Carfilzomib and Hyper-CVAD in Treating Patients With Newly Diagnosed Acute Lymphoblastic Leukemia or Lymphoma

NCT ID: NCT02293109

Last Updated: 2022-03-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-17

Study Completion Date

2018-01-11

Brief Summary

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This phase I trial studies the side effects and best dose of carfilzomib when given together with the hyperfractionated (hyper)-cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride, and dexamethasone (CVAD) chemotherapy regimen in treating patients with newly diagnosed acute lymphoblastic leukemia or lymphoma. Carfilzomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride, and dexamethasone, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving carfilzomib with combination chemotherapy may kill more cancer cells.

Detailed Description

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PRIMARY OBJECTIVES:

I. Safety and tolerability of administering carfilzomib in combination with hyper-CVAD chemotherapy.

II. Recommended dose of carfilzomib in combination with hyper-CVAD chemotherapy for the future phase II trial.

SECONDARY OBJECTIVES:

I. Rate of remission after 2nd and 4th cycles. II. Incidence of minimal residual disease by flow cytometry at 4th cycle.

OUTLINE: This is a dose escalation study of carfilzomib.

Patients receive carfilzomib intravenously (IV) over 30 minutes on days 0, 1, 7, and 8. Patients also receive hyper-CVAD comprising cyclophosphamide IV over 2 hours every 12 hours for 6 doses beginning on day 1, vincristine sulfate IV on days 4 and 11, doxorubicin hydrochloride IV over 2-24 hours on day 4, and dexamethasone orally (PO) on days 1-4 and 11-14 (courses 1 and 3) and methotrexate IV over 24 hours on day 1, cytarabine IV over 2 hours every 12 hours for 4 doses starting on day 2, leucovorin calcium IV or PO every 6 hours beginning 36 hours after the start of methotrexate infusion, and methylprednisolone IV every 12 hours for 6 doses beginning on day 1 (courses 2 and 4). Patients with cluster of differentiation (CD)20 positive disease also receive rituximab twice daily on days 1 and 11 of courses 1 and 3 and days 1 and 8 of courses 2 and 4. Treatment repeats every 3-4 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up for 28 days.

Conditions

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Contiguous Stage II Adult Lymphoblastic Lymphoma Noncontiguous Stage II Adult Lymphoblastic Lymphoma Stage I Adult Lymphoblastic Lymphoma Stage III Adult Lymphoblastic Lymphoma Stage IV Adult Lymphoblastic Lymphoma Untreated Adult Acute Lymphoblastic Leukemia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment (carfilzomib and hyper-CVAD)

Patients receive carfilzomib IV over 30 minutes on days 0, 1, 7, and 8. Patients also receive hyper-CVAD comprising cyclophosphamide IV over 2 hours every 12 hours for 6 doses beginning on day 1, vincristine sulfate IV on days 4 and 11, doxorubicin hydrochloride IV over 2-24 hours on day 4, and dexamethasone PO on days 1-4 and 11-14 (courses 1 and 3) and methotrexate IV over 24 hours on day 1, cytarabine IV over 2 hours every 12 hours for 4 doses starting on day 2, leucovorin calcium IV or PO every 6 hours beginning 36 hours after the start of methotrexate infusion, and methylprednisolone IV every 12 hours for 6 doses beginning on day 1 (courses 2 and 4). Patients with CD20 positive disease also receive rituximab twice daily on days 1 and 11 of courses 1 and 3 and days 1 and 8 of courses 2 and 4. Treatment repeats every 3-4 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

carfilzomib

Intervention Type DRUG

Given IV

cyclophosphamide

Intervention Type DRUG

Given IV

vincristine sulfate

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

dexamethasone

Intervention Type DRUG

Given PO

methotrexate

Intervention Type DRUG

Given IV

cytarabine

Intervention Type DRUG

Given IV

leucovorin calcium

Intervention Type DRUG

Given IV or PO

methylprednisolone

Intervention Type DRUG

Given IV

rituximab

Intervention Type BIOLOGICAL

laboratory biomarker analysis

Intervention Type OTHER

Correlative studies

Interventions

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carfilzomib

Given IV

Intervention Type DRUG

cyclophosphamide

Given IV

Intervention Type DRUG

vincristine sulfate

Given IV

Intervention Type DRUG

doxorubicin hydrochloride

Given IV

Intervention Type DRUG

dexamethasone

Given PO

Intervention Type DRUG

methotrexate

Given IV

Intervention Type DRUG

cytarabine

Given IV

Intervention Type DRUG

leucovorin calcium

Given IV or PO

Intervention Type DRUG

methylprednisolone

Given IV

Intervention Type DRUG

rituximab

Intervention Type BIOLOGICAL

laboratory biomarker analysis

Correlative studies

Intervention Type OTHER

Other Intervention Names

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Kyprolis PR-171 CPM CTX Cytoxan Endoxan Endoxana leurocristine sulfate VCR Vincasar PFS ADM ADR Adria Aeroseb-Dex Decaderm Decadron DM DXM amethopterin Folex methylaminopterin Mexate MTX ARA-C arabinofuranosylcytosine arabinosylcytosine Cytosar-U cytosine arabinoside CF CFR LV Depo-Medrol Medrol MePRDL Solu-Medrol Wyacort IDEC-C2B8 IDEC-C2B8 monoclonal antibody Mabthera MOAB IDEC-C2B8 Rituxan

Eligibility Criteria

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Inclusion Criteria

* Understand and voluntarily sign an informed consent form
* Able to adhere to the study visit schedule and other protocol requirements
* Newly diagnosed acute lymphoblastic leukemia/lymphoma
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2 (3 if it is directly disease related and is expected to get better if the acute lymphoblastic leukemia/lymphoma \[ALL\] is under control)
* Left ventricular ejection fraction (LVEF) \> 40%
* Total bilirubin =\< 3 mg/dL
* Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 3.5 x upper limit of normal
* Creatinine clearance (CrCl) \>= 45 mL/minute within 7 days prior to enrollment either measured or calculated using a standard formula (eg, Cockcroft and Gault); in cases that creatinine clearance cannot be measured accurately, 24 hour urine can be used
* Disease free of other malignancies beside the ALL at the time of the study
* Male subjects must agree to practice contraception
* Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 24 hours prior to the initiation of the study and they must agree to ongoing pregnancy testing and to practice contraception

Exclusion Criteria

* Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form
* Pregnant or breast feeding females
* Active congestive heart failure (New York Heart Association \[NYHA\] class III to IV), symptomatic ischemia, or conduction abnormalities uncontrolled by conventional intervention
* Unstable angina or myocardial infarction within 6 months prior to enrollment, NYHA class III or IV heart failure, uncontrolled angina, history of severe coronary artery disease, severe uncontrolled ventricular arrhythmias, sick sinus syndrome, or electrocardiographic evidence of acute ischemia or grade 3 conduction system abnormalities unless subject has a pacemaker
* Uncontrolled hypertension, uncontrolled pulmonary hypertension or uncontrolled diabetes within 14 days prior to enrollment
* Subjects with pleural effusions requiring thoracentesis or ascites requiring paracentesis within 14 days prior to enrollment
* Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study
* Use of any other experimental drug or therapy within 14 days of baseline
* Known history of allergy to Captisol®
* Known sero-positive for active viral infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV); patients who are sero-positive because of hepatitis B virus vaccine are eligible
* Breakpoint cluster region-Abelson positive (BCR-ABL +) patients will be excluded from the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Amgen

INDUSTRY

Sponsor Role collaborator

Mehrdad Abedi, MD

OTHER

Sponsor Role lead

Responsible Party

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Mehrdad Abedi, MD

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Mehrdad Abedi

Role: PRINCIPAL_INVESTIGATOR

University of California, Davis

Locations

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University of California Davis

Sacramento, California, United States

Site Status

Countries

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United States

Other Identifiers

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UCDCC#246

Identifier Type: REGISTRY

Identifier Source: secondary_id

UCDCC#246

Identifier Type: OTHER

Identifier Source: secondary_id

NCI-2014-02245

Identifier Type: REGISTRY

Identifier Source: secondary_id

660258

Identifier Type: -

Identifier Source: org_study_id

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