This phase II trial studies how well vosaroxin and cytarabine work in treating patients with untreated acute myeloid leukemia. Drugs used in chemotherapy, such as vosaroxin and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.
PRIMARY OBJECTIVES: I. To assess the rate of complete remission (CR) after induction therapy with the combination of "7+V" (vosaroxin and standard dose infusional cytosine arabinoside \[ara-C\]) for patients with newly diagnosed, previously untreated acute myelogenous leukemia (AML). SECONDARY OBJECTIVES: I. Frequency of grade 3-5 adverse events related to administration of "7+V". II. To evaluate for the presence of minimal residual disease (MRD) remaining after "7+V" induction and/or re-induction. III. To determine the CR/CR with incomplete blood count recovery (CRi) rate after one and/or 2 cycles of "7+V" induction. IV. To determine the time to neutrophil and platelet recovery following "7+V" induction. V. To assess disease-free survival (DFS) at 1 year (yr) of patients achieving CR/CRi after "7+V" induction. VI. To assess overall survival (OS) at 1 yr of all patients receiving protocol-defined therapy. VII. To determine the correlation of hematopoietic stem cell transplant (HSCT) comorbidity index and Wheatley Index scores with disease response, DFS and OS. TERTIARY OBJECTIVES: * I. To describe the mutational burden of this cohort of AML patients. * II. To correlate genomic aberration with response rate, DFS, and OS. * III. To determine the number of patients treated with vosaroxin who eventually go to allogeneic HSCT. OUTLINE: Patients receive vosaroxin intravenously (IV) on days 1 and 4 and cytarabine IV continuously on days 1-7 (Induction-I). Patients with residual leukemia and for whom a second course is indicated in the judgment of the investigator may undergo a second course of treatment (Induction-II) 14-57 days after day 1 of Induction-1 After completion of study treatment, patients are followed every 3 months for 1 year.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
42
Given IV
Given IV
Yale University
New Haven, Connecticut, United States
Medical University of South Carolina Hollings Cancer Center
Charleston, South Carolina, United States
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, United States
Complete Remission Rate (CR)
CR is calculated as the percentage of patients with complete remission after the therapy. The response criteria is based on International Working Group Criteria. Complete Remission: Neutrophils(cells/μl)\>1000, Platelets (plt/μl)≥ 100,000,Bone marrow blasts (%) \<5; CR with incomplete count recovery (CRi): meets criteria for CR except for neutrophils ≤1000 or Meets criteria for CR except for platelets\< 100,000; Partial Remission: CR except for Bone marrow blasts (%) Decrease of ≥ 50% to value between 5% and 25%; Treatment Failure:Persistent acute myeloid leukemia in blood or bone marrow, or therapy fails to achieve a remission of any category, or death prior to response assessment
Time frame: Up to 3 months
Event-free Survival
Survival distribution will be estimated using the method of Kaplan and Meier. Event-free survival time is defined as the time from start of therapy to progression or death for any reason (which ever comes first), and those alive without progression are censored at the last day of follow up.
Time frame: From start of therapy up to 1 year
Frequency of Grade 3-5 Adverse Event Related to Cytarabine and Vosaroxin (7+V)
Events will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Counts of all events are summed up.
Time frame: Up to 3 months
Leukemia-free Survival (LFS or DFS)
Survival distribution will be estimated using the method of Kaplan and Meier. LFS time is defined as the time from complete remission to disease progression or death for any reason and those disease free and alive are censored at the last day of follow up.
Time frame: The time from complete remission to disease progression or death for any reason, assessed up to 1 year
Overall Survival
Survival distribution will be estimated using the method of Kaplan and Meier. The overall survival time is defined as time from start of therapy to death of any reason. Those alive are censored at the last day of known alive.
Time frame: The time from start of therapy to death, assessed up to 1 year
Minimal Residual Disease
Frequency of minimal residual disease (MRD) remaining after "7+V" induction and/or re-induction
Time frame: Up to 3 months
Rate of CR/CRi
Frequency of Complete Remission / Complete Remission with Incomplete Count Recovery (CR/CRi) after "7+V" induction and/or re-induction
Time frame: Up to 3 months
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