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RecruitingNCT01409161Updated May 20, 2026

Tretinoin and Arsenic Trioxide With or Without Gemtuzumab Ozogamicin in Treating Patients With Previously Untreated Acute Promyelocytic Leukemia

A Phase 2 interventional study of Arsenic Trioxide and Gemtuzumab Ozogamicin in Acute Promyelocytic Leukemia With PML-RARA, sponsored by M.D. Anderson Cancer Center. Recruiting at 5 sites in United States. Open to participants aged 10 Years and older. Per ClinicalTrials.gov, last updated 2026-05-20.

Sponsored by M.D. Anderson Cancer Center · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
151
Allocation
Not applicable
Ages
10 Years and older
Sex
All
01

Study summary

This phase II trial studies how well tretinoin and arsenic trioxide with or without gemtuzumab ozogamicin works in treating patients with previously untreated acute promyelocytic leukemia. Drugs used in chemotherapy, such as tretinoin and arsenic trioxide, 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. Immunotoxins, such as gemtuzumab ozogamicin, may find certain cancer cells and kill them without harming normal cells. Giving tretinoin and arsenic trioxide together with gemtuzumab ozogamicin may kill more cancer cells.

Read the detailed description

PRIMARY OBJECTIVES:

I. Assess whether a combination of all-trans retinoic acid (ATRA [tretinoin]), and arsenic trioxide (ATO) can produce long-term event-free survival in patients with low-risk untreated acute promyelocytic leukemia (APL).

II. Assess whether administration of gemtuzumab ozogamicin (GO) at the diagnosis in patients with high-risk APL (white blood cell [WBC] > 10,000) and if the WBC rises to > 10,000 after start of treatment (in patients with low-risk disease) will improve complete response (CR) rate without increasing toxicity in high-risk untreated APL.

OUTLINE:

INDUCTION: Patients receive tretinoin orally (PO) twice daily (BID), arsenic trioxide intravenously (IV) over 1-2 hours daily, and gemtuzumab ozogamicin IV over 2 hours once at weeks 1-4.

CONSOLIDATION: Patients achieving CR receive arsenic trioxide IV 5 days per week during weeks 1-4, 9-12, 17-20, and 25-28 and tretinoin PO BID for 2 weeks on and 2 weeks off. Treatment repeats every 8 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 6-12 months.

02

Conditions studied

  • Acute Promyelocytic Leukemia With PML-RARA
03

Who can participate

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

Inclusion criteria

  • A diagnosis of APL based on the presence of the PML-RAR-alpha fusion gene by cytogenetics, polymerase chain reaction (PCR), or POD test
  • Ability to understand and the willingness to sign a written informed consent document indicating that they are aware of the investigational nature of the study
  • Patients in whom therapy for APL was initiated on an emergent basis are eligible (patients may have already started treatment with ATRA, ATO, and/or one dose of idarubicin due to the urgency to start therapy early)
  • Women of child-bearing potential must have a negative serum pregnancy test at screening; in addition to having a negative pregnancy test confirmed at screening, all female participants of childbearing potential must have a negative pregnancy test confirmed within 48 hours prior to dosing with the study drug
  • All sexually active subjects (males and females of child-bearing potential) agree to use 2 effective methods of contraception for the duration of the study

Exclusion criteria

Exclusion Criteria:

  • Fridericia corrected QT (QTcF) interval on the electrocardiogram (EKG) greater than 480 milliseconds
  • Patients with creatinine > 2.5 times upper limit of normal unless felt to be related the underlying leukemia by the treating physician or hemolysis or Gilbert's disease
  • Patients with total bilirubin >= 2.0 times upper limit of normal unless felt to be related the underlying leukemia by the treating physician or hemolysis or Gilbert's disease
  • Patients with alanine aminotransferase (ALT)/aspartate aminotransferase (AST) > 3 times upper limit of normal unless felt to be related the underlying leukemia by the treating physician or hemolysis or Gilbert's disease
04

Study design

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

Study arms

  • Experimental
    Treatment (tretinoin, arsenic trioxide, gemtuzumab ozogamicin)

    INDUCTION: Patients receive tretinoin PO BID, arsenic trioxide IV over 1-2 hours daily, and gemtuzumab ozogamicin IV over 2 hours once at weeks 1-4. CONSOLIDATION: Patients achieving CR receive arsenic trioxide IV 5 days per week during weeks 1-4, 9-12, 17-20, and 25-28 and tretinoin PO BID for 2 weeks on and 2 weeks off. Treatment repeats every 8 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.

    Drug: Arsenic Trioxide · Drug: Gemtuzumab Ozogamicin · Other: Laboratory Biomarker Analysis · Drug: Tretinoin

Interventions

  • DrugArsenic Trioxide

    Given IV

    Also known as: Arsenic (III) Oxide, Arsenic Sesquioxide, Arsenous Acid, Arsenous Acid Anhydride, Arsenous Oxide, Trisenox, White Arsenic

  • DrugGemtuzumab Ozogamicin

    Given IV

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

  • OtherLaboratory Biomarker Analysis

    Correlative studies

  • DrugTretinoin

    Given PO

    Also known as: 2,4,6,8-Nonatetraenoic acid, 3, 7-dimethyl-9-(2,6,6-trimethyl-1-cyclohexen-1-yl)-, (all-E)-, Aberel, Airol, Aknoten, all trans-Retinoic acid, All-trans Retinoic Acid, All-trans Vitamin A Acid, all-trans-Retinoic acid, all-trans-Vitamin A acid, ATRA, Avita, beta-Retinoic Acid, Cordes Vas, Dermairol, Epi-Aberel, Eudyna, Renova, Retin-A, Retin-A MICRO, Retin-A-Micro, retinoic acid, Retisol-A, Ro 5488, Stieva-A, Stieva-A Forte, Trans Retinoic Acid, Trans Vitamin A Acid, trans-Retinoic acid, Tretinoinum, Vesanoid, vitamin A acid, Vitamin A acid, all-trans-, Vitinoin

05

What researchers measure

Primary outcomes

  1. Event free survival

    Monitored using a Bayesian time-to-event model.

    Time frame: The time from the start of treatment to first documentation of disease relapse or death, assessed up to 2 years

06

Study locations

5 of 5 sites recruiting
  • M D Anderson Cancer Center
    Houston, Texas 77030, United States
    • Farhad Ravandi-Kashani · Contact · 713-745-0394
    • Farhad Ravandi-Kashani · Principal investigator
    Recruiting
  • MD Anderson Regional Care Center-Katy
    Houston, Texas 77094, United States
    • Farhad Ravandi-Kashani · Contact · 713-745-0394
    • Farhad Ravandi-Kashani · Principal investigator
    Recruiting
  • MD Anderson Regional Care Center-Bay Area
    Nassau Bay, Texas 77058, United States
    • Farhad Ravandi-Kashani · Contact · 713-745-0394
    • Farhad Ravandi-Kashani · Principal investigator
    Recruiting
  • MD Anderson Regional Care Center-Sugar Land
    Sugar Land, Texas 77478, United States
    • Farhad Ravandi-Kashani · Contact · 713-745-0394
    • Farhad Ravandi-Kashani · Principal investigator
    Recruiting
  • MD Anderson Regional Care Center-The Woodlands
    The Woodlands, Texas 77384, United States
    • Farhad Ravandi-Kashani · Contact · 713-745-0394
    • Farhad Ravandi-Kashani · Principal investigator
    Recruiting
07

References and documents

Publications

  • Jen WY, Marvin-Peek J, Kantarjian HM, Alvarado Y, Borthakur G, Jabbour E, Wierda W, Kadia TM, Daver NG, DiNardo CD, Short NJ, Jain N, Ferrajoli A, Kornblau S, Yilmaz M, Ohanian M, McCue D, Burger J, Hammond D, Patel K, Issa GC, Pemmaraju N, Sasaki K, Maiti A, Abbas HA, Chien K, Takahashi K, Haddad F, Bose P, Masarova L, Montalban-Bravo G, Swaminathan M, Brandt M, Pierce S, Garcia-Manero G, Ravandi F. Long-term follow-up of a phase 2 study of all-trans retinoic acid, arsenic trioxide, and gemtuzumab ozogamicin in acute promyelocytic leukemia. Cancer. 2025 Jan 1;131(1):e35662. doi: 10.1002/cncr.35662. Epub 2024 Nov 25. PubMed 39584789 ↗
08

Registry details

Key details

Study ID
NCT01409161
Lead sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Aug 4, 2011
Start date
Oct 5, 2011
Primary completion
Dec 18, 2027 (estimated)
Completion
Dec 18, 2027 (estimated)
Last update
May 20, 2026

Study contacts

Farhad Ravandi-Kashani
Contact
fravandi@mdanderson.org
713-745-0394
Farhad Ravandi-Kashani
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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