This study is to test escalating doses of carfilzomib in patients with relapsed acute myeloid and acute lymphoblastic leukemia.
Several published studies have demonstrated the in vitro anti-leukemic activity of carfilzomib in leukemia cell lines as well as in primary human acute myeloid and acute lymphoblastic leukemia cells. The anti-leukemic activity of carfilzomib was consistently more potent than that of bortezomib, particularly at doses ≥27mg/m2. Importantly, patients treated on the phase I and phase II carfilzomib trials have had low rates of treatment-associated neuropathy. Several large collaborative groups have current phase II clinical trials that incorporate bortezomib into the treatment regimens for acute myeloid or acute lymphoblastic leukemia. Thus, there is a strong rationale for a study of carfilzomib, a potentially more potent proteasome inhibitor with less toxicity, in patients with relapsed acute leukemias.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Washington University School of Medicine
St Louis, Missouri, United States
To determine the maximum tolerated dose (MTD) and dose limiting toxicity (DLT)
A hematologic adverse event will not be considered a dose-limiting toxicity. Tumor lysis syndrome is not a dose-limiting toxicity.
Time frame: End of cycle 1
To determine the rate of morphologic complete remission (CR)
Time frame: Every 2 months for 2 years after first dose of study drug
To determine the rates of cytogenetic complete remission (CRc) morphologic complete remission with incomplete count recovery (CRi), overall response rate (CR+ CRi), partial remission (PR), stable disease and hematologic improvement.
Time frame: Every 2 months for 2 years after first dose of study drug
To determine the time to response, remission duration, progression-free survival, event-free survival and overall survival of patients treated with carfilzomib.
Time frame: Every 2 months for 2 years after first dose of study drug
To determine the safety and tolerability of carfilzomib by evaluating the number of participants with adverse events as a measure of safety and tolerability.
Time frame: 30 days after end of treatment
To prospectively collect serum and bone marrow specimens to determine biomarkers of response and correlative ex vivo studies of the anti-leukemic activity of carfilzomib.
Time frame: Baseline, Day 28 of cycles 1, 2, 4, 6 & End of Study
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