This pilot clinical trial studies 6, 8-bis (benzylthio) octanoic acid (CPI-613) in treating patients with myelodysplastic syndromes who failed previous therapy. Sometimes when chemotherapy or biological therapy is given, it does not stop the growth of tumor cells. The tumor is said to be resistant to treatment. 6, 8-bis (benzylthio) octanoic acid may interfere with the growth of tumor cells and may be an effective treatment for myelodysplastic syndromes that did not respond to previous therapy.
PRIMARY OBJECTIVES: I. To evaluate the safety and anti-cancer activities of CPI-613 in myelodysplastic syndrome (MDS) patients who have failed previous agents (such as decitabine \[Dacogen\], azacitidine \[Vidaza\], growth factors or lenalidomide). OUTLINE: Patients receive 6, 8-bis (benzylthio) octanoic acid intravenously (IV) over 2 hours on days 1 and 4 of weeks 1-3. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 5 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Given IV
Comprehensive Cancer Center of Wake Forest University
Winston-Salem, North Carolina, United States
Response Rate (RR), Defined as the Combined Rate of Complete Remission (CR), Marrow CR, Partial Remission (PR), or Stable Disease (SD), as Described by Cheson, et al. (2006)
Response rate (RR), defined as the combined of complete remission (CR), marrow CR, partial remission (PR), or stable disease (SD), as described by Cheson, et al. (2006). The number of patients achieving RR will be presented. Complete remission - Bone marrow: ≤ 5% myeloblasts with normal maturation of all cell lines; Marrow CR - Bone marrow: ≤ 5% myeloblasts and decrease by ≥ 50% over pretreatment Partial remission - All CR criteria if abnormal before treatment except: Bone marrow blasts decreased by ≥ 50% over pretreatment but still \> 5%, cellularity and morphology not relevant Stable disease - Failure to achieve at least PR, but no evidence of progression for \> 8 wks
Time frame: Up to 5 years
Safety Profile of CPI-613, Based on Evaluation of Symptoms, Vital Signs, ECOG Performance Status and Survival, Clinical Chemistry, Hematology, and Coagulation, Assessed by National Cancer Institute Common Terminology Criteria for Adverse Events v 4.0
Safety profile of CPI-613, based on evaluation of symptoms, vital signs, ECOG performance status and survival, clinical chemistry, hematology, and coagulation, assessed by National Cancer Institute Common Terminology Criteria for Adverse Events v 4.0. Toxicities related to the treatment will be examined by looking at each toxicity identified by grade (highest grade of each toxicity per patient so that there is only one event attributed to each patient for a given toxicity).
Time frame: During treatment, a median of 4 months with a maximum of 40 months
Progression-free Survival (PFS)
Survival curves for PFS using Kaplan-Meier techniques will be estimated. In addition, the 6 month and 1-year PFS rates for these participants will be estimated. Disease progression: For patients with: Less than 5% blasts: ≥ 50% increase in blasts to \> 5% blasts 5%-10% blasts: ≥ 50% increase to \> 10% blasts 10%-20% blasts: ≥ 50% increase to \> 20% blasts 20%-30% blasts: ≥ 50% increase to \> 30% blasts Any of the following: At least 50% decrement from maximum remission/response in granulocytes or platelets Reduction in Hgb by ≥ 2 g/dL Transfusion dependence Survival Endpoints: Overall: death from any cause Event free: failure or death from any cause PFS: disease progression or death from MDS DFS: time to relapse Cause-specific death: death related to MDS
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Time frame: 6 and 12 months post treatment start
Overall Survival (OS)
Survival curves for OS using Kaplan-Meier techniques will be estimated. In addition, the 6 month and 1-year OS rates for these participants will be estimated.
Time frame: 6 and 12 months post treatment start
Number of Patients Who Achieve a Reduction in Blood Transfusion Requirements
Number of patients who achieve a reduction in blood transfusion requirements.
Time frame: Up to 5 years
Number of Patients Who Achieve Hematologic Improvement (HI), as Defined by Cheson, et al. (2006)
Number of patients who achieve hematologic improvement (HI), as defined by Cheson, et al. (2006). Criteria: Erythroid response (pretreatment, \< 11 g/dL) - Hgb increase by ≥ 1.5 g/dL. Platelet response (pretreatment, \< 100 × 109/L) - Absolute increase of ≥ 30 × 109/L for patients starting with \> 20 × 109/L platelets. Increase from \< 20 × 109/L to \> 20 × 109/L and by at least 100% Neutrophil response (pretreatment, \< 1.0 × 109/L) - At least 100% increase and an absolute increase \> 0.5 × 109/L Progression or relapse after HI - At least 1 of the following: At least 50% decrement from maximum response levels in granulocytes or platelets Reduction in Hgb by ≥ 1.5 g/dL
Time frame: Up to 5 years