Acute Myeloid Leukemia Clinical Trial
GTI-2040 in Treating Patients With Relapsed, Refractory, or High-Risk Acute Leukemia, High-Grade Myelodysplastic Syndromes, or Refractory or Blastic Phase Chronic Myelogenous Leukemia
Summary
This phase I trial is studying the side effects and best dose of GTI-2040 in treating patients with relapsed, refractory, or high-risk acute leukemia, high-grade myelodysplastic syndromes, or refractory or blastic phase chronic myelogenous leukemia. Drugs used in chemotherapy, such as GTI-2040, work in different ways to stop the growth of cancer or abnormal cells, either by killing the cells or by stopping them from dividing.
Full Description
OBJECTIVES:
I. Determine the maximum tolerated dose of GTI-2040 in patients with relapsed, refractory, or high-risk acute leukemia, high-grade myelodysplastic syndromes, or refractory or blastic phase chronic myelogenous leukemia.
II. Assess the toxicity and efficacy of this drug in these patients. III. Assess plasma and intracellular pharmacokinetics of this drug in these patients.
OUTLINE: This is a multicenter, dose-escalation study.
Patients receive GTI-2040 IV continuously on days 1-4 and 15-18. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of GTI-2040 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.
Blood samples are collected on days 1, 4, 15, and 19 of course 1 for pharmacokinetic studies. Samples are analyzed by proteomic assay, dCTP pool measurement, and real-time polymerase chain reaction for mRNA of RRM2, RRM1, and p53R2.
Eligibility Criteria
Inclusion Criteria:
Diagnosis of 1 of the following:
Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) refractory to primary standard induction therapy
Relapsed or refractory acute leukemia
Chronic myelogenous leukemia (CML) in blast crisis at diagnosis OR that failed prior aggressive induction chemotherapy
Diagnosis of 1 of the following:
Acute leukemia secondary to preexisting hematologic condition or prior chemotherapy at diagnosis OR that failed prior aggressive induction chemotherapy
Advanced myelodysplastic syndromes (intermediate-1 or greater)
De novo acute leukemia (myeloid or nonmyeloid)
Not a candidate for aggressive standard induction chemotherapy
De novo AML or ALL (patients > 60 years of age)
No suspected or proven active CNS leukemia
ECOG performance status (PS) 0-2 OR Karnofsky PS 50-100%
Life expectancy >= 8 weeks
Bilirubin =< 1.5 mg/dL
AST and ALT < 3 times upper limit of normal (ULN)
Creatinine =< 1.5 times ULN
No HIV positivity
Fertile patients must use effective contraception
No history of allergic reactions attributed to other phosphorothiolated oligonucleotides
No uncontrolled intercurrent illness including, but not limited to, any of the following:
Ongoing, active, or poorly controlled infection
Symptomatic congestive heart failure
Unstable angina pectoris
No uncontrolled intercurrent illness including, but not limited to, any of the following:
Cardiac arrhythmia
Poorly controlled pulmonary disease
Psychiatric illness or social situation that would preclude study compliance
Recovered from all prior therapies
Prior autologous or allogeneic stem cell transplantation allowed (No active graft-vs-host disease > grade 2)
At least 2 weeks since prior and no concurrent cytotoxic chemotherapy
At least 2 weeks since prior and no concurrent biologic therapy
At least 2 weeks since any other prior investigational agent
No other concurrent anticancer therapy, including radiotherapy or hormonal therapy
Concurrent imatinib mesylate for CML allowed
Not pregnant or nursing
Negative pregancy test
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There is 1 Location for this study
Duarte California, 91010, United States
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