Status:
COMPLETED
Nilotinib and Imatinib Mesylate After Donor Stem Cell Transplant in Treating Patients With ALL or CML
Lead Sponsor:
Fred Hutchinson Cancer Center
Collaborating Sponsors:
National Cancer Institute (NCI)
Conditions:
Accelerated Phase Chronic Myelogenous Leukemia
Adult Acute Lymphoblastic Leukemia in Remission
Eligibility:
All Genders
Phase:
PHASE1
PHASE2
Brief Summary
This phase I/II trial is studying the side effects and best way to give nilotinib when given alone or sequentially after imatinib mesylate after donor stem cell transplant in treating patients with ac...
Detailed Description
PRIMARY OBJECTIVES: I. To determine the safety of the administration of nilotinib between Day 81 and Day 365 after hematopoietic cell transplantation (HCT) in patients with Philadelphia chromosome po...
Eligibility Criteria
Inclusion
- Body surface area \>= 1 m\^2
- Allogeneic HCT
- Acute lymphocytic leukemia (ALL) or chronic myelogenous leukemia (CML) characterized by the p190 and/or p210 BCR/ABL gene rearrangement
- CML in accelerated phase, blast crisis, or blast crisis remission as defined by World Health Organization (WHO) criteria
- CML in chronic phase if patient age =\< 17 years or a patient of any age with CML in second chronic phase or beyond
- Patients with minimal residual disease (MRD) that is not declining in response to tyrosine kinase inhibitor therapy must be screened for the T315I and other mutations
- An appropriately matched related or unrelated donor
- Signed informed consent
- Patient must have a life expectancy of at least 2 months
- Stated willingness of the patient to comply with study procedures and reporting requirements
- Creatinine =\< 2.0 x upper limit normal (ULN)
- Platelets \> 20 x 10\^9 /L
- Serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 3 x ULN, conjugated bilirubin \< 3 x ULN
- Serum potassium phosphorus, magnesium, and calcium \>= lower limit normal (LLN) or correctable with supplements prior to first dose of study drug; calcium levels may be corrected for hypoalbuminemia
- Serum amylase and lipase \< 1.5 x ULN
- Female patients of childbearing potential must have negative pregnancy test within 7 days before initiation of study drug dosing; postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential; male and female patients of reproductive potential must agree to employ an effective barrier method of birth control throughout the study and for up to 3 months following discontinuation of study drug
- Careful rationalization with a view to discontinuing or considering alternatives to any concomitant medications that have potential to prolong the QT interval
Exclusion
- Autologous transplant
- Non-myeloablative transplant
- Patient age \> 17 years with CML in first chronic phase
- Aberrant antigen expression on marrow leukemic blasts \>= 5% by multidimensional flow cytometric assay immediately before conditioning (CML patients in chronic phase exempt from flow cytometry screening)
- Ph+ ALL without complete cytogenetic remission immediately before conditioning
- Known T315I mutation
- Hypersensitivity to Gleevec or Tasigna
- Patients who are Tasigna-resistant or intolerant
- Central nervous system (CNS) involvement with leukemia at baseline (pre-imatinib therapy); CML chronic phase (CP), accelerated phase (AP) patients exempt from CNS involvement screening
- Female patients who are pregnant, breast-feeding, or of childbearing potential without a negative serum pregnancy test at screening; male or female patients of childbearing potential unwilling to use effective contraceptive precautions throughout the trial; post-menopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential
- Life expectancy severely limited by diseases other than leukemia
- Myocardial infarction within one year prior to starting nilotinib
- Other clinically significant heart disease (e.g. congestive heart failure, uncontrolled hypertension, unstable angina)
- Absolute neutrophil count (ANC) less than 1500 per microliter at study entry despite the use of filgrastim (G-CSF)
- Impaired cardiac function, including any one of the following:
- Complete left bundle branch block or bifascicular block (right bundle branch block plus left anterior hemiblock) or use of ventricular-paced pacemaker
- Congenital long QT syndrome or a family history of long QT syndrome
- History of or presence of significant ventricular or atrial tachyarrhythmias
- Clinically significant resting bradycardia (\< 50 beats per minute)
- Corrected QT interval (QTc) \> 450 milliseconds on screening electrocardiogram (ECG); if QTc \> 450 and electrolytes are not within normal ranges, electrolytes should be corrected and then the patient rescreened for QTc
Key Trial Info
Start Date :
August 14 2008
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
December 1 2013
Estimated Enrollment :
40 Patients enrolled
Trial Details
Trial ID
NCT00702403
Start Date
August 14 2008
End Date
December 1 2013
Last Update
August 10 2017
Active Locations (5)
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1
Stanford University Hospitals and Clinics
Stanford, California, United States, 94305
2
H Lee Moffitt Cancer Center and Research Institute Phase 2 Consortium
Tampa, Florida, United States, 33612
3
H. Lee Moffitt Cancer Center and Research Institute
Tampa, Florida, United States, 33612
4
Oregon Health and Science University
Portland, Oregon, United States, 97239