Overview
A Study of the Efficacy and Safety of Lenalidomide Combined to Escalating Doses of Chemotherapy in Intermediate-2-or High Risk Myelodysplastic Syndrome (MDS) and Acute Myeloid Leukemia (AML) With Del 5q
Status:
Unknown status
Unknown status
Trial end date:
2015-12-01
2015-12-01
Target enrollment:
0
0
Participant gender:
All
All
Summary
In this trial, the investigators will test the combination of escalating doses of chemotherapy (starting at relatively low dose) with lenalidomide in intermediate-2-or high risk MDS and AML with del 5 q31. It is hoped that this combined therapy will further increase response rate in intermediate-2-or high risk MDS and AML with del 5 q31, without major toxicity in comparison to historical results obtained with chemotherapy alone in the same subset of patients.Phase:
Phase 2Accepts Healthy Volunteers?
NoDetails
Lead Sponsor:
Groupe Francophone des MyelodysplasiesCollaborator:
Celgene CorporationTreatments:
Lenalidomide
Thalidomide
Criteria
Inclusion Criteria:1. Age ≥ 18 years
2. Must understand and voluntarily sign an informed consent form
3. Must be able to adhere to the study visit schedule and other protocol requirements
4. No contra indication to anthracycline based chemotherapy
5. Documented diagnosis of MDS, or CMML with WBC < 13,000/mm3 that meets IPSS criteria
for intermediate-2 or high-risk disease, or AML with an associated del 5q[31] (the
deleted chromosomal region must include 5q[31]), with or without additional
cytogenetic abnormalities
6. Female subjects of childbearing potential must:
- Understand that the study medication could have a potential teratogenic risk
- Agree to use, and be able to comply with, effective contraception without
interruption, 4 weeks before starting study drug, throughout study drug therapy
(including dose interruptions) and for 4 weeks after the end of study drug
therapy, even if she has amenorrhoea. This applies unless the subject commits to
absolute and continued abstinence confirmed on a monthly basis. The following are
effective methods of contraception:
- Implant, Levonorgestrel-releasing intrauterine system (IUS) (prophylactic
antibiotics should be considered at the time of insertion particularly in
patients with neutropenia due to risk of infection) , Medroxyprogesterone
acetate depot, Tubal sterilization, Ovulation inhibitory progesterone-only
pills (i.e., desogestrel), Sexual intercourse with a vasectomised male
partner only; vasectomy must be confirmed by two negative semen analyses.
- Combined oral contraceptive pills are not recommended. If a subject was
using combined oral contraception, she must switch to one of the methods
above. The increased risk of VTE continues for 4 to 6 weeks after stopping
combined oral contraception.
- Agree to have a medically supervised pregnancy test with a minimum sensitivity of
25 mIU/ml not more than 3 days from the start of study medication once the
subject has been on effective contraception for at least 4 weeks. This
requirement also applies to women of childbearing potential who practice complete
and continued abstinence.
- Agree to have a medically supervised pregnancy test every 4 weeks including 4
weeks after the end of study treatment, except in the case of confirmed tubal
sterilization. These tests should be performed not more than 3 days before the
start of next treatment. This requirement also applies to women of childbearing
potential who practice complete and continued abstinence
7. Male subjects must:
- Agree to use condoms throughout study drug therapy, during any dose interruption
and for one week after cessation of study therapy if their partner is of
childbearing potential and has no contraception.
- Agree not to donate semen during study drug therapy and for one week after end of
study drug therapy.
8. All subjects must:
- Agree to abstain from donating blood while taking study drug therapy and for one
week following discontinuation of study drug therapy.
- Agree not to share study medication with another person and to return all unused
study drug to the investigator
Exclusion Criteria:
1. Pregnant or lactating females.
2. Contra indication to anthracycline based chemotherapy.
3. Proliferative (WBC ≥ 13,000/mL) CMML.
4. Prior ≥ grade-2 NCI CTCAE (v 3.0) allergic reaction to thalidomide.
5. Prior desquamating (blistering) rash while taking thalidomide.
6. Prior history of malignancy other than MDS unless the subject has been free of disease
for ≥ 5 years.
7. Use of cytotoxic chemotherapeutic agents or experimental agents (agents that are not
commercially available) for the treatment of MDS within 28 days .
8. Less than 6 months since prior allogeneic bone marrow transplantation.
9. Less than 3 months since prior autologous bone marrow or stem cell transplantation.
10. Recombinant human erythropoietin (rHuEPO) therapy received within 28 days.
11. Known HIV-1 positivity.
12. Any serious medical condition or psychiatric illness that will prevent the subject
from signing the informed consent form or will place the subject at unacceptable risk
if he or she participates in the study.
13. Creatinine Clearance< 50 ml/min
14. Serum aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT)
or alanine transaminase (ALT)/serum glutamate pyruvate transaminase (SGPT) > 3.0 x
upper limit of normal (ULN)
15. Serum total bilirubin > 1.5 mg/dL (expect for unconjugated hyperbilirubinemia due to
Gilbert's disease or secondary to MDS).
16. Subjects with ≥ grade-2 neuropathy