The purpose of this study is to assess whether treatment with cenersen in combination with 4 cycles of high and low-dose chemotherapy (idarubicin and cytarabine) improves the complete response rate in acute myelogenous leukemia (AML) patients ≥ 55 years of age who did not show a response (CR, CRi, or PR) to a single aggressive frontline induction course.
Cenersen is a phosphorothioate antisense oligonucleotide of sequence 5'-CCCTG5-CTCCC10-CCCTG15-GCTCC20-3'. For AML, cenersen is specific for blocking p53 expression in the stem cells. When AML stem cells are dividing, cenersen sensitizes them to even low-level DNA damage of the type caused by idarubicin, etoposide and possibly ara-C. Because AML stem cells are not all dividing at any given time, this protocol is designed to treat patients with a total of four cycles of cenersen plus chemotherapy within a two to three month period. For a limited period of time, proliferating non-stem cells can be expected to maintain or even expand the tumor while the stem cells are being depleted. If the proliferating non-stem cells are not resupplied by the stem cells, they will all become end stage blasts after a few divisions and undergo elimination.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Complete Remission Rate
Time frame: within day 28-42 of Course 1, and within day 28-42 of Course 2
Overall Survival
Time frame: 2 years
Safety Profile
Time frame: up to 2 years
Complete Remission + Complete Remission with Incomplete Blood Count Recovery Rate
Time frame: within day 28-42 of Course 1, and within day 28-42 of Course 2
Morphologic Leukemia-Free State Rate
Time frame: within day 28-42 of Course 1, and within day 28-42 of Course 2
Partial Remission Rate
Time frame: within day 28-42 of Course 1, and within day 28-42 of Course 2
Remission Duration
Time frame: 2 years
Early deaths measured as deaths at 30, 60 and 90 days of the start of treatment
Time frame: 30, 90, and 90 days from start of treatment
Time to Neutrophil and Platelet Recovery
Time frame: within day 28-42 of Course 1, and within day 28-42 of Course 2
Death in Complete Remission
Time frame: 2 years
Zubrod Score
Time frame: during Frontline Assessment (screening); Course 1: on days 6, 15, 18, and within day 28-42; Course 2: on days 1, 7, 15, 18, and within day 28-42; Course 3: on days 1 and 6; and Course 4: on days 1 and 6
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