This is a multicenter, prospective, non-randomized, Phase I-II trial to assess the efficacy and safety of the combination of oral quizartinib and FLAG-IDA chemotherapy schedule (FLAG-QUIDA regimen) in first relapsed/refractory AML (acute myeloid leukemia) patients.
Patients of approximately 20 sites (in Spain and Portugal) will receive FLAG-QUIDA regimen followed by transplantation, when possible, with up to 3 optional consolidation cycles. All patients in CR/CRi (complete remission / complete remission with incomplete hematologic recovery) will receive a maintenance schedule. A Phase I (dose escalation) will be performed at 40 mg x 14 days of quizartinib in the first 3 patients, and if no dose-limiting toxicity (DLT) is observed, the next cohort of patients will receive 60 mg x 14 days. There is also the possibility of de-escalation cohorts at 60 mg x 7 days and at 40 mg x 7 days. Patients participating in the Phase I will receive the allocated dose level, and therefore, they must not receive strong CYP3A4 inhibitors concomitantly with quizartinib The Phase II will include 68 patients treated at the RP2D (recommended phase 2 dose). A 1-year maintenance schedule starting at 30 mg will be increased to 60 mg/day if appropriate. Patients will be followed up for a minimum period of 1 year since the first visit of the last patient included.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
63
Quizartinib at different doses in the phase I (40mg-14 days; 60mg-14 days; 60mg-7days, 40mg-7days). RP2D in the phase II part.
30 mg/m2 intravenous days 1 to 4 of the cycle
2 g/m 2 intravenous days 1 to 4 (1 g/m2 in patients older than 59) of the cycle
10 mg/ 2 intravenous days 1 to 3 of the cycle
daily dose of 300 mcg/m 2 , from day -1 until day 5 of the cycle
Complexo Hospitalario Universitario A Coruña
A Coruña, Spain
Hospital General Universitario de Alicante
Alicante, Spain
Institut Català D'Oncologia-Hospital Germans Trias I Pujol
Badalona, Spain
Institut Català D'Oncologia-Hospital Duran I Reynals
Bellvitge, Spain
Hospital Universitario Puerta Del Mar
Cadiz, Spain
Hospital San Pedro de Alcántara
Cáceres, Spain
Hospital Universitario Reina Sofía
Córdoba, Spain
ICO Girona - Hospital Josep Trueta
Girona, Spain
Hospital Universitario de Jerez de La Frontera
Jerez de la Frontera, Spain
Complejo Hospitalario de Gran Canaria Dr. Negrin
Las Palmas de Gran Canaria, Spain
...and 10 more locations
RP2D finding
Maximum Tolerated dose of the combination of quizartinib a FLAG-IDA regimen
Time frame: 1 cycle (4 weeks)
Rate CR/CRi
To assess the rate of CR/CRi after one cycle of FLAG-QUIDA
Time frame: 3 years
Disease-free survival (DFS)
time from the first documentation of remission to the documentation of disease recurrence or death
Time frame: 3 years
Overall survival (OS)
Number of days from randomization until death from any cause
Time frame: 3 years
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