of a combination of 8 anti-cancer medications. The 8 anticancer medicines are ABT-751, dexamethasone, PEG-asparaginase, doxorubicin, cytarabine (Ara-C), methotrexate (MTX), cyclophosphamide, and 6-thioguanine. All the drugs except ABT-751 are well known anti-cancer drugs and have been used extensively in the treatment of cancer.

During the Phase I portion of this study, when you enroll, you will be given an assigned dose of ABT-751. The dose of ABT-751 will be based on doses given in previous studies done with adults and children. At each dose level of ABT-751, between 3 and 6 children will receive ABT-751 in combination with chemotherapy. If the side effects are not too severe, the next group of children will receive a higher dose. The dose will continue to be increased until we find the dose that causes serious side effects. Your dose of ABT-751 will not be increased. If you have bad side effects, your dose may be decreased.

The dose used during the Phase 2 part of this study will be determined by the outcome of the Phase I study. The highest dose used in Phase I that was tolerated without serious side effects will be the one used in Phase 2.

Study Design

Study Type:
Interventional
Actual Enrollment :
9 participants
Allocation:
Non-Randomized
Intervention Model:
Sequential Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase I/II Trial of ABT-751 Combined With Dexamethasone, PEG-asparaginase, and Doxorubicin in Relapsed Acute Lymphoblastic Leukemia (ALL)
Study Start Date :
May 22, 2006
Actual Primary Completion Date :
May 19, 2009
Actual Study Completion Date :
Sep 23, 2009

Arms and Interventions

Arm Intervention/Treatment
Experimental: Dose Level 1

Treatment Dose of ABT-751 is 80 mg/m2/day Tx Course 1: • ABT-751, Dexamethasone, PEG-asparaginase, Doxorubicin, Cytarabine, IT Methotrexate Tx Course 2: • Cyclophosphamide, 6-Thioguanine, IT Methotrexate, Cytarabine, PEG-asparaginase, ABT-751 Tx Courses 3-12 (maintenance courses): • ABT-751, IT Methotrexate

Drug: ABT-751
Treatment Course 1: Oral capsule to be given daily for 21 days at assigned dose. Treatment Course 2: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 15-35. Treatment Course 3: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 1-21 followed by 1 week of rest.
Other Names:
  • Antineoplastics
  • Drug: Dexamethasone
    In Treatment Course 1 only: 10 mg/m2/day divided BID. Take dexamethasone by mouth days 1-14.
    Other Names:
  • Decadron
  • Dexasone
  • Diodex
  • Hexadrol
  • Maxidex
  • Drug: PEG-asparaginase
    In Treatment Course 1: 2500 IU's/m2/day. Intramuscular injection (IM) on days 4, 11 and 18. In Treatment Course 2: 2500 IU's/m2/day. Intramuscular injection (IM) on day 15.
    Other Names:
  • Elspar
  • Kidrolase
  • L-asparaginase
  • Erwinia L-asparaginase
  • Drug: Doxorubicin
    In Treatment Course 1 only: • 60 mg/m2/day IV over 15 minutes on day 1.
    Other Names:
  • Adriamycin
  • Rubex
  • Drug: Cytarabine
    Given Intrathecally on day 1 of course 1 at the dose defined by age below. 30 mg for patients age 1-1.99 50 mg for patients age 2-2.99 70 mg for patients >3 years of age Omit IT Ara-C on Day 1 if patient received IT therapy prior to study enrollment as part of diagnostic lumbar puncture procedure. In Treatment Course 2: • 75 mg/m2/day IV on days 2 through 5 and days 9 through 12.
    Other Names:
  • Cytosar-U
  • Ara-C
  • Arabinosylcytosine
  • Drug: Methotrexate
    In Treatment Course 1: • Given Intrathecally on day 15 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 2: • Given Intrathecally on day 1, 8, 15 and 22 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 3: Intrathecally on day 1 at the age-defined dose
    Other Names:
  • Otrexup
  • Rasuvo
  • Rheumatrex
  • Trexall
  • Amethopterin
  • Methotrexate Sodium
  • MTX
  • Drug: Cyclophosphamide
    Course 2 only: • 1000mg/m2/day IV over 30 minutes to be given on day 1.
    Other Names:
  • Cytoxan
  • Neosar
  • Drug: 6-thioguanine
    Treatment Course 2 only: • 60 mg/m2/day to be given orally on days 1 through 14.
    Other Names:
  • Thioguanine Tabloid
  • 6-TG
  • 2-Amino-6-Mercaptopurine
  • Experimental: Dose Level 2

    Treatment Dose of ABT-751 is 100 mg/m2/day Tx Course 1: • ABT-751, Dexamethasone, PEG-asparaginase, Doxorubicin, Cytarabine, IT Methotrexate Tx Course 2: • Cyclophosphamide, 6-Thioguanine, IT Methotrexate, Cytarabine, PEG-asparaginase, ABT-751 Tx Courses 3-12 (maintenance courses): • ABT-751, IT Methotrexate

    Drug: ABT-751
    Treatment Course 1: Oral capsule to be given daily for 21 days at assigned dose. Treatment Course 2: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 15-35. Treatment Course 3: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 1-21 followed by 1 week of rest.
    Other Names:
  • Antineoplastics
  • Drug: Dexamethasone
    In Treatment Course 1 only: 10 mg/m2/day divided BID. Take dexamethasone by mouth days 1-14.
    Other Names:
  • Decadron
  • Dexasone
  • Diodex
  • Hexadrol
  • Maxidex
  • Drug: PEG-asparaginase
    In Treatment Course 1: 2500 IU's/m2/day. Intramuscular injection (IM) on days 4, 11 and 18. In Treatment Course 2: 2500 IU's/m2/day. Intramuscular injection (IM) on day 15.
    Other Names:
  • Elspar
  • Kidrolase
  • L-asparaginase
  • Erwinia L-asparaginase
  • Drug: Doxorubicin
    In Treatment Course 1 only: • 60 mg/m2/day IV over 15 minutes on day 1.
    Other Names:
  • Adriamycin
  • Rubex
  • Drug: Cytarabine
    Given Intrathecally on day 1 of course 1 at the dose defined by age below. 30 mg for patients age 1-1.99 50 mg for patients age 2-2.99 70 mg for patients >3 years of age Omit IT Ara-C on Day 1 if patient received IT therapy prior to study enrollment as part of diagnostic lumbar puncture procedure. In Treatment Course 2: • 75 mg/m2/day IV on days 2 through 5 and days 9 through 12.
    Other Names:
  • Cytosar-U
  • Ara-C
  • Arabinosylcytosine
  • Drug: Methotrexate
    In Treatment Course 1: • Given Intrathecally on day 15 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 2: • Given Intrathecally on day 1, 8, 15 and 22 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 3: Intrathecally on day 1 at the age-defined dose
    Other Names:
  • Otrexup
  • Rasuvo
  • Rheumatrex
  • Trexall
  • Amethopterin
  • Methotrexate Sodium
  • MTX
  • Drug: Cyclophosphamide
    Course 2 only: • 1000mg/m2/day IV over 30 minutes to be given on day 1.
    Other Names:
  • Cytoxan
  • Neosar
  • Drug: 6-thioguanine
    Treatment Course 2 only: • 60 mg/m2/day to be given orally on days 1 through 14.
    Other Names:
  • Thioguanine Tabloid
  • 6-TG
  • 2-Amino-6-Mercaptopurine
  • Experimental: Dose Level 3

    Treatment Dose of ABT-751 is 125 mg/m2/day Tx Course 1: • ABT-751, Dexamethasone, PEG-asparaginase, Doxorubicin, Cytarabine, IT Methotrexate Tx Course 2: • Cyclophosphamide, 6-Thioguanine, IT Methotrexate, Cytarabine, PEG-asparaginase, ABT-751 Tx Courses 3-12 (maintenance courses): • ABT-751, IT Methotrexate

    Drug: ABT-751
    Treatment Course 1: Oral capsule to be given daily for 21 days at assigned dose. Treatment Course 2: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 15-35. Treatment Course 3: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 1-21 followed by 1 week of rest.
    Other Names:
  • Antineoplastics
  • Drug: Dexamethasone
    In Treatment Course 1 only: 10 mg/m2/day divided BID. Take dexamethasone by mouth days 1-14.
    Other Names:
  • Decadron
  • Dexasone
  • Diodex
  • Hexadrol
  • Maxidex
  • Drug: PEG-asparaginase
    In Treatment Course 1: 2500 IU's/m2/day. Intramuscular injection (IM) on days 4, 11 and 18. In Treatment Course 2: 2500 IU's/m2/day. Intramuscular injection (IM) on day 15.
    Other Names:
  • Elspar
  • Kidrolase
  • L-asparaginase
  • Erwinia L-asparaginase
  • Drug: Doxorubicin
    In Treatment Course 1 only: • 60 mg/m2/day IV over 15 minutes on day 1.
    Other Names:
  • Adriamycin
  • Rubex
  • Drug: Cytarabine
    Given Intrathecally on day 1 of course 1 at the dose defined by age below. 30 mg for patients age 1-1.99 50 mg for patients age 2-2.99 70 mg for patients >3 years of age Omit IT Ara-C on Day 1 if patient received IT therapy prior to study enrollment as part of diagnostic lumbar puncture procedure. In Treatment Course 2: • 75 mg/m2/day IV on days 2 through 5 and days 9 through 12.
    Other Names:
  • Cytosar-U
  • Ara-C
  • Arabinosylcytosine
  • Drug: Methotrexate
    In Treatment Course 1: • Given Intrathecally on day 15 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 2: • Given Intrathecally on day 1, 8, 15 and 22 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 3: Intrathecally on day 1 at the age-defined dose
    Other Names:
  • Otrexup
  • Rasuvo
  • Rheumatrex
  • Trexall
  • Amethopterin
  • Methotrexate Sodium
  • MTX
  • Drug: Cyclophosphamide
    Course 2 only: • 1000mg/m2/day IV over 30 minutes to be given on day 1.
    Other Names:
  • Cytoxan
  • Neosar
  • Drug: 6-thioguanine
    Treatment Course 2 only: • 60 mg/m2/day to be given orally on days 1 through 14.
    Other Names:
  • Thioguanine Tabloid
  • 6-TG
  • 2-Amino-6-Mercaptopurine
  • Experimental: Dose Level 4

    Treatment Dose of ABT-751 is 150 mg/m2/day Tx Course 1: • ABT-751, Dexamethasone, PEG-asparaginase, Doxorubicin, Cytarabine, IT Methotrexate Tx Course 2: • Cyclophosphamide, 6-Thioguanine, IT Methotrexate, Cytarabine, PEG-asparaginase, ABT-751 Tx Courses 3-12 (maintenance courses): • ABT-751, IT Methotrexate

    Drug: ABT-751
    Treatment Course 1: Oral capsule to be given daily for 21 days at assigned dose. Treatment Course 2: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 15-35. Treatment Course 3: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 1-21 followed by 1 week of rest.
    Other Names:
  • Antineoplastics
  • Drug: Dexamethasone
    In Treatment Course 1 only: 10 mg/m2/day divided BID. Take dexamethasone by mouth days 1-14.
    Other Names:
  • Decadron
  • Dexasone
  • Diodex
  • Hexadrol
  • Maxidex
  • Drug: PEG-asparaginase
    In Treatment Course 1: 2500 IU's/m2/day. Intramuscular injection (IM) on days 4, 11 and 18. In Treatment Course 2: 2500 IU's/m2/day. Intramuscular injection (IM) on day 15.
    Other Names:
  • Elspar
  • Kidrolase
  • L-asparaginase
  • Erwinia L-asparaginase
  • Drug: Doxorubicin
    In Treatment Course 1 only: • 60 mg/m2/day IV over 15 minutes on day 1.
    Other Names:
  • Adriamycin
  • Rubex
  • Drug: Cytarabine
    Given Intrathecally on day 1 of course 1 at the dose defined by age below. 30 mg for patients age 1-1.99 50 mg for patients age 2-2.99 70 mg for patients >3 years of age Omit IT Ara-C on Day 1 if patient received IT therapy prior to study enrollment as part of diagnostic lumbar puncture procedure. In Treatment Course 2: • 75 mg/m2/day IV on days 2 through 5 and days 9 through 12.
    Other Names:
  • Cytosar-U
  • Ara-C
  • Arabinosylcytosine
  • Drug: Methotrexate
    In Treatment Course 1: • Given Intrathecally on day 15 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 2: • Given Intrathecally on day 1, 8, 15 and 22 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 3: Intrathecally on day 1 at the age-defined dose
    Other Names:
  • Otrexup
  • Rasuvo
  • Rheumatrex
  • Trexall
  • Amethopterin
  • Methotrexate Sodium
  • MTX
  • Drug: Cyclophosphamide
    Course 2 only: • 1000mg/m2/day IV over 30 minutes to be given on day 1.
    Other Names:
  • Cytoxan
  • Neosar
  • Drug: 6-thioguanine
    Treatment Course 2 only: • 60 mg/m2/day to be given orally on days 1 through 14.
    Other Names:
  • Thioguanine Tabloid
  • 6-TG
  • 2-Amino-6-Mercaptopurine
  • Experimental: Dose Level 5

    Treatment Dose of ABT-751 is 175 mg/m2/day Tx Course 1: • ABT-751, Dexamethasone, PEG-asparaginase, Doxorubicin, Cytarabine, IT Methotrexate Tx Course 2: • Cyclophosphamide, 6-Thioguanine, IT Methotrexate, Cytarabine, PEG-asparaginase, ABT-751 Tx Courses 3-12 (maintenance courses): • ABT-751, IT Methotrexate

    Drug: ABT-751
    Treatment Course 1: Oral capsule to be given daily for 21 days at assigned dose. Treatment Course 2: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 15-35. Treatment Course 3: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 1-21 followed by 1 week of rest.
    Other Names:
  • Antineoplastics
  • Drug: Dexamethasone
    In Treatment Course 1 only: 10 mg/m2/day divided BID. Take dexamethasone by mouth days 1-14.
    Other Names:
  • Decadron
  • Dexasone
  • Diodex
  • Hexadrol
  • Maxidex
  • Drug: PEG-asparaginase
    In Treatment Course 1: 2500 IU's/m2/day. Intramuscular injection (IM) on days 4, 11 and 18. In Treatment Course 2: 2500 IU's/m2/day. Intramuscular injection (IM) on day 15.
    Other Names:
  • Elspar
  • Kidrolase
  • L-asparaginase
  • Erwinia L-asparaginase
  • Drug: Doxorubicin
    In Treatment Course 1 only: • 60 mg/m2/day IV over 15 minutes on day 1.
    Other Names:
  • Adriamycin
  • Rubex
  • Drug: Cytarabine
    Given Intrathecally on day 1 of course 1 at the dose defined by age below. 30 mg for patients age 1-1.99 50 mg for patients age 2-2.99 70 mg for patients >3 years of age Omit IT Ara-C on Day 1 if patient received IT therapy prior to study enrollment as part of diagnostic lumbar puncture procedure. In Treatment Course 2: • 75 mg/m2/day IV on days 2 through 5 and days 9 through 12.
    Other Names:
  • Cytosar-U
  • Ara-C
  • Arabinosylcytosine
  • Drug: Methotrexate
    In Treatment Course 1: • Given Intrathecally on day 15 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 2: • Given Intrathecally on day 1, 8, 15 and 22 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 3: Intrathecally on day 1 at the age-defined dose
    Other Names:
  • Otrexup
  • Rasuvo
  • Rheumatrex
  • Trexall
  • Amethopterin
  • Methotrexate Sodium
  • MTX
  • Drug: Cyclophosphamide
    Course 2 only: • 1000mg/m2/day IV over 30 minutes to be given on day 1.
    Other Names:
  • Cytoxan
  • Neosar
  • Drug: 6-thioguanine
    Treatment Course 2 only: • 60 mg/m2/day to be given orally on days 1 through 14.
    Other Names:
  • Thioguanine Tabloid
  • 6-TG
  • 2-Amino-6-Mercaptopurine
  • Experimental: Dose Level 0

    Treatment Dose of ABT-751 is 65 mg/m2/day Tx Course 1: • ABT-751, Dexamethasone, PEG-asparaginase, Doxorubicin, Cytarabine, IT Methotrexate Tx Course 2: • Cyclophosphamide, 6-Thioguanine, IT Methotrexate, Cytarabine, PEG-asparaginase, ABT-751 Tx Courses 3-12 (maintenance courses): • ABT-751, IT Methotrexate

    Drug: ABT-751
    Treatment Course 1: Oral capsule to be given daily for 21 days at assigned dose. Treatment Course 2: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 15-35. Treatment Course 3: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 1-21 followed by 1 week of rest.
    Other Names:
  • Antineoplastics
  • Drug: Dexamethasone
    In Treatment Course 1 only: 10 mg/m2/day divided BID. Take dexamethasone by mouth days 1-14.
    Other Names:
  • Decadron
  • Dexasone
  • Diodex
  • Hexadrol
  • Maxidex
  • Drug: PEG-asparaginase
    In Treatment Course 1: 2500 IU's/m2/day. Intramuscular injection (IM) on days 4, 11 and 18. In Treatment Course 2: 2500 IU's/m2/day. Intramuscular injection (IM) on day 15.
    Other Names:
  • Elspar
  • Kidrolase
  • L-asparaginase
  • Erwinia L-asparaginase
  • Drug: Doxorubicin
    In Treatment Course 1 only: • 60 mg/m2/day IV over 15 minutes on day 1.
    Other Names:
  • Adriamycin
  • Rubex
  • Drug: Cytarabine
    Given Intrathecally on day 1 of course 1 at the dose defined by age below. 30 mg for patients age 1-1.99 50 mg for patients age 2-2.99 70 mg for patients >3 years of age Omit IT Ara-C on Day 1 if patient received IT therapy prior to study enrollment as part of diagnostic lumbar puncture procedure. In Treatment Course 2: • 75 mg/m2/day IV on days 2 through 5 and days 9 through 12.
    Other Names:
  • Cytosar-U
  • Ara-C
  • Arabinosylcytosine
  • Drug: Methotrexate
    In Treatment Course 1: • Given Intrathecally on day 15 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 2: • Given Intrathecally on day 1, 8, 15 and 22 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 3: Intrathecally on day 1 at the age-defined dose
    Other Names:
  • Otrexup
  • Rasuvo
  • Rheumatrex
  • Trexall
  • Amethopterin
  • Methotrexate Sodium
  • MTX
  • Drug: Cyclophosphamide
    Course 2 only: • 1000mg/m2/day IV over 30 minutes to be given on day 1.
    Other Names:
  • Cytoxan
  • Neosar
  • Drug: 6-thioguanine
    Treatment Course 2 only: • 60 mg/m2/day to be given orally on days 1 through 14.
    Other Names:
  • Thioguanine Tabloid
  • 6-TG
  • 2-Amino-6-Mercaptopurine
  • Experimental: Dose Level -1

    Treatment Dose of ABT-751 is 50 mg/m2/day Tx Course 1: • ABT-751, Dexamethasone, PEG-asparaginase, Doxorubicin, Cytarabine, IT Methotrexate Tx Course 2: • Cyclophosphamide, 6-Thioguanine, IT Methotrexate, Cytarabine, PEG-asparaginase, ABT-751 Tx Courses 3-12 (maintenance courses): • ABT-751, IT Methotrexate

    Drug: ABT-751
    Treatment Course 1: Oral capsule to be given daily for 21 days at assigned dose. Treatment Course 2: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 15-35. Treatment Course 3: ABT-751 will be taken once daily, by mouth, at the assigned dose on days 1-21 followed by 1 week of rest.
    Other Names:
  • Antineoplastics
  • Drug: Dexamethasone
    In Treatment Course 1 only: 10 mg/m2/day divided BID. Take dexamethasone by mouth days 1-14.
    Other Names:
  • Decadron
  • Dexasone
  • Diodex
  • Hexadrol
  • Maxidex
  • Drug: PEG-asparaginase
    In Treatment Course 1: 2500 IU's/m2/day. Intramuscular injection (IM) on days 4, 11 and 18. In Treatment Course 2: 2500 IU's/m2/day. Intramuscular injection (IM) on day 15.
    Other Names:
  • Elspar
  • Kidrolase
  • L-asparaginase
  • Erwinia L-asparaginase
  • Drug: Doxorubicin
    In Treatment Course 1 only: • 60 mg/m2/day IV over 15 minutes on day 1.
    Other Names:
  • Adriamycin
  • Rubex
  • Drug: Cytarabine
    Given Intrathecally on day 1 of course 1 at the dose defined by age below. 30 mg for patients age 1-1.99 50 mg for patients age 2-2.99 70 mg for patients >3 years of age Omit IT Ara-C on Day 1 if patient received IT therapy prior to study enrollment as part of diagnostic lumbar puncture procedure. In Treatment Course 2: • 75 mg/m2/day IV on days 2 through 5 and days 9 through 12.
    Other Names:
  • Cytosar-U
  • Ara-C
  • Arabinosylcytosine
  • Drug: Methotrexate
    In Treatment Course 1: • Given Intrathecally on day 15 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 2: • Given Intrathecally on day 1, 8, 15 and 22 at the dose defined by age below. 8 mg for patients age 1-1.99 10 mg for patients age 2-2.99 12 mg for patients 3-8.99 years of age 15 mg for patients >9 years of age In Treatment Course 3: Intrathecally on day 1 at the age-defined dose
    Other Names:
  • Otrexup
  • Rasuvo
  • Rheumatrex
  • Trexall
  • Amethopterin
  • Methotrexate Sodium
  • MTX
  • Drug: Cyclophosphamide
    Course 2 only: • 1000mg/m2/day IV over 30 minutes to be given on day 1.
    Other Names:
  • Cytoxan
  • Neosar
  • Drug: 6-thioguanine
    Treatment Course 2 only: • 60 mg/m2/day to be given orally on days 1 through 14.
    Other Names:
  • Thioguanine Tabloid
  • 6-TG
  • 2-Amino-6-Mercaptopurine
  • Outcome Measures

    Primary Outcome Measures

    1. Number of Patients That Experienced Dose Limiting Toxicity From ABT-751 [Each dose level is evaluated]

      ABT-751 was given daily for 21 days for a period of 28 day course in combination with dexamethasone, PEG-asparaginase, and doxorubicin. The occurrence of a dose limiting toxicity (DLT) was evaluated at the end of the 28 day course. DLT will be defined as any of the following events that are deemed by the investigator as probably or definitely attributable to ABT-751. Toxicity grade follows the CTCAE criteria, version 3.0. A copy of the CTCAE can be downloaded from the CTEP home page (http://ctep.cancer.gov). Grade 3 or 4 Ileus Grade 3 or 4 Constipation Grade 3 or 4 Gastrointestinal obstruction, any location Grade 3 or 4 Sensory Neuropathy Grade 3 or 4 Motor Neuropathy Grade 3 or 4 Neuropathic pain lasting longer than 24 hours despite medical intervention Grade 3 or 4 Hypoxia in the absence of anemia or infection Grade 4 Alanine aminotransferase (ALT) which does not return to

    2. Number of Patients That Achieved Complete Response to ABT-751 [Day 29 of Course 1]

      Complete response (CR) is the occurrence of all of the following on approximately Day 29: less than 5% leukemic blasts in the bone marrow aspirate with no evidence of leukemic blasts in the CSF or peripheral blood and recovery of peripheral blood counts of an Absolute neutrophil count (ANC) > 750/μL and Platelet count > 75,000 μL.

    Secondary Outcome Measures

    1. Number of Patients With Occurrence of Toxic Death [From the first dose of study therapy until 30 days after last therapy dose. Last dose protocol therapy is on day 21.]

      The occurrence of toxic death at anytime that is definitely, probably or possibly related to the treatment.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    N/A to 21 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No

    Inclusion Criteria

    1. Age Patients must be < 21 years of age when enrolled onto this study. T2005-001 Protocol version 6/27/2007 17

    2. Diagnosis

    Patients must have relapsed or refractory ALL with a M3 marrow (marrow blasts >25%) without clinical evidence of testicular disease or laboratory evidence of CNS disease defined as CSF WBC > 5 cells/microliter and blasts. (See Appendix I for method of evaluating traumatic lumbar punctures.) Patients in early first relapse (defined as a patient who relapses less than 36 months from their initial remission [CR1]) are eligible for the phase I portion of the trial.

    1. Performance Level Karnofsky > 60% for patients > 10 years of age and Lansky > 60% for patients < 10 years of age.

    2. Prior Therapy Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study.

    3. Prior anthracycline exposure: Patients must have less than 300mg/m2 lifetime exposure of anthracycline chemotherapy. (See Appendix III for calculation criteria)

    4. Stem Cell Transplant (SCT): Patients are eligible 6 months after allogeneic stem cell transplant as long as patients are not actively being treated for graft-versus-host-disease (GvHD).

    5. During the phase I portion of the trial, there is no limit on the number of prior treatment regimens.

    6. During the phase II portion of the trial, patients must have had two or more prior therapeutic attempts defined as:

    • Persistent initial disease after two induction attempts, or

    • Relapse after one-reinduction attempt (2nd relapse), or

    • Persistent disease after first relapse and initial re-induction attempt (Patients in any first relapse are not eligible for the phase II portion of the study)

    1. During the phase II portion of the trial, patients must have no more than 3 prior therapeutic attempts and it must be at least 6 months since the last treatment with a "VPLD" induction/re-induction regimen.

    2. Reproductive Function

    3. Female patients of childbearing potential must have a negative urine or serum pregnancy test confirmed prior to enrollment and within 48 hours of starting therapy.

    4. Female patients with infants must agree not to breastfeed their infants while on this study.

    5. Male and female patients of child-bearing potential must agree to use an effective method of contraception approved by the investigator during the study and for 3 months following completion of therapy.

    Exclusion Criteria

    1. Drug Allergies
    Patients will be excluded if they have allergies to the following drugs:
    • Asparaginase products

    • Sulfa containing medications

    1. Renal Function Patients will be excluded if their serum creatinine is > the upper limit of normal (ULN) for age at the institution's laboratory.

    2. Liver/Pancreatic Function

    3. Direct bilirubin > 1.5x the institutional ULN for age. A total bilirubin result that is less than 1.5 times the institutional ULN for age may be used for eligibility if a direct bilirubin result is not available.

    4. SGPT (ALT) > 4 x institutional ULN

    5. Grade 3 or greater pancreatitis as defined by the CTCAE v3.0

    6. Amylase or Lipase > 2 x institutional ULN

    7. Cardiac Function Patients will be excluded if their shortening fraction by echocardiogram is less than 30%.

    8. Infection Patients will be excluded if they have an active, uncontrolled infection.

    9. Patients with grade 2 or greater motor or sensory neuropathy per CTC 3.0 criteria.

    10. Patients with grade 2 or greater Ileus (neuroconstipation) per CTC 3.0 criteria.

    11. Patients currently being treated with coumadin.

    12. Patients currently being treated with colchicines.

    13. Patients planning on receiving other investigational agents while on this study. (An investigational agent is defined as any drug not currently approved for use in humans.)

    14. Patients planning on receiving other anti-cancer therapies while on this study.

    15. Patients who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study.

    16. Patients who, based on BSA and current dose level, require a daily dose of ABT-751 that is less than 25mg per day.

    17. Patients who have started protocol therapy prior to enrollment. Patient may still enroll if IT Ara-C or IT MTX were given within 48 hours of study enrollment as part of the diagnostic lumbar procedure. These patients will not participate in the CSF PK portion of the study.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Childrens Hospital Los Angeles Los Angeles California United States 90027
    2 Stanford University Medical Center Palo Alto California United States 94304-1812
    3 UCSF School of Medicine San Francisco California United States 94143-0106
    4 C.S. Mott Children's Hospital Ann Arbor Michigan United States 48109-0914
    5 Seattle Children's Hospital Seattle Washington United States 98105

    Sponsors and Collaborators

    • Therapeutic Advances in Childhood Leukemia Consortium
    • Abbott

    Investigators

    • Study Chair: Paul S Gaynon, MD, Childrens Hospital Los Angeles, Therapeutic Advances in Childhood Leukemia Consortium

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    Therapeutic Advances in Childhood Leukemia Consortium
    ClinicalTrials.gov Identifier:
    NCT00439296
    Other Study ID Numbers:
    • T2005-001
    First Posted:
    Feb 23, 2007
    Last Update Posted:
    Mar 17, 2021
    Last Verified:
    Feb 1, 2021

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Dose Level 1 Dose Level 0
    Arm/Group Description Starting dose for study is 80 mg/m2/day of ABT-751 De-escalation dose due to DLTs: 65 mg/m2/day of ABT-751
    Period Title: Overall Study
    STARTED 5 4
    Treatment Course 1 5 3
    Treatment Course 2 1 1
    COMPLETED 5 4
    NOT COMPLETED 0 0

    Baseline Characteristics

    Arm/Group Title Dose Level 1 Dose Level 0 Total
    Arm/Group Description Starting dose for study is 80 mg/m2/day of ABT-751 De-escalation dose due to DLTs: 65 mg/m2/day of ABT-751 Total of all reporting groups
    Overall Participants 5 4 9
    Age (Count of Participants)
    <=18 years
    4
    80%
    3
    75%
    7
    77.8%
    Between 18 and 65 years
    1
    20%
    1
    25%
    2
    22.2%
    >=65 years
    0
    0%
    0
    0%
    0
    0%
    Sex: Female, Male (Count of Participants)
    Female
    2
    40%
    2
    50%
    4
    44.4%
    Male
    3
    60%
    2
    50%
    5
    55.6%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    3
    60%
    2
    50%
    5
    55.6%
    Not Hispanic or Latino
    2
    40%
    1
    25%
    3
    33.3%
    Unknown or Not Reported
    0
    0%
    1
    25%
    1
    11.1%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    Asian
    0
    0%
    1
    25%
    1
    11.1%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    0
    0%
    0
    0%
    0
    0%
    White
    4
    80%
    3
    75%
    7
    77.8%
    More than one race
    0
    0%
    0
    0%
    0
    0%
    Unknown or Not Reported
    1
    20%
    0
    0%
    1
    11.1%

    Outcome Measures

    1. Primary Outcome
    Title Number of Patients That Experienced Dose Limiting Toxicity From ABT-751
    Description ABT-751 was given daily for 21 days for a period of 28 day course in combination with dexamethasone, PEG-asparaginase, and doxorubicin. The occurrence of a dose limiting toxicity (DLT) was evaluated at the end of the 28 day course. DLT will be defined as any of the following events that are deemed by the investigator as probably or definitely attributable to ABT-751. Toxicity grade follows the CTCAE criteria, version 3.0. A copy of the CTCAE can be downloaded from the CTEP home page (http://ctep.cancer.gov). Grade 3 or 4 Ileus Grade 3 or 4 Constipation Grade 3 or 4 Gastrointestinal obstruction, any location Grade 3 or 4 Sensory Neuropathy Grade 3 or 4 Motor Neuropathy Grade 3 or 4 Neuropathic pain lasting longer than 24 hours despite medical intervention Grade 3 or 4 Hypoxia in the absence of anemia or infection Grade 4 Alanine aminotransferase (ALT) which does not return to
    Time Frame Each dose level is evaluated

    Outcome Measure Data

    Analysis Population Description
    Number of participants that completed at least 1 course of treatment and are evaluable for toxicities.
    Arm/Group Title Dose Level 1 Dose Level 0
    Arm/Group Description Starting dose for study is 80 mg/m2/day of ABT-751 De-escalation dose due to DLTs: 65 mg/m2/day of ABT-751
    Measure Participants 5 4
    # of patients with DLT
    2
    40%
    0
    0%
    # of patients without DLT
    3
    60%
    4
    100%
    2. Primary Outcome
    Title Number of Patients That Achieved Complete Response to ABT-751
    Description Complete response (CR) is the occurrence of all of the following on approximately Day 29: less than 5% leukemic blasts in the bone marrow aspirate with no evidence of leukemic blasts in the CSF or peripheral blood and recovery of peripheral blood counts of an Absolute neutrophil count (ANC) > 750/μL and Platelet count > 75,000 μL.
    Time Frame Day 29 of Course 1

    Outcome Measure Data

    Analysis Population Description
    Number of patients that completed at least 1 course of treatment and was evaluable for response assessment.
    Arm/Group Title Dose Level 1 Dose Level 0
    Arm/Group Description Starting dose for study is 80 mg/m2/day of ABT-751 De-escalation dose due to DLTs: 65 mg/m2/day of ABT-751
    Measure Participants 5 4
    # of patients not achieving complete response
    4
    80%
    1
    25%
    # of patients who achieved complete response
    1
    20%
    3
    75%
    3. Secondary Outcome
    Title Number of Patients With Occurrence of Toxic Death
    Description The occurrence of toxic death at anytime that is definitely, probably or possibly related to the treatment.
    Time Frame From the first dose of study therapy until 30 days after last therapy dose. Last dose protocol therapy is on day 21.

    Outcome Measure Data

    Analysis Population Description
    Number of patients that completed at least 1 course of treatment.
    Arm/Group Title Dose Level 1 Dose Level 0
    Arm/Group Description Starting dose for study is 80 mg/m2/day of ABT-751 De-escalation dose due to DLTs: 65 mg/m2/day of ABT-751
    Measure Participants 5 4
    # of patients that experienced toxic death
    0
    0%
    0
    0%
    # of patients that did not experience toxic death
    5
    100%
    4
    100%

    Adverse Events

    Time Frame Adverse events and serious adverse events will be collected and reported on the electronic case report forms beginning with the first dose of investigational product until 30 days following the last dose of ABT-751, whether elicited or spontaneously reported by the patient, up to day 51 days (30 days after day 21, last day of the protocol therapy).
    Adverse Event Reporting Description The definition of adverse event (AE) and serious adverse event (SAE) do not differ from the clinicaltrials.gov definitions
    Arm/Group Title Dose Level 1 Dose Level 0
    Arm/Group Description Starting dose for study is 80 mg/m2/day of ABT-751 De-escalation dose due to DLTs: 65 mg/m2/day of ABT-751
    All Cause Mortality
    Dose Level 1 Dose Level 0
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 4/5 (80%) 0/4 (0%)
    Serious Adverse Events
    Dose Level 1 Dose Level 0
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 5/5 (100%) 4/4 (100%)
    Blood and lymphatic system disorders
    Febrile neutropenia 1/5 (20%) 3/4 (75%)
    Gastrointestinal disorders
    Dehydration 1/5 (20%) 0/4 (0%)
    Diarrhea NOS 1/5 (20%) 0/4 (0%)
    Ileus paralytic 1/5 (20%) 0/4 (0%)
    Infections and infestations
    Infection w/ Gr 3/4 ANC, Blood 4/5 (80%) 1/4 (25%)
    Infection w/ Gr 3/4 ANC, Nose 1/5 (20%) 0/4 (0%)
    Infection w/ Gr 3/4 ANC, Skin 1/5 (20%) 1/4 (25%)
    Metabolism and nutrition disorders
    Anorexia 1/5 (20%) 0/4 (0%)
    Hyperglycemia NOS 1/5 (20%) 0/4 (0%)
    Musculoskeletal and connective tissue disorders
    Bone pain 0/5 (0%) 1/4 (25%)
    Other (Not Including Serious) Adverse Events
    Dose Level 1 Dose Level 0
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 5/5 (100%) 4/4 (100%)
    Blood and lymphatic system disorders
    Activated partial thromboplastin time prolonged 0/5 (0%) 1/4 (25%)
    Blood/Bone Marrow-Other 5/5 (100%) 4/4 (100%)
    Febrile neutropenia 1/5 (20%) 0/4 (0%)
    Haemoglobin 4/5 (80%) 4/4 (100%)
    Leukopenia NOS 2/5 (40%) 2/4 (50%)
    Neutrophil count 2/5 (40%) 2/4 (50%)
    Platelet count decreased 3/5 (60%) 3/4 (75%)
    Cardiac disorders
    Cardiac-Other 2/5 (40%) 1/4 (25%)
    Left ventricular failure 5/5 (100%) 4/4 (100%)
    Sinus tachycardia 1/5 (20%) 1/4 (25%)
    Supraventricular tachycardia 0/5 (0%) 1/4 (25%)
    Ventricular tachycardia 1/5 (20%) 0/4 (0%)
    Gastrointestinal disorders
    Ascites 1/5 (20%) 0/4 (0%)
    Caecitis 1/5 (20%) 0/4 (0%)
    Colitis NOS 1/5 (20%) 0/4 (0%)
    Constipation 5/5 (100%) 4/4 (100%)
    Diarrhea NOS 3/5 (60%) 2/4 (50%)
    Dyspepsia Heartburn 0/5 (0%) 1/4 (25%)
    Dysphagia 0/5 (0%) 1/4 (25%)
    Gastro-Other 1/5 (20%) 0/4 (0%)
    Ileus paralytic 4/5 (80%) 4/4 (100%)
    Nausea 1/5 (20%) 1/4 (25%)
    Rectal haemorrhage 1/5 (20%) 0/4 (0%)
    Stomatitis 2/5 (40%) 0/4 (0%)
    Vomiting NOS 3/5 (60%) 3/4 (75%)
    General disorders
    Abdominal distention 1/5 (20%) 0/4 (0%)
    Abdominal pain NOS 2/5 (40%) 3/4 (75%)
    Edema - limb 1/5 (20%) 0/4 (0%)
    Fatigue 2/5 (40%) 2/4 (50%)
    Oral pain 1/5 (20%) 1/4 (25%)
    Pain NOS 1/5 (20%) 0/4 (0%)
    Pain-Other 2/5 (40%) 2/4 (50%)
    Pyrexia 0/5 (0%) 1/4 (25%)
    Rigors 2/5 (40%) 1/4 (25%)
    Hepatobiliary disorders
    Hepatic infection 1/5 (20%) 0/4 (0%)
    Hepatobiliary/Pancreas-Other 1/5 (20%) 0/4 (0%)
    Infections and infestations
    Clostridial infection NOS 1/5 (20%) 0/4 (0%)
    Infection w/ Gr 3/4 ANC, Blood 1/5 (20%) 0/4 (0%)
    Infection w/ Gr 3/4 ANC, Urinary tract NOS 1/5 (20%) 0/4 (0%)
    Infection w/ unk ANC, Urinary tract NOS 1/5 (20%) 0/4 (0%)
    Injury, poisoning and procedural complications
    Radiation mucositis 0/5 (0%) 1/4 (25%)
    Investigations
    Alanine aminotransferase increased 5/5 (100%) 4/4 (100%)
    Aspartate aminotransferase increased 2/5 (40%) 3/4 (75%)
    Blood alkaline phosphatase increased 0/5 (0%) 2/4 (50%)
    Blood bicarbonate decreased 0/5 (0%) 1/4 (25%)
    Blood creatinine increased 0/5 (0%) 1/4 (25%)
    Blood bilirubin increased 2/5 (40%) 0/4 (0%)
    Blood fibrinogen 1/5 (20%) 1/4 (25%)
    Gamma-glutamyltransferase increased 0/5 (0%) 1/4 (25%)
    Metabolism and nutrition disorders
    Alkalosis NOS 1/5 (20%) 0/4 (0%)
    Anorexia 3/5 (60%) 1/4 (25%)
    Hypercholesterolemia 1/5 (20%) 0/4 (0%)
    Hyperglycemia NOS 3/5 (60%) 4/4 (100%)
    Hyperkalemia 3/5 (60%) 0/4 (0%)
    Hypermagnesemia 2/5 (40%) 2/4 (50%)
    Hypernatremia 1/5 (20%) 1/4 (25%)
    Hypertriglyceridaemia 1/5 (20%) 1/4 (25%)
    Hypoalbuminemia 3/5 (60%) 2/4 (50%)
    Hypocalcemia 3/5 (60%) 3/4 (75%)
    Hypoglycemia NOS 2/5 (40%) 3/4 (75%)
    Hypokalemia 3/5 (60%) 2/4 (50%)
    Hypomagnesemia 5/5 (100%) 1/4 (25%)
    Hyponatraemia 5/5 (100%) 4/4 (100%)
    Hypophosphataemia 3/5 (60%) 1/4 (25%)
    Metabolic/Lab-Other 0/5 (0%) 1/4 (25%)
    Weight decreased 3/5 (60%) 1/4 (25%)
    Musculoskeletal and connective tissue disorders
    Pain in extremity 1/5 (20%) 1/4 (25%)
    Nervous system disorders
    Dizziness 0/5 (0%) 1/4 (25%)
    Headache 5/5 (100%) 4/4 (100%)
    Neuralgia NOS 5/5 (100%) 4/4 (100%)
    Neurology - Other 1/5 (20%) 0/4 (0%)
    Peripheral motor neuropathy 5/5 (100%) 4/4 (100%)
    Peripheral sensory neuropathy 5/5 (100%) 4/4 (100%)
    Psychiatric disorders
    Anxiety 0/5 (0%) 1/4 (25%)
    Depression 1/5 (20%) 0/4 (0%)
    Respiratory, thoracic and mediastinal disorders
    Atelectasis 1/5 (20%) 0/4 (0%)
    Bronchospasm 0/5 (0%) 1/4 (25%)
    Cough 1/5 (20%) 2/4 (50%)
    Hypoxia 5/5 (100%) 4/4 (100%)
    Pharyngitis 1/5 (20%) 0/4 (0%)
    Pleural effusion 1/5 (20%) 0/4 (0%)
    Pulmonary-Other 2/5 (40%) 2/4 (50%)
    Respiratory tract infection NOS 0/5 (0%) 1/4 (25%)
    Skin and subcutaneous tissue disorders
    Alopecia 0/5 (0%) 1/4 (25%)
    Dry skin 0/5 (0%) 2/4 (50%)
    Dermatology - Other 1/5 (20%) 0/4 (0%)
    Pruritus 0/5 (0%) 1/4 (25%)
    Vascular disorders
    Epistaxis 2/5 (40%) 0/4 (0%)
    Hypertension NOS 1/5 (20%) 1/4 (25%)
    Hypotension NOS 1/5 (20%) 1/4 (25%)
    Thrombosis 1/5 (20%) 0/4 (0%)

    Limitations/Caveats

    Study was terminated early due to lack of accrual. Data were not analyzed for outcome variables.

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

    Results Point of Contact

    Name/Title Peggy Romano, BA, CCRP
    Organization Therapeutic Advances in Childhood Leukemia & Lymphoma (TACL) / Children's Hospital Los Angeles
    Phone 323-361-5505
    Email promano@chla.usc.edu
    Responsible Party:
    Therapeutic Advances in Childhood Leukemia Consortium
    ClinicalTrials.gov Identifier:
    NCT00439296
    Other Study ID Numbers:
    • T2005-001
    First Posted:
    Feb 23, 2007
    Last Update Posted:
    Mar 17, 2021
    Last Verified:
    Feb 1, 2021