An Open-label, Phase II, Two-stage, Study of Xantrene® (Bisantrene) in combination with Fludarabine and Clofarabine as Salvage Therapy for Adult Patients with Relapsed or Refractory Acute Myeloid Leukemia (AML) Lead-in stage: up to 12 (up to 2 cohorts in a 3+3 dose escalation design) Efficacy stage: up to 17 (Simon 2-stage design 9+8) Study Objectives: * Confirm safety and tolerability of the combination regimen * Time to response with combination treatment * Overall survival The treatment regimen will comprise daily IV infusion of Fludarabine (Flu), Clofarabine (Clo) and Bisantrene (Xan) administered via central venous line and controlled-rate infusion pump with a 1-hour break between each agent infusion, amounting to a total of 6 hours for each daily FluCloXan treatment in the following sequence: * First, infusion over 60 minutes of Fludarabine (Flu) at 10 mg/m2 * Followed by infusion of Clofarabine (Clo) at 30 mg/m2 over 60 minutes * Followed by infusion of Bisantrene (Xan) at 250 mg/m2 over 2 hours. One cycle will comprise daily IV infusion of the combination treatment course for 4 or 5 consecutive days and rest period to between Day 30 and Day 42, based on patient performance and disease status.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
29
Combined escalated dose chemotherapy
Combined escalated dose chemotherapy
Combined escalated dose chemotherapy
Chaim Sheba Medical Center
Ramat Gan, Israel
RECRUITINGThe recommended Phase 2 dose (RP2D) , assessed by the number of treatment days of FluCloXan
Time frame: 12 months
The maximum tolerated dose (MTD) of Bisantre in mg per day
To evaluate safety and tolerability
Time frame: 12 months
The overall response rate (ORR)
Overall Response Rate (ORR) defined as the proportion of patients with complete remission (CR) and complete remission with incomplete blood count recovery (CRi) between Day 30 to Day 42.
Time frame: between Day 30 to Day 42.
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0.
Confirm safety and tolerability of the combination regimen.
Time frame: 12 months
Time of respons in months
Number of months for each patient with no evidence of diseases.
Time frame: 12 months
Overall survival
Median surviving months for each patients.
Time frame: 12 months
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