This study will evaluate two doses of Quizartinib in patients with relapsed or refractory acute myeloid leukemia who are also FMS-like tyrosine kinase - internal tandem duplication ( FLT3-ITD) positive. Patient will be randomly assigned in a 1:1 ratio to one of two treatment arms. Both treatment arms will receive Quizartinib but at different doses. The study treatment is taken orally in 28 day cycles until either disease progression occurs or an unacceptable toxicity occurs. In addition to the study assessments to evaluate the disease, blood will be drawn to measure drug levels and biomarkers. Patients will be followed for survival at three month intervals after the end of treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
76
oral
UCLA School of Medicine
Los Angeles, California, United States
Northwestern University
Chicago, Illinois, United States
University of Chicago
Chicago, Illinois, United States
University of Maryland Greenebaum Cancer Center
Baltimore, Maryland, United States
John Hopkins University
Baltimore, Maryland, United States
Tufts University School of Medicine-Tufts Medical Center
Boston, Massachusetts, United States
University of Minnesota
Minneapolis, Minnesota, United States
Mayo Clinic
Rochester, Minnesota, United States
Hackensack University Medical Center
Hackensack, New Jersey, United States
Memorial Sloan-Kettering Cancer Center
New York, New York, United States
...and 14 more locations
Number of Participants Who Achieved Composite Complete Response (CRc) (Intent-to-Treat Population)
CRc is defined as Complete remission (CR) + Complete remission with incomplete platelet recovery (CRp) + Complete remission with incomplete hematological recovery (CRi). * Participants with CR must have normal hematopoietic cells and achieved a morphologic leukemia-free state (\<5% bone marrow blasts in bone marrow, no blasts with Auer rods and no persistence of extramedullary disease) and must have had an absolute neutrophil count (ANC) ≥1 × 10\^9/L and platelet count ≥100 × 10\^9/L and were red blood cell (RBC) and platelet transfusion independent. Blasts in the peripheral blood was to be ≤1% (if blood sample was available). * Participants with CRp must have achieved CR except for incomplete platelet recovery (\< 100 ×10\^9/L). * Participants with CRi must have fulfilled all the criteria for CR except for incomplete hematological recovery with residual neutropenia \<1 × 10\^9/L with or without complete platelet recovery. RBC and platelet transfusion independence were not required.
Time frame: At end of Cycle 2 (after two complete 28-day cycles post treatment)
Number of Participants Who Achieved Complete Remission (CR) (Intent-to-Treat Population)
Participant must have bone marrow regenerating normal hematopoietic cells and achieve a morphologic leukemia-free state (\< 5% bone marrow blasts in bone marrow, no blasts with Auer rods and no persistence of extramedullary disease) and must have an absolute neutrophil count (ANC) ≥ 1x10\^9/L and platelet count ≥ 100 x 10\^9/L and they will be red blood cell (RBC) and platelet transfusion independent (defined as 4 weeks without RBC transfusions and 1 week without platelet transfusion).
Time frame: At end of treatment visit (approximately 3 years post treatment)
Overall Survival (OS) After Approximately 3 Years (Intent-to-Treat Population)
OS was defined as the time from the date of randomization until the date of death from any cause.
Time frame: Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Event Free Survival (EFS) After Approximately 3 Years (Intent-to-Treat Population)
EFS was defined as the time from the date of randomization until the date of documented relapse or death.
Time frame: Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Leukemia Free Survival (LFS) After Approximately 3 Years (Intent-to-Treat Population)
LFS was defined as the time from the date of first CRc until the date of documented relapse or death for participants who achieved CRc.
Time frame: Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Duration of Remission After Approximately 3 Years (Intent-to-Treat Population)
Duration of remission was defined as the time from first documented remission until documented relapse. CRc was defined as composite complete remission and CRi was defined as complete remission with incomplete hematological recovery.
Time frame: Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Time to Composite Complete Remission (CRc) in Participants Who Achieved CRc After Approximately 3 Years (Intent-to-Treat Population)
Time to CRc was defined as the time from the date of randomization until the first disease assessment of CRc. Time to CRc was only evaluated in participants who achieved CRc.
Time frame: Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Percentage of Participants Undergoing Hematopoietic Stem Cell Transplantation (HSCT) After Approximately 3 Years (Intent-to-Treat Population)
Transplantation rate was defined as the percentage of participants who underwent HSCT directly after treatment with quizartinib (no other intervening acute myeloid leukemia therapies other than conditioning regimens for the HSCT).
Time frame: Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
Percentage of Participants With Grade 2 or Higher QT Interval Corrected for Heart Rate Using Fridericia's Formula (QTcF) Prolongation After Receiving Quizartinib (Safety Analysis Set)
QT interval corrected for heart rate using Fridericia's formula (QTcF) grading was to be done according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 and the definition of Grade 2 or higher prolongation is QTcF more than 480 msec.
Time frame: Evaluated at end of study, up to 6 months (approximately 3 years post treatment)
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