The purpose of this Phase I study is to determine the safety and tolerability including the maximum dose (MTD) and dose-limiting toxicities (DLTs) of alvocidib when administered over a range of doses on Days 1-3 followed by cytarabine/daunorubicin (7+3) on Days 5-11 in adults with newly diagnosed and previously untreated AML
Primary Objective: • To determine the safety and tolerability including the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of alvocidib when administered over a range of doses on Days 1-3 followed by cytarabine/daunorubicin (7+3) on Days 5-11 in adults with newly diagnosed and previously untreated AML Secondary Objectives: * To observe patients for any evidence of antileukemic activity of alvocidib plus 7+3 using the 2017 ELN response criteria * To establish the Recommended Phase 2 Dose (RP2D) for future studies with alvocidib in combination with 7+3 Exploratory Objective: • To assess levels of minimal residual disease (MRD) using standardized techniques (ie, multiparametric flow cytometry \[MPFC\] and next generation sequencing \[NGS\] and evaluate other potential biomarkers including, but not limited to, MCL-1 dependency.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
32
IV bolus followed by IV infusion
continuous infusion
IV bolus
Sidney Kimmel Cancer Center at Johns Hopkins
Baltimore, Maryland, United States
Columbia University
New York, New York, United States
University of North Carolina
Chapel Hill, North Carolina, United States
Maximum Tolerated Dose (MTD) of Alvocidib
Determine the safety and tolerability including the maximum tolerated dose (MTD) of alvocidib when administered over a range of doses on Days 1-3 followed by Ara-c/daunorubicin (7+3) on Days 5-11 in adults with newly diagnosed and previously untreated AML
Time frame: During the first cycle
Number of Participants Who Experienced Dose Limiting Toxicities (DLTs) of Alvocidib
Determine the safety and tolerability including dose-limiting toxicities (DLTs) of alvocidib when administered over a range of doses on Days 1-3 followed by Ara-c/daunorubicin (7+3) on Days 5-11 in adults with newly diagnosed and previously untreated AML
Time frame: During the first cycle
Antileukemic Activity of Alvocidib Plus 7+3 - Response to Treatment Based on 2017 ELN Response Criteria
CR: Measurable residual disease is positive or unknown; BM blasts (bls) \<5%; no circulating bls and bls w/ Auer rods; no extramedullary disease; ANC \>1.0 x 109/L; platelets \>100 x 109/L. CRMRD-: CR w/ negativity genetic marker. CRi: CR except residual neutropenia or thrombocytopenia. MLFS: BM bls \<5%; no bls with Auer rods; no extramedullary disease; no hematologic recovery required. PR: all hematologic CR criteria; decrease (dec) BM bls % to 5-25%; dec pretreatment BM bls % by \>50%. SD: no CRMRD-/CR/CRi/PR/MLFS; PD criteria not met. PD: increase (inc) BM bls % and/or inc absolute bls in blood: 50% inc BM bls over baseline (\>15% point inc required in cases w/ \<30% bls at baseline or persistent BM bls % of \>70% over at least 3 months; without at least 100% improvement in ANC to absolute level \[\>0.5 x 109/L and/or platelet count to \>50 x 109/L non-transfused); or \>50% inc in peripheral bls to \>25 x 109/L (in the absence of differentiation syndrome); or new extramedullary disease.
Time frame: Best response during duration of study
Recommended Phase 2 Dose (RP2D) of Alvocidib in Combination With 7+3
The dose at which \< 1 of 6 patients experience a DLT during Cycle 1 with the next higher dose having at least 2 of 3 to 6 patients experiencing a DLT during Cycle 1
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Time frame: During Cycle 1 beginning at 1st dose of study drug through Day 50 + or - 3 days