Prospective nonrandomized phase I study The purpose of this study is to determine safety and efficacy of zileuton when added to dasatinib in patients with chronic myelogenous leukemia (CML).
The standard treatment for chronic myelogenous leukemia is therapy with tyrosine kinase inhibitors (TKIs). This treatment can diminish the amount of disease to very low levels that only very sensitive and specialized techniques can measure; it does not, however, provide a cure. Dr. Shaoguang Li and colleagues at University of Massachusetts have published a unique discovery that the arachidonate 5-lipoxygenase (5-LO) gene (Alox5) is a critical regulator for LSCs in BCR-ABL-induced CML (Chen Y et al. Loss of the Alox5 gene impairs leukemia stem cells and prevents chronic myeloid leukemia. Nature Genetics 41:783-792, 2009). In the absence of Alox5, BCR-ABL failed to induce CML in preclinical studies. While deficiency in Alox5 had no effect on normal hematopoiesis, impairment of the LSCs function through differentiation and cell division of CML LSCs was observed. This defect led to a depletion of LSCs and a failure of CML development. Treatment with a 5-LO inhibitor (zileuton) also impaired the function of LSCs and prolonged survival. These results demonstrate that a specific target gene can be found in cancer stem cells and its inhibition can completely inhibit the function of these stem cells. These findings provide an exciting opportunity to develop the first anti-cancer stem cell therapy for treating CML. Patients who did not respond or did not tolerate two TKIs will be considered for this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
2
To determine the maximum dose of zileuton/dasatinib in subjects with CML
Three dose levels of daily zileuton will be studied in conjunction with dasatinib to define the MTD
Three dose levels of daily zileuton will be studied in conjunction with dasatinib to define the MTD
University of Massachusetts Medical School
Worcester, Massachusetts, United States
To determine the maximal tolerated dose (MTD) of zileuton when added to dasatinib in patients with CML
Time frame: 36 mos
To assess the efficacy of zileuton combined with dasatinib in terms of:
* 5-lipoxygenase (5-LO) blockade in patients * The rate of hematological response (where applicable) * The rate of complete cytogenetic response (where applicable) * The rate of major molecular response (where applicable) * Assessment of residual CML stem cells
Time frame: 36 mos
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Three dose levels of daily zileuton will be studied in conjunction with dasatinib to define the MTD