With this research study has following goals * To confirm the highest tolerable dose of palbociclib in combination with chemotherapy is safe and well-tolerated. * To learn more about side effects of palbociclib in combination with chemotherapy; * To learn more about the biological effects of palbociclib on the cells in your body
Primary objective: To confirm the safety of the previously estimated MTD of 100 mg/m2/daily palbociclib on Days 1 to 5; 11 to 15; and 21 to 30, in combination with chemotherapy, on the basis of observed DLTs for pediatric relapsed ALL patients that do not have Ph+ and Ph like mutations (Cohort 1), and to determine the MTD of palbociclib in combination with chemotherapy and kinase inhibition in pediatric relapsed ALL patients with Ph+ and Ph like subtypes (Cohort 2). Secondary objective: To estimate the overall response rate (ORR) to the combination of palbociclib and chemotherapy in pediatric subjects with relapsed or refractory ALL that does not carry Ph+ or Ph like mutations (Cohort 2).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
2
Oral
8 mg/m2/day divided BID, PO, NG, or IV
1.3 mg/m2/dose, IV (preferred) or SC
Lucile Packard Children's Hospital Stanford
Stanford, California, United States
Dose-limiting Toxicity (DLT)
The primary outcome for this study, for the purposes of Clinical Trials.gov registration and results reporting, is dose-limiting toxicities (DLTs) experience by subjects without the Ph+ / Ph-like mutation (Cohort 1), and those with the Ph+ / Ph-like mutation (Cohort 2). The outcome will be reported for Cohorts 1 and 2 as the number of DLTs that occur within 30 days of last treatment with palbociclib. Results for Cohort 2 may be stratified by dose level administered.
Time frame: within 30 days from last treatment with palbociclib.
Overall response rate (ORR)
The efficacy of the combination of palbociclib and chemotherapy with kinase inhibition will be assessed as the overall clinical response rate of subjects treated at the MTD, consisting of those with complete remission (CR); complete remission morphologic (CRM); and partial response (PR), defined as the flow cytometric results below. * CR: minimal residual disease (MRD) in bone marrow \< 0.01% ("MRD-negative"). * CRM: minimal residual disease (MRD) in bone marrow 0.01% to 5%. * PR: Decrease of at least 50% in the percentage of blasts and 5% to 25% blasts. The outcome will be reported as the number of participants Cohorts 1 and 2 with a clinical response, a number without dispersion. Results for Cohort 2 may be stratified by dose level administered.
Time frame: 24 months
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25 mg/m2/dose IV