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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00098839
Registration number
NCT00098839
Ethics application status
Date submitted
8/12/2004
Date registered
9/12/2004
Date last updated
12/12/2017
Titles & IDs
Public title
Chemoimmunotherapy With Epratuzumab in Relapsed Acute Lymphoblastic Leukemia (ALL)
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Scientific title
A Feasibility Pilot and Phase II Study Of Chemoimmunotherapy With Epratuzumab (IND #12034) for Children With Relapsed CD22-Positive Acute Lymphoblastic Leukemia (ALL)
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Secondary ID [1]
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NCI-2011-01624
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Secondary ID [2]
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ADVL04P2
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Recurrent Childhood Acute Lymphoblastic Leukemia
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Cancer
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Cancer
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Lymphoma (non Hodgkin's lymphoma) - Low grade lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - L-asparaginase
Treatment: Drugs - doxorubicin hydrochloride
Treatment: Drugs - therapeutic hydrocortisone
Treatment: Drugs - vincristine sulfate
Treatment: Other - epratuzumab
Treatment: Drugs - cytarabine
Treatment: Drugs - prednisone
Treatment: Drugs - pegaspargase
Treatment: Drugs - dexrazoxane hydrochloride
Treatment: Drugs - methotrexate
Treatment: Drugs - etoposide
Treatment: Drugs - cyclophosphamide
Treatment: Drugs - leucovorin calcium
Treatment: Other - filgrastim
Experimental: Reinduction Chemoimmunotherapy with Epratuzumab once weekly - Four weekly doses of epratuzumab (360 mg/m2/dose) IV days 1, 8, 15, 22. Also received vincristine sulfate, prednisone, pegaspargase, doxorubicin hydrochloride, dexrazoxane hydrochloride, etoposide, cyclophosphamide, filgrastim, high-dose (HD) methotrexate with Leucovorin calcium rescue, L-asparaginase, cytarabine, IT cytarabine, IT methotrexate (CNS-negative), Intrathecal triple therapy (ITT) (methotrexate, cytarabine, therapeutic hydrocortisone for CNS-positive) during the 3 blocks of reinduction therapy.
Experimental: Reinduction Chemoimmunotherapy with Epratuzumab twice weekly - Eight 8 twice-weekly doses of epratuzumab (360 mg/m2/dose) IV days 1, 4, 8, 11, 15, 18, 22 \& 25. Also received vincristine sulfate, prednisone, pegaspargase, doxorubicin hydrochloride, dexrazoxane hydrochloride, etoposide, cyclophosphamide, filgrastim, high-dose (HD) methotrexate with Leucovorin calcium rescue, L-asparaginase, cytarabine, IT cytarabine, IT methotrexate (CNS-negative), Intrathecal triple therapy (ITT) (methotrexate, cytarabine, therapeutic hydrocortisone for CNS-positive) during the 3 blocks of reinduction therapy.
Treatment: Drugs: L-asparaginase
Given IM
Treatment: Drugs: doxorubicin hydrochloride
Given IV
Treatment: Drugs: therapeutic hydrocortisone
40 mg/m2/day PO divided BID or TID
Treatment: Drugs: vincristine sulfate
Given IV
Treatment: Other: epratuzumab
Given IV
Treatment: Drugs: cytarabine
Given IT
Treatment: Drugs: prednisone
Given orally
Treatment: Drugs: pegaspargase
Given IM
Treatment: Drugs: dexrazoxane hydrochloride
Given IV
Treatment: Drugs: methotrexate
Given IT
Treatment: Drugs: etoposide
Given IV
Treatment: Drugs: cyclophosphamide
Given IV
Treatment: Drugs: leucovorin calcium
Given IV
Treatment: Other: filgrastim
Given SC
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Remission Re-induction (CR2) Rate
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Assessment method [1]
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The proportion of patients who achieved complete response at the end Block 1 of re-induction therapy. Complete Remission (CR) - Attainment of M1 bone marrow (\<5% blasts) with no evidence of circulating blasts or extramedullary disease and with recovery of peripheral counts (ANC \>1000/uL and platelet count \>100,000/uL). Partial Remission (PR) - Complete disappearance of circulating blasts and achievement of M2 marrow status (5% or \< 25% blast cells and adequate cellularity). Partial Remission Cytolytic (PRCL) - Complete disappearance of circulating blasts and achievement of at least 50% reduction from baseline in bone marrow blast count. Minimal Response Cytolytic (MRCL) - 50% reduction in the peripheral blast count with no increase in peripheral white blood cell count.
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Timepoint [1]
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At the end of Block 1 of re-induction therapy (day 36)
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Primary outcome [2]
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Event-free Survival Rate
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Assessment method [2]
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Proportion of patients who were event free at 4 months
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Timepoint [2]
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At 4 months after enrollment
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Primary outcome [3]
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Rate of Minimal Residual Disease (MRD) < 0.01%
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Assessment method [3]
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Proportion of patients (evaluable and had MRD measured at the end of Block 1) who had MRD \< 0.01%.
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Timepoint [3]
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At the end of Block 1 of re-induction therapy (day 36)
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Secondary outcome [1]
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Pharmacokinetics
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Assessment method [1]
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Mean trough serum concentration measured before final dose of epratuzumab.
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Timepoint [1]
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Up to day 36
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Eligibility
Key inclusion criteria
* Diagnosis of B lymphoblastic leukemia (B-ALL)
* At least 25% expression of CD22 by immunophenotyping
* In marrow relapse (M3 bone marrow) with or without associated extramedullary disease as defined by 1 of the following:
* In first or later marrow relapse occurring any time after initial diagnosis (part A [closed to accrual as of 10/30/06] or B)
* In first, early marrow relapse with or without associated extramedullary disease occurring < 36 months from the time of initial diagnosis (part B only)
* No B-cell L3 morphology OR evidence of a regulator gene that codes for a transcription factor (MYC) translocation by molecular or cytogenetic analysis
* No Down syndrome
* Patients with CNS or other extramedullary site involvement are allowed
* Performance status - Karnofsky 50-100% (for patients > 10 years of age)
* Performance status - Lansky 50-100% (for patients = 10 years of age)
* White Blood Count (WBC) = 50,000/mm^3 (part A only [closed to accrual as of 10/30/06])
* Bilirubin = 1.5 times upper limit of normal unless disease-related (ULN)
* Alanine aminotransferase (ALT) = 5 times ULN
* Albumin = 2 g/dL
* Creatinine clearance OR radioisotope glomerular filtration rate = 70 mL/min
* Creatinine as defined by age as follows:
* = 0.5 mg/dL (for patients < 1 year old)
* = 0.8 mg/dL (for patients 1 to 5 years old)
* = 1.0 mg/dL (for patients 6 to 10 years old)
* = 1.2 mg/dL (for patients 11 to 15 years old)
* = 1.5 mg/dL (for patients > 15 years old)
* Shortening fraction = 27% by echocardiogram
* Ejection fraction = 45% by Multi Gated Acquisition Scan (MUGA)
* No dyspnea at rest
* No exercise intolerance
* Pulse oximetry > 94%
* No active or uncontrolled infection
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Recovered from prior immunotherapy
* At least 4 months since prior stem cell transplantation or rescue AND no evidence of active graft-vs-host disease
* At least 7 days since prior hematopoietic growth factors
* At least 7 days since prior biologic therapy*
* No other concurrent immunotherapy
* No other concurrent biologic therapy
* Recovered from prior chemotherapy
* No waiting period for children who relapse while receiving standard ALL maintenance therapy
* No prior cumulative anthracycline exposure > 400 mg/m^2*
* No concurrent chemotherapy
* Recovered from prior radiotherapy
* No concurrent radiotherapy
* At least 2 days since prior hydroxyurea
* No other concurrent investigational drugs
* No other concurrent anticancer agents
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Minimum age
2
Years
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Maximum age
31
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/02/2005
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
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Accrual to date
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Final
134
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Recruitment in Australia
Recruitment state(s)
NSW,WA
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Recruitment hospital [1]
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The Children's Hospital at Westmead - Sydney
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Recruitment hospital [2]
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Princess Margaret Hospital for Children - Perth
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Recruitment postcode(s) [1]
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2145 - Sydney
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Recruitment postcode(s) [2]
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6008 - Perth
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Recruitment outside Australia
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United States of America
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Alabama
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California
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United States of America
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Colorado
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United States of America
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District of Columbia
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Florida
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Georgia
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Louisiana
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Maine
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Maryland
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Massachusetts
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Funding & Sponsors
Primary sponsor type
Other
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Name
Children's Oncology Group
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Address
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Other collaborator category [1]
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Government body
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Name [1]
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National Cancer Institute (NCI)
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Ethics approval
Ethics application status
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Summary
Brief summary
This Phase II trial is studying how well giving epratuzumab together with an established chemotherapy platform works in treating young patients with relapsed acute lymphoblastic leukemia. Monoclonal antibodies, such as epratuzumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Chemotherapy drugs work in different ways to stop the growth of cancer cells, either by killing them or by stopping them from dividing. Giving monoclonal antibody therapy in combination chemotherapy may kill cancer cells more effectively.
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Trial website
https://clinicaltrials.gov/study/NCT00098839
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Elizabeth Raetz, MD
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Address
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Children's Oncology Group
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT00098839
Download to PDF