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TerminatedNCT00673153Updated Jun 1, 2017Results posted

Vorinostat and Gemtuzumab Ozogamicin in Treating Older Patients With Previously Untreated Acute Myeloid Leukemia

A Phase 2 interventional study of gemtuzumab ozogamicin and vorinostat in Adult Acute Megakaryoblastic Leukemia (M7), Adult Acute Minimally Differentiated Myeloid Leukemia (M0) and Adult Acute Monoblastic Leukemia (M5a), sponsored by Fred Hutchinson Cancer Center. Terminated at 4 sites in United States. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2017-06-01.

Sponsored by Fred Hutchinson Cancer Center · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
31
Allocation
Not applicable
Ages
60 Years and older
Sex
All
01

Study summary

RATIONALE: Vorinostat may stop the growth of cancer cells by interfering with various proteins needed for cell growth. Monoclonal antibodies, such as gemtuzumab ozogamicin (GO), can block cancer growth in different ways. GO finds cancer cells and helps kill them by carrying a cancer-killing substance to them. Giving vorinostat together with gemtuzumab ozogamicin may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving vorinostat together with gemtuzumab ozogamicin works in treating older patients with previously untreated acute myeloid leukemia.

Read the detailed description

PRIMARY OBJECTIVES:

I. To determine the CR/CRi rate after treatment with vorinostat plus GO. (Good risk group) II. To determine the 30-day survival after treatment with vorinostat plus GO. (Poor risk group)

SECONDARY OBJECTIVES:

I. To estimate the frequency and severity of regimen-associated toxicities, along with 30-day survival after start of treatment with vorinostat plus GO. (Good risk group) II. To determine the CR/CRi rate after treatment with vorinostat plus GO, and estimate the frequency and severity of regimen-associated toxicities. (Poor risk group) III. To investigate the relapse-free survival of patients who achieve CR/CRi and receive maintenance therapy on this study.

IV. To define cellular factors associated with clinical response to GO/vorinostat and determine the mechanisms underlying the synergistic effect between GO and vorinostat on primary AML cells (in vitro correlative and mechanistic studies).

OUTLINE:

REMISSION INDUCTION THERAPY: Patients receive oral vorinostat once daily on days 1-9 and gemtuzumab ozogamicin IV over 2 hours on day 8. Treatment repeats every 15-22 days for up to 3 courses.

CONSOLIDATION THERAPY: Beginning within 60 days after the completion of remission induction therapy, patients receive oral vorinostat once daily on days 1-9 and gemtuzumab ozogamicin IV over 2 hours on day 8.

MAINTENANCE THERAPY: Patients receive oral vorinostat once daily on days 1-14. Treatment repeats every 28 days for 4 courses.

All treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months for up to 3 years.

02

Conditions studied

  • Adult Acute Megakaryoblastic Leukemia (M7)
  • Adult Acute Minimally Differentiated Myeloid Leukemia (M0)
  • Adult Acute Monoblastic Leukemia (M5a)
  • Adult Acute Monocytic Leukemia (M5b)
  • Adult Acute Myeloblastic Leukemia With Maturation (M2)
  • Adult Acute Myeloblastic Leukemia Without Maturation (M1)
  • Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities
  • Adult Acute Myeloid Leukemia With Del(5q)
  • Adult Acute Myeloid Leukemia With Inv(16)(p13;q22)
  • Adult Acute Myeloid Leukemia With t(16;16)(p13;q22)
  • Adult Acute Myeloid Leukemia With t(8;21)(q22;q22)
  • Adult Acute Myelomonocytic Leukemia (M4)
  • Adult Erythroleukemia (M6a)
  • Adult Pure Erythroid Leukemia (M6b)
  • Untreated Adult Acute Myeloid Leukemia
03

In context

Leukemia

5,441 studies on the registry are indexed under Leukemia; 636 are open to participants now.

This study's enrollment of 31 is below the median of 38 across 4,247 interventional studies indexed under Leukemia.

Browse Leukemia studies →

Lead sponsor

Fred Hutchinson Cancer Center is the lead sponsor of 537 studies on the registry; 79 are open to participants now.

Of its 57 completed or terminated interventional studies of FDA-regulated products, 45 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
60 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Morphological diagnosis of AML other then acute promyelocytic leukemia (FAB M3) according to WHO diagnostic criteria; diagnosis of AML must be based on bone marrow or peripheral blood studies obtained within 28 days prior to study registration or start of hydroxyurea (for patients presenting with WBC >= 10,000/uL), and no potentially anti-leukemic therapy (with the exception of hydroxyurea) must have been given between AML diagnosis and study registration; a bone marrow biopsy is not routinely required but should be obtained if the aspirate is dilute, hypocellular, or inaspirable; outside bone marrows performed within the stipulated time period are acceptable as long as the slides are reviewed at a study institution
  • Cytogenetic analysis on bone marrow or peripheral blood specimen is available; based on the result from the first interim analysis, patients stratified into the good-risk group are only eligible if their AML has favorable cytogenetics (core-binding factor AML) or has a normal karyotype; patients stratified into the poor-risk group are eligible independent of the cytogenetic analysis
  • Pretreatment bone marrow and peripheral blood specimens for correlative studies are available; if bone marrow was performed at an outside facility, submission of peripheral blood only is acceptable as long as the peripheral blast count is > 5,000/uL and > 50% of total WBC
  • Patients with a history of antecedent MDS are eligible, if prior treatment did not include intensive chemotherapy; patients may have received hematopoietic growth factors, thalidomide/lenalidomide, 5-azacytidine/decitabine, arsenic trioxide, signal transduction inhibitors, or low dose cytarabine (\< 100 mg/m2/day) for treatment of MDS; patients must be off prior therapy for MDS at least 30 days prior to study registration, and all non-hematologic toxicities must have resolved to \< grade 2
  • ECOG/WHO/Zubrod performance status of 0-3
  • Bilirubin =\< 2.5 x Institutional Upper Limit of Normal (IULN) unless elevation is thought to be due to hepatic infiltration by AML, Gilbert's syndrome, or hemolysis (assessed within 14 days prior to registration)
  • SGOT (AST) and SPGT (ALT) =\< 1.5 x IULN unless elevation is thought to be due to hepatic infiltration by AML (assessed within 14 days prior to registration)
  • Serum creatinine =\< 1.5 x IULN (assessed within 14 days prior to registration)
  • Left ventricular ejection fraction >= 40% and no clinical evidence of congestive heart failure (assessed within 28 days prior to registration, e.g. by MUGA scan or echocardiography)
  • Men of reproductive potential must use an effective contraceptive method throughout the study and for a period of at least 3 months after the study
  • Women must be postmenopausal; a postmenopausal woman is defined as a woman who has experienced amenorrhea > 12 consecutive months or a woman on hormone replacement therapy with documented FSH level > 35 mIU/mL (women of childbearing potential must have a pregnancy test within 28 days prior to registration, and must use an adequate method of contraception to avoid pregnancy throughout the study and for a period of at least 3 months after the study)
  • Provide signed written informed consent
  • Willingness to undergo bone marrow examination on day 8 of first induction cycle
  • WBC \< 10,000/uL (patients with WBC >= 10,000/uL must undergo cytoreduction with hydroxyurea prior to enrollment and will not be enrolled if the WBC remains >= 10,000/uL (of note, patients with symptoms/signs of hyperleukocytosis or WBC > 100,000/uL can be treated with leukapheresis prior to enrollment)

Exclusion criteria

Exclusion Criteria:

  • Diagnosis of another malignancy, unless the patient was diagnosed at least 2 years earlier and has been disease-free for at least 6 months following the completion of curative intent therapy; there should be no plan to begin therapy for the prior malignancy at the time of study registration; prior treatment with AML induction-type chemotherapy is not allowed (note the following exceptions: patients with treated non-melanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia, regardless of the disease-free duration, are eligible for this study if definitive treatment for the condition has been completed; patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on prostate-specific antigen [PSA] values are also eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed; concurrent hormonal therapy is allowed)
  • Myeloid blast crisis of chronic myelogenous leukemia (CML)
  • Prior systemic chemotherapy for AML with the exception of hydroxyurea
  • Prior treatment with AML induction-type chemotherapy, GO, HDAC inhibitors, or high dose chemotherapy with hematopoietic stem cell support
  • Treatment with HDAC inhibitors during the last 3 years prior to registration, including the use of valproic acid for seizure activity or other purposes
  • Known hypersensitivity to hydroxyurea, GO, or vorinostat
  • Clinical evidence suggestive of central nervous system (CNS) involvement with leukemia unless a lumbar puncture confirms the absence of leukemic blasts in the cerebrospinal fluid (CSF)
  • Prior positive test for the human immunodeficiency virus (HIV)
  • Breastfeeding
  • Uncontrolled systemic fungal, bacterial, viral, or other infection (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment)
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
31 participants (actual)

Study arms

  • Experimental
    Arm I

    REMISSION INDUCTION THERAPY: Patients receive oral vorinostat once daily on days 1-9 and gemtuzumab ozogamicin IV over 2 hours on day 8. Treatment repeats every 15-22 days for up to 3 courses. . CONSOLIDATION THERAPY: Beginning within 60 days after the completion of remission induction therapy, patients receive oral vorinostat once daily on days 1-9 and gemtuzumab ozogamicin IV over 2 hours on day 8. MAINTENANCE THERAPY: Patients receive oral vorinostat once daily on days 1-14. Treatment repeats every 28 days for 4 courses.

    Drug: gemtuzumab ozogamicin · Drug: vorinostat · Other: laboratory biomarker analysis

Interventions

  • Druggemtuzumab ozogamicin

    Given IV

    Also known as: Calicheamicin-Conjugated Humanized Anti-CD33 Monoclonal Antibody, CDP-771, CMA-676, hP67.6-Calicheamicin, Mylotarg, WAY-CMA-676

  • Drugvorinostat

    Given orally

    Also known as: L-001079038, SAHA, suberoylanilide hydroxamic acid, Zolinza

  • Otherlaboratory biomarker analysis

    Correlative studies

06

What researchers measure

Primary outcomes

  1. Number of Participants Achieving CR or CRi With Induction Therapy (Good-risk Group)

    Time frame: after completion of induction therapy, administered every 21-42 days for up to two courses

  2. Number of Participants Alive at Day 30 (Poor-risk Group)

    Time frame: At day 30

Secondary outcomes

  1. Relapse-free Survival (Good- and Poor-risk Group)

    Time frame: At relapse

  2. Number of Participants Achieving CR or CRi With Induction Therapy (Poor-risk Group)

    Time frame: after completion of induction therapy, administered every 21-42 days for up to two courses

  3. Number of Participants Alive at Day 30 (Good-risk Group)

    Time frame: At day 30

07

Results

Posted Jun 1, 2017

Participant flow

Participant flow — Overall Study
MilestoneArm I
Started31
Completed30
Not completed1

Outcome measures

PrimaryNumber of Participants Achieving CR or CRi With Induction Therapy (Good-risk Group)
Time frame:
after completion of induction therapy, administered every 21-42 days for up to two courses
Reported as:
Count of participants · Participants
Number of Participants Achieving CR or CRi With Induction Therapy (Good-risk Group)
ParticipantsArm I
Number of Participants Achieving CR or CRi With Induction Therapy (Good-risk Group)6
PrimaryNumber of Participants Alive at Day 30 (Poor-risk Group)
Time frame:
At day 30
Reported as:
Count of participants · Participants
Number of Participants Alive at Day 30 (Poor-risk Group)
ParticipantsArm I
Number of Participants Alive at Day 30 (Poor-risk Group)8
SecondaryRelapse-free Survival (Good- and Poor-risk Group)
Time frame:
At relapse
Reported as:
Count of participants · Participants
Relapse-free Survival (Good- and Poor-risk Group)
ParticipantsArm I
Relapse-free Survival (Good- and Poor-risk Group)7
SecondaryNumber of Participants Achieving CR or CRi With Induction Therapy (Poor-risk Group)
Time frame:
after completion of induction therapy, administered every 21-42 days for up to two courses
Reported as:
Count of participants · Participants
Number of Participants Achieving CR or CRi With Induction Therapy (Poor-risk Group)
ParticipantsArm I
Number of Participants Achieving CR or CRi With Induction Therapy (Poor-risk Group)1
SecondaryNumber of Participants Alive at Day 30 (Good-risk Group)
Time frame:
At day 30
Reported as:
Count of participants · Participants
Number of Participants Alive at Day 30 (Good-risk Group)
ParticipantsArm I
Number of Participants Alive at Day 30 (Good-risk Group)20

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Arm I—12/31 (38.7%)29/31 (93.5%)
Most frequent serious events
Most frequent serious events
EventArm I
Neutropenic FeverInfections and infestations5/31
DeathGeneral disorders4/31
PneumoniaInfections and infestations2/31
GI BleedGastrointestinal disorders1/31
FallInjury, poisoning and procedural complications1/31
Bleeding at PICC siteSurgical and medical procedures1/31
Perirectal cellulitisSkin and subcutaneous tissue disorders1/31
Septic ShockInfections and infestations1/31
EpistaxisBlood and lymphatic system disorders1/31
E-coli InfectionInfections and infestations1/31
Most frequent other events
Showing 10 of 46
Most frequent other events
EventArm I
NeutropeniaBlood and lymphatic system disorders19/31
ThrombocytopeniaBlood and lymphatic system disorders18/31
AnemiaBlood and lymphatic system disorders10/31
Neutropenic FeverInfections and infestations7/31
PneumoniaRespiratory, thoracic and mediastinal disorders4/31
ChillsGeneral disorders3/31
FatigueGeneral disorders3/31
DiarrheaGastrointestinal disorders3/31
EpistaxisRespiratory, thoracic and mediastinal disorders3/31
Creatinine increasedInvestigations3/31

Baseline characteristics

Age, Continuous
Age, Continuous(years)Arm I
Mean72 (61 to 80)
Sex: Female, Male
Sex: Female, Male(Participants)Arm I
Female11
Male20
Region of Enrollment
Region of Enrollment(participants)Arm I
United States31
Risk Group
Risk Group(Participants)Arm I
Poor-risk Group10
Good-risk Group21
08

Study locations

4 sites
  • Stanford University
    Stanford, California 94305, United States
  • Barbara Ann Karmanos Cancer Institute
    Detroit, Michigan 48201, United States
  • Wake Forest University Health Sciences
    Winston-Salem, North Carolina 27157, United States
  • Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
    Seattle, Washington 98109, United States
09

References and documents

Publications

  • Walter RB, Medeiros BC, Powell BL, Schiffer CA, Appelbaum FR, Estey EH. Phase II trial of vorinostat and gemtuzumab ozogamicin as induction and post-remission therapy in older adults with previously untreated acute myeloid leukemia. Haematologica. 2012 May;97(5):739-42. doi: 10.3324/haematol.2011.055822. Epub 2011 Dec 1. PubMed 22133771 ↗

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 1, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00673153
Lead sponsor
Fred Hutchinson Cancer Center
Collaborators
National Cancer Institute (NCI)
Responsible party
Roland Walter (Principal Investigator, Fred Hutchinson Cancer Center) — Principal investigator
First posted
May 7, 2008
Start date
Mar 2008
Primary completion
Aug 2010
Results posted
Jun 1, 2017
Last update
Jun 1, 2017

Study contacts

Roland Walter
principal investigator · Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in May 2017. You cannot join it, but the record below documents what was studied.

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