This is a research study to be done at multiple sites in participants with advanced acute myeloid leukemia (AML) that have a mutation in Fms-like tyrosine kinase-3 internal tandem duplications (FLT3-ITD). This study is to learn more about an investigational drug, quizartinib, being tested with the anti-cancer medicine CPX-351 (also called Vyxeos™), which is approved and widely used to treat AML. The purpose of this study is to assess the safety, tolerability and survival of patients receiving the combination of CPX-351 and quizartinib.
This is an open-label, two-part Phase II clinical trial in patients with relapsed or refractory FLT3-ITD mutation-positive acute myeloid leukemia (AML). The study is designed to assess the safety and tolerability as well as the efficacy of administering CPX-351 (cytarabine:daunorubicin liposome complex) with quizartinib. CPX-351 is a formulation of two drugs, cytarabine and daunorubicin, that is administered as the first part of treatment to get rid of as many leukemia cells in your bone marrow as possible. Quizartinib is an investigational drug made of a protein that inhibits FLT3 and will be given after CPX-351 has been given. The plan for administration is divided into three phases: induction, consolidation, and maintenance.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
1
Given during the induction and consildation phase and will consist of 44 mg/m\^2 daunorubicin with 100 mg/m\^2 cytarabine administered intravenously on Days 1, 3, and 5 during induction phase and Days 1 and 3 of consolidation phase.
Given during induction, consolidation, and maintenance phases and will be taken orally at a dose of 30mg on Days 8-21 of induction phase, Days 6-21 of consolidation phase, and daily in maintenance phase.
Colorado Blood Cancer Institute
Denver, Colorado, United States
HCA Midwest
Kansas City, Missouri, United States
Tennessee Oncology
Nashville, Tennessee, United States
St. David's South Austin Medical Center
Austin, Texas, United States
Texas Transplant Institute
San Antonio, Texas, United States
Number of Patients With Treatment Related Adverse Events After Taking CPX-351 and Quizartinib
Counting the number of patients with treatment related adverse events as a measure of safety and tolerability.
Time frame: Collected during treatment and for 30 days after last dose, approximately 35 total days for the 1 patient treated.
Number of Patients With an Overall Response Taking CPX-351 and Quizartinib
Overall response is defined by the International Working Group response criteria (Cheson et al 2003) as having a complete remission (CR) - a complete morphologic response with complete blood count recovery absolute neutrophil count ≥1000/μL and platelet count ≥100,000/μL) or a complete morphologic response with an incomplete blood count recovery (CRi) - absolute neutrophil count \<1000/μL and/or platelet count \<100,000/μL)
Time frame: from cycle 1 day 1 (each cycle is 28 days) until disease progression for up to 2 years post treatment
Median Time to Platelet Count Recovery
Time to platelet recovery is defined as the time to when the peripheral blood platelet count is \>50, 000/ μL
Time frame: from cycle 1 Day 1 (each cycle is 28 days) for up to 24 months
Median Time to Absolute Neutrophil Count (ANC) Recovery
Time to neutrophil recovery is defined as the time to when the peripheral blood ANC is ≥500/μL
Time frame: from Cycle 1 Day 1 (each cycle is 28 days) for up to 24 months
Number of Patients Proceeding to an Allogeneic Hematopoietic Cell Transplantation (alloHCT)
Patients receiving allogeneic hematopoietic cell transplantation (alloHCT) following treatment in induction and consolidation therapies.
Time frame: up to 60 days after consolidation therapy
Median Time to Disease Progression
Time to disease progression, confirmed by bone marrow biopsy.
Time frame: from diagnosis of relapse or refractory AML until disease progression for up to 2 years post treatment
Event-free Survival Time
Defined as the number of days until evidence of PD by bone marrow biopsy/aspirate, or death, regardless of cause. Patients who are alive without a disease response assessment of relapsed disease will be censored at the last adequate disease assessment date. Patients without a disease response assessment will be censored at the first date of treatment.
Time frame: from day 1 for up to 4 years
Overall Survival (OS)
Overall survival is defined as the time from the first date of treatment until death as a result of any cause. For OS time, patients that have not died or are lost to follow-up will be censored at the date the patient was last known to be alive or the date of last contact.
Time frame: Up to 8 months
Number of Patients Who Develop Late Responses
Late responses as defined by the International Working Group response criteria (Cheson et al 2003) as having a complete remission (CR) - a complete morphologic response with complete blood count recovery absolute neutrophil count ≥1000/μL and platelet count ≥100,000/μL) or a complete morphologic response with an incomplete blood count recovery (CRi) - absolute neutrophil count \<1000/μL and/or platelet count \<100,000/μL
Time frame: up to 4 years
Number of Patients Who Can Receive Consolidation and Maintenance Therapy
Patients who proceed through induction to next stages of consolidation and maintenance
Time frame: approximately 3 months
Treatment-related Mortality Rate
As determined by the number of treatment related deaths during study treatment
Time frame: Observed during treatment and for 30 days after last dose, so approximately 35 days for the 1 patient treated.
Percentage of Patients Who Achieve a PR or Molecular Complete Remission
A PR is defined as persistent disease by morphology but with a \>50% reduction in the blast count/cellularity ratio compared to the most recent BM biopsy prior to treatment. A molecular complete remission is defined as no evidence of disease by bone marrow biopsy/aspirate by morphology, immunohistochemistry, or flow cytometry, and FLT3 mutation by MRD analysis.
Time frame: from cycle 1 day 1 (each cycle is 28 days) until disease progression for up to 2 years post treatment
Mean Elapsed Time for Patients to Achieve Molecular CR
The mean time to achievement of a complete morphologic CR with persistent disease detected by flow or molecular minimal residual disease (MRD) analysis.
Time frame: From Date of First Treatment to up to 2 years
Quizartinib Tolerability After Allogeneic Hematopoietic Cell Transplantation (alloHCT) or Donor Lymphocyte Infusion (DLI)
Defined as the number of patients who received quizartinib and proceeded to alloHCT or DLI as part of this study and had treatment-related adverse events
Time frame: From Date of First Treatment, up to 2 years
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