Phase III clinical trial with CPX-351 for the treatment of myeloid leukemia in children with Down syndrome 2018
Descrizione riassuntiva dello studio
Myeloid leukemia is a rare blood cancer that affects the entire body in children and adolescents. Children with Down syndrome have a significantly increased risk of developing myeloid leukemia. Although they have a better prognosis compared to children without Down syndrome, these patients suffer more from the side effects of intensive chemotherapy. Due to these aspects, a special treatment for children with ML-DS is necessary. The aim of this study is to assess whether the introduction of the new drug called 'Vyxeos' can reduce the rate of side effects without reducing the chances of cure. The study investigates how children respond to this therapy and what side effects they show. At the same time, the drug dose towards the end of treatment will be reduced for children who have responded well to chemotherapy, in order to lessen the side effects. Based on the good data from previous international studies, it is expected that this treatment will lead to a similar survival rate, but that acute side effects and late consequences of the therapy can be significantly reduced.
(BASEC)
Intervento studiato
As with the standard treatment, the study treatment is divided into four cycles of intensive chemotherapy, each lasting 28 days. Unlike the standard treatment, in the study, the drug Vyxeos is administered in the first two cycles. Vyxeos is already approved for the treatment of acute myeloid leukemias in adults and achieves promising results. The drug has not yet been approved for children, although it has already been successfully used in studies in children with leukemia. However, this is the first study in which Vyxeos is used in children with Down syndrome and ML or MDS.
The third cycle is identical to the standard treatment and consists of the drugs Cytarabine and Mitoxantrone. The fourth cycle also consists of these two drugs. However, as part of the study, after the first cycle, the number of remaining leukemia cells in the blood and bone marrow will be measured for further treatment planning. This assessment serves to estimate the likelihood that the disease will return after treatment. For children with a low relapse probability, a reduced dose of Cytarabine will be chosen in the fourth cycle compared to standard therapy.
To correctly and in detail study the efficacy and safety of the study treatment, on one hand, standardized diagnostics will be performed in so-called reference laboratories, and on the other hand, medical data from all participating patients will be collected, stored, and evaluated together.
(BASEC)
Malattie studiate
Myeloid leukemia (ML) or myelodysplastic syndrome (MDS) in children with Down syndrome (ML-DS)
(BASEC)
Diagnosis of myeloid leukemia (ML) or myelodysplastic syndrome (MDS) Trisomy 21: Down syndrome or mosaic Age: > 6 months and ≤ 4 years with/without GATA1 mutation OR > 4 and < 6 years with GATA1 mutation (BASEC)
Criteri di esclusione
Children with transient abnormal myelopoiesis (TAM) Cytogenetics: AML with certain genetic changes Previous stem cell or bone marrow transplant or other organ transplant (BASEC)
Luogo dello studio
Basilea, Berna, Ginevra, Losanna, Luzern, San Gallo, Zurigo
(BASEC)
Sponsor
German Pediatric Oncology Group (GPOH) gGmbH Swiss Paediatric Oncology Group (SPOG)
(BASEC)
Contatto per ulteriori informazioni sullo studio
Persona di contatto in Svizzera
Dr. med. Nastassja Scheidegger
+41 44 249 67 72
nastassja.scheidegger@clutterkispi.uzh.chUniversitäts-Kinderspital Zürich
(BASEC)
Informazioni generali
University Clinic Frankfurt
00496963015094
nastassja.scheidegger@clutterkispi.uzh.ch(ICTRP)
Informazioni scientifiche
University Clinic Frankfurt
00496963015094
nastassja.scheidegger@clutterkispi.uzh.ch(ICTRP)
Nome del comitato etico approvante (per studi multicentrici solo il comitato principale)
Commissione etica Zurigo
(BASEC)
Data di approvazione del comitato etico
14.06.2022
(BASEC)
ID di studio ICTRP
EUCTR2018-002988-25 (ICTRP)
Titolo ufficiale (approvato dal comitato etico)
Phase III Clinical Trial for CPX-351 in Myeloid Leukemia in Children with Down Syndrome 2018 (BASEC)
Titolo accademico
Phase III Clinical Trial for CPX-351 in Myeloid Leukemia in Children with Down Syndrome 2018 (ICTRP)
Titolo pubblico
Clinical Trial for the Treatment of Myeloid Leukemia in Children with Down Syndrome (ICTRP)
Malattie studiate
Myeloid Leukemia in Children with Down Syndrome;Therapeutic area: Diseases [C] - Blood and lymphatic diseases [C15] (ICTRP)
Intervento studiato
Trade Name: Vyxeos liposomal 44mg/100mg Pulver f?r ein Konzentrat zur Herstellung einer infusionsl?sung
Product Name: Vyxeos
Product Code: CPX-351
Pharmaceutical Form: Powder for concentrate for solution for injection/infusion
INN or Proposed INN: Cytarabine
CAS Number: 147-94-4
Other descriptive name: CYTARABINE
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 100-
INN or Proposed INN: DAUNORUBICIN
CAS Number: 20830-81-3
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 44-
(ICTRP)
Tipo di studio
Interventional clinical trial of medicinal product (ICTRP)
Disegno dello studio
Controlled: yes Randomised: no Open: yes Single blind: no Double blind: no Parallel group: no Cross over: no Other: yes Other trial design description: Prospective, open-label, non-randomized, historically-controlled phase II/III trial If controlled, specify comparator, Other Medicinial Product: no Placebo: no Other: yes Other specify the comparator: Historic Control Number of treatment arms in the trial: 1 (ICTRP)
Criteri di inclusione/esclusione
Gender:
Female: yes
Male: yes
Inclusion criteria:
?Myeloid Leukemia (ML) or Myelodysplastic Syndrome (MDS), according to WHO
?Trisomy 21: Down syndrome or mosaic
?Age: > 6 months and = 4 years of age with/without GATA1 mutation OR > 4 years of age < 6 years of age with GATA1 mutation
?Morphology/Immunophenotyping: FAB M0, M6 or M7
?Lansky performance score at least equal to 50; or Karnofsky performance status at least equal to 50, whichever is applicable
?Understand and voluntarily provide written permission of parental/legal representative(s) to the ICF prior to conducting any study related assessments/procedures, also concerning data and tumor material transfer according to ICH/GCP and national/local regulations
?Able to adhere to the study visit schedule and other protocol requirements
? Acceptance that vaccination with live vaccines is not possible while participating in the trial
Are the trial subjects under 18? yes
Number of subjects for this age range: 150
F.1.2 Adults (18-64 years) no
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) no
F.1.3.1 Number of subjects for this age range
(ICTRP)
Exclusion criteria:
?Children with Transient Abnormal Myelopoiesis (TAM), according to WHO
?Cytogenetics: AML with recurrent genetic abnormalities (WHO 2016)
?Previous allogeneic bone marrow, stem cell or organ transplantation
?Evidence of invasive fungal infection or other severe systemic infection requiring treatment doses of systemic/parenteral therapy including known active viral infection with human immunodeficiency virus (HIV) or Hepatitis Type B and C
?Symptomatic cardiac disorders (CTCAE 4.0 Grade 3 or 4)
? Diagnosed Wilson?s Disease
?Major surgery within 21 days of the first dose.
?Any anti-cancer therapy (e.g., intensive chemotherapy, biologics or radiotherapy) for more than 14 days or within 4 weeks before start of therapy, except low-dose cytarabine for the treatment of TAM.
?Concomitant treatment with any other anticancer therapy except those specified in protocol during the study therapy
?Treated by any investigational agent in a clinical study within previous 4 weeks
?History of hypersensitivity to the investigational medicinal product or to any drug with similar chemical structure or to any excipient present in the pharmaceutical form of the investigational medicinal product
?Former Enrolment to this study
?The patient concerned has been committed to an institution by virtue of an order issued either by the judicial or the administrative authorities
Endpoint primari e secondari
Main Objective: ?Achieving an EFS, which is not inferior to the ML-DS 2006 trial: 5yr-EFS; 87?3%;Secondary Objective: ?Reduction of toxicity: severe adverse events (CTCAE v4.0 grade III or higher)
?Identification of prognostic factors concerning the risk of relapse, toxicity and poor outcome
?Evaluate the role of different methods in the determination of minimal residual disease measurement
?Evaluation of somatic SNVs as a predictive biomarker: relation of patients? outcome to the specific somatic SNVs
?Exploration of the role of trisomy 8 as a predictive biomarker
?Exploration of molecular resistance/relapse mechanisms
;Primary end point(s): Event-free survival (EFS), defined as time from diagnosis to the first event or last follow-up. Events are death from any cause, failure to achieve remission, relapse, and secondary malignancy. Failure to achieve remission is considered as an event on day 0.
;Timepoint(s) of evaluation of this end point: After 150 are included and the 5-yrs-follow up is over. (ICTRP)
Secondary end point(s): ?Overall survival (OS), as defined as the time of diagnosis to death from any cause or last follow-up.
?Disease-free survival (DFS)
?Early Response Rate (CR, CRp, CRi)) after induction
?Treatment-related mortality (TRM)
?Minimal residual disease (FACS and NGS)
?Adverse events (according to NCI CTCAE v4.0)
?Duration of myelosuppression
;Timepoint(s) of evaluation of this end point: After 150 are included and the 5-yrs-follow up is over. (ICTRP)
Data di registrazione
17.03.2022 (ICTRP)
Inclusione del primo partecipante
30.06.2022 (ICTRP)
Sponsor secondari
non disponibile
Contatti aggiuntivi
Prof. Jan-Henning Klusmann (LKP), KKJM-Direktor@kgu.de, 00496963015094, University Clinic Frankfurt (ICTRP)
ID secondari
ML-DS2018, 2018-002988-25-DE (ICTRP)
Risultati-Dati individuali dei partecipanti
non disponibile
Ulteriori informazioni sullo studio
https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2018-002988-25 (ICTRP)
Risultati dello studio
Riepilogo dei risultati
Phase III Clinical Trial for CPX-351 in Myeloid Leukemia in Children with Down Syndrome 2018 (ICTRP)
Link ai risultati nel registro primario
non disponibile