The primary purpose of this study is to determine complete remission rate of a novel combination induction chemotherapy treatment based upon 20 patients with newly diagnosed secondary AML.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Venetoclax administered orally once daily on days 3-16.
FLAG consists of daily infusions of Fludarabine (30mg/m2/day over 30 minutes) and Ara-C (2g/m2/day over 4 hours) for 5 days with daily subcutaneous injections of G-CSF until count recovery. Tbo-filgrastim will be administered as follows: WBC count \>50,000 - 5mcg/kg; WBC count \<50,000 - hold Tbo-filgrastim. Given the national shortage of Fludarabine, Cladrabine (5mg/m2/day IV over 2 hours) has been substituted (CLAG) with similar toxicity profile.
University of Michigan Rogel Cancer Center
Ann Arbor, Michigan, United States
Morphologic complete remission (CR)
If at least 12/20 (60%) of patients achieve a CR (based upon a bone marrow aspiration, biopsy, and peripheral blood studies according to the International Working Group criteria for AML), the combination treatment will be considered successful. If the true CR rate is 40%, then the trial will be considered successful with probability 0.06 (type I error). Conversely, if the true CR rate is 70%, then the trial will be considered successful with probability 0.89 (power).
Time frame: up to 43 days (+/- 2 days)
Overall response rate (ORR)
{Percentage of patients?} with complete remission (CR), complete remission with incomplete count recovery (CRi), morphologic leukemia free state rate (MLFS), and partial response rate (PR) per AML Response Criteria.
Time frame: 28 days (+/- 7 days) days post remission marrow collection
Progression-free survival (PFS)
PFS defined as the time between first dose of study treatment to the event of disease progression or death; analyzed using Kaplan Meier methods.
Time frame: 6 months and 1 year following the conclusion of study enrollment
Overall survival (OS)
OS defined as the time from start of treatment to death; analyzed using Kaplan Meier methods.
Time frame: 6 months and 1 year following the conclusion of study enrollment
Event free survival (EFS)
EFS defined as the time from start of treatment to resistant leukemia, relapsed leukemia, second malignancy, or death; analyzed using Kaplan Meier methods.
Time frame: 6 months and 1 year following the conclusion of study enrollment
Mortality rate
Defined as whether the patient was alive 30 days post-study treatment start (died/not died).
Time frame: 30 days post study treatment start
Allogeneic transplantation
Defined as the total number of patients requiring allogeneic transplantation after protocol treatment.
Time frame: 1 year after study entry
Percentage of patients who develop drug-related non-hematologic grade 3 or higher toxicity
Percent of patients who develop drug-related non-hematologic grade 3 or higher toxicities within 30 days after study treatment initiation (excluding nausea and vomiting or electrolyte abnormalities that are corrected with standard clinical care).
Time frame: 30 days post study treatment start
Number of patients who develop drug-related non-hematologic grade 3 or higher toxicity
Number of patients who develop drug-related non-hematologic grade 3 or higher toxicities within 30 days after study treatment initiation (excluding nausea and vomiting or electrolyte abnormalities that are corrected with standard clinical care).
Time frame: 30 days post study treatment start
Bone marrow aplasia
Defined as a bone marrow biopsy with an overall cellularity of \< 5% with no evidence of leukemia as well as an ANC \<0.5 and a platelet count of \< 10 requiring transfusion support.
Time frame: up to 43 days (+/- 2 days)
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