This phase II trial studies how well isavuconazole works in preventing invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia or myelodysplastic syndrome and neutropenia. Isavuconazole may help to prevent invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia or myelodysplastic syndrome and neutropenia.
PRIMARY OBJECTIVES: I. To assess whether prophylaxis with isavuconazole effectively prevents the occurrence of proven or probable invasive fungal infections (IFIs) in patients with newly diagnosed acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) receiving successive cycles of intensive chemotherapy or other therapies for up to 100 days from prophylaxis initiation. SECONDARY OBJECTIVES: I. To evaluate the incidence of invasive aspergillosis (IA) within 100 days of beginning isavuconazole prophylaxis in newly diagnosed patients with AML/MDS receiving intensive chemotherapy or other therapies. II. To evaluate the incidence of other IFIs within 100 days of beginning isavuconazole prophylaxis in newly diagnosed patients with AML/MDS receiving intensive chemotherapy or other therapies. III. To evaluate the composite outcome of treatment success versus (vs.) failure in this patient population. IV. To measure the overall survival (OS) of study participants. V. To measure the IFI-free survival of study participants. VI. To document the time to death from any cause in the study population. VII. To document the time to death related to IFI in the study population. VIII. To document the time to diagnosis of proven or probable IFI in the study population. IX. To document the time to initiation of empiric anti-fungal therapy in the study population. X. To characterize the safety, tolerability and adverse event (AE) profile of isavuconazole in the prophylactic setting. EXPLORATORY OBJECTIVES: I. To assess the potential role, if any, of therapeutic drug monitoring (TDM) of isavuconazole levels in the prophylactic setting in patients with newly diagnosed AML/MDS receiving cytotoxic chemotherapy or other therapies. II. To determine the in vitro susceptibility of agents causing "breakthrough" IFIs to antifungal agents. OUTLINE: Patients receive isavuconazole orally (PO) every 8 hours for 6 doses and then once daily (QD) or intravenously (IV) over 1 hour every 8 hours for 6 doses and then QD for up to 4 days for 12 weeks in the absence of disease progression or unacceptable toxicity.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
65
Given PO or IV
M D Anderson Cancer Center
Houston, Texas, United States
Number of Participants With Proven or Probable Invasive Fungal Infections (IFIs)
Participants with proven or possible invasive fungal infections.
Time frame: Up to 100 days from prophylaxis initiation
Number of Participants With Invasive Aspergillosis
Participants with invasive aspergillosissured.
Time frame: Up to 100 days from prophylaxis initiation
Number of Participants With Other Invasive Fungal Infections (IFIs)
Participants with other IFIs will be measured.
Time frame: Up to 100 days from prophylaxis initiation
Number of Participants With Treatment Success
Will evaluate versus (vs.) failure (defined as Participants with proven or probable IFI, receipt of any other systemic antifungal agent for +/- 4 days for suspected IFI, occurrence of an adverse events possibly or probably related to the study drug resulting in discontinuation of treatment, or withdrawal from the study with no additional follow-up).
Time frame: Up to 3 years
Number of Participants Who Failed Treatment
Will evaluate versus success. Success is defined as Participants with proven or probable IFI, receipt of any other systemic antifungal agent for +/- 4 days for suspected IFI, occurrence of an adverse events possibly or probably related to the study drug resulting in discontinuation of treatment, or withdrawal from the study with no additional follow-up).
Time frame: Up to 3 years
Overall Survival (OS)
Time from date of treatment start until date of death due to any cause or last Follow-up.
Time frame: Up to 3 years
Invasive Fungal Infections (IFIs)-Free Survival
Time measured in days from start of treatment to IFI or off study date
Time frame: Up to 3 years
Time to Death From Any Cause
Time to death from any cause will be measured.
Time frame: Up to 3 years
Number of Participants With Death Related to Invasive Fungal Infections (IFIs)
Death's from invasive fungal infections
Time frame: Up to 3 years
Time to Diagnosis of Proven or Probable Invasive Fungal Infections (IFIs)
Time measured in days from start of treatment to invasive fungal infections
Time frame: Up to 3 years
Time to Initiation of Empiric Anti-fungal Therapy
Time days from start of empiric anti-fungal therapy.
Time frame: Up to 3 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.