The purpose of this study is primarily to assess the safety, tolerability and pharmacokinetics (PK) of clofarabine intravenously administered to pediatric patients with relapsed or refractory acute lymphoblastic leukemia (ALL) or for whom no other therapy with greater potential clinical benefit exists. The dosing regimen for the intravenous (IV) clofarabine is 30 or 52 mg/m2/day for 5 consecutive days. The secondary objectives are to document the activity of clofarabine and to explore the impact of deoxycytidine kinase (dCK) promoter polymorphism on PK and treatment outcome.
This is a Phase I Study of Clofarabine in Japanese Paediatric Patients With Relapsed or Refractory Acute Lymphoblastic Leukaemia. Subjects will receive intravenous administration of clofarabine at 30 or 52 mg/m2/day (2 hours) for 5 consecutive days and then the administration will be withheld until Day 14. If there is no evidence of recovery in neutrophil (≥750/mm3) and/or platelet count (≥50,000/mm3), the therapy may be withheld up to Day 42. However, in the absence of progression based on the judgment of the investigator after each cycle of treatment and the benefit of continued treatment is judged to exceed the risk, subjects may receive up to a total of six cycles. If a subject is receiving two or more cycles, a written consent must be obtained prior to start of Cycle 2. When a subject completes the final dose, the safety will be observed and followed-up for 45 days after the final study drug administration. Cohort 1 will receive 30 mg/m2/day x 5 days at Cycle 1 and will be assessed for tolerability. Samples will be drawn to assess pharmacokinetics at this dose. If subjects do not develop adverse events indicative of dose limiting toxicity (DLT) at Cycle 1, the dose will be increased to 52 mg/m2/day x 5 days from Cycle 2 and the subjects will be assessed for safety and activity only. Cohort 2 will receive 52 mg/m2/day x 5 days at Cycle 1 and will be assessed for the tolerability. Samples will be drawn to assess pharmacokinetics at this dose. Whether or not proceeding to Cohort 2 after the Cycle 1 of Cohort 1 is completed will be determined by the sponsor based on the assessment of the safety data and the recommendation of the Data Safety Monitoring Board (DSMB).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
7
Intravenous, 30 mg/m2, 52 mg/m2
National Kyusyu Cancer Center
Fukuoka, Japan
Fukushima Medical University Hospital
Fukushima, Japan
Kagoshima University Medical and Dental Hospital
Kagoshima, Japan
Tokai University Hospital
Kanagawa, Japan
Niigata Cancer Center Hospital
Niigata, Japan
Osaka City General Hospital
Osaka, Japan
Saitama Chilidren's Medical Center
Saitama, Japan
Shizuoka Children's Hospital
Shizuoka, Japan
St. Luke's International Hospital
Tokyo, Japan
Maximum Tolerated Dose (MTD)
Time frame: 14 days (1st cycle)
Safety as evaluated by adverse events (incidence, severity, duration, causality, seriousness, type)
Time frame: 45 days after final study drug administration
Pharmacokinetics as measured by maximum drug serum concentration (Cmax)
Time frame: Day 1 to Day 5
Pharmacokinetics as measured by Time to maximum serum concentration (Tmax)
Time frame: Day 1 to Day 5
Pharmacokinetics as measured by Area Under the drug-concentration curve (AUC)
Time frame: Day 1 to Day 5
Pharmacokinetics as measured by half life (t1/2)
Time frame: Day 1 to Day 5
Pharmacokinetics as measured by renal clearance (CLr)
Time frame: Day 1 to Day 5
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