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Liposomal Annamycin in Children and Young Adults With Refractory or Relapsed ALL or AML

2014-08-27 03:40:19 | BioPortfolio

Summary

This is a Phase I, multi-center, open-label, dose escalation, MTD study of liposomal annamycin in children and young adults with refractory or relapsed ALL or AML. Enrollment will occur in cohorts of approximately 3 subjects with 10 additional subjects enrolled at the MTD. The liposomal annamycin doses will be escalated in sequential cohorts. Six dose levels of liposomal annamycin are planned: 130, 160, 190, 230, 280, and 310 mg/m2/day.The primary objectives of this study are 1) to evaluate the safety and identify the maximum tolerated dose (MTD) of liposomal annamycin when given in 3 consecutive daily doses, starting at 130 mg/m2/day and ranging to as high as 310 mg/m2/day, or the MTD, whichever is lower, in children and young adults with refractory or relapsed acute lymphocytic leukemia (ALL) or acute myelogenous leukemia (AML), and 2) to evaluate the antileukemic activity of liposomal annamycin in children and young adults with refractory or relapsed ALL or AML. The secondary objective is to measure the pharmacokinetics of annamycin and its metabolite, annamycinol.

Description

This is a Phase I, multi-center, open-label, dose escalation, MTD study of liposomal annamycin in children and young adults with refractory or relapsed ALL or AML. Enrollment will occur in cohorts of approximately 3 subjects with 10 additional subjects enrolled at the MTD. The liposomal annamycin doses will be escalated in sequential cohorts. Six dose levels of liposomal annamycin are planned: 130, 160, 190, 230, 280, and 310 mg/m2/day.

The initial group of 3 subjects will receive a treatment cycle of 130 mg/m2/day liposomal annamycin daily for 3 consecutive days followed by 18 days off liposomal annamycin (i.e., 1 treatment cycle = 21 days). A prophylactic mouthwash for use with anthracyline-based chemotherapies (composition described below under Test Product, Dose, and Mode of Administration) will be used 4 times a day on Days 1-4, with one of the 4 times being immediately 1 hour prior to liposomal annamycin treatment on Days 1 3, to prevent oral mucositis. Anti-allergic pre-medication with diphenydramine will be administered before each dose of liposomal annamycin.

Provided that no subject experiences dose limiting toxicity (DLT) [defined as a study drug related Grade 3 or higher non-hematologic toxicity using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v3.0] during the first 21 days (i.e., during the first treatment cycle), the subsequent group of 3 subjects will receive the next higher liposomal annamycin dose. However, if 1 of the 3 initial subjects experiences DLT, the cohort of subjects at the initial dose level will be expanded to 6 subjects. If at least 2 of the 6 subjects experience DLT, then 3 subjects will be treated at the next lower dose. The MTD is defined as the highest dose of liposomal annamycin at which fewer than 2 (of a cohort of up to 6) subjects experience a DLT.

Subsequent dose escalation will occur in a similar fashion. If a subject discontinues treatment for reasons other than study drug related adverse events such that safety cannot be fully evaluated, an additional subject may be enrolled; these will be reviewed on a case-by-case basis in conjunction with the Sponsor. The dose will be escalated until either a MTD is identified or the maximum dose, 310 mg/m2/day, is achieved. Ten additional subjects will be enrolled at the MTD to better define toxicity and to better evaluate efficacy at the MTD.

Subjects will be evaluated before the start of liposomal annamycin treatment and during the first 3 days of liposomal annamycin treatment. Subjects will be evaluated weekly thereafter during the first cycle of treatment (1 cycle consists of 3 weeks, with 3 consecutive days of daily liposomal annamycin treatment followed by 18 days off of liposomal annamycin) and weekly during each subsequent cycle that they are eligible to receive further treatment. A follow-up visit will be conducted 1 to 2 weeks after the final treatment cycle or after the last study drug administration, if the treatment period was prematurely terminated.

Study Design

Allocation: Non-Randomized, Control: Active Control, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Conditions

Acute Lymphocytic Leukemia

Intervention

Liposomal Annamycin

Location

Phoenix Children's Hospital
Phoenix
Arizona
United States
85016

Status

Recruiting

Source

Callisto Pharmaceuticals

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:40:19-0400

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Medical and Biotech [MESH] Definitions

A chronic leukemia characterized by abnormal B-lymphocytes and often generalized lymphadenopathy. In patients presenting predominately with blood and bone marrow involvement it is called chronic lymphocytic leukemia (CLL); in those predominately with enlarged lymph nodes it is called small lymphocytic lymphoma. These terms represent spectrums of the same disease.

A pathologic change in leukemia in which leukemic cells permeate various organs at any stage of the disease. All types of leukemia show various degrees of infiltration, depending upon the type of leukemia. The degree of infiltration may vary from site to site. The liver and spleen are common sites of infiltration, the greatest appearing in myelocytic leukemia, but infiltration is seen also in the granulocytic and lymphocytic types. The kidney is also a common site and of the gastrointestinal system, the stomach and ileum are commonly involved. In lymphocytic leukemia the skin is often infiltrated. The central nervous system too is a common site.

Enzyme that is a major constituent of kidney brush-border membranes and is also present to a lesser degree in the brain and other tissues. It preferentially catalyzes cleavage at the amino group of hydrophobic residues of the B-chain of insulin as well as opioid peptides and other biologically active peptides. The enzyme is inhibited primarily by EDTA, phosphoramidon, and thiorphan and is reactivated by zinc. Neprilysin is identical to common acute lymphoblastic leukemia antigen (CALLA Antigen), an important marker in the diagnosis of human acute lymphocytic leukemia. There is no relationship with CALLA PLANT.

A chronic leukemia characterized by a large number of circulating prolymphocytes. It can arise spontaneously or as a consequence of transformation of CHRONIC LYMPHOCYTIC LEUKEMIA.

A lymphoid leukemia characterized by a profound LYMPHOCYTOSIS with or without LYMPHADENOPATHY, hepatosplenomegaly, frequently rapid progression, and short survival. It was formerly called T-cell chronic lymphocytic leukemia.

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